Over a billion adolescents face a major health crisis by 2030

By 2030, more than a billion adolescents aged 10 to 24 will still be growing up in countries where basic health risks remain widespread.

Issues like HIV/AIDS, early pregnancy, unsafe sex, poor mental health, malnutrition, and injury are expected to continue threatening adolescent well-being – despite being largely preventable or treatable.

These are the findings of a new report from the second Lancet Commission on Adolescent Health and Well-being. The researchers concluded that the world is making slow, uneven progress – and many young people are at risk of being left behind.

“The health and well-being of adolescents worldwide is at a tipping point,” said Professor Sarah Baird of George Washington University.

Mixed gains for teen health

The new report updates a landmark 2016 Commission by examining changes over the past ten years. It shows some positive signs.

Smoking and alcohol use among adolescents are down. More young people are finishing high school and attending college. But these gains are overshadowed by rising problems.

In some parts of Africa and Asia, adolescent obesity rates have jumped eightfold. Mental health issues are becoming more severe and widespread.

Even more concerning is how little has changed in key areas. In 2016, about 1 billion adolescents lived in what the Commission terms “multi-burden countries” – places where young people face multiple, daily health threats. That number has now grown to nearly 1.1 billion. Projections show that without urgent action, it will still top a billion by 2030.

Investing in young people’s health and well-being is essential to securing our shared future. “We must prioritize investment in adolescent health and wellbeing through initiatives including those that strengthen schools to promote health and wellbeing and to ensure universal access to healthcare for adolescents,” said Baird.

Growing health risks for adolescents

One of the most alarming trends is the state of adolescent mental health. In countries with data, mental health among young people has worsened over the last 30 years.

The COVID-19 pandemic made things even harder. By 2030, mental illness and suicide will cost adolescents 42 million healthy life years – 2 million more than in 2015.

Another issue is anemia, especially among girls. Nearly one in three adolescent girls could be anaemic by 2030. The condition is linked to fatigue, poor growth, and – in severe cases – organ damage. Yet progress in addressing it has been slow.

Obesity is also increasing at a worrying pace. By 2030, one-third of adolescents in high-income countries, Latin America, and the Middle East may exceed recommended weight. Global numbers will rise to 464 million, up from 321 million in 2015.

Demographic shifts and global progress

Professor Alex Ezeh of Drexel University noted that demographic shifts will continue to drive global progress – or lack thereof – in adolescent health and well-being.

“Africa’s share of global adolescents will increase from under 25% currently to more than 46% by 2100,” said Professor Ezeh.

“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.”

The challenge of climate change

The Commission points to two emerging issues that will shape adolescent health in the decades to come: climate change and digital technology.

Climate change is already impacting today’s youth. For the first time, a generation will grow up with global temperatures consistently 0.5°C above pre-industrial levels.

By 2100, that could rise to 2.8°C. This increase brings serious risks – heat-related illnesses, reduced food and water supplies, and mental health problems linked to climate trauma.

A new review by the Commission shows both sudden disasters (like hurricanes) and slower events (like long-term food insecurity) are harming adolescents’ mental health. Conditions like PTSD, anxiety, and depression are on the rise.

Social media and mental health

Digital life is another double-edged sword. On the one hand, it gives adolescents access to new learning, work, and health tools. On the other, it replaces many in-person experiences with online ones.

Though research is limited, concern is growing over social media’s impact on mental health. The Commission calls for balance – early protective steps without harsh restrictions that could isolate young people further.

Adolescent aid is underfunded

Despite the scale of these challenges, funding has not kept pace. Adolescents make up 25% of the world’s population and face 9% of the global disease burden. Yet only 2.4% of global aid is directed toward their health and wellbeing.

The Commission argues this is a poor investment strategy. Spending on adolescents yields results equal to or greater than investing in early childhood.

But funding often goes to adults or younger children, partly because adolescent health lacks strong leadership and coordination at both global and national levels.

Strategies to protect adolescent health

Dr. Aaron Jenkins of the University of Sydney said that he is profoundly encouraged by our Second Lancet Commission on adolescent health and well-being, which embraces the ecological foundations of human well-being.

“For the first time, we are identifying and encouraging interventions that simultaneously advance adolescent health, ecological integrity, biodiversity conservation, climate change mitigation, and social justice.”

A youth-led push for change

The research stands out for how it involved young people. Ten youth commissioners aged 23 to 35 helped lead the work, representing diverse sectors like academia, civil society, and international organizations. Their experiences and leadership shaped the final recommendations.

In addition, more than 200 adolescents from 36 countries participated in Youth Solution Labs to identify top priorities and solutions.

“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,” said Youth Commissioner Dr. Shakira Choonara.

“However, there are also opportunities – and we’ve seen firsthand and through the Commission findings how adolescents are already stepping up as active citizens and powerful agents of change.”

“I am deeply inspired by the change youth leaders are bringing to their communities and to the global landscape. Investing in and engaging with our generation will build a healthier, more empowered, and better-equipped generation of future leaders.”

The full study was published in the journal The Lancet.

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