Why the fight against non-communicable diseases starts in adolescence

Among the many projects I have led in recent years this has been among the most rewarding. The prevention of non-communicable diseases (NCDs) cannot start early enough. This research programme, developed by The Economist Intelligence Unit, has focused on addressing NCDs in adolescence. It introduces an exciting new tool: the Policy Scorecard on Preventing Non-Communicable Disease in Youth. The scorecard assesses how ten representative countries of different income levels are addressing these challenges.

The research highlights the need to address the root causes of NCDs as early as possible and to give young people a seat around the policy table. The Sustainable Development Goals explicitly commit to a reduction in premature mortality from NCDs by a third by 2030. Yet there has been little focus on the 10-24 age group, although the majority of behavioural risk factors for NCDs first emerge at a young age.

Highlights from the research:

  • The scorecard assesses how ten representative countries of different income levels are addressing the challenges associated with non-communicable diseases (NCDs) among adolescents.
  • The scorecard shows that political will is half the battle. Low- and middle-income countries can do well at addressing the risk factors for NCDs, despite their lack of financial resources.
  • More attention should be devoted to the social determinants of health. Addressing risk factors in adolescents will require governments to look at the entire environment young people are living in.
  • Multi-sector approaches to NCDs work best. Efforts to confront NCDs in the adolescent population are most effective when they are embedded in a broad-based public health programme.
  • Policymaking should include young people. Young people need to have a seat at the policy table, and to be actively involved in establishing programmes and campaigns that will be directed at their peers.

Globally, around 41m people die from non-communicable diseases (NCDs) per year, 15m of which are considered premature. Around 70% of premature deaths in adults are associated with behaviours that began in childhood. Therefore, a sustained focus on the 10-24 age group delivers a “triple dividend”: benefitting young people during adolescent years, during adult life, and passing to future generations. The need to prevent NCDs among adolescents is the subject of a new study by The Economist Intelligence Unit (EIU).

Addressing non-communicable diseases in adolescence, commissioned by AstraZeneca, is based on a NCD scorecard evaluating national efforts in policy, awareness and implementation, with a focus on four risk factors/health areas: healthy diets, nutrition and physical exercise; alcohol and tobacco; sexual and reproductive health; and mental health. The countries assessed in the scorecard include three high-income countries (Hungary, Saudi Arabia and the US), five middle-income countries (Brazil, India, Indonesia, Russia and South Africa) and two low-income countries (Ethiopia and Sierra Leone), which were selected to ensure geographic and economic diversity.

The EIU’s scorecard shows that political will is half the battle. Low-income countries are doing well at addressing some of the risk factors for NCDs, despite their lack of financial resources. For example, Ethiopia and India show progress on addressing tobacco use, while India scores well on the promotion of healthy diets.

However, more attention should be devoted to the social determinants of health. Addressing risk factors in adolescents will require governments to look at the entire environment young people are living in, including the food they eat, the areas they live in and the air they breathe. Multi-sector approaches to NCDs work best. While standalone programmes can be useful for agenda-setting, efforts to confront NCDs in the adolescent population are most effective when they are embedded in a broad-based public health programme. For example, whole-school interventions in Bihar, India, involved both educational engagement and health outcomes.

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