According to a report published April 25 by The Lancet, with the global decline of childhood and adolescent mortality from infectious diseases, policymakers are shifting their focus onto the prevention of deaths from noncommunicable causes, for instance, alcohol and drug use, obesity, unsafe sex practices, mental health problems, traffic accidents and violence.

Richard Catalano, director of the University of Washington’s Social Development Research Group, explained:

“We now need to think of how to prevent these behavior problems and conditions early in life because they don’t only cause problems in adolescence, they can launch health issues across life.”

In the report, the researchers highlight cost-effective policies and programs that have been demonstrated to prevent a variety of conditions and behavior problems that contribute to poor health.

Catalano said:

“Despite the growing prevention science research base and the shift in the importance of behavioral problems implicated in noncommunicable disease worldwide, communicable disease prevention and treatment of behavior problems gets the vast majority of resources dedicated to child and adolescent health.”

Over the past three decades the practices have been developed and tested in high-income countries, and have been tested more recently in lower and middle-income countries.

According to the researchers, high, middle and lower-income countries should use these policies and programs more extensively in order to prevent global adolescent behavior problems, as well as states that are associated to lifelong illness and death.

Prevention policies recommended by the team are:

  • Traffic accidents in U.S., Canadian and Australian studies have decreased as a result of introducing a legal minimum drinking age of 21 years and higher alcohol taxation.
  • The number of traffic accidents could be greatly influenced by introducing driving laws and safe roads, which are both the leading cause of mortality amongst adolescents. By restricting the number of fellow passengers that can be carried, as well as nighttime driving and more driving practice before issuing new drivers with a license have been linked to less road traffic accidents.

Their recommended programs are:

  • The Conditional Cash Transfer programs – In low-income countries these programs paid school fees and also gave approximately $10 per month to mothers to make sure that their children would go to school. This program resulted in less teenage pregnancies and more girls stayed in school.
  • The Gatehouse Project – This program focuses on building social, problem-solving and coping skills in school children and promoting positive classroom and school-wide environments. As a result less tobacco and substance use as well as delayed the onset of sexual intercourse in teenagers.
  • The Nurse-Family Partnership program – This program provides poor, first-time mothers with regular home. The program decreased the mothers’ welfare use, smoking, and arrests and resulted in 43% less subsequent pregnancies. In addition, children of these mothers were less likely to drink when they grew up, had less sexual partners and were less likely to be arrested than children whose mothers did not participate in the program.

According to the researchers, the most difficult challenge is getting parents, schools and governments to buy into effective prevention policies and programs. They note that one option is to select local based programs, which can be evaluated with the Communities That Care youth survey.

In the review, the team include 6 programs that have demonstrated a return on investment – ranging for $2 to $42 for each dollar invested.

Catalano explained:

“Prevention science requires you to think systemically across society to see the savings. If we ward off adolescent behavior problems and states that impact adolescent and adult health, like smoking, drinking and risky sex, that means we will likely have less health care expenses, as well as better workers, students, parents and scientists, all involved with making the world a better place.”

Written By Grace Rattue