New centre to reverse lost decade of poor health in teen years

Launched in Westmead in Sydney’s west, the new NHMRC Centre of Research Excellence in Adolescent Health unites researchers, clinicians and young people across Australia in a program of research and advocacy to reverse what has been called “the lost decade” where health gains made in childhood are reversed by climbing rates of preventable health risks, such as adolescent injury, self-harm, obesity and mental health issues.

“The health gains achieved in childhood may be short-lived,” says the University of Sydney’s Professor Kate Steinbeck, the Medical Foundation Chair in Adolescent Medicine, who leads the Centre of Research Excellence.

This is confirmed by data showing upswings in rates of suicide, self-harm, injuries and poisonings, obesity and Type 1 Diabetes that accelerate in adolescence.

“Beyond the problems posed by declining health in the teenage years, adolescence is when many health pathways are set for life,” she says.

Poor health in the teen years also predicts poorer health in adulthood and foreshadows ever-increasing demands on over-stretched health budgets.

“Overcoming these challenges requires new knowledge and approaches that build on the achievements of childhood health initiatives and that support the continuation of positive health pathways before the foundations of adult illnesses are laid.”

“To accomplish this we need a paradigm shift to support the health of young people by enacting what the World Health Organization (WHO) terms a ‘Second Chance in the Second Decade’.”

Unlocking the potential of this ‘second chance’ involves a re-think of the way health services for adolescents are planned and provided to young people. We need to include young people in this conversation.

“This is an ambitious undertaking,” Professor Steinbeck concedes.

“It can only be achieved by developing an integrated program of research that fills knowledge gaps, increases workforce capacity in adolescent health research, and delivers on knowledge, policy and practice. To achieve this, we will be drawing on the huge potential that digital technologies offer young people.”

Funded by the NHMRC, the Centre of Research Excellence in Adolescent Health is a national research partnership comprising the University of Sydney, University of Melbourne, University of Technology Sydney, Western Sydney University, University of New South Wales, Curtin University and Macquarie University.

Fast facts

Increase in health risk behaviours that are largely preventable:

• unintentional injury and poisoning (80,000 hospitalisations in 2013-2014)
• problematic substance use (in 30 percent of young people)
• unsafe sex (in 39 percent of sexually active young people)

Increased appearance of mood and affect disorders and self-harm:

• The rate of depression increases fourfold from childhood to adolescence
• The peak age for self-harm is the teenage years. The four-week prevalence of self-harm for teenagers is around 4 percent for girls and 2 percent for boys

Increasing prevalence of obesity

• The prevalence of combined overweight and obesity has significantly increased among adolescents, from 22 percent in 2010 to 27.4 percent in 2015 in boys, and among girls, from 19.5 percent in 2010 to 26.9 percent in 2015.
• Overall, the prevalence of waist- to-height ratio ≥0.5 as a marker of poorer metabolic health significantly increased among adolescents, in girls  from 9.5 percent in 2010 to 13.1 percent in 2015, and among boys from 10.8 percent in 2010 to 16.9 percent  in 2015.

Increased survival in chronic childhood illness which increases the number of adolescents transitioning to health care services:

• In 1938, most babies afflicted with cystic fibrosis died before their first birthday. Today the average life expectancy for Australians with CF is 38  and the survival rate for children with CF has increased to 50 percent
• Type 1 diabetes: ; global increase, including Australia in both incidence and life expectancy. For 10-19 years olds: 25 (females) and 28 (males) new cases per 100,000
• Inflammatory bowel disease: 60-year study of incidence of childhood ulcerative colitis finds eleven-fold increase beginning in 1990s.