Abstract

Young people's health is continuing to improve in line with historic trends. Death rates are low and falling, and most young people say they are healthy, happy and enjoying life. For most, social conditions and opportunities have got better. Health efforts need to focus on the minorities whose well-being is lagging behind, especially the disadvantaged and marginalised. This is the widely accepted story of young people's health. There is another very different story. It suggests young people's health may be declining – in contrast to historic trends. Mortality rates understate the importance of non-fatal, chronic ill-health, and self-reported health and happiness do not give an accurate picture of well-being. Mental illness and obesity-related health problems and risks have increased. The trends are not confined to the disadvantaged. The causes stem from fundamental social and cultural changes of the past several decades. Which story is the more accurate matters. Stories inform and define how governments and society as a whole address youth health issues. The usual narrative says interventions should target the minorities at risk. The new narrative argues that broader efforts to improve social conditions are also needed.

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