As we celebrate Youth Day, we are reminded that the choices we make today play a role in shaping the future of our nation – and this begins with investing in our adolescents. Africa is expected to be home to more than 45% of adolescents globally by the year 2100. In South Africa, it is estimated that adolescents account for 18.5% of the population, which is about 10 million young people between 10 and 19 years old. If we want to prepare our youth for the future, we need to invest in their health and well-being today.

On Youth Day, we celebrate the brave young people of the 1976 Soweto Uprising, and honour the role they played in fighting to empower youth. Yet today, the health and well-being of South African adolescents – shaped by the unique challenges they face, including socio-economic pressures – continue to be overlooked.

Data from recent studies paint a deeply concerning picture of the developmental period of adolescence in South Africa: those between 10 and 19 years of age are reporting higher depression and anxiety symptoms, particularly older adolescents from low-income settings; while 45% of adolescents from rural environments report having used substances in the past 12 months, with alcohol being the most prevalent, followed by tobacco and cannabis. A more recent trend has seen just over 16% of school-going adolescents engaging in vaping. The median age of sexual debut is 16 years, with reported incidence of sexually transmitted infections being higher among female adolescents. In addition, female adolescents from socio-economically challenged areas have a higher prevalence of non-communicable disease risk factors – which include being overweight or obese and having elevated cholesterol – when compared to male adolescents.

This worrying state is expected to be exacerbated by trends such as climate change and the rapid changes associated with the digital world, as reported in the recent Lancet Commission on adolescent health and well-being.

While existing studies provide some insight into the state of adolescent health in South Africa, it is worth noting that many were conducted with small samples or geographically concentrated areas, highlighting a critical need for nationally representative data.

In investing in the health and well-being of South African adolescents, our first step should be to have nationally representative and contextually relevant data to guide policies and interventions. In an attempt to do just this, the Healthy Adolescent Behaviours: Investigating Trajectories in South Africa (HABITS) study by the University of Pretoria’s Department of Psychology is exploring the health and well-being of adolescents, and the factors that influence it.

HABITS is a three-phased, mixed-methods study funded by the National Research Foundation that aims to assess the overall health and well-being of adolescents in two provinces in South Africa. It seeks to address the gap in nationally and contextually relevant data, as much of it is either out of date or has been discontinued. The study would yield data on a range of adolescent experiences, including their mental well-being, lifestyle behaviours, school experiences, relationships, safety, how climate change affects them and their decision-making abilities. The data would help us to better understand the needs and concerns of adolescents, and can be used to work with young people, schools and relevant stakeholders to plan and implement targeted interventions.

Another pathway to shaping health and well-being is by encouraging decision-making that promotes healthy alternatives. This involves adolescents evaluating all the available options and choosing one that yields the best result, in this case, the happier and healthier outcome. When engaging in decision-making, adolescents should remember that rushing a decision or putting it off can lead to detrimental outcomes.

Young people generally engage in one of the following types of decision-making:

• Evaluating all the available options and choosing the one that would lead to the best outcome;
• Making a rushed decision because of time constraints, which often leads to less desirable outcomes; and
• Putting off making a decision or shifting the responsibility of making the decision onto someone else, which is often associated with less desirable outcomes.

Adolescents make up a large proportion of the South African population, and investing in their health would yield a triple dividend on investment. In celebrating Youth Day, let us start investing in the health and well-being of adolescents in South Africa and around the world to create pathways for young people to thrive.

Schools that may be interested in the HABITS study and in finding out how this data can benefit them and promote pathways to thriving, healthy adolescents, can contact Prof Davids at [email protected].

Disclaimer: The opinions expressed in this article are solely those of the author and do not necessarily reflect the views of the University of Pretoria.