Elsevier

The Lancet

Volume 387, Issue 10036, 11–17 June 2016, Pages 2423-2478
The Lancet

The Lancet Commissions
Our future: a Lancet commission on adolescent health and wellbeing

https://doi.org/10.1016/S0140-6736(16)00579-1Get rights and content

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Executive summary

Unprecedented global forces are shaping the health and wellbeing of the largest generation of 10 to 24 year olds in human history. Population mobility, global communications, economic development, and the sustainability of ecosystems are setting the future course for this generation and, in turn, humankind.1, 2 At the same time, we have come to new understandings of adolescence as a critical phase in life for achieving human potential. Adolescence is characterised by dynamic brain development

Why adolescent health and wellbeing?

Adolescence is often considered the healthiest time of life. In most countries, adolescence is the point of lowest mortality across the life course, sitting between the peaks of early life mortality and of chronic disease in later adulthood. It is a time where many attributes of good health are at their height,13 and from the perspective of health services, adolescents appear to have fewer needs than those in early childhood or in later years. This dominant view of adolescent health has been

Enabling and protective systems

Adolescent development takes place within a complex web of family, peer, school, community, media, and broader cultural influences.55 Puberty triggers greater engagement beyond an individual's family, with a shift to peers, youth cultures, and the social environments created and fostered by new media. This wider social engagement is an important aspect of healthy development in which young people test the values and ideas that have shaped their childhood lives.28 Not only is the range of social

The global health profile of adolescents and young adults

The epidemiological transition has changed health profiles across all age groups. Adolescents and young adults have also benefited from the control of infectious diseases, including diarrhoeal disease, lower respiratory tract infections, tuberculosis, and malaria. Adolescent girls and young women have benefited from gains in maternal health, though there is ongoing debate as to whether gains have been as great in this younger age group.180 However, the epidemiological transition often brings an

Actions for health

Investments in adolescent health extend from those directed toward conspicuous health problems to health risks that emerge during these years and to the broader social determinants of health (figure 6). Yet there are challenges in responding to these health needs, whether through health services, community actions, or structural actions. Adolescents and young adults have the poorest level of universal health coverage of any age group.197 Social and environmental determinants of adolescent

Adolescent and young adult engagement

Two ideas around youth engagement have gained traction in international development. The first is that adolescents and young adults make an essential contribution to the design and implementation of programmes and policies that affect them and their peers. The second is that with structures, support, and processes to do so effectively, meaningful engagement leads to healthier, more just, and egalitarian communities.329

The UN's definition of youth participation is “the active and meaningful

Responses and recommendations

Despite making up around a third of the population in many countries, adolescents and young adults are generally overlooked in health and social policies. The neglect has resulted in limited service development, and low human and technical capacities. Major investments are now needed to take advantage of the opportunities that come with the largest generation of adolescents in human history. The UN Secretary-General's Global Strategy for Women's, Children's and Adolescents' Health is an

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