Adolescence

OPPORTUNITIESareas for adolescents are still hidden from view, partly owingto intractable difficulties associated with the collection ofsuch information in circumstances often involving secrecyand illegality. Furthermore, the international household surveysfrom which much of the data on adolescents is deriveddo not, by definition, capture adolescent males and femalesliving outside the household – in institutions, for example, oron the streets, in slums or in informal peri-urban settlementswhere records do not exist.Oft-quoted estimates of the number of childrenassociated with or affected by armedconflict and child trafficking and of thosein conflict with the law – to name but threeareas – are outdated, not fully reliable andgenerally believed to vastly underestimatethe true scope of the abuse.This pattern of data collection is beginningto change. Enhanced national surveys andcensuses, along with international householdsurveys such as MICS and DHS, areproviding an increasingly rich vein of evidence on the situationof adolescents and young people on a wide range ofissues. Recent work by the UNESCO Institute of Statistics,the Education for All Initiative and other mechanisms areproviding a stronger evidence base on education thanbefore. Analysis of this new data is enriching our understandingof the state of adolescents worldwide and willenhance the international community’s ability to realizetheir rights.Health in adolescenceHealthier adolescents today, despite lingering risksDespite popular perceptions to the contrary, adolescentsacross the world are generally healthier today than inprevious generations. This is in large measure a legacy ofgreater attention to and investment in early childhood,higher rates of infant immunization and improved infant“Adolescents needthe opportunity toassert themselves,express themselves,to flourish.”Mamadou, 19, Senegalnutrition, which yield physiological benefits that persistinto adolescence.Those children who reach adolescence have already negotiatedthe years of greatest mortality risk. While the survival ofchildren in their earliest years is threatened on many fronts– for example, by birth complications, infectious diseases andundernutrition – mortality rates for adolescents aged 10–14are lower than for any other age cohort.Rates for young people aged 15–24, whileslightly higher, are still relatively low. Girlshave lower rates of mortality in adolescencethan boys, though the difference ismuch more marked in industrialized countriesthan in developing countries. 1Yet in 2004 almost 1 million childrenunder age 18 died of an injury. 2 Risks toadolescent survival and health stem fromseveral causes, including accidents, AIDS,early pregnancy, unsafe abortions, riskybehaviours such as tobacco consumptionand drug use, mental health issues and violence. These risksare addressed below, with the exception of violence, which istackled later on in the section on gender and protection.Survival and general health risksAccidents are the greatest cause of mortalityamong adolescentsInjuries are a growing concern in public health in relationto younger children and adolescents alike. They are theleading cause of death among adolescents aged 10–19,accounting for almost 400,000 deaths each year amongthis age group. Many of these deaths are related to roadtraffic accidents. 3Fatalities from injuries among adolescents are highestamong the poor, with low- and middle-income countriesexperiencing the greatest burden. Road traffic accidentsrealizing the rights of adolescents 19