Our Future: Lancet Commission on Adolescent Health & Wellbeing

By Amy Peterson, MSc | June 6, 2016

A few weeks ago I attended a symposium on the Lancet Commission on Adolescent Health and Wellbeing in London. The symposium marked the launch of the third and most comprehensive report the Commission has produced on the state of global adolescent health.

 

With over 1.8 billion young people ages 10 to 24 in the world, the promotion of healthy adolescents could have huge benefits to social and economic outcomes globally. Yet, historically, adolescents have largely been left out. They’ve lacked representation in global health indicators and a voice in the conversation about their own health and well-being.

 

The Lancet Commission represents a shift in the way we frame adolescent health. It elevates the importance of social determinants of health and young people's right to participate in the health discourse.

 

This Commission resonates and aligns with ETR’s work in the area of adolescent health, particularly sexual and reproductive health. In the report, as in ETR’s work, social determinants and neurodevelopment play a significant role in the discussion.

Social Determinants, Neurodevelopment and Transdisciplinary Approaches

Social determinants of health—the conditions in which we are born, live, work and play—may affect adolescents more than any other group. As youth transition into adulthood, new environmental factors such as education, gender inequity, employment and migration play a significant role in their social, physical and neuro development.

The healthy development of young people is critical for navigating new and evolving relationships with family, romantic partners, peers and society at large. By adopting and applying a social determinants framework—as ETR and other agencies working with youth have—we can begin to transform the social factors that influence unintended pregnancy, substance and tobacco use, injury and violence among young people. Policies and programs addressing social determinants will not only have an immediate impact on youth today, but a lasting effect on future generations.

Looking at Neurodevelopment

One highlight of the Commission report is the inclusion of neurodevelopment. The report offers an excellent summary of the significance of the developing brain during this period of life (see the Patton et al. chapter in the Commission report, pages 6–7).

ETR recently hosted the first annual Kirby Summit on this topic. The Summit brought together a nationally recognized group of sexual and reproductive health researchers and neurodevelopmental scientists to discuss how findings from neurodevelopment can inform intervention work in the area of adolescent sexual and reproductive health.

Examining adolescent health from a neurodevelopmental perspective compels us to think about young people in terms of their contexts, relationships and values, and not just through a set of behaviors. Much potential lies in teaching young people about their social and emotional processes, and in listening to youth opinions about how to change or improve the structures and systems that affect their ability to stay healthy and safe.

Our experience at the Summit reinforced our belief in the transdisciplinary process. While multidisciplinary approaches bring together various disciplines to share expertise and perspectives, transdisciplinary encounters involve greater blending and synergy between disciplines. This creates ideas and opportunities that are unique, distinct from and greater than what any individual discipline might develop on its own.  The Lancet Commission makes it clear that a transdisciplinary (or multisectoral) approach is essential for addressing the complex social factors leading to adverse health outcomes by opening up new and promising avenues for research, policy and practice in adolescent health.

Highlight of the Symposium: Young People Speak

We cannot leave our transdisciplinary approach in the adult sphere. We must also engage youth in the research and decision-making process. This was the message from a panel at the symposium of young people working in adolescent health. They offered some incredible insights on youth engagement.

Here are some of my favorite quotes and messages:

• "Youth are often treated as human becomings rather than human beings."
• "Keep the door open for those who have not yet entered." (Talking about the engagement of marginalized groups.)
• “One outcome of the patriarchal system in which we live is that we focus on process rather than people.”
• "[Agency is] the ability to do, to be, to thrive." (Talking about helping youth develop personal agency.)
• "Youth do not live in silos." (In reference to the focus on engaging youth through sexual and reproductive health programs—youth lives are affected by many more issues.)
• "Youth have the right to be healthy, the right to be involved and the right to have their capacities built.”

Youth Recommendations

The Commission and youth speakers also provided some powerful recommendations for engaging and working with young people. These included:

1. Train youth to speak and adults to listen.
2. Change negative attitudes that adults hold about youth.
3. Support youth in overcoming their lack of self-esteem, and give them opportunities to build their confidence to speak up.
4. Overcome cultural subordination (e.g., young vs. old, boy vs. girl, able-bodied vs. disabled).
5. Provide space for youth
6. Build youth skills.
7. Give youth real authority.
8. Involve youth in research and translate research findings so they are accessible to youth audiences.
9. Define, strategize and invest in meaningful youth engagement.
10. Adopt a rights-based approach to adolescent health and well-being.
11. Protect the agency of youth. Young people risk a lot when they speak up. Adults often take advantage of youth voices, using them to say things they can't or won't say themselves. We must protect youth from the aftermath of their own honesty.

A Reframe That Makes a Difference

The full Lancet Commission report presents a comprehensive picture of the state of global adolescent health and demonstrates that there are still major health inequities to tackle. By reframing our approach to adolescent health, focusing on evidence and context, and engaging young people in research and implementation, great strides can be made toward improving the health and well-being of young people. If you are in Washington, D.C., on June 9^th, the Commission will hold a U.S. event to promote the report.

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Amy Peterson, MSc, is a project coordinator for ETR’s research, professional development and business development teams. Her expertise is in the implementation of sexual health programs for adolescent populations and building the capacity of adults who work with youth. She is also a doctoral student at the London School of Hygiene and Tropical Medicine.