Teenagers and young people are facing new threats that could see their health and wellbeing go backwards, a new Lancet report warns.
Researchers found that, as the first digital natives and members of the climate change generation, the adolescents faced a unique set of challenges.
But progress to address their specific health and wellbeing needs was lagging, they said.
With adolescents today making up the largest generation in history, researchers say now is the time to act.
They predict that in the next five years, about 1 billion teenagers will live in countries where they are at risk of poor health.
A global issue
Mental ill health, obesity, climate change and conflicts were among the main issues highlighted in the 2025 Lancet Commission on Adolescent Health and Wellbeing report.
Published in The Lancet, the peer-reviewed report brought together 44 leading experts from Australia and across the globe.
It also engaged with a group of youth commissioners to better understand the health needs of 10–24-year-olds.
Poor mental health is among the key challenges facing adolescents today. (ABC News: Alice Roberts)
The report puts the settings that adolescents live in three different categories.
Australia was among the countries where young people predominantly experienced non-communicable diseases such as mental disorders, chronic pain and respiratory conditions.
Countries across South America and Latin America, in particular, were also exposed to an increased burden of injury.
The greatest health challenges were in “multi-burden countries”, many of which are in parts of the Pacific, Asia and Sub-Saharan Africa.
Young people in those countries face higher risks of non-communicable diseases, excess injury, and communicable diseases such as pneumonia, HIV and tuberculosis.
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 years.
Peter Azzopardi, commission member and leader of the Global Adolescent Health Group at the Murdoch Children’s Research Institute, 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.
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”.
The report found that environmental challenges and climate change were impacting young people’s health. (Supplied: Wallcliffe volunteer fire brigade)
Professor Azzopardi said there were direct and indirect impacts climate change could have on health and wellbeing.
He said it could lead to young people being displaced or being at risk of chronic food insecurity.
There is also evidence that climate change contributes to mental disorders, including post-traumatic stress disorder, anxiety, and depression.
“Young people carry a large amount of climate-related anxiety,”
Professor Azzopardi said.
Record-breaking floods in Pakistan in 2022 sparked a food crisis. (AP: Pervez Masih)
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 said there was the risk of exposure to cyberbullying, violent and sexualised content, and dangerous misinformation.
The report highlights how the explosion of digital technology creates both opportunities and potential harms. (ABC News: Mary Lloyd)
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 said 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,” Professor 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.
Ukraine is one conflict that has led to a major displacement of young people. (AP: Bernat Armangue)
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 health care.
‘A new way forward’
Researchers are presenting the report at the World Health Organization’s health assembly in Geneva this week.
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.
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,” Professor Sawyer 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.”
