UK young people let down on long-term illness, new international report finds

Young people in the UK are making healthier life choices for themselves than before, but are more likely to die from asthma or have a poor quality of life from long-term conditions compared to counterparts in other high-income countries.

This is according to the first ever international comparison of young people’s health measures over time, comparing the UK to 18 other high-income countries, published today by the Nuffield Trust and the Association for Young People’s Health [AYPH].

The report, written by paediatricians and researchers at the Nuffield Trust and AYPH, is based on analysis of 17 measures of the health and wellbeing of young people, aged 10-24, between the mid-1990s and the last year for which data are comparable. The indicators examined by the authors include long-standing illnesses; alcohol consumption; cancer mortality; obesity and deprivation.

The UK sits in the bottom third of the comparative countries in nine out of 17 indicators, and in the top third in three. In four out of 17 indicators, trends over time have been getting worse, and in five areas previous improvements have stalled.  

Key findings from the report conclude that:

• The UK has the highest rate of deaths from asthma for young people aged 10-24, compared to all European countries in the comparator group, and the fourth highest overall behind the USA, Australia and New Zealand. The asthma mortality rate in the UK was approximately twice as high as that of the next worst country in Europe, and any improvements made have started to stall in the last few years.
• Nearly one in five young people in the UK are estimated to be living with a long-standing health condition, and the UK is one of the worst countries for young people to suffer from years lost to ill health and the burden of their diseases like diabetes.
• As well as having the highest rates of obesity in 15 to 19-year-olds compared to the 14 European countries, the UK also has one of the greatest differences in obesity levels between young people living in the poorest areas of the country and the richest.
• The UK is in the middle of the pack compared to other countries on some indicators for young people, including cancer mortality, smoking, alcohol consumption and cannabis use. Trends in health-related behaviours like smoking and alcohol consumption have been improving in recent years, with falls in smoking rates and use of cannabis.
• The UK has some of the lowest rates of road traffic injury deaths, which have also been steadily improving over time. Authors put this down to a concerted effort from industry and government to make both cars and roads safer.
• On the whole, the UK performs in the top third of countries on mortality rates for 10 to 19-year-olds. Recently, however, progress has stalled and for young people aged 20-24 got worse between 2013 and 2016.

The report calls into question whether health services are adequately helping young people to manage their long-term conditions. For example, a National Paediatric Diabetes Audit for 2016–17 reported that only 43.6% of those aged over 12 received all seven key health care checks during the previous year of care.

These findings are made in the context of 20 to 24-year-olds in the UK having the third highest levels of material deprivation in Europe (behind Greece and Italy), which the authors argue is having a knock-on effect on all other indicators. The report warns that the government and senior health leaders should look at these findings with real foreboding: inequalities must be closed and cuts to public health budgets addressed if they are serious about reversing these worrying trends.

Nigel Edwards, Chief Executive of the Nuffield Trust said:

“Making sure we have a healthy population requires us all to do our bit. More than ever, young people are holding up their side of the bargain, with more of them choosing to smoke and drink less, yet our health system seems to be getting something badly wrong. I worry this reflects a dangerous complacency. 

“Young people in the UK are entering adulthood with more long-term health conditions and as a result a poorer quality of life, storing up problems further down the line. If we don’t take action now, the next generation will be entering adulthood sicker than the one before it.”

Emma Rigby, Chief Executive at the Association for Young People’s Health said:

“The crucial thing to note here is how important long-term health conditions are in the 10-24 age group. We need more understanding of young people’s health needs, improved support for young people to understand and manage their own health, and we need to provide more youth friendly health services. This will help improve our standing internationally in terms of youth health outcomes.”

Baroness Doreen Massey of Darwen, Patron of the Association for Young People’s Health and Chair of All Party Parliamentary Group for Young People’s Health said:

“This comprehensive report is a wake-up call to improve health services for our young people and is a timely inspiration in the wake of the new NHS Long Term Plan. Investment in young people aged 10 to 24 is urgently needed in order to have healthy adults in the future.

“It is encouraging to see that young people are taking the initiative to have healthier lives in some areas, but policy initiatives and youth friendly services are needed, coupled with more action to tackle determinants of health including deprivation, inequality and young people not in education, employment and training.”