Britain has the third-highest proportion of teenagers who are sexually active at an early age and also ranks badly among high-income nations for harmful teenage drinking, according to a series of studies published in the Lancet medical journal on Tuesday. The research, plus a report by Unicef, call for more attention to be paid to the changing needs of the young, warning they are at risk of mental and physical illness, vulnerable to unhealthy product marketing and that too many will die early. The studies found neglect across the globe, including in affluent countries such as Britain and the US. Among 40 countries with broadly comparable data, England had the fourth-highest number of adolescents who had been drunk by the age of 13. Wales came fifth and Scotland eighth. Wales had the third-highest number of 15-year-olds who drank every week, with England fourth and Scotland again eighth. For early adolescent deaths, Britain ranked in the middle of high-income countries. Worst was the US, because of a very high rate of violent deaths – 10 to 20 times above that of other developed countries. The US also had high binge-drinking rates (despite alcohol being prohibited for those under 21) and the top rate of cannabis use of all high-income countries with data. This generation is unlike those that have gone before, say Professor Susan Sawyer and Professor George Patton from the Murdoch children's research institute and University of Melbourne in Australia. Earlier puberty and later marriage means that 18 is no longer considered the point of transition to adulthood in many societies. The years of experimentation and uncertainty have expanded, and with them, the potential harms of substance and alcohol abuse, and early and unsafe sex. Education and jobs are often inadequate. The Arab spring showed the crucial role of the young as agents of social change, but they are vulnerable, says the paper. "Young people were at the forefront of the social unrest across north Africa and the Middle East that began in Tunisia in December, 2010. "Although many succeeded in toppling the restrictive regimes that they fought against, they faced serious threats to their lives and health. Such engagement is a powerful reminder that, by stark contrast with younger children, adolescents have an increasing capacity to be active agents of change within their communities. "It raises concerns about the extent of young people's exposure to violence, exploitation and abuse, and suggests the need for greater protection of human rights," write the authors. About 70% of premature deaths in adults were the result of behaviours begun when young. It may get worse. "Marketing of unhealthy products and lifestyles (eg, tobacco, alcohol and foods high in fat, sugar and salt) clearly targets young people," says their paper, comparing mass media to an infectious disease epidemic. And while social media has brought enormous benefits, giving young people a voice and an ability to communicate with each other and circumvent restrictive authority, there are potential harms as well, in the form of cyberbullying, pornography, "sexting" [sending sexually explicit texts], copycat suicides and self-harm and sleep deprivation. More than 2.6 million 10-24-year-olds died in 2004, with mortality increasing from early to mid-adolescence and into young adulthood, say the researchers. The leading causes of death were: injuries (including road traffic accidents and suicides); pregnancy and childbirth; communicable, nutritional and perinatal diseases (eg, tuberculosis, meningitis, and HIV/Aids); and non-communicable diseases (such as diabetes and cancer). Most of these deaths were preventable. There has been much attention paid to the health of young children and babies, but the health of the 1.8 billion 10- to 24-year-olds has not improved, say the experts. Globally, Unicef, which published its own report card to coincide with the Lancet series, says millions of the under 19s are falling behind and need to be protected from traffic accidents, violence and in the case of teenage girls, early pregnancy and childbirth – the commonest killer. "The disadvantages of poverty, social status, gender or disability prevent millions of adolescents from realising their rights to quality education, healthcare, protection and participation," said Unicef deputy executive director Geeta Rao Gupta in a statement.
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