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The current health status of Australian adolescents is concerning. Over 80% are not meeting national dietary or physical activity guidelines. Rates of mental ill-health are also rising, with around three quarters of Australian adolescents experiencing depression or anxiety symptoms. Yet as a nation adolescent health is not invested in enough.
The everyday lives of adolescents are intertwined with technology. With 95% of adolescents having access to a smartphone, digital health tools provide a promising opportunity to reshape how youth access healthcare services.
However, are Australian digital health initiatives meeting adolescents needs? The short answer is no.
A recent study led by Imogen Croucher and Mariah Issa from Youth Well Lab, The University of Sydney, found that the 21 currently publicly available digital health prevention initiatives for adolescents are limited in scope. Most focused on mental wellbeing, leaving gaps in support for nutrition and physical activity — which are known protective factors for mental wellbeing and physical health.
Australian federal funding strongly supports culturally targeted health interventions. However, digital health initiatives were found to lack specificity for priority population groups. For example, across Australia, only four digital initiatives were specifically designed for First Nations adolescents.
Additionally, available digital health initiatives were rarely co-designed with adolescents, the language used was complex, and initiatives were found on platforms that are unlikely to be used by young people, like government websites. As a result, digital health initiatives fall short of meeting their needs.
The digital world is evolving rapidly, and evidence-based digital health initiatives are falling behind. It is important to view these gaps as an opportunity to intervene and provide “benefits for young people today, the adults they become and the next generation of children they will parent”.
The bigger problem
Health and wellbeing status are declining globally, with the majority of adults not meeting physical activity or nutrition recommendations. Now, non-communicable diseases are now the leading causes of death globally.
The escalating prevalence of these conditions places psychological and physical burdens on individuals, but also financial, workforce and healthcare burdens.
The Australian federal government’s primary focus on Healthy Ageing aims to improve the overall health and wellbeing for Australians aged 65 years and over.
However, 45.6% of adolescents report a diagnosis of at least one non-communicable disease (i.e., Irritable Bowel Syndrome, Asthma, Type 2 Diabetes). To successfully promote Healthy Ageing, it must be recognised that intervention should begin much earlier than adulthood.
Adolescents are part of the solution to healthy ageing
Investment into adolescents has been described as “one of the strongest mechanisms available to safeguard the collective future of humanity”.
The global population of adolescents is the largest in history. 3.3 million young people (aged 15-24 years) are living in Australia. Promoting good health in adolescents establishes lifelong protective behaviours that prevents future burden of disease.
The National Preventive Health Strategy emphasises how preventive health action is ‘the key to achieving a healthier Australia’. However, the lack of prevention investment into adolescents may limit progress to achieve targets of this strategy.
Investment goes beyond dollars
In Australia, investment into adolescents is often a part of broader health initiatives, yet it could yield potential returns of $10 USD for every $1 USD spent.
However, supporting adolescents requires more than financial investment.
A study found that adolescents highly valued their involvement in decision making processes. This involvement was also found to improve adolescent health outcomes.
However, opportunities for adolescents to engage in initiatives that improve their health and wellbeing are rare. This goes against the expert advice from the United Nations, The World Health Organisation and The Lancet Commission.
The Health Advisory Panel for Youth at The University of Sydney (HAPYUS) is a youth advisory group established by Youth Well Lab. HAPYUS is a successful example of how utilising the voices of young people is crucial to shape research. Sara Wardak, a previous HAPYUS youth advisor stated, “We want to be involved in research that is about us, but the area seems so inaccessible and unapproachable to many our age, that we remain disconnected rather than engaged”.
Adolescents should not be passive recipients of initiatives which directly impact their health and wellbeing.
Digital technologies are part of an equitable solution.
With the technology sector expanding by 80% in just five years, potential of its use to improve health is growing.
It should be recognised that digital solutions may present challenges, including accessibility (i.e. to devices, stable internet connection, data) and poor digital literacy. However, unlike traditional interventions, digital health solutions can be more of an equitable solution. At a relatively fixed cost, they can be scaled globally to deliver accessible healthcare.
The National Digital Health Strategy (2023-2028) affirms this and encourages us to “embrace the digital revolution” to provide better access to healthcare.
Researchers have taken advantage of the digital revolution. Artificial intelligence, social media, and text messaging have been used to deliver preventative health care to adolescents.
The Health4Me study, led by Dr Rebecca Raeside proved to be a successful co-designed, text-message health prevention initiative for adolescents. This study highlighted how adolescents advocate for co-designed digital health solutions. One participant stated, “it (text-message health initiative) should definitely become a public thing … I’d take full advantage of it again”.
While the digital world is harnessed to improve health, we need to simultaneously empower adolescents to be involved in initiatives that are for them. Their first-hand experiences ensures that solutions are relevant and effective. This would prevent a USD $4.1 trillion cost of inaction by 2050.
We cannot afford to not invest in adolescents.
Mariah Issa (she/her) is an Accredited Practising Dietitian and Research Assistant at the University of Sydney with a focus on public health nutrition. Her work explores how digital modalities can be leveraged to improve health outcomes among young people.
Imogen Croucher (she/her) is a clinical dietitian working across inpatient and outpatient settings and is passionate about preventative health, improving health outcomes for minority groups.
Allyson Todd (she/her) holds a Bachelor of Global Studies (Health Major) and Master of Public Health. Her PhD research aims to transform adolescent-led public health nutrition research and build capacity in adolescents to meaningfully contribute to research and policy decisions that impact them.
Professor Stephanie Partridge (she/her) is an Associate Professor, Sydney Horizon and National Heart Foundation Future Leader Fellow at The Faculty of Medicine and Health, University of Sydney.
Dr Rebecca Raeside (she/her) is a Research Fellow with a background in Public Health. Her research focuses on maximising the benefits of digital technologies to improve the health and wellbeing of adolescents. She has expertise in consumer engagement, clinical trials, and mixed-methods research.
The authors declare they have no conflicts of interest.
ART is supported by a University of Sydney Postgraduate Research Scholarship in Adolescent Health and Nutrition. SRP is supported by a University of Sydney Horizon Fellowship and a National Heart Foundation Future Leader Fellowship (Award ID: 106646).
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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