The Data-Poor Lives of Adolescents

SEATTLE – Data can save lives. Without it, we wouldn’t know that smoking causes lung cancer and coronary disease, that helmets reduce death rates for motorcycle accidents, and that better education for women improves child survival – and much else. Given the importance of reliable data, collecting it must be a high priority.

One area where data collection is particularly inadequate is adolescent health. People aged ten to 24 receive far less attention than other age groups. More broadly, as the new Lancet Commission on Adolescent Health and Wellbeing highlights, global health and social policy largely tends to ignore adolescent health.

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In many ways, our future depends on the health of our adolescents. In low- and middle-income countries, there are more adolescents than ever before. And their health today will affect their future wellbeing, shaping their ability to earn a living, produce and raise healthy children, care for aging parents, and lead their societies toward peace and prosperity.

By enabling governments and others to design effective and targeted health programs for adolescents, data on adolescent health can play a critical role in securing a better future. The first step is to find out where, why, and how many adolescents are dying.

Myriad surveys conducted in recent decades have aimed specifically to determine death rates among adults and children under the age of five. Yet those in between are not specifically addressed, making it very difficult to track adolescent deaths in countries that lack adequate systems for civil registration and recording of vital statistics.

To address this shortcoming, donors and governments should fund the development of survey methods to measure adolescent death rates. Questions designed to elicit the needed information could be incorporated into surveys already being conducted regularly in low- and middle-income countries, such as the Demographic and Health Surveys and Multiple Indicator Cluster Surveys.

Of course, we also need data about adolescents during their lives – ideally, data that come from the adolescents directly. As it stands, individuals under the age of 15 are generally excluded from household surveys. And while school surveys are conducted in some countries, funding constraints often mean that they are carried out infrequently. More problematic, school-based surveys in low- and middle-income countries typically exclude those who are not in school, whether because they dropped out or never enrolled at all.

Governments and donors must therefore also work to develop and carry out targeted surveys of adolescents. Among other things, such surveys should aim to create a clear picture of adolescents’ exposure to avoidable risk factors, such as alcohol and illicit drug use, unsafe sexual behaviors, violence, obesity, physical inactivity, and unhealthy diet.

To complement this effort, we must also invest in improving our understanding of how these risk factors – most often studied in connection with early childhood and adulthood – affect adolescents’ health. According to the Global Burden of Disease Study, health risk factors explain at least 50% of the early death and disability of adults aged 50 and over; for young people, the figure drops to 26%. More studies are needed to inform health policy and planning adequately.

The data-collection effort should also include a focus on mental health. The Global Burden of Disease Study has estimated that, in 2013, depression was one of the top three causes of adolescent females’ loss of healthy years, and one of the top seven causes of lost healthy years in adolescent males.

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Yet the data on mental health for individuals under the age of 18 are poor, particularly in low-income countries, and what is available is not comparable across countries. It is thus imperative that governments and donors invest in building an expert consensus on how best to measure mental health and implement those methods globally, including in low-resource settings.

Before long, today’s adolescents will be running the world. If they are to lead it well, they need to be healthy. And we need to invest in collecting the data that are so essential to ensuring that they are.