Non-communicable diseases among

adolescents: current status, determinants,

interventions and policies related to Mental
Health
Kellyana Irawati.,M.Kep.,Ns.,Sp.Kep.J
INSS, July 2021
Outline
• Background
• Burden and trend of NCD outcome in Adolescent
• Burden, Behavioral, and Socioeconomic risk Factors
• Determinant of NCDs Among Adolescent
• National Policies, Laws, and Legislation for NCD
prevention
• Evidence – based intervention and delivery platform for
NCD prevention
• Conclusion
Background
• In Sustainable Development Goals (SDGs), Non
Communicable Disease is a global priority for adolescent.
• In adolescent drug and substance use are represent a threat
for multiple health outcome including poor mental health.
• existing literature on NCD burden, risk factors and
determinants, and effective interventions and policies for
targeting these diseases in adolescents, is limited
Burden and trend of NCD outcome in
Adolescent
• Based on World Health Organization (WHO) the current burden of NCDs among adolescent that
explore by age (10-19 y o) is mental illnesses.
• NCD Disability-Adjusted Life Years (DALY) was count that Conduct Disorder are highest rank in
adolescent age 10-14 years old followed by anxiety disorder and major depressive disorder.
• In 15-19 years olds major depressive disorder is the top NCD cause of DALYs of the total burden in
this age group.
• DALYs due to NCD causes by sex, in 10-14 years old Conduct Disorder contributes NCD DALYs for
males, followed by Asthma, anxiety disorder, migraine and acne vulgaris. In females with the same
age migraine contributes the greatest burden of disease followed by anxiety disorders, asthma,
conduct disorder and major depressive disorder.
• Major Depressive disorder contributes the most NCD DALYs for both males and females.
Burden, Behavioral, and Socioeconomic
risk Factors
• Regards to lifestyle and behavioural factors,the prevalence of
alcohol drinking among 15-19 years olds is more common
among boys than girls. Tobacco use are similar among young
adolescent is higher among males compared to females.
• Poor sanitation can result in for instance, diarrhea, which can
impact nutrient absorption and disease burden. It’s also
linked to individual and social perceptions about health and
wellbeing, which can influence an adolescent’ mental health.
Determinant of NCDs Among
Adolescent 1/2
• Condition in which people are born, grow, develop, live, work, and age. This include the
social, political, economic, environmental, and cultural system and shape the health and
Social
Determinant wellbeing of individuals.

• Societal and political determinants including national wealth, policies, and laws,
Societal and infrastructure, population density, governance and culture.
Political

• Circumstances of daily life where adolescent live, work and learn, including youth and
womens empowerment, quality and access to health services, education,
Community
and School transportation, access to health services and employment opportunities and condition.
Determinant of NCDs Among
Adolescent 2/2
• The primary protective and enabling structures that shape the health and development of young
people. Relationships, connectedness, and the behaviours of family (e.g. parents, guardians,
Family and caretakers and siblings) and peers significantly influence the behaviour and health of adolescents.
Peer

• Individual developmental milestones and social role transitions, including sexual and reproductive
Individuals health, early marriage, age of puberty, education and employment

• Behavioral, biological, metabolic, nutritional, environmental and occupational factors are

Protective protective factors for individual adolescent health
Factor
Determinants of NCDs Among
Adolescents and Adults
• In the distal level, macro factor such as indicator of conflict and humanitarian crises (e.g refugee
population), state governance, corruption were independently associated with higher NCD burden
correlates of NCD DALYs among adolescent.
• At intermediate I level, urbanization, GDP per capita were more strongly related to the outcome.
• At the intermediate II level, other indicators of household socioeconomic status, youth literacy and
fertility rates, proxies of women empowerment, income inequities, and availability of human
resources for health were all significant correlates of adolescent NCDs
National Policies, Laws, and Legislation
for NCD prevention
• The availability of policies and laws targeting NCD-related lifestyle and behavioral risk factors
among adolescent varied substantially across region. In African region majority perform well with
available national policies and strategies for sexual heath/ family planning (95%), violence (85%),
and mental health (82%), nutritional interventions (80%), alcohol use prevention, tobacco control
activities 979%) and injury prevention (71%) and similar pattern are observed in the South East
Asia.
• The Western Pacific region specifically lacked in policies on mental health and nutritional
interventions. In the Eastern Mediterranean, less than 45% of countries had adolescent specific
policies on alcohol use and injury/violence prevention
Evidence – based intervention and delivery platform for
NCD prevention
• Evidence-based interventions for adolescent populations that specifically target
their modifiable risk factors for NCDs in adolescent and later life, can be broadly
categorized into those delivered through community-based, school-based, peer-
based, and family-based platforms.
• Another intervention related to mental health problem are cash incentive
programs which seek to improve school retention, addressing issues of poverty by
providing payment incentives to student and their parents. These program have
been effective in improving educational attainment and decrease aggression,
crime rates, alcohol and tobacco use, unwanted pregnancies.
Conclusion
• To prevent and reduce the NCD burden among adolescent that related in mental health should be
have more holistic approach.
• Development and implementation of this approach requires a multilevel design that applies a life
course perspective and addresses determinant across individual, community, national and societal
levels,
• Cross sectoral collaboration is critical to ensure effective development and implementation of
policies to prevent NCDs among teenager
Reference
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Hipgrave D B, Schwalbe N, and Bhuta Z A. 2020. Non-communicable diseases among adolescent:
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