Rapid reductions in child
mortality globally have resulted
in the largest population of
adolescents in human history –
a ‘youth bulge’ of 1.8 billion. In
countries like Papua New Guinea
and Myanmar, 10-24-year-olds
now account for almost a third of
the population.
This story appeared in the Spring edition of IMPACT. Read the entire edition here online.
Burnet’s Co-Heads of the Global Adolescent
Health Group, Dr Elissa Kennedy and
Dr Peter Azzopardi, and Women’s and
Children’s Health Specialist Ms Liz Comrie-
Thomson contributed to a landmark
report, ‘Our future: a Lancet Commission
on adolescent health and wellbeing’, in
2016.
A key message of the commission
was to recognise adolescence as a key
developmental stage within the life-course,
where investments in adolescent health
bring a triple dividend of benefits – now,
into future adult life, and for the next
generation of children.
“What the Lancet report did for the first
time was try to describe the specific health
needs of adolescents globally and how
these can be addressed. This is important as
adolescents don’t automatically benefit from
interventions targeting children or adults,”
Dr Azzopardi said.
“Adolescence is a time when many health
risk behaviours particularly around
substance use and poor diet emerge,
which have important implications for
future health.
“It’s also an important time when young
people start making decisions around having
a family. In many low- and middle-income
countries adolescent fertility rates remain
very high, so there’s a real opportunity to
ensure the health of the next generation
as well.”
Non-communicable diseases (including poor
mental health and substance use disorders)
are health issues common to adolescents
globally. Injuries caused by road traffic
accidents and violence are also common
causes of poor health. More than half of
adolescents grow up in countries which are
additionally burdened by high rates of HIV,
under-nutrition and infectious disease, as
well as high rates of adolescent pregnancy
and unmet need for contraception.
Understanding and responding
to the needs of adolescents in
Australia and globally
Good quality data is essential to
addressing adolescent health but is often
difficult to collect, as adolescents don’t
typically respond to traditional surveys.
Burnet is leading the way with novel
methods and sampling for improved
adolescent health data.
Through the Sex
Drugs and Rock’n’Roll Survey, Deputy
Program Director, Behaviours and Health
Risks, Dr Megan Lim and her team have
measured the sexual health risk amongst
young people at music festivals and on
social media annually for the past 13
years. This study has helped identify
emerging issues (such as sexting,
pornography and risky alcohol use)
and led to interventions addressing
these risks.
Linked to this, the Mobile Intervention for
Drinking in Young People (MIDY) study
tested the feasibility and acceptability
of a mobile phone-based intervention
to deliver tailored text messages to
address risky drinking in young people.
SMS questionnaires tracked participants’
consumption, spending, location and
mood, and encouraged participants
to relate their plans, priorities, and
any adverse events.
In response to the
success of the MIDY study, researchers
at Victoria University in Melbourne have
begun a two-year pilot study targeting
students at four residential colleges at
Melbourne University with SMS texts
before, during and after they engage in
drinking sessions.

Image: Burnet is working to engage Indonesian young people in prevention strategies.
Burnet is also leading the way to improve
methods of data collection relating to
adolescent health globally. Dr Azzopardi
and Dr Kennedy recently collaborated on
a policy brief for humanitarian agency
UNICEF, highlighting what specific data
needs to be gathered for adolescent health
globally and how data collection could be
improved.
They have also collaborated in
global efforts to identify the unique health
issues affecting adolescents, including
work creating global profiles of adolescent
health, and regional profiles with a focus on
the Asia-Pacific region.
“Adolescence is a time of rapid transitions
in social role and culture, and a life-stage
when young people are particularly at risk of
becoming marginalised,” Dr Azzopardi said.
“Deputy Program Director, Disease
Elimination, Mr Chad Hughes and his team
have led a number of projects to better
understand the needs of young people
living with HIV in the Asia-Pacific region
and how to better address their needs.
“This team is also looking at how to avert
harms associated with substance use
amongst young people in Myanmar.”
Through his work at the Wardliparringa
Aboriginal Research Unit within the South
Australian Health & Medical Research
Institute, Dr Azzopardi has also been
leading a project to better understand the
health needs of Aboriginal and Torres Strait
Islander adolescents in Australia.
Addressing health risks for
future adult health
Non-communicable diseases (NCDs)
such as diabetes, cardiovascular disease
and poor mental health are emerging
as the leading causes of poor health in
Australia and globally.
Many of the health
risks related to these diseases, such as
poor-quality diet, physical inactivity and
substance use, typically arise during
adolescence, providing opportunities for
effective prevention strategies.
In collaboration with researchers through
the Australia-Indonesia Centre, Adolescent
Health Officer Ms Lisa Willenberg and
Dr Azzopardi are undertaking a series of
studies to better understand NCD risk
amongst adolescents in Indonesia.
These
studies aim to measure the prevalence
of key risks (including substance use and
unhealthy body weight) and how young
people perceive these risks. The study is
also engaging young people to inform a
public health approach to prevention.
Providing the best start for the
next generation
In many parts of the world adolescent
pregnancy remains high, and these
pregnancies are associated with poorer
health outcomes for both mothers and
their babies, according to Dr Kennedy.
“Adolescent pregnancy also entrenches
socioeconomic poverty and disadvantage,”
Dr Kennedy said.
“Providing young
people with the knowledge and skills to
negotiate safe relationships, and ensuring
access to sexual and reproductive health
services, is important to ensuring the
health of adolescents and that of the
next generation.”
In Myanmar, Burnet’s Country Program
Manager Ms Lia Burns and Dr Kennedy are
leading a five-year project to improve the
sexual and reproductive health of young
people.
This development project aims to
improve delivery of reproductive health
education in schools; engage with parents
and community leaders to address barriers
to improving health for young people; and
work with health staff to improve delivery
of interventions for young people’s health.
Adolescents are also an important focus in
Burnet’s flagship project, Healthy Mothers,
Healthy Babies (HMHB) based in East New
Britain province in Papua New Guinea (PNG).
“Almost one in six girls and young women
in PNG are pregnant or have given birth by
the age of 18, and young mothers account
for around 30 per cent of maternal deaths,”
Dr Kennedy said.
“Our upcoming HMHB Young People’s Study
in PNG will seek to better understand the
factors that contribute to early pregnancy in
order to develop novel interventions.”
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