A Lancet report into adolescent health has identified unique threats to young people around the world, highlighting poor mental health, rising obesity, and exposure to climate change as being among the key health challenges, and calling for urgent action.
Researchers also found that, as the first digital natives and members of the climate change generation, the youngsters faced a unique set of challenges, but progress to address their specific health and well-being needs was lagging, they warned.
With adolescents today making up the largest generation in history, they say now is the time to act.
They predict that in the next five years, about 1bn teenagers will live in countries where they are at risk of poor health, and that in 2030, 464m adolescents globally will be overweight or obese (143m more than in 2015) and 42m years of health life will be lost to mental disorders or suicide (2m more than in 2015).
The 2025 Lancet Commission on Adolescent Health and Well-being report brought together 44 global experts, and also engaged with a group of youth commissioners to better understand the health needs of 10-24-year-olds, and some of the conclusions were alarming.
Changing world
Building on the 2016 Lancet Commission on Adolescent Health and Well-being which catalysed interest in adolescent health globally, the Second Commission aims to catalyse progress in adolescent health and well-being in today’s rapidly changing world.
Professor Nicole De Wet-Billings, senior director: academic affairs at Wits University and whose PhD researched determinants of adolescent mortality in SA, and who co-authored A call to action: the second Lancet Commission on adolescent health and well-being, said adolescent health research was crucial for understanding the unique physical, mental, and social challenges faced by teenagers.
“It helps in developing targeted interventions to prevent and manage health issues early on,” she said.
“Additionally, promoting healthy behaviours during adolescence can lead to healthier adult populations and reduce long-term healthcare costs. This Lancet Commission publication is the culmination of years of work with researchers from across the world.”
Commission co-chair, Professor Alex Ezeh, Drexel University (USA) said: “Africa’s share of global adolescents will increase from under 25% currently to more than 46% by 2100. Consequently, progress in improving the health and well-being of adolescents in Africa will increasingly determine progress in improving the health and well-being of adolescents globally.
“This calls for targeted attention to the needs of adolescents on that continent.”
Living through climate change
The report states that young people today are the first generation to live their entire lives under the shadow of climate change.
“Nearly every adolescent globally has already been exposed to at least one major climate or environmental hazard, shock, or stress,” it said.
It added that many young people were growing up in countries with a “highly inequitable exposure to the consequences of climate change and environmental degradation”, reports ABC News.
Professor Peter Azzopardi, Commission member and leader of the Global Adolescent Health Group at the Murdoch Children’s Research Institute (Australia), said there were direct and indirect impacts climate change could have on health and well-being, which could lead to young people being displaced or being at risk of chronic food insecurity.
Climate change contributes to mental disorders, including post-traumatic stress disorder, anxiety, and depression, he added.
‘Burden of injury’
Countries across South America and Latin America, in particular, were also exposed to an increased burden of injury, but the greatest health challenges were in "multi-burden countries", many of which are in parts of sub-Saharan Africa, the Pacific and Asia, said the report.
Young people in those countries face higher risks of non-communicable diseases, excess injury, and communicable diseases such as pneumonia, HIV and TB.
Due to population growth, more than half of adolescents would be living in countries where their demographic experienced an excess burden of complex disease by 2030, the report found.
Focus on mental health
Although the needs of adolescents varied considerably across different settings, mental ill health emerged as a major issue for young people across the globe.
Mental disorders and expressions of distress, such as self-harm, were the single-largest cause of disease burden among adolescents across all countries, the report found.
Researchers noted that adolescence was well recognised as a time of risk for mental ill health. Three-quarters of lifetime mental disorders have their onset before people reach the age of 24.
Azzopardi said that for such a big issue, mental health was poorly funded.
“It is an area where we have not seen substantial gains made at all,” he said. “We would certainly be recommending that mental health be an area of specific attention.”
He suggested that new approaches were also needed to address mental health literacy and stigma.
Lack of digital safety
In almost every country, digital technologies are increasingly dominating the lives of adolescents. While they create opportunities, the report warns of their potential harms, particularly for socially marginalised and young adolescents.
“Many of the formative social and emotional learning experiences of adolescence are increasingly occurring online, often away from parental supervision,” the report said.
It noted the risk of exposure to cyberbullying, violent and sexualised content, and dangerous misinformation.
Researchers suggested a “carefully considered approach” given the fast-moving nature of digital interactions.
Some young people were already moving on from using social media and adopting new ways of interacting with the online world, including through artificial intelligence, they said.
They warned the effect of digital media – and particularly social media – on adolescent mental health was still highly contested, so it was important to balance acting early to ensure online harm was reduced, while ensuring young people were not “unduly constrained” from the digital world.
Obesity numbers soaring
The risk of being overweight or obese had substantially increased across all regions, the report found.
Every city across the globe was seeing increased rates of obesity, but high-income countries were of greatest concern.
It is projected that across Latin America, the Caribbean, North Africa and the Middle East, a third of adolescents will be overweight by 2030.
“By 2050, close to half of the world’s young people will be overweight,” Azzopardi said. “That's a huge number, so we need to really be acting urgently on this.”
The report attributed the issue to a change in food culture, with unhealthy food products featuring prominently in adolescent diets. Diet was accompanied by shifts from rural to urban environments, which offered fewer opportunities for physical activity.
Growing up among conflict
Adolescents today were both increasingly exposed to conflict and disproportionately affected by war, the report found.
The number of young people exposed to conflict and war more than doubled between 1990 and 2022.
Researchers said the effect of conflict on young people was immense, and could have lifelong and intergenerational consequences.
Conflicts can lead to forced displacement and migration, which expose adolescents to violence and sexual exploitation. It also disrupts food and water systems and reduces access to healthcare.
'A new way forward'
Overall, the commission is calling for “a new way forward” in which young people are involved in policymaking and the funding matches “the magnitude of the challenge”.
While the health of young children has been improving in recent decades, researchers say the report shows teens are at risk of being left behind.
Professor Susan Sawyer from the Murdoch Children’s Research Institute said partnerships with young people were a cornerstone of the report.
“The findings are alarming and they demand urgent action and accountability, in collaboration with adolescents, to create safer spaces and meaningful change,” she said.
A lack of national leadership around adolescent health remained a major barrier to overcoming the challenges, she added.
“A common myth is that adolescents are healthy and therefore don’t need health services.”
Wits University alumna Dr Shakira Choonara, Lancet Youth Commissioner and Steering Group Member, said: “Young people are navigating a rapidly changing world, and through this Commission we’ve heard the diverse and alarming concerns adolescents have about their health and well-being.
“However, there are also opportunities – and we’ve seen first hand and through the Commission findings, how adolescents are already stepping up as active citizens and powerful agents of change, from leading advocacy and activism to co-designing policies that shape the future of human health and planetary health.”
See more from MedicalBrief archives:
Rising global obesity presents ‘unparalleled’ health threat – Lancet report
Spike in “problematic” teenage social media use – global study
SA warnings of possible post-pandemic mental health crisis echo global study
US health chief warns of social media perils for youngsters