Chakraborty S, Sagar S, Patil P. Placing youth at the forefront of tackling non-communicable diseases: an op-ed piece. HPHR. 2021;34.
Non–communicable diseases (NCDs) is an umbrella term used to describe a cluster of diseases constituting of Cardiovascular and Chronic Respiratory complications, Cancer, Diabetes and Mental Health conditions. The World Health Organisation (WHO) estimates that nearly 71% of all deaths worldwide (41 million people) can be attributed to inadequate and untimely intervention for Non–communicable diseases. Out of the 41 million people affected, the most vulnerable groups placed at the epicentre to face the repercussions of the growing impacts of NCDs are children, young people, people of lower socio-economic status (SES) and those belonging to lower and lower-middle income countries (LMICs). We call for policies to be more youth-inclusive and suggest further recommendations to incorporate youth voices and interventions to combat the global burden of NCDs as young people constitute of a major demographic widely affected by NCDs yet remain underrepresented in their say on tackling NCDs across local, regional, national and global levels.
The prevalence of non-communicable diseases (NCDs) globally is disconcerting. 1.7 million deaths annually among young people are attributable to NCDs. Despite significant burden of NCDs among the youth, they continue to be under-represented in policy formulation and implementation. Two out of three countries do not consult young people as part of their policy-building processes. With the advent of the internet, the youth have unparalleled access to information and avenues for networking. Therefore, nations armed with a high population of young individuals stand to reap benefits from effectively engaging them.
Effective policies concerning the youth require their direct input and meaningful participation. Their experiences and knowledge must be consolidated in the formulation, actualization and surveillance of health policies. Active participation fosters a sense of ownership which is essential for inclusion and development. Youth participation may be sought through establishment of online and offline forums. Training programs can be utilized as catalysts and incubators for leadership roles. We suggest sensitising the youth regarding involvement in policy formation. These could incorporate extending invitations for internships programs, equipping and mobilising youth influencers from various communities to encourage questioning current policies and envisioning reform. One example of an inclusive policy discussion is the use of the Get Heard Toolkit to structure discussions. Using a Get Heard Toolkit to structure discussion, 146 workshops were held throughout the UK between December 2004 and December 2005 to enable people with experience of poverty to feed their views into the 2006-08 NAP. This could be extended for inclusion of youth voices and channelling them into mainstream policy discussions.
Youth involvement in policy making is often limited to them being recipients of information or as nodal points for dissemination of information. Their opinions are infantilized and inadequately addressed in mainstream policy formulation. While young people are involved in informal politically relevant activities such as activism, they tend to be under-represented in formal political bodies. Youth tokenism and its prevention must be considered in this regard. Objective evaluation processes of participation need to be formulated and implemented to rule out quasi–participation of the youth.
The presence of youth wing within decision making bodies could provide a platform for the youth to directly voice their opinions on health policies and the prevailing healthcare scenario; it allows issue based alliance formation. A powerful youth-based branch across generations could ensure that there are senior former members who could function as champions for strengthening the youth’s capacity building in healthcare policies.
The youth is not a homogenous group of people and thus require interventions to be inclusive of the entire spectrum of youth. Online interventions contingent on access to the internet, tend to push the marginalized youth further towards the peripheries. It is imperative to strategically highlight the voices of underrepresented youth demographics such as women, marginalised youth and LGBTQI communities through acceptance and empowerment. There is a growing need for incorporating youth specific policies into mainstream policy framework of various ministries. This diminishes the possibility of the marginalized youth from being excluded during policy implementation.
Often, awareness regarding NCDs and the concerning policies is limited in its dissemination to healthcare professionals and those directly involved in formulating policies. However, conversations about NCDs should be normalized beyond the curriculum and permeate everyday conversations. As outlined by the WHO Global action plan on NCDs, there is a need to disseminate knowledge and share information based on scientific evidence. We urge the incorporation of information about national and global NCD policies through formal as well as informal means of education.
Suicides are the second most common cause of death among the ages of 15-29 years. However, data regarding deliberate self-harm is clouded by social stigma and medicolegal factors. Estimates suggest that for each death due to suicide, there are 20 other suicide attempts. Even in the face of glaring statistics, most countries do not have a stand-alone strategy for suicide prevention. Approximately half of the suicides occur in low and lower middle income countries, however, a mere 10% of these countries have a specific strategy adopted by the government for suicide prevention. Evidence-based suicide prevention measures need to be emphasised with the goal of generating awareness and eliminating social stigma regarding seeking professional help. Counsellors and trained mental health professionals must be appointed by administrative boards across institutions, companies or other places frequented by young people under the supervision of local or regional centres.
The prevalence of non-communicable diseases globally is alarmingly high with 71% of deaths being attributable to NCDs. In the absence of concrete measures, 15 million individuals will die prematurely each year, a majority of which could be young people. Investing in and effectively engaging younger generations is pivotal to ensure a sustainable future for the attainment of Universal Health Coverage.
The United Nations (2014). The Global Youth Call “Prioritizing Youth in the Post-2015 Development Agenda.” Retrieved February 15, 2020 from un.org: https://www.un.org/youthenvoy/wp-content/uploads/2014/09/The_Global_Youth_Call.pdf
World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. World Health Organization, 2013.
Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2017 global survey. Geneva: World Health Organization; 2018. Licence: CC BYNC-SA 3.0 IGO.
Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000–2016. Geneva, World Health Organization; 2018.
Alwan AD, Maclean D, Mandil A. Assessment of national capacity for noncommunicable disease prevention and control: the report of a global survey, Geneva: World Health Organization, 2001.
The United Nations (2014). “Global Partnership for Youth in the Post 2015 Agenda, 2015.” Retrieved February 14, 2020 from academicimpact.un.org: https://academicimpact.un.org/content/global-partnership-youth-post-2015-agenda
Reddy, K. Srinath. “Global Burden of Disease Study 2015 provides GPS for global health 2030.” The Lancet 388, no. 10053 (2016): 1448-1449.
World Health Organization. “Noncommunicable diseases in low and middle income countries” (Geneva: World Health Organization, 2010).
Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370:1929-38. Medline:18063029 doi:10.1016/S0140-6736(07)61696-1
Youth participation in national parliaments, Inter Parliamentary Union, 2016.
Lister, Ruth. “From object to subject: including marginalised citizens in policy making.” Policy and Politics 35, no. 3 (2007): 437.
Sheeba Sagar is a medical doctor currently working at Evangelical Hospital, Khariar, Odisha.
Stuti Chakraborty is currently working at Christian Medical College, Vellore. She is the co-founder of Stimulus, a youth-led non-profit organisation which aims to raise awareness about the brain sciences and counter ableism.
Poorvaprabha Patil is a final year medical student at Kasturba Medical College, Manipal Academy of Higher Education and is also the President of the Medical Students’ Association of India