Health 2020: policy framework and strategy health and development. Developing these skills and optimizing well-being in early childhood establish the basis for ongoing well-being across the lifecourse. Children born into disadvantaged home and family circumstances have a higher risk of poor growth and development. Optimizing health and wellbeing in later life requires investing in positive early childhood experiences and development. Good social, emotional and mental health helps to protect children against emotional and behavioural problems, violence and crime, teenage pregnancy and misusing drugs and alcohol, and determines how well they do in school (92–100). Many serious diseases and types of exposure to risk factors (such as tobacco use and poor eating and exercise habits) in adulthood originate in childhood and adolescence. For example, tobacco use, mental ill health, sexually transmitted infections including HIV, and poor eating and exercise habits may all lead to illness or premature death later in life. The prevalence of overweight among children younger than 16 years is between 10% and 20% in the European Region, with rates higher among children in southern Europe. The dietary habits of young people are not optimal for health: they include fruit and vegetable consumption below recommended levels and high consumption of sweetened beverages. Physical activity levels decrease during adolescence, more markedly among girls. Smoking prevalence at age 13 years is 5%, rising to 19% by age 15 years in the European Region. Almost two thirds of 16-yearolds have consumed alcohol in the previous 30 days. The percentage of 15-year-olds reporting that they have experienced sexual intercourse ranges from 12% to 38% across countries in the European Region (58,101–103). The use of condoms and other contraceptives differs between countries, as well as between boys and girls. Adolescence is usually a time of good health for both girls and boys, with opportunities for growth and development. Today young people mature physically and grow up at an earlier age than hitherto. Nevertheless, adolescence can also be time of risk, particularly with regard to unsafe sexual activity, substance use and accidents. The social and economic environment in which adolescents grow up often determines the behaviour they develop during adolescence (93). Research shows that boys and girls differ in their exposure and vulnerability to health risks and conditions such as depressive disorders, injuries, substance abuse, eating disorders, sexually transmitted infections, violence, suicide and self-inflicted injuries (91).
Solutions that work Much of the morbidity and mortality among children and adolescents is preventable. Low-cost, effective measures could prevent two thirds of deaths. Several childhood illnesses can be prevented by immunization and relatively simple, low-cost measures. The WHO Integrated Management of Childhood Illnesses (IMCI) strategy promotes a package of simple, affordable and effective interventions for combined management of the major childhood illnesses and malnutrition, including antibiotics, treatment of anaemia, immunization and promoting breastfeeding (104,105). Measures to control tobacco use and the harmful use of alcohol need to emphasize protecting children through effective population-level measures and regulatory frameworks such as banning advertising, banning sales to minors, promoting smoke-free environments and pricing policies. Children are vulnerable and exposed to marketing pressure, and interventions can reduce the effects on children of the marketing of foods high in saturated fat, trans-fatty acids, free sugar or salt. Environmental measures can be put
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