CH 12 PBH

Page 1: Case Vignettes of Adolescents

• Carmen (El Salvador)

  • Age: 16

  • Became sexually active at 14, pregnant by 16

  • Dropped out of high school, moved to the countryside

  • Economic prospects severely damaged due to early motherhood

• Rachel (South Africa)

  • Age: 15

  • Born to an HIV-positive mother

  • Taking HIV medication but struggles with adherence and peer stigma

• John (Chicago, USA)

  • Age: 18

  • Did not complete secondary school, part of a youth gang

  • Engaged in drug dealing, eventually murdered

• Rashmi (Punjab, India)

  • Age: 14

  • Intelligent but pressured by family expectations

  • Struggles with chores, academic demands, and future marriage

  • Experiences mood fluctuations without understanding the cause

Page 2: Juan's Story

• Juan (Peru)

  • Age: 21

  • Died in a car accident shortly after obtaining a driver’s license

  • Misunderstood traffic signals leading to fatal collision

  • Highlighting risks of driving for young people in chaotic environments

Page 3: Key Terms and Definitions

• Adolescence: Traditionally defined as the period between puberty and marriage/parenthood.

• World Health Organization (WHO): Defines adolescents as those aged 10-19.

• United Nations: Defines youth as 15-24; child as under 18.

• Recent studies cover 10-24 years, emphasizing different age groups.

Page 4: Age Group Classifications

• Groups:

  • 10–14: Early Adolescence

  • 15–19: Older Adolescence

  • 20–24: Young Adulthood

• Terminology respects age differences while addressing health needs.

Page 5: Importance of Adolescent Health

• Demographics:

  • Adolescents comprise 24% of the global population, higher in low/middle-income countries.

  • Example: Nigeria (32%) vs Germany (17%).

• Health Burdens:

  • Unique challenges must be addressed, such as sexual health and violence.

• Behavior Formation: Establishing healthy habits during this period significantly impacts future health behaviors and outcomes.

• Sustainable Development Goals (SDGs): Strong links between adolescent health and SDG targets, e.g., maternal mortality and mental health.

Page 6: Critical SDG Targets

• Target 3.1: Reduce maternal mortality; link to early marriage.

• Target 3.2: End preventable deaths in children; maternal health directly relates to child survival.

• Target 3.3: Combat communicable diseases, focusing on at-risk adolescents.

• Target 3.4: Reduce premature death rates from noncommunicable diseases, especially mental health.

• Target 3.5: Address substance abuse for adolescents, including alcohol.

• Target 3.7: Ensure sexual and reproductive healthcare access for youths.

• Target 3.8: Universal health coverage to meet adolescents' unique needs.

Page 7-8: Data Sources on Health Burdens

• Data Sources: Primarily from the Global Burden of Disease Study 2016, WHO reports, and The Lancet commissions.

• Noted gaps in data focus, with more emphasis historically on children under 5.

Page 9-10: Developmental Changes

• Biological & Psychological Changes:

  • Hormonal and cognitive development during adolescence.

  • Brain development continues into mid-20s—focus on impulse control and decision-making.

  • Peer influence varies by age.

• Table 12-3: Changes from Early Adolescence to Young Adulthood

  • Early Adolescence (10-14):

    • Biological: Puberty effects

    • Psychological: Peer influence, identity formation.

  • Late Adolescence (15-19):

    • Biological: Pubertal maturation

    • Psychological: Development of executive skills and autonomy.

  • Young Adulthood (20-24):

    • Biological: Completion of brain maturation

    • Psychological: Adoption of adult responsibilities.

Page 11: Extended Adolescence

• Trends:

  • Adolescence is extending; earlier onset of puberty and later social role assumption noted.

Page 12-13: Key Health Burdens in Different Regions

• Health Issues: Burdens and leading causes of death vary by income level, age, and gender.

• Table 12-4: Leading Causes of Death

  • Low-Income Countries: Emphasis on communicable diseases and maternal causes.

  • High-Income Countries: Focus on road injuries, suicide, and noncommunicable diseases.

Page 14-15: Disability-Adjusted Life Years (DALYs)

• Table 12-5: Leading causes of DALYs across age groups.

• Highlights:

  • Mental disorders significant for both genders.

  • Males: Road injuries and violence primary concerns.

  • Females: Anxiety, depression, and reproductive health issues notable.

Page 16-20: Risk Factors and Determinants

• Common Risk Factors: Poor living conditions, unsafe water, violence, lack of education.

• Gender Disparities: Male risks include road injury and violence; females face educational and health service access challenges.

• Vulnerability: Marginalized groups face increased risks.

Page 21-23: Specific Health Issues

• Adolescent Pregnancy: High risks and complications in low-resource settings for young mothers.

• Anemia: Significant health burden for youths due to poverty.

• HIV/AIDS: Rising challenge for adolescents; focus on preventive strategies needed.

Page 24-25: Noncommunicable Diseases (NCDs)

• Health Behaviors Impact: Eating habits, physical activity levels, tobacco use, and alcohol consumption trends among youths.

• Obesity: Increasing prevalence of adolescent obesity, particularly in low-income regions.

Page 26-30: Mental Health and Risk Behaviors

• Mental Health Statistics: Between 10%-20% of adolescents face significant mental health issues.

• Substance Abuse: Trends in alcohol and drug use are concerning; highlight need for interventions.

• Suicide: Leading cause of death in older youth; urgent need for preventive measures.

Page 31-34: Transportation and Violence

• Transport Injuries: Major contributor to adolescent mortality, particularly in low-income countries.

• Interpersonal Violence: High rates of violence among youth, especially in certain regions.

Page 35-38: Case Study - Malawi Cash Transfer Program

• Objective: Reduce HIV risks among adolescent girls through conditional cash transfers.

• Results: Significant reduction in HIV rates; suggests economic support can mitigate risky behaviors.

Page 39-44: Improving Youth Health

• Actionable Measures:

  • Enhance educational opportunities, particularly for girls.

  • Address social determinants affecting health.

  • Involvement of youth in health program development is critical.

  • Intersectoral approaches needed for comprehensive health improvement.

Page 45-48: Main Messages and Future Steps

• Central Importance: Adolescent health is critical for future populations and overall public health.

• Strategies for Improvement: Focus on education, health system adaptation, and intersectoral programs to effectively improve health outcomes.