Background: Exploring how multidimensional social factors are linked with adolescent health could inform policies to achieve equitable and sustainable well-being. We aimed to examine the associations between adolescent health and three dimensions of social development globally. Methods: We conducted a global ecological analysis across 193 countries using data from the Global Burden of Disease 2021. We analysed age-standardised DALY rates (ASDR) for adolescents aged 10-24 years (2010-2035) in relation to well-being (human development index (HDI)), inclusion (gender inequality index (GII)), and sustainability (adjusted net savings (ANS)). We performed the main analyses using data from 2010 to 2021. We generated forecasts to 2035, presented as scenario analyses, using autoregressive integrated moving average models, and log-linear regressions were used to estimate associations and temporal trends. Results: Global adolescent ASDR declined from 14 280.1 (95% uncertainty interval (UI) = 14 264.3, 14 296.0) in 2010 to 13 260.5 (95% UI = 13 245.2, 13 275.8) in 2021, and is forecasted to be 11 187.7 (95% UI = 11 173.8, 11 201.6) per 100 000 by 2035. HDI showed attenuating negative associations with all-cause ASDR (rate ratio (RR) = 0.79; 95% confidence interval (CI) = 0.74, 0.84 in 2010 vs. RR = 0.84; 95% CI = 0.79, 0.89 in 2021), with further attenuation in the scenario analysis to 2035 (RR = 0.92; 95% CI = 0.88, 0.96). GII demonstrated strengthening positive associations (RR = 1.09; 95% CI = 1.02, 1.15 in 2010 vs. RR = 1.11; 95% CI = 1.06, 1.17 in 2021), with further strengthening in the scenario analysis (RR = 1.15; 95% CI = 1.11, 1.20). ANS showed no significant associations in 2010 or 2021, but showed emerging associations with the adolescent health burden of non-communicable diseases (NCDs) in NCD-predominant countries. Conclusions: While gains in well-being were linked to reduced adolescent health burden, this relationship appeared to attenuate in our main analysis between 2010 and 2021 and the scenario analysis for 2035. Inclusion shows increasingly strong associations with the adolescent health burden across diseases, and sustainability is emerging in developed regions. Findings indicate the benefits of equity-focused, intersectoral policies that promote inclusive development and intergenerational justice.
Huang et al. (Fri,) studied this question.
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