Publications

Mental health is increasingly gaining the spotlight in the media and public discourse of industrialized countries. The problem is not new, but thanks to more open discussions and fading stigma, it is emerging as one of the most critical concerns of public health today. Psychological problems among children and adolescents can be wide-ranging and may include attention deficit hyperactivity disorder (ADHD), disruptive conduct, anxiety, eating and mood disorders and other mental illnesses. Consistent evidence shows the links between adolescents’ mental health and the experience of bullying. Collecting internationally comparable data to measure mental health problems among children and adolescents will provide important evidence and stimulate governments to improve psychological support and services to vulnerable children.

This brief focuses on quantitative data and indicators to measure adolescent health, social development and well-being. It covers: the principles of good indicator definition; common use of indicators; examples of indicators for adolescent health and social development; existing global data to describe - and populate indicators of - adolescent health and social development; and how to improve data collection efforts.

The brief is one of seven on research methodologies, designed to expand and improve the conduct and interpretation of research on adolescent health and well-being in low- and middle-income countries (LMICs). Building on the recent Lancet Commission on Adolescent Health and Wellbeing, these briefs provide an overview of the methodological quality of research on adolescents. They cover topics including: indicators and data sources; research ethics; research with disadvantaged, vulnerable and/or marginalized populations; participatory research; measuring enabling and protective systems for adolescent health; and economic strengthening interventions for improving adolescent well-being.

Enabling and protective systems for adolescents are the family, peers and the education and legal systems. In addition to research that focuses on individual adolescents, it is also important for researchers to consider measuring social determinants when conducting research on adolescent well-being. This brief reviews the key concepts of social and structural determinants of health and the methodological issues related to their measurement in adolescence.

The brief is one of seven on research methodologies designed to expand and improve the conduct and interpretation of research on adolescent health and well-being in low- and middle-income countries (LMICs). Building on the recent Lancet Commission on Adolescent Health and Wellbeing, these briefs provide an overview of the methodological quality of research on adolescents. They cover topics including: indicators and data sources; research ethics; research with disadvantaged, vulnerable and/or marginalized populations; participatory research; measuring enabling and protective systems for adolescent health; and economic strengthening interventions for improving adolescent well-being.

Although child and adolescent inequalities are still less understood than those of adults, we have made progress in understanding the pathways that lead to negative outcomes and the limitations of some ‘adult-specific’ indicators as proxies of young people’s health and well-being. Nonetheless, the academic literature has been able to establish a clear negative relationship between a person’s material circumstances and their health outcomes and behaviours such as being overweight, lack of physical activity, higher levels of smoking and mental health problems, all of which persist throughout a person’s life. The personal and societal toll of these effects is clear, yet policies are still lagging behind, tackling proximal causes rather than ‘the causes of the causes’ of these health inequalities. This paper aims to summarise relevant knowledge on the socio-economic causes of health inequalities in children. It will not only provide a foundation to the Innocenti Report Card 13 in terms of outlining our knowledge regarding the drivers of health inequality but it will also help us shed light on its consequences.

International studies of inequalities in adolescent health tend to focus on the socio-economic gradient in average outcomes rather than their dispersion within countries. Although understanding the extent to which differences in health are related to socio-economic disadvantage is important, focusing exclusively on socio-economic status risks neglecting differences in the distribution of health outcomes within and between countries. To fill this research gap, this study analyses variation in the extent of inequality in the lower half of the distribution in five indicators of adolescent health and well-being – health symptoms, physical activity, healthy eating, unhealthy eating, and life satisfaction – across EU and/or OECD countries that took part in the latest cycle of the Health Behaviour in School-aged Children study.

A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.

Adolescence is a time of transitions when experimentation, risk taking and active peer interactions can be viewed as a part of the development process. Yet, for some groups of young people with reported poor psychosomatic health, low life satisfaction or unhealthy eating habits these experiences may be different. Empirical evidence is limited for recognising the overlapping and cumulative risks of adolescents’ health disadvantage and multiple externalized risk behaviours and outcomes (smoking, drinking, binge drinking, regular fighting, injuries and bullying). Drawing on the most recent 2013/2014 data of the Health Behaviour of School Children (HBSC) study, this paper examines the risks of individual and cumulative risks (three or more types) associated with being in the bottom group of psychosomatic health complaints, life satisfaction and unhealthy eating (excessive sugar consumption) across 29 countries.

This quarterly digest syntheses the latest research findings in adolescent well-being over the previous three months. In this issue of the Adolescence Research Digest we highlight the results of the ground-breaking Lancet Commission on adolescent health and wellbeing, which were presented in London in May and Washington in June. The Digest also includes the lasts news, upcoming events, resources and the latest high profile research studies on adolescent well-being and health. Additional readings are also listed. The Digest aims to promote awareness and uptake of new adolescent well-being research findings amongst UNICEF staff, practitioners, policymakers and academics in the development and humanitarian sectors.

Based on an evidence-focused literature review, this paper examines existing knowledge on raising adolescents in east and southern African countries, including Kenya, Malawi, Mozambique, South Africa, Tanzania and Zimbabwe. Country selection was based on the availability of relevant literature and data. The vast majority of studies on parenting and adolescent development is based on research from the global north. This research sought to deepen understandings of family life, care practices and support networks in the east and southern African region so as to inform policy and interventions that seek to improve adolescent-family relations and reduce risk behaviours. An evidence-informed model for understanding the ecology of adolescent-parent relationships in the cultural and economic contexts of the region is provided. In addition, a framework for exploring contextually-relevant dimensions of parenting through research and practice is offered.

The impact of the economic crisis is reflected in the increase of parental unemployment, tensions and fights within the family, constraints on going on holidays, and in fewer private lessons. Student’s life satisfaction has fallen. Findings enhance our understanding of the impact of the economic crisis on adolescents and families in Greece. These data may aid the shaping of policies to protect families and their offspring from the repercussions of the current crisis.