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Cardiovascular Disease (CVD)

Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels, historically manifested in adulthood, but gradually affecting more children, adolescents and youth (young people). CVDs are currently the number one cause of death globally, attributed to 17.5 million deaths in 2012, and disproportionately affecting low and middle income countries. A number of CVDs can be observed in young people including congenital heart diseases such as atrial and ventricular septal defects, and acquired heart diseases such as rheumatic heart disease and Kawasaki disease.

Childhood and adolescence is a critical time for the prevention of CVD. Unhealthy lifestyle factors, adopted at a young age, are a leading cause of the development of preventable CVDs in later life.  For children, the process of atherosclerosis can begin to accumulate at a young age, accelerate with exposure to modifiable risk factors, and ultimately develop into a life-threatening CVD. Approaches to the prevention and management of CVDs must proactively address the individual and population-level risk factors that underlie the progressive loss of cardiovascular health, leading to a substantial risk of CVD outcomes in adulthood.

For additional resources on childhood CVD prevention and management, please visit: 

World Health Organization CVD Fact Sheet

World Heart Federation

Cancer

Each year, 8.2 million people die from cancer accounting for 13% of global deaths. Childhood cancers (arising before the age of 15) rates ranges from 50 to 200 million cases across the globe. Leukemias, tumors of the brain and nervous system, the lymphatic system, kidneys, bones and muscles are the most common childhood cancers.  Some tumors like neuroblastoma, nephroblastoma, medulloblastoma and retinoblastoma, are typically diagnosed in only young people. Of the estimated 176,000 young people diagnosed with cancer every year, 80% live in countries with limited resources, which account for more than 90% of childhood cancer deaths. In high-income countries, childhood cancers have an estimated 75% cure rate, with leukemia leading the success with close to 90% overall cure rate. By contrast, survival rates are far lower in low-and-middle-income countries due to a number of factors including, but not limited to, poor diagnostic capacity, multi-morbidity, poor health care infrastructure and inadequate access to treatment, essential medicines and pain management.

In contrast to cancers in adults, only a relatively small proportion of childhood cancers have known or preventable causes. Conversely, the incidence of adult cancers can be reduced by avoiding key risk factors in childhood and adolescence. Approximately one-third of cancer deaths in adulthood are due to unhealthy lifestyle factors such as high BMI, lack of physical activity, tobacco use, and alcohol use, therefore, early primary prevention can be particularly effective.

For additional resources on childhood cancer, please visit:  Union for International Cancer Control (UICC)

 

Chronic Respiratory Diseases

Chronic respiratory diseases (CRDs) are diseases of the airways and other structures that include asthma, chronic obstructive pulmonary disease (COPD), lung cancer, cystic fibrosis, sleep apnea and occupational lung diseases.  Asthma is the most common condition that affects children and adults alike and though it affects people at all levels of development, it’s disproportionately fatal in LMICs. It’s estimated that 235 million people currently suffer from asthma. Chronic obstructive pulmonary disease (COPD) is another common CRD that affects more than 3 million people worldwide. Risk factors for most CRDs include tobacco smoke, air pollution, occupational chemicals, dusts, and frequent lower respiratory infections during childhood.  Childhood and adult CRD is closely linked. Early childhood respiratory infection, asthma or environmental exposures may lead to chronic disease in adulthood.

CRD prevention requires action at various levels. Primary prevention can reduce levels of exposure to common risk factors including tobacco, environmental air pollution, and poor nutrition. Secondary prevention involves strengthening health care services for people suffering with CRDs including access to care, treatment, and specialty care. Tertiary prevention requires strengthening surveillance systems and to advocate the integration of prevention and control of CRDs into policies across all government departments.  

For additional resources on chronic respiratory diseases, please visit: WHO and the Global Alliance against Respiratory Diseases

Diabetes

The frequency of diabetes is rising around the world, and studies are showing young people are at increasing risk of developing the disease. Since 1980, the number of adults with diabetes worldwide has increased from 108 million to 422 million in 2014. 

Type 1 diabetes, traditionally called childhood-onset diabetes, occurs when the pancreas does not produce enough insulin, a hormone that regulates blood sugar. A combination of genetic and environmental factors is thought to cause the majority of Type 1 diabetes cases. At present, Type 1 diabetes cannot be prevented.

Type 2 diabetes develops when the body cannot effectively use the insulin it produces. Type 2 diabetes is increasing exponentially and developing at a younger age, including in adolescence and childhood. The most prevalent risk factor for Type 2 diabetes is obesity.  Lifestyle modification programmes for young people are crucial for the prevention of diabetes and a number of other medical complications and conditions associated with childhood obesity. Strategies for the prevention of Type 2 diabetes include healthy eating and increased physical activity. Cost-effective medicines and equipment to diagnose and manage diabetes are available, safe and highly effective, but remain inaccessible and unaffordable to many people in LMICs.

For additional resources on diabetes, please visit:  International Diabetes Federation

Mental Health

Mental disorders include anxiety disorders, attention deficit/hyperactivity disorder, autism Spectrum disorder, behaviour disorders, conduct disorder, mood disorders, eating disorders, schizophrenia, and substance abuse.. They also include intellectual disabilities and neurological disorders such as epilepsy and dementia.  Approaches to the prevention and treatment of mental disorders are heavily influenced by context and vary across countries and cultures.

It’s estimated that 10-20% of young people experience mental disorders. Untreated mental disorders can severely influence young people’s development, their educational attainments and their quality of life. Young people with mental disorders also contribute to an increased prevalence of disability and are faced with stigma, isolation and discrimination, as well as lack of access to health care and education facilities.

For additional resources on mental health in young people, please visit: WHO

Adolescent sexual and reproductive health

Sexual initiation and sexual activity vary widely by region, country, and gender. However, in all regions young people are reaching puberty earlier, often engaging in sexual activity at a younger age. Adolescents are particularly vulnerable to sexually transmitted infections, HIV transmission, unplanned pregnancies, and sexual abuse.

Some sexually transmitted infections (STIs) can be easily cured with antibiotics when caught early but others have no known cure. Left untreated, some STIs can lead to infertility, pregnancy complications, organ damage, and even death.

Adolescent pregnancies increasingly lead to a number of complications for the mother including anaemia, malaria, HIV and other sexually transmitted infections, postpartum haemorrhage and mental disorders, such as depression. Stillbirths and sudden infant death syndrome are also more common among babies born to adolescent mothers.

Many young people face barriers to reproductive health information and family planning services. Even where they exist, a large proportion of reproductive health services fail to provide age-appropriate, non-judgmental and full range supportive care to adolescents. Many societies openly disapprove adolescent sexual activity due to embedded cultural and religious factors and beliefs. Support for adolescent sexual and reproductive health must include comprehensive sexuality education; services to prevent, diagnose and treat STIs; and counseling on family planning.

For additional resources on adolescent sexual and reproductive health, please visit: United Nations Population Fund

Injury prevention and violence

Injury and violence are a significant cause of childhood morbidity, mortality and disability. An estimated 900,000 young people die every year as a result of injuries and violence. The burden of violence and injury is greatest in low-income countries and communities. Overall, more than 95% of all injury deaths in young people occur in low-income and middle-income countries.

Every year, there are an estimated 41,000 homicide deaths in children under 15 years of age.  This number underestimates the true extent of the problem, as a significant proportion of child maltreatment deaths are incorrectly attributed to falls, burns, drowning, and other unintentional accidents. Adverse childhood events are also associated with significantly increased risk of substance abuse, depression, suicide attempt, smoking and sexually transmitted disease.

Injury and violence prevention requires a wide range of approaches, including implementing and enforcing safety legislation and standards, promoting home and transport safety, modifying products or the environment, improving family support services and improving care and rehabilitation of injured young people.

For additional resources on injury and violence prevention, please visit: UNICEF and WHO

Disabilities

According to the World Report on Disability approximately one billion people in the world are living with a disability, with at least 1 in 10 being young people and 80% living in developing countries. young people with disabilities are one of the most marginalized, discriminated and excluded groups of young people. It’s estimated that between 93 million and 150 million young people live with disabilities though globally, very few countries collect reliable information on the number of young people with disabilities, the types of disabilities present or how these disabilities impact the lives of those affected.

The global increase in NCDs is having a profound effect on disability trends with the four most prevalent NCDs – cardiovascular diseases, diabetes, cancers and chronic respiratory diseases – estimated to account for about two thirds of all years lived with disability in LMICs. While young people may experience impairment as a result of an NCD, it is not the cause of, nor does it justify disability. Instead, disability is the result of an interaction between a person with impairment, for example, paralysis or a hearing impairment, and the attitudinal and environmental barriers that impede their full participation in society on an equal basis with others, for example, attending school. Communities and governments must reduce these barriers to ensure that young people with impairments caused by NCDs are able to fully participate in all aspects of society to the best of their capacity.

For additional resources on disability and young people, please visit: UNICEF