Factors affecting adolescent health
When thinking about determinants, it is important first to be clear about the type of outcomes we are considering: health problems, health-related behaviours or conditions, or positive health and transitions to adulthood. It is also important to recognize that, while some factors can lead to negative outcomes (termed “risk factors”), others (termed “protective factors”) can help buffer against such outcomes despite exposure to negative factors. They protect against risk behaviours or contribute to positive development. For example, living in communities with strong social cohesion can protect against violence even if family risk factors for violence are present.10
DifferencesEcological models help us understand the many determinants that may affect outcomes during adolescence. These models highlight the range of different actors, relationships and exposures that affect adolescent health and development. They help position adolescents in the context of their families and peers, teachers and service providers, social values and national policies, all of which interact and influence, both positively and negatively, the choices that adolescents make, their aspirations and their actions.
GraphicEcological models complement rights-based analyses that focus on entitlements, which similarly emphasize the many actions that multiple sectors and partners need to take (the obligations of duty-bearers).11
The behaviour-determinant-intervention (BDI) logic model12 has proved particularly helpful for understanding the links between health outcomes, health-compromising behaviours and underlying determinants (risk and protective factors). Interventions that affect these determinants subsequently influence behaviours and health outcomes.
Graphic
The BDI model explains why understanding determinants is important for developing and selecting effective interventions to promote adolescents’ health and well-being. Analysing the factors that contribute to the development of health problems helps the health sector prioritize and target interventions. Such analysis is essential for identifying vulnerable adolescents and situations likely to increase adolescents’ exposure to risk factors.
Adolescents on what makes them sad: The situation in my country. To not have a way to get products that are very important like medicine, food and hygienic products. Injustices and unemployment.
female, 18-19, Venezuela
I get sad when I see indigenous people begging on the street, sick with skin diseases like vitiligo, breathing the dirty, smoggy air that they’re exposed to all day under the hot sun, to see other people begging for food, seeing that they’re dirty and sometimes mentally ill, begging to no avail and being exposed to the difficult life on the streets.
female, 18-19, Mexico
Adolescents on what makes them sad: To see the situation not only in my city but in my country. To know that in my city the government can’t finish a simple public transportation project. Not being able to walk the streets without being in fear.
female, 15–17, Mexico
I have a group of very close friends who looked out for me when I needed them most. I then talked to my parents and then saw a doctor about my situation. Since then I have been much happier and more content.
male, 15-17, United Kingdom
I feel like I am safe when I am at school.
12-14, female, Malawi
Adolescents on what can be done to improve their health: Intervene and inform us more, create a web site where we can talk online with a psychologist, nurse, doctor, etc. Especially on the Internet and Facebook, as we are young and we tend to use these technologies very often.
female, 15–17, country not specified
I am currently drinking water from the well and we share with animals, my mosquito net is torn and I do not have money to buy a new net and drought has hit our area and am not eating well balanced food.
male, 18–19, Uganda
My country is poor, especially in this post-conflict era, and there are many risks to my health. Daily life is costly, and health care is difficult to access
male, 18–19, Burundi
The conditions in my country are so unsafe that I couldn’t just take a leisurely walk or do any sort of exercise outside, like running.
female, 18–19, Venezuela
Adolescents on what makes them feel safe: Knowing that my family and friends are there supporting me and that their reasons for not letting me do something is because they care about me or feel like I can do better.
18-19, Female, Thailand
The support, presence, tenderness, trust and above all the love of those close to me make me feel safe.
female, 15-17, France
Adolescents on what makes them feel safe: To see that the results of my efforts are becoming reality for myself and for others.
female, 18-19, Peru
I usually procrastinate homework, and I have gotten into an habit when I "need" to do something funny and relax on my iPhone 30 minutes before I sleep. This combined leads to a habit where I go to sleep late
female, 15–17, Norway
My culture/environment does not encourage exercise. For instance, housing areas are not fit/safe/appropriate for a morning jog.
female, 18–19, United Arab Emirates
I often use websites that allow for anonymous communication.
male, 18–19, Canada
Adolescents on what can be done to improve their health: To protect the development of my country.
male, 18–19, Democratic Republic of Congo
Adolescents on what makes them feel safe: Having confidence in myself and in my potential.
male, 15-17, Venezuela
