Executive summary

This report presents the latest available data from countries of the Region with the aim to: 1) analyze the health situation of adolescents and youth in the Region; 2) summarize the current status of the implementation of PAHO’s Regional Strategy and the Plan of Action; and 3) provide perspective on how stakeholders can act to improve the health and well-being of young persons in the Americas, taking into account recent regional and global commitments, strategies, and targets. In doing so, the report offers a comprehensive view of health relating to young people in the Americas.

The report is divided into five parts:

  • Part I provides a profile of adolescents and youth in the Americas, with a focus on demographic and socioeconomic characteristics.
  • Part II analyzes the health status of adolescents and youth in the Americas, guided by the health-related targets and indicators from the regional Plan of Action.
  • Part III reviews key actions taken on the regional and country level in the seven strategic areas proposed by the Plan of Action, highlighting progress and challenges.
  • Part IV describes the evolving global and regional context of the health and development of young people and the implications that has for the regional response.
  • Part V presents adolescent and youth health profiles with the latest available data from countries in the Region on a range of adolescent and youth health indicators.

Current state of adolescent and youth health:

This report discusses the opportunities and challenges for adolescent and youth health in the Americas. We currently have the largest cohort of young people in the history of the Americas, an estimated 237 million. In 2015, those aged 10-24 constituted 24% of the total population in the Americas and 26% of that in Latin America and the Caribbean (LAC). The current demographics create a window of opportunity for fast economic growth, if the appropriate social and economic investments are made in health, education, and the economy.

Adolescence is generally a healthy stage of life, with low mortality and morbidity, compared with other age groups. However, each year, more than 80,000 adolescents aged 10-19 years die in the Region, many due to preventable causes such as homicide, suicide, and traffic fatalities. Moreover, the inequities in many parts of the Region pose challenges for young people. These include the disproportionate burden of poverty and unemployment among young people, and significant numbers who are neither in school nor employed.

In recent decades, the Region has made marked socioeconomic progress. Over the 2004-2014 period, the income pyramid in LAC underwent a historic transformation, in which 72 million people escaped poverty and 94 million joined the middle class. Significant progress has been made in the development and implementation of regional and country-level adolescent and youth health actions, including the establishment of adolescent health programs in most countries, strengthening of the availability and use of strategic information, expansion of health services for adolescents, capacity-building of stakeholders in a range of adolescent health topics, and introduction of school- and family-based interventions.

While these efforts have brought some health gains for adolescents and youth, these gains are limited, and not all groups benefitted equally from this progress. Some 25 to 30 million people in the Region risk falling into poverty, many of whom are youth. Around 150,000 young people aged 15-24 die each year in the Region, of which around 80% are males, indicating the significantly higher risk of young males to die prematurely. Many more youth suffer from ill health due to mental health challenges, nonfatal injuries, and other causes. Adolescent pregnancy, unsafe abortions, HIV, and STIs continue to threaten the health of our young people. LAC has the second-highest adolescent fertility rate in the world, estimated at 66.5 births per 1,000 girls 15-19 years old for 2010-2015, compared to 46 births per 1,000 girls in the same age group worldwide. This report also profiles youth who are living in specific situations of vulnerability, such as those with disabilities, LGBT, indigenous, and Afro-descendant youth.

The Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health highlight young persons as a critical group, reiterating the triple benefit generated by investment in young people: healthy young people now, healthy adults in the future, and healthy future generations. The potential to reap the benefits from the demographic dividend, and to achieve the SDGs without leaving any young person behind, will require comprehensive, intersectoral and pro-equity actions aimed at empowering young people, addressing the social determinants of their health, and maximizing the positive benefits of the family, schools, communities, social media, and other social platforms, to create an environment in which every young person can thrive.

Lessons learned and recommendations:

The lessons learned suggest some changes needed to accelerate progress towards improving the health and well-being of young people in the Region. These include:

  • Ensuring that adolescent and youth health programs are adequately funded, are multisectoral, and address the social determinants of health;
  • Fostering an adolescent-responsive health system, and implementing school-, family- and community-based interventions to protect and promote the health of children and adolescents from a life course perspective;
  • Ensuring that approaches are evidence-based, target the groups in situations of vulnerability from an equity perspective, and are scaled up;
  • Implementing rigorous monitoring and evaluation to inform strategic planning and timely adaptations to improve efficiency and effectiveness of programs and services;
  • Developing new modalities for capacity-building that will yield sustainable results; and
  • Empowering and engaging young people as agents of change.

By implementing these recommendations and learning from past experiences, the Region can improve the health situation for today’s young persons and for generations to come.