Non-communicable diseases: not just in older adults

In recent weeks and months, non-communicable diseases (NCDs) have become a key talking point in the global health sphere. Despite common misconceptions, NCDs (defined by the World Health Organization to mainly include cancer, heart diseases, diabetes, and chronic lung disease) are the leading causes of death worldwide. Another misconception around NCDs is that most of these diseases occur in richer countries and are diseases of affluence. Not true either. According to the Population Reference Bureau (PRB), 80 percent of NCD deaths occurred in lower-income countries, up from 40 percent in 1990.

And lastly, NCDs only occur in adults, especially older adults. Wrong again.

Our generation of young people is the largest ever: 43% of the world’s population is under the age of 25. Many risk factors for NCDs, including tobacco and alcohol use and diet, are established during adolescence. Evidence and statistics back this up: 20-40% of adolescents are overweight; and globally, between 80,000 and 100,000 young people start smoking EVERY DAY.

Not only are young people not immune to NCDs… the prevalence of NCDs among youth and adolescents is on the rise. For example, according to a study by Johns Hopkins, 1 in 10 young people have asthma and by the age of 15 more than 25% of obese adolescents have early signs of diabetes.

But NCDs include other health issues like mental illness, motor vehicle accidents, homicides, suicides, and other types of violence. It is estimated that 500 young people die every day due to interpersonal violence.

At the end of last year, the Lancet published its first ever series entirely dedicated to the subject of adolescent health. The papers in this series noted, among many other things, that there remains a huge gap in data pertaining to NCDs in young people. Researchers also found that while the health outcomes for younger children (especially those under 5 years of age) has improved significantly in the last 50 years, the health of adolescents has improved far less so. Much of this is due to both a general focus in the global health community to children under 5 (ie the MDGs) and due to the changing burden of disease among adolescents.

Sawyer et. al’s paper, “Adolescence: a foundation for future health,” road traffic accidents are the leading cause of death among people aged 10-24 years. When combined with suicide and homicide, violence and war, drownings and other accidents accounted for 40 percent of ALL deaths of people aged 10-24.

So what does this all mean? It means that youth and adolescents are indeed vulnerable to NCDs. It also means that because of this, young people have to be involved in the development of the new set of international development and health targets beyond 2015 (when the Millennium Development Goals, or MDGs, expire). And finally, it means that without addressing the specific preventative health needs of young people – like obesity, tobacco and alcohol use, mental health, and accidents – such goals and targets cannot be achieved.

Thoughts on 2012 International Youth Day

The following opinion piece is a re-posting from Kenny Ayeni, Communications Coordinator at LEAP Africa. The piece originally appeared on Punch Nigeria online.

Every year, since 2000, the United Nations has celebrated the International Youth Day on August 12. This year, the Day’s event which held last Sunday, is aptly titled, “Building A better World, partnering with youth”. This is in recognition of the need to encourage youths to be ambitious and recommendations to the older generation to partner with young people to achieve their goals. In addition, the UN is showcasing outstanding works done by young people around the world whilst also emphasising the need to improve and strengthen connections with them in order to advance their quality of life.

The 2012 event is geared towards providing opportunities for the improvement of youth organisations and for UN Member States worldwide to fortify partnerships with youths through diverse and innovative means. This would include exploring the ways through which the UN, member states, civil society, the private sector, the academic sector and humanitarians could team up and work with young people to improve their living standards as well as improve their education, employment opportunities, entrepreneurship, citizenship and, most importantly, human rights.

The UN Secretary-General, Ban Ki-moon, is quoted as saying that, “to unleash the power of young people, we need to partner with them”. Also, in an address by Kofi Annan, United Nations-Arab League joint special envoy for Syria and seventh UN Secretary-General, on the International Youth Day in 2004, he urged the international community “to prepare for the future, so as to promote solidarity between generations today”. Consequently, countries across the world are devoting resources to youth development to ensure that their youths are adequately trained and prepared to address personal, organisational and societal challenges. The case should not be different in Nigeria. There is an urgent need for the government to invest in youths to create a sustainable and successful future, most especially to survive in a competitive and changing world that we live in.

In order to effectively alleviate global challenges faced by the youth, such as poverty, gender discrimination, human trafficking, drug abuse, high illiteracy and unemployment, there is an urgent need for stakeholders to work together. This underscores the importance of establishing a global strategy to build a better world; a world that is free and fair. A world that recognises that if the youth are constructively engaged, they will emerge as great leaders and become useful resources to their nations.

It is germaine to mention that there are organisations in Nigeria that are dedicated to working to achieve this year’s theme. One such organisation is the Leadership, Effectiveness, Accountability and Professionalism (LEAP) Africa, a non-profit organisation committed to developing dynamic, innovative and principled leaders. For the past decade, the organisation has trained more than 20, 000 youths and partnered with many youth-led organisations in an attempt to amplify their leadership capacity. The organisation also offers training programmes targeted at disadvantaged youths aged between 14 and 35 years through its various leadership programmes such as the Leadership, Ethics and Civics Programme, Employability Programme and Values and Leadership Skills Programme.

It is instructive that beneficiaries of such programmes have initiated high impact social change projects in their local communities across Nigeria and Africa. These young innovators are championing global discussions in areas like climate change resolution. Locally, they are also contributing to national issues including agriculture, corruption, human rights, and providing basic health care to the underserved — in an attempt to alleviate social and economic problems in the society. Beyond these activities, seminars to impart knowledge to their peers and young adults on topical issues ranging from teenage pregnancies to entrepreneurship are encouraged.

The actions of these young people demonstrate that leadership is not a position but an act that clearly defies the belief that only successful and influential individuals can positively transform lives and influence situations in their community.

To celebrate the 2012 International Youth Day, the United Nations and LEAP Africa urge non-governmental organisations, government, private sector and well-meaning citizens to partner with and support young people in the key areas of need such as employment, entrepreneurship, political inclusion, citizenship and protection of rights, education and sexual/reproductive health.

The dedicated and collective efforts of organisations and citizens towards establishing positive and strategic youth engagement on a national scale would eventually lead to improvements in the global state of affairs.

•Ayeni is the Communications Coordinator, LEAP Africa. kayeni@leapafrica.org

Remarks for U.S. Secretary of State Hillary Clinton on International Youth Day

Press Statement

Hillary Rodham Clinton, Secretary of State

Washington, DC

12 August 2012

There are more than three billion people under the age of 30. Young people represent a growing class who are yearning to have their voices heard. But in too many places around the world, the needs and concerns of young women and men continue to be marginalized. Countries are failing to provide young people with the chance to realize even their most basic aspirations. Their political will has too often been suppressed. Yet they are inextricably tied to the problems we all face, from security issues and the economy to changes in governments and society.

We have all witnessed over the last two years that youth are shaping the political landscape of their countries. I have seen young people driving innovations and economic and social entrepreneurship in every region of the world. I believe the best solutions to our shared challenges will come from harnessing the energy and creativity of youth.

As we celebrate the achievements of young people, it is incumbent on the leaders of today – in politics, civil society, the private sector, academia, and scientific fields – to mentor and to cultivate the next generation. It is only through partnership that we can equip young people with the skills, resources, and networks they need, while also empowering them to be agents of change in their communities. The United States stands with young people everywhere as we work to build a brighter future together.

The Art of Engaging Indigenous Youth Via Social Media

The following is a guest blog by Kishan Kariippanon, MD, MPH at Youthhealth2.0

Media consumption today has become personalized, through emergent technology, especially mobile technology and social media (which enables peer-to-peer sharing).Indigenous youth have more control over what their choices are in terms of what they want to view online. More and more access to media is neither ‘only offline’ or ‘only online’ as the shift to a seamless media consumption consumer becomes more widespread.

Media and Social Media

Until the dawn of emergent technology, media has always been within the grasp of a finite group of people and their companies. Today, media has become social where ‘You” are the central actor or director and your media content can be shared with anyone, anywhere, with access to the Internet.

The novelty in media consumption (my first TV vs my first iPhone)  is no longer about the tools but more on the content. Engaging, relevant, simple and targeted content is what makes a successful social media effort. Every minute, 24 hours or more of video material is being uploaded to YouTube. How then does health related videos compete with popular video for viewership if it is not tailor-made to reflect local content, local actors and especially local efforts and ideas. Engagement, for the purpose of behavior change, targeting Indigenous youth today is far  from simply raising awareness on  television or radio and definitely not on social media either.

The 3 elements of ‘Engagement’

Engagement in the days before social media meant it involved a more hands off process. Health promotion project officers would take their project plan to a dedicated team in the local/national radio and television company and based on the available budget, a series of advertisements will be produced and aired. The media companies having done extensive research on what time slots are worth in dollars and cents, and will advise your air time. This was best practice in the days of ’one way’ health communications via traditional media.

Media and marketing companies are wired to sell, they are focused on converting information dissemination (advertising) to sales (behavior change). Social marketing campaigns that are geared for behavior change seldom go beyond raising awareness and  (advertising) assuming that knowledge is the key to behavior change. It is quite different to sell a brand (E.g. Coke, Dunhill) as  opposed to promoting a new behavior or stopping an unhealthy one. The comparison between commercial marketing and social marketing is unfortunately not within the scope of this article.

To engage today’s Indigenous youth,  your product or program must:

  1. Be relevant to your target audience; the more precisely defined target audience, the more relevant will be your marketing strategy
  2. Co produce media and social marketing content with motivated representatives of target audience
  3. Make the ability to “share” social marketing content easy to do; e.g. via Bluetooth, share via social media, word of mouth

Target audience

We must stop referring to Indigenous youth as a homogenous group of young people. Firstly, there are hundreds of Indigenous languages, clans, moieties, totems, songs, dances and ceremonies that make up the identity of a particular Indigenous youth. When mainstream health promotion efforts contribute to the homogenization of Indigenous youth, we are indirectly, killing the diversity and richness of knowledge and culture of Indigenous communities.

In order to engage Indigenous youth from a remote community, ( post community consultations) the project must group their youth within their natural clusters; taking into consideration kin, land, traditional beliefs and clan affiliations. The project must be capable of focusing on the process of negotiation, so paramount to Indigenous community life where everyone has a role to play; even the land and the tree that we will sit under and the language that will be spoken, to plan the social marketing and social media campaign.

Indigenous youth from more urban settings would apply to the same process of working with them to produce locally driven content. When content is authentic and empowering then, even when it crosses borders and cultures, it will rarely lose its luster and effect as media and  social media has a trans-cultural effect in knowledge and information dissemination.

Are we creating a  Digital Divide?

The focus of this article is to discuss the importance of relevant, co produced and sharable media made by local youth for their peers. The tools that are used to achieve this have been different based on the available technology at the time. Today, with smartphones, high-speed internet (3G and 4G) and social media sites like Facebook and YouTube, the ability to create targeted media is within the grasp of any motivated and capable health promotion officer and NGO.

The digital divide cannot undermine or disadvantage youth, even Indigenous youth from remote communities. If the main cause of this so-called ’digital divide’ is due to socio-economic disadvantage then, employment and skills training needs must be met first. If young people expressly refuse to use the Internet and social media, and their ability to access information via Internet is halted,  then the process of developing media content for them will take on another form with different dissemination tools. The strategies or principles remain the same.

Creating access to services and health information does not have to end in a “divide”. Innovation in health communications practice is yet to take on the attributes and attitudes of a silicon valley startup. As Lucien Engelen from the ‘Radboud REshape and Innovation Centre’ (Nijmegen University Medical Centre) says: “If you’re afraid of failure and only want 100% positive results, don’t innovate.”

As long as we still have a socio-economic divide, we will continue to have the digital divide amongst young people. What matters the most is that we don’t create a divide called the ‘innovation divide’ because innovation exists everywhere and those disadvantaged are innovating constantly to survive.

UNICEF Begins to Tackle NCDs in Children and Adolescents

The following is a guest blog from Jeff Meer, Special Advisor for Global Health Policy and Development at the Public Health Institute (PHI). 

Dr. Nicholas Alipui, director of programs at UNICEF, announced last week that the agency has decided to update its iconic information resource “Facts for Life” to include information about non communicable diseases (NCDs) in children and adolescents. Speaking at a Ministerial breakfast as part of the UN Economic and Social Council (ECOSOC) on July 6, Dr. Alipui said that by updating “Facts for Life” with information about NCDs, ordinary people the world over will have access to vital information they need about preventing NCDs in children and adolescents, as well as non-technical information about diagnosis and treatment.

“Facts for Life,” first published in 1989, has 14 chapters devoted to ensuring children’s rights to survival, growth, development and well-being. The information is presented in simple and compelling language and clear images for use among families and communities the world over. The new chapter on NCDs will be ready in “about a year,” according to Dr. Alipui.

Speaking to UN member states at the breakfast, Dr. Alipui said that UNICEF has decided to keep the face of children and adolescents squarely in front of the NCD community.  “It is a fallacy that NCDs affect only older people,” he said, “just as it is untrue that NCDs only affect the wealthy.”  NCDs including cancer, diabetes, chronic heart disease and chronic lung disease represent the cause of almost two thirds of all deaths worldwide today. “UNICEF believes that the best way to approach NCDs is to adopt a lifestyle perspective,” Dr. Alipui said.

The Ministerial Breakfast, entitled “Working Well! Safeguarding Adolescents and Youth Livelihood in the Face of NCDs and their Risk Factors” was co-sponsored by UNICEF, the Pan-American Health Organization (PAHO), and NCD Child (PHI is a member of the steering committee of NCD Child). The breakfast was moderated by Henry Mac-Donald, the Permanent Representative of Suriname to the United Nations.  Dr. Arturo Cervantes Trejo, General Director of Mexico’s National Center for Injury Prevention at the Ministry of Health, delivered closing remarks.  Speakers included Dr. John Andrus, deputy director of PAHO, Sir George Alleyne, former PAHO executive director, and Dr. Kate Armstrong, President of the Australian NGO Caring and Living as Neighbors.  Representatives from at least 15 member states, including the United States, attended.

Member state representatives reviewed several documents at the breakfast, including the Oakland Statement on NCDs in Children and Adolescents, as well as an issues paper prepared by NCD Child on the effects of NCDs on employment of young people.

Following the breakfast, Dr. Alipui reconvened interested representatives from nonprofits and for-profit corporations at UNICEF headquarters for further informal conversations. Here, he continued the theme he had discussed in the Ministerial Breakfast, noting that “the heaviest burdens are now squarely in younger generations and in lower and middle-income countries.”  According to Dr. Alipui, there is widespread recognition now that NCDs have origins very early in life, and so only a lifecycle approach will work to prevent and treat them.  “This completes the circle for UNICEF,” he said “instead of focusing on one set of issues, we need to focus on the entire set of issues that children, adolescents and their families face.”

Rio+20: An Introduction for Youth

Rio+20 is a Sustainable Development conference organised by the UN for governments with some members of Civil Society attending. It is a 3 day event that will focus on two themes and has only one objective—to have governments commit to sustainable development.

This means that they are going to look at the progress to date and the remaining gaps in the implementation of agreements. This will also include how to tackle new and emerging challenges.

The event will mark the 20th anniversary of the 1992 United Nations Conference on Environment and Development (the Earth Summit), in Rio de Janeiro, and the 10th anniversary of the 2002 World Summit on Sustainable Development  in Johannesburg. It is seen as a conference at the highest possible level, including Heads of State and Government or other representatives. We want the Conference to result in a focused political document.

So, how can you(th) make this happen? Put pressure on your government. Get involved! Mobilise your friends and make sure that your government knows that this matters to you.

Rio+twenties is a youth-led, completely volunteer-based organization. It strives to create a platform for active youth participation in what could become one of the most important international events in years, the UN Conference for Sustainable Development (aka Rio + 20).

Watch the video below, An Introduction to Rio+20 for children and youth.

Rio+20: an introduction for children and youth from Rio+twenties on Vimeo.

UNICEF: Climate change among most serious problems facing global youth

In its recent reportThe State of the World’s Children 2011, UNICEF includes climate change among the most serious issues confronting the next generation. Youth will have to confront climate change long after our current leaders have died. But, even now, they are disproportionately affected by it.

“Natural disasters are increasingly frequent,” the report notes, and “[a]t times of crisis, children and adolescents are most vulnerable. While the youngest are most likely to perish or succumb to disease, all children and young people suffer as a result of food shortages, poor water and sanitation, interrupted education and family separation or displacement.”

While it’s widely recognized that developing countries will be hit harder by climate change than the industrialized world, the report offers this additional piece of information: 88 percent of all adolescents live in developing countries.

There may be a silver lining: UNICEF sees an opportunity for young people to become “effective agents of change for the long-term protection and stewardship of the earth if” — and it’s a crucial if — “they are provided with knowledge and opportunity.” Among young people climate skepticism is all but unheard of, and youth groups have repeatedly called for immediate and aggressive action against climate change.

It’s a testament to how serious an issue climate change is that a report with as broad a focus as “youth” hones in on it. The human lens on the problem also leads to an acknowledgement of the diversity of effects climate change will have on us: “Climate change is not just an ‘environmental’ issue,” says UNICEF, echoing a claim that we at ClimateHealthConnect find ourselves making regularly. “It requires collective action that brings together sustainable development, energy security, and actions to safeguard children’s health and well-being.”

Among those that don’t care about glaciers or polar bears, there must be many who do care about human health. And among those who don’t care much about health, perhaps there will be some who do care about children.

 

*Photo courtesy of Stoonn.

Young People and the Environment

“It is imperative that youth from all parts of the world participate
actively in all relevant levels of decision-making processes because it
affects their lives today and has implications for their futures. In addition
to their intellectual contribution and their ability to mobilize support,
they bring unique perspectives that need to be taken into
account.”  –   Chapter 25 of Agenda 21, adopted at the 1992 United Nations Conference on Environment and Development (UNCED) in Rio de Janeiro

Seven billion people now live on our earth; only 12 years ago, our global population hit six billion.  There are more young people living in the world today than ever before. The number of young people (aged 14-24) in the world has increased dramatically in the the last few decades: from 461 million in 1950 to more than 1.2 billion in 2010 (UN 2010) .  Additionally, more than half of the world’s people are under the age of 25.

The World Health Organization (WHO) defines environmental health as ” all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments.”  Therefore, environmental health pertains to both our immediate environment (our house or community) and our greater environment (the planet’s changing weather patterns, etc).

There are a number of environmental risks and climate hazards that disproportionately affect young people and their health and well being. For example, young children are especially vulnerable to risks associated with access to clean and safe drinking water.

In this section, we will be posting on a variety of topics pertaining to environmental health and young people. These topics include, but are not limited to: water security, food security, climate change mitigation and adaptation, severe weather,and indoor and outdoor air pollution.

LGBTQ Youth: facing unique health challenges

Lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth face tremendous and unique challenges in societies that privilege heterosexuality while oppressing other sexual identities and expressions. Within such cultures, to identify (or to be identified) as LGBTQ is to be marked as deviant and unnatural, and to be marginalized and even harassed.

Research suggests that homophobia, transphobia and heterosexism contribute negatively to the health outcomes of LGBTQ youth, including their mental, physical, spiritual, and emotional well-being.  This also includes evidence of “higher rates of suicide, violence victimization, risk behavior for HIV infection, and substance abuse” among LGBT youth as compared to their heterosexual peers.

As members of multiple minority groups, LGBTQ youth of color face additional challenges in societies which often accept heterosexuality as the only sexual orientation and in which nonwhites have disproportionate rates of sexually transmitted infections (STIs), including HIV.

In countries around the world, especially where there are laws prohibiting homosexuality and which accept only a strict binary understanding of gender and gender expression, LGBTQ youth struggle to find safe spaces where they can find support and resources that can help them answer questions, access certain physical and mental health services, and improve cultural dialogue around LGBTQ issues. Below are a number of resources for LGBTQ Youth.

 

Discussion Prompt: Have you witnessed LGBTQ inequality or discrimination in your community? If so, how does it make you feel? How do you react?

Coming up in the next few weeks: Health issues surrounding young men who have sex with men (YMSM) and young women who have sex with women (YWSW).

 

 

Some of the above information is drawn from Advocates for Youth’s “GLBTQ Issues” website and Gay, Lesbian, Bisexual, Transgender and Questioning (GLBTQ) Youth Fact Sheet. 

The context of this site

This is the thematic youth policy resource page on youth and health.

The Public Health Institute

As part of the knowledge base and community at www.youthpolicy.org, it is curated by the independent, non-profit Public Health Institute (PHI). Understanding health as a human right, the Public Health Institute generates and promotes research, leadership and partnerships to build capacity for strong public health policy, programs, systems and practices.