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What Is the Most Significant And/Or Harmful Health Issue or Risky Behavior Affecting Adolescents and What Initiatives Can Be Used to Prevent It?

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Risk and protective factors can affect children at different stages of their lives. At each stage, risks occur that can be changed through prevention intervention. Early childhood risks, such as aggressive behavior, can be changed or prevented with family, school, and community interventions that focus on helping children develop appropriate, positive behaviors. If not addressed, negative behaviors can lead to more risks, such as academic failure and social difficulties, which put children at further risk for later drug abuse.

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Around 1.2 billion people, or 1 in 6 of the world’s population, are adolescents aged 10 to 19. Most are healthy, but there is still substantial premature death, illness, and injury among adolescents. Illnesses can hinder their ability to grow and develop to their full potential. Alcohol or tobacco use, lack of physical activity, unprotected sex and/or exposure to violence can jeopardize not only their current health, but also their health as adults, and even the health of their future children. Promoting healthy behaviours during adolescence, and taking steps to better protect young people from health risks are critical for the prevention of health problems in adulthood, and for countries’ future health and ability to develop and thrive. Unintentional injuries are the leading cause of death and disability among adolescents. In 2016, over 135 000 adolescents died as a result of road traffic accidents. Many of those who died were “vulnerable road users”, including pedestrians, cyclists or users of motorized two-wheelers. In many countries, road safety laws need to be made more comprehensive, and enforcement of such laws needs to be strengthened. Furthermore, young drivers need advice on driving safely, while laws that prohibit driving under the influence of alcohol and drugs need to be strictly enforced among all age groups. Blood alcohol levels should be set lower for young drivers than for adults. Graduated licenses for novice drivers with zero-tolerance for drink-driving are recommended. Drowning is also among the top 10 causes of death among adolescents – nearly 50 000 adolescents, over two thirds of them boys, are estimated to have drowned in 2016. Teaching children and adolescents to swim is an essential intervention to prevent these deaths. Depression is one of the leading causes of illness and disability among adolescents, and suicide is the second leading cause of death in adolescents

Violence, poverty, humiliation and feeling devalued can increase the risk of developing mental health problems. Building life skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health. Programmes to help strengthen the ties between adolescents and their families are also important. If problems arise, they should be detected and managed by competent and caring health workers.

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Broadly speaking, adolescence is understood to mean the period between childhood and adulthood. Although the precise age range it encompasses is debatable, it is agreed that during this period young people experience rapid physical and cognitive growth, reach puberty, and move from the relative security of childhood to confront an array of social and other life challenges. Adolescents are defined here as 10- to 19-year-olds and are currently 13.9 percent of the U.S. population. They are generally healthy, yet an overview of the health status of this demographic group illustrates the breadth of the public health challenge they present. Demographically, adolescents are a changing group, as workshop presenter Robert Wm. Blum explained. In 1980, 80 percent of young people ages 15 to 24 in the United States were white. In 2010, that figure is closer to 60 percent, and by 2040 it is projected to be under 50 percent (Mulye et al., 2009). As in the population at large, the fastest growing group is of Hispanic and Latino origin. Youth violence is another area, in Blum’s view, in which public policy has an important influence. The United States has a higher rate of deaths by firearm among children and youth than the rates of the next 25 industrialized nations combined

Despite an almost 50 percent decline in the nation’s overall victimization rate between 1993 and 2005, 3.4 million teens annually are victims of violence. Data from the Youth Risk Behavior Surveillance System (YRBSS) also show that, in 2005, 4.2 percent of male adolescents and nearly 11 percent of females reported having been physically forced to have sex, although this type of violence is often difficult to measure (CDC, 2009). One-third of all firearm deaths among young people are self-inflicted. YRBSS data indicate that, in 2005, 17 percent of youth contemplated suicide and 13 percent said that they had made a suicide plan.

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Overall, positive youth development (PYD) interventions are intentional processes that provide all youth with the support, relationships, experiences, resources, and opportunities needed to become competent, thriving adults. Their use is growing for preventing AYA health risk behaviors

An expanding evidence base demonstrates that well-designed PYD interventions can lead to positive outcomes, including the prevention of AYA health risk behaviors. Additional evaluation is necessary to learn how to tailor successful interventions to meet the needs of different groups of AYAs

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Mulye T, Park MJ, Nelson C, Adams S, Irwin C, Brindis C. Trends in adolescent and young adult health in the United States. Journal of Adolescent Health. 2009;45:8–24

Beesdo K, Lau JYF, Guyer AE, McClure-Tone EB, Monk CS, Nelson EE, Fromm SJ, Goldwin MA, Wittchen HU, Leibenluft E, Ernst M, Pine DS. Common and distinct amygdala-function perturbations in depressed vs. anxious adolescents. Archives of General Psychiatry. 2009;66(3):275–285.

Gleid S, Pine DS. Consequences and correlates of adolescent depression. Archives of Pediatrics and Adolescent Medicine. 2002;156:1009–1014.

Wolfgang M, Thornberry T, Figalo R. From boy to man, from delinquency to crime. Chicago: University of Chicago Press; 1987.

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