Fogarty's adolescent research key to future good health

March / April 2018 | Volume 17, Number 2

Full March / April 2018 Global Health Matters newsletter [PDF <1M]

Group of teenagers in outdoor courtyard in Haiti pose for camera, some jump and raise hands
Photo courtesy of GHESKIO

Adolescents are often overlooked by health researchers but
have unique health issues that require study.

By Karin Zeitvogel

The world is sitting on a global health time bomb as the largest adolescent population in history - 1.8 billion youth - transitions into adulthood. HIV deaths among adolescents are rising, even as they decline for other age groups. AIDS-related illnesses claim more adolescent lives than any other cause except road accidents, according to UNAIDS. Adolescence is a time of risk-taking, when many social behaviors related to health - things like smoking, drinking, sexual behaviors and delinquency - are established.

"It's a time of a whole set of serious social transformations which are important for adolescents but really have major importance down the road," said adolescent health specialist and long-time National Institute of Child Health and Human Development (NICHD) grantee, Dr. John Santelli of Columbia University. "Adolescents don't die from tobacco use but if you wait 20-30 years, you'll see the serious health consequences of teen smoking. And then, of course, in most of the world, adolescents rapidly become the parents of tomorrow. So their health, their well-being predicts the health of their children."

And yet, until recently, the health needs of adolescents have been largely overlooked by the research community. "Adolescents are perceived by many researchers and policymakers to be a healthy lot, with few pressing needs," said Fogarty grantee, Dr. Monika Arora, director of the health promotion division at the Public Health Foundation of India - the country with the largest number of adolescents in the world. "But adolescent mortality has fallen at a slower rate than it has in children aged 0 to 9 years old, and the adolescent age group is the only one in which AIDS-related deaths are not decreasing."

Adolescent research has lagged behind other age groups, in part because the factors that influence youth health - the conditions in which a person is born, grows, lives, works and ages - fall outside the health system. Called the social determinants of health, these include how long youth stay in school, how a country regulates tobacco and alcohol, child marriage, the poverty rate, and so on. Behaviors adopted during this time of life can impact youth in the short term, when they're older, and influence the quality of life and health of the next generation.

Every year, more than 18 million girls, some younger than 15, give birth in developing regions, according to the WHO. Complications during pregnancy and childbirth are the leading cause of death for 15- to 19-year-old females globally and giving birth during adolescence has a negative impact on the future well-being of both mothers and infants.

Fogarty has long supported research into multiple aspects of youth health, from tobacco use to teen pregnancy and how it affects women's health later in life, to HIV testing and care. Many Fogarty-funded projects take a multisectoral, life-course approach to adolescent health, looking not just at the clinical aspects of teen health but also seeking to address the social determinants that impact health from the time a child is in the womb through adolescence and into adulthood.