The recent Lancet series emphasizes the urgent need to increase attention to adolescent health, with a growing acceptance for a life-course framework. This more holistic approach is an important step in moving the health issues of young people from a marginalized minority into mainstream global health. Yet, as the fourth paper in the series demonstrates, there are not only major gaps in youth programs targeting these issues, but also insufficient data collected on both risk and protective factors in many countries. Without comprehensive data, it is extremely difficult for practitioners and policy-makers to take the necessary steps to improve health outcomes of young people worldwide.
The article “Health of the world’s adolescents: a synthesis of internationally comparable data” uses 25 core indicators to assess the available sources of health information for young people. Details about how the indicators were determined and the countries included in the review are outlined in the article.
The authors included 192 countries in this review, constituting 99.53% of the 1.79 billion young people (ages 10-24) living in UN member states. They describe the discrepancies in health outcomes between countries based on geography, income level, population size and other relevant demographics. However, the article quickly shifts focus from the differences in health outcomes to the lack of data available for many of the indicators around the world, particularly in low-income regions. Several key points were clear at the conclusion of the article: most glaring are the incomplete health information and inequities between country profiles for almost all aspects of adolescent health. These differences are apparent not only between, but also within geographical regions. Information on mental health and non-fatal disabilities in this age group is particularly lacking. Aside from a Millennium Development Goal focus on HIV, there are also major gaps on data about health service delivery in every region.
Young people’s sexual and reproductive health has had significant policy and programmatic attention in recent years, leading to more clearly defined indicators and better data collection than many other issues. However, the article highlights concerns about the strength of these current data collection methods, particularly as they relate to the exclusion of young people at highest risk– including those out-of-school, homeless, and in juvenile detention. As outlined in a previous blog post, for the proposed comprehensive approach to be effective, young people’s sexual and reproductive health must be at the forefront of the movement. Many of the health indicators raised by the authors of this series are closely linked to YSRH and should not be reviewed in isolation.
The authors provided three sets of recommendations for improving the gaps and obstacles in collecting data on the health of young people worldwide. They include:
- Improving development and measurement of indicators
- Stronger research and the development of indicators in neglected areas of adolescent heath
- Better coordination and integration of present data collection
- Define a core set of global indicators
- Synchronize measures across surveys, including school-based
- Extending data coverage
- Improvement of data coverage for major health problems affecting young people
- Development of strategies to collect data on most-at-risk young people
- Enhanced leadership and coordination
- Development of strategies to fill the present knowledge gaps and align current systems, drawing in expertise from UN and its agencies, academia and other global partners
- Countries should be encouraged to produce a report on the health of young people to allow for coordinated efforts (both governmental and NGO) of health initiatives
- There is a need for detailed data strategies to guide policies for young people within future global health initiatives, considering age and sex disaggregation, risk and protective factors that occur during adolescence
The attention given to young people’s health in this series is sure to provide momentum toward improved programs and policies around the world. However, without consistent monitoring and review of existing health indicators at the global level, young people’s health will continue to languish in many regions around the world. Simply put, it will be difficult for global health leaders to improve future outcomes for young people when the current health information systems are so incomplete. This article takes the important first steps of outlining not only the current gaps in adolescent health data, but also proposes guidance for improvement. The future of young people may depend on paying attention to it.