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Young Australians confront risks from unhealthy diets and physical inactivity, highlighting the importance of fostering healthy habits and adapting to their distinct needs within an evolving digital landscape.
Treating chronic diseases in Australia costs about $27 billion yearly — one-third of our national health budget — yet only $2 billion are spent on preventive health. The latest Intergenerational Report found that the number of people aged 65 years and over in Australia will more than double over the next four decades, putting unprecedented pressure on the health system.
In this context, a treatment-focused approach to managing chronic diseases without adequately addressing prevention will have an adverse impact on our society. This will significantly affect young people, hindering them from leading a fulfilling and productive life.
Young people are at a critical stage of life for health. Without health-promoting environments and communities, adolescence coincides with a worsening in chronic disease risk factors, such as unhealthy diets and physical inactivity. It’s no surprise that nowadays more adolescents enter young adulthood at a much higher risk of chronic diseases, such as mental health conditions, obesity, heart disease and diabetes, than when they entered adolescence — a globally recognised trend.
Healthy diets and increased physical activity should be the foundations for preventing chronic diseases and mental health conditions. To help young people in particular, policies and health care systems need to recognise that young people, particularly those aged between ten and 19 years, are an age group with different influences that affect their health behaviours compared with adults. As the digital world evolves, shaping their health outcomes demands even greater attention.
How do we navigate the ever-evolving digital world?
Social media has woven itself into the daily lives of young Australians, with 97% of 14–17-year-olds actively engaging across an average of four social media platforms. Within this digital world, commercial companies and influencers have seized opportunities to leverage the vulnerabilities of young audiences for their product promotions, brand endorsements, or to spread misinformation.
For example, a study published in Australia in 2021 found that young people aged 13–17 years were exposed to almost 100 unhealthy food promotions on their mobile phones weekly. This includes meal delivery application (app) companies, which heavily promote unhealthy foods on social media.
Spending too much time on social media is also associated with mental health problems, including depression, anxiety, psychological distress, sleep problems, and body image issues.
Despite these well documented risks, using social media and other digital technologies as channels for providing health-related information to adolescents remains promising. Yet, the online content currently offered by government and health care organisations is often complex and rarely tailored specifically to young people.
Young people are asking for online resources that are not only informative but also engaging, credible, pertinent, and actionable to support their health behaviours. So, in this congested digital world, how can health professionals effectively cut through the noise and deliver meaningful support on eating well and being physically active in a way that works with young people?
What current digital initiatives exist for young people?
Supporting adolescents to eat well and be physically active requires a combination of interventions that empower them to make healthy choices and create environments that support healthy decision making. To date, Australia’s state-based responses have been piecemeal. For example, in New South Wales, there are minimal adolescent-targeted public or school-based education campaigns on physical activity or nutrition.
There is emerging evidence that suggests that digital health interventions in schools addressing multiple risk behaviours can be effective in improving physical activity and eating behaviours. So far, digital health interventions targeting nutrition and physical activity behaviours show promise in improving quality of life, depressive symptoms, and anxiety.
However, current government initiatives for young people are often seen through either an obesity or mental health lens and are generally targeted at those requiring treatment. Some examples of telehealth and online initiatives young people can access for mental health support include ReachOut (which is specifically designed with and for young people), headspace (the national youth mental health foundation) and Kids Helpline.
Similarly, health services exist to support adolescents with obesity, but recent research suggests the current availability and accessibility of tertiary weight management services is inadequate to service adolescents with obesity. Almost all services remain in-person. Adolescents with severe obesity and those living in rural and remote communities are often subject to long wait lists or unable to access such services. Concerningly as well, in NSW most secondary obesity services for adolescents have criteria for referral which include established chronic disease risk factors (eg, hypertension or insulin resistance) or pre-existing chronic diseases (eg, type 2 diabetes)
These are essential services for young people in need of mental health and obesity management that need adequate investment. However, these services should not be the entry point for health care for young people. Investment is required to orientate our health system to see the value in prevention and to support young people with health risk behaviours better before the management of chronic conditions is needed.
For example, a recent global study revealed that every $1 invested in a comprehensive range of interventions to prevent and treat mental health issues such as anxiety among adolescents could yield an estimated $24 in combined health and economic benefits over 80 years across the 36 countries examined in the study. Furthermore, digital health interventions aimed at preventing and treating adolescent obesity show considerable potential for cost-effectiveness and warrant serious consideration by health care decision makers.
Young people are asking for holistic prevention programs focusing on building good nutrition and physical activity behaviours — the foundation for good mental health and chronic disease prevention. This is emphasised in the National Obesity Strategy and National Action Plan for the Health of Children and Young People. These holistic programs may help to tackle stigma associated with traditional obesity or mental health programs, by addressing the social and environmental drivers of chronic diseases.
So, there is a need for health professionals, researchers, policy makers and young people to come together to tackle these complex issues. One promising strategy to help aid this complex problem is cocreating holistic digital prevention programs.
Cocreating digital health interventions with young people
Under the general principles in the United Nations Convention of the Rights of the Child, young people have the right to be involved in health research about them. We aim to address this by involving a youth advisory group and youth researchers throughout our study. Through this, we can better adapt our health interventions to the needs of young people.
In line with the needs of GPs, who prefer to refer patients to tailored nutrition and physical activity interventions, our team is currently testing a novel digital health intervention for adolescents, which has been codesigned with them (funded by Medical Research Future Fund Primary Care Grant). The codesign process confirmed that today’s adolescents want broad, holistic support to improve their lifestyle health behaviours and prevent future chronic diseases. The study was designed in line with recommendations from the Access 3 Report, including youth participation in design and delivery, utilisation of technology, and supporting young people to navigate the health system.
The Health4Me Study aims to improve adolescents’ physical and mental health through a six-month text message intervention (here). It also provides information and hyperlinks to young people to help them navigate the health system independently. Within eight months, we have recruited over 350 young people into the study and have developed strong links with important referral services, including the InsideOut Institute for Eating Disorders. We anticipate the results of this study to be available in late 2024.
Rebecca Raeside is a Research Associate and PhD Candidate in the Faculty of Medicine and Health at the University of Sydney. She is also a board member of the Australian Association for Adolescent Health.
Dr Stephanie Partridge is a National Heart Foundation of Australia Future Leader Fellow and Senior Research Fellow in the Faculty of Medicine and Health at the University of Sydney. She is also the cochair of the International Association of Adolescent Health Emerging Professionals Network.
Allyson Todd is a Research Officer in the Faculty of Medicine and Health at the University of Sydney.
Sara Wardak is a Research Assistant and former Youth Advisor in the Faculty of Medicine and Health at the University of Sydney.
Surabhi Dogra is a Lancet Youth Commissioner and an officer of the International Association of Adolescent Health Emerging Professionals Network.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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