A second chance in the second decade

Adolescence: a period needing special attention


Implications for policies and programmes

The changes that take place during adolescence suggest nine observations with implications for health policies and programmes:

  1. Adolescents need explicit attention. Adolescents are not simply big children or small adults. Unique developmental processes take place during this period. Adolescents have specific characteristics that need to be taken into consideration in policies and programmes and in the strategies to reach this section of the population with health promotion, prevention, treatment and care.
  2. Adolescents are not all the same. During adolescence the components of physical and psychosocial development take place at different speeds and duration, even if the sequence is universal. Policies and programmes need to take into consideration the heterogeneity of adolescents, including the differing developmental phases and abilities of younger and older adolescents and of adolescent girls and boys.
  3. Some adolescents are particularly vulnerable. The environments in which some adolescents live, learn and grow can undermine their physical, psychosocial and emotional development—for example, where adolescents lack parental guidance and support, face food shortages, or are surrounded by violence, exploitation and abuse. Policies and programmes need to specifically and explicitly address these adolescents to protect, respect and fulfil their rights to the highest attainable standard of health.
  4. Adolescent development has implications for adolescent health Developmental changes during adolescence have broad implications for health and disease and for the initiation of health-related behaviours during adolescence. Prevention efforts need to direct interventions to factors that negatively affect development and increase health-compromising behaviours. Service delivery programmes and providers need the awareness and skills to diagnose and respond to health problems related to the developmental changes taking place.
  5. Adolescent development has health implications throughout life. Adolescence provides opportunities to make up, both physically and mentally, for developmental deficits in the first decade of life. At the same time, health interventions are needed in adolescence to build on the investments made during the first decade, in order to maintain positive momentum for transitions to adulthood and health throughout life.
  6. The changes during adolescence affect how adolescents think and act. Recent findings about neurodevelopment have implications for policies and programmes in a range of sectors. For example, understanding the impact of emotionally charged situations on adolescent behaviour (so-called “hot cognition”) supports policies for graduated driving licenses.

    Realizing that adolescents are more motivated by reward than punishment calls into question correctional approaches to deviant behaviour during adolescence. Appreciating that adolescents are more focused on the present than the future has implications for health education messages. The fact that adolescent brains are in some ways designed to encourage risk-taking supports efforts to reduce the harm associated with health-compromising behaviours rather than simply trying to prevent all risk-taking—use of condoms is a good example. And the changes taking place in the circadian rhythm of adolescents has implications for school start times.

    Fighting the Clock: Later School Start, The Forum, Harvard School of Public Health
  7. Adolescents need to understand the processes taking place during adolescence. Adolescents may have concerns about the normal developmental processes that are taking place, ranging from the physical manifestations of menarche and spermarche to volatile feelings and emotions. The health sector can be an important source of correct information and offer opportunities for adolescents to discuss their concerns with trained service providers or peers, through health facilities or in other settings such as schools.
  8. To contribute positively, adults need to understand the processes taking place during adolescence. How adolescents are supported during this period of rapid development determines whether they can take advantage of the opportunities and avoid the threats that are inherent in this period of first-time experiences. To provide the support that is needed, the significant adults in their lives, including parents, teachers, service providers and other duty-bearers, need to understand the changes taking place during the adolescent years.
  9. Public health and human rights converge around concepts of adolescent development. There are important parallels between current scientific understanding of the changes during adolescence and a range of human rights principles, including evolving capacities and best interests of the child. These principles can guide health-sector decisions on issues of importance to adolescent health, for example, prevention interventions (e.g. harm reduction) and the provision of services (e.g. informed consent by mature minors). A human rights-based approach also helps support good practices in public health, for example, non-discrimination, ensuring the participation of adolescents (Article 12)36 and promoting intersectoral collaboration (i.e. the indivisibility of human rights).

    Human rights

The proper functioning of one person is crucial for the society because our problems affect our behaviour, which will sooner or later affect the whole society.

trans, 12-14, Argentina

If you feel well, you produce, you contribute, you are happy and you create a positive social environment.

female, 18-19, Mexico

Health is important to me because being in a state of complete health means being able to function at my full potential, and hence being able to perform at my best and contribute as much as I can to the activities I am involved in.

female, 15-17, Switzerland

It is important because I want to live a long life, and I don't want to be restricted by any illness that would be the result of being unhealthy. I want to be a role model to children that I may have because I know how important it is to have someone that you can look up to and to motivate you to be healthy and to exercise.

female, 15-17, United Kingdom

Adolescents on the meaning of health: To have the ability to do things well, without any sort of discomfort or pain. To ensure a comfortable future, without any complications like diabetes or any sort of cardiac disease, etc., caused by what was done in the past.

Gender not specified, 18–19, Mexico

Health is relative, based on the way you observe it. You can have a healthy body but an aching soul. I think it sums up to a balance of forces that make your body and mind work together to be able to experience freedom and with that, to create goals.

male, 15-17, Mexico

Your health is not only your future but also the future of those around you. If I were to die at a young age, I would be unable to contribute to the economy or the population. An individual contracting a disease increases the risk of other individuals within that community contracting it. Therefore, it is important to keep healthy to ensure my safety and the safety of others.

female, 15-17, Saudi Arabia

Health is the basis for everything. If you want to study or work, you need to be in good physical and mental health.

female, 15-17, South Africa

Health is life. Being in good health allows you to really throw yourself into life.

female, 15-17, France