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The Health of Young PeopleYoung people are 12-24 years of age The nature of young people’s livesHow the developmental stage can vary in motivations, values, sociocultural backgroundLevel of motivation:A result of mental attitude and emotional maturity can be affected by life experiences, family values and self esteemSociocultural background:The multicultural nature of Aus. Society variety of values, customs, beliefs and traditions as young people mix socially, they absorb new experiences that promote personal growthSocioeconomic background:Different levels of socioeconomic status mean that some young people may have limited opportunities while others may have greater opportunitiesThe influence of family/peersFAMILY:Due to a range of sociocultural factors (values, customs, traditions) and socioeconomic factors, families have varying degrees of influence over young peopleSome families have strict limitations on adolescents while others may appear to allow them to have greater freedomCommunication between parents and adolescents becomes more important when dealing with adolescent issues, and when negotiating roles and responsibilitiesIn families where parents work due to financial reasons, children may have to be independent at a younger age family may have less influence of their livesPEERS:Can influence in a positive way when peers support each other to not participate in risky behaviourCan influence in a negative way peer pressure or the need to ‘fit in’ can influence them to participate in risky behaviour such as speeding, smokingThe influence of prevailing youth culturesThe need to develop a certain look and be a part of a youth subculture is about trying to express their feelings about the world around them to confirm identity or maintaining self-esteem and self-confidenceCan provide a way to resist the established order by creating their own language and lifestyles can be seen as rebellionThe support and security that youth culture provides can enable young people to develop into well-adjusted adultsThe influence of global events and trendsModern communication allows young people to view news instantly images and reports of tragedy are flashed around the world within minutes of it happeningY.p may develop a pessimistic view of the futureMay increase anxiety and other mental health issuesIncreased fear of war or terrorist attacksEnvironmental issues such as global warming/climate change have prompted y.p into taking action in their communityInternational competitions, such as the Olympics, have influence y.p into increasing participation in sport and physical activityThe influence of technologyRapid technological advances mean that y.p have greater access to information in comparison to their parents able to communicate locally and internationally at any time of the day or nightNew jobs are being created, e.g. software developers, programmers, etc easier for y.p to access than older people can result in y.p having higher salaries higher socioeconomic status leads to better quality of lifeTechnologically based language abbreviations and codes used to communicate across social networksY.p have unrestricted and mostly uncensored access to material, e.g. violent images desensitisation towards violenceCyberbullying and identity theft are increasingDistinguish those aspects of y.p’s lives that make them similar and different to the young people of different generationsY.P (12-24)Similarities25+ (adults and grandparents)Youth cultureNew age religion and exposure to more religions, more diversity and secularism.TechnologyBigger influence of technology on socialisation (more alerts on global events) influencing how one sets and perceives the world.Cyber bullying.Family peersPeers have more of an influence - peer pressure.More independence, more common that both parents work.Global events and trendsAre not allowed to stay out at late - too dangerous.Culture Both generations have grown up exposed to some form of world violence i.e. WW2, terrorist attacks.Still a strong sporting culture in Australia.Family / peersHave a large influence over lifestyle.Youth cultureBig Christian influences.Sport culture.TechnologyNot much technology → fridges, mainstream cars, black and white TV.Radio was very popular.Family / peersStrong female influence.Household → men were the breadwinner.Global events / trendsWere able to play outside after dark as it was safer then.Epidemiology of the health of young peoplePatterns of morbidity and mortalityMorbidity52% of young people were sufficiently active57% were in the normal weight range10% reduction from 2001 to 2013 (49% to 39%) of consuming alcohol levels that put young people at risk of harm81% of young people have never smoked13 births were experienced per 100,000 young individuals, which has substantially decreased from 16 births per 100,000 in 2014 (teenage pregnancy)65% of 12-17 year olds with mental health disorders accessed services in the last 12 monthsLeading causes of morbidity are mental disorders, injury and poisoningMortalityIn 2015, there were 225 deaths due to road traffic accidents → significantly less than in 2010, with 332 deathsMajor causes of death are accidents, poisoning, violence suicide and cancerA steady decline of mortality rates over the past decades Comparisons of health status with that of other age groupsMortality1-14Injury and poisoningCancerCardiovascular disease15-24: ?Young adults are more likely to partake in risky behaviour that leads to high mortality rates of injury and poisoningInjury and poisoning CancerCardiovascular disease25-44Injury and poisoningCancerCardiovascular disease45-64Cancer (For women, breast cancer and other cancers develop during menopause as an effect of developing hormones)Cardiovascular diseaseInjury and poisoning65-84: Lifetime of unhealthy lifestyle choices and behaviours result in such diseasesCancerCardiovascular diseaseInjury and poisoningCOMPARISON OF HEALTH STATUS WITH THAT OF OTHER AGESHEALTH STATUS OF INFANTS AND YOUNG CHILDREN (birth to 14yrs) HEALTH STATUS OF PEOPLE AGED OVER 65The major factors affecting their health Congenital malformations (a medical condition that occurs at birth) e.g. down syndromeAccidents and injuriesPerinatal (around the time of birth) conditions Leading causes of death are cardiovascular disease, stroke and cancerMost common general health problems:Arthritis Vision and hearing problemsDementiaCirculatory diseasesThe effects of the determinants of health on young people Individual factorsExamine how a range of factors adversely affect the health of y.p. and propose strategies to overcome these factorsGenetics:Hereditary diseases can affect y.p, e.g. heart disease (strategy) healthy diet, education on self-careGenderFemales experience problems like menstruation, urinary infections and reproduction (strategy for menstruation as it can cause iron deficiency) iron supplementsYoung men have more injuries, e.g. work-relayed strains and sprains or the result of accidents due to risk taking behavioursSociety expectations pressure girls to be attractive and to conform to specific body images presented by the media can lead to many girls suffering from depressions and developing eating disorders, e.g. anorexia, bulimia or overeatingYoung females are at greater risk of sexual harassment, violent aggression and sexual assaultPersonal SkillsSkills such as assertiveness, decision making, problem solving, coping and goal setting can improve health or a lack of these skills can impact negatively, e.g. when y.p. use assertiveness skills to control their alcohol intakeLack of effective decision-making skills young females may not choose to use contraceptive, leading to unwanted pregnancies or shortening their life span by contracting diseases like HIV/AIDS (strategy) education programs in schoolsAttitudesWhen y.p. think they can do things without being unpunished, they are more likely to participate in risky behaviour like motor accidentsSexual orientationFor young gay people, a health concern is their mental health and self-identityHomophobia contributes to behaviours such as bullying, harassment and violence, causing feelings of isolationSociocultural factorsFamily / culture / religionY.p. may want to participate in unsafe practices, e.g. smoking, unprotected sex, speeding, excessive drinking, as a way to rebel against strict family/religious/cultural values that are restrictiveMediaThe media presents unhealthy expectations of appearances, which may cause the young person to conform to these standards and seek validation they may develop eating disorders or an extremely unhealthy view on their bodyPeersPeer group may peer pressure/influence the y.p. into participating in risky behaviour, e.g. smoking, speeding, as a way to fit in with their peers (strategy) developing assertiveness and effective communication skills to prevent peers from pressuring themAboriginalityDue to their history of discrimination and forced assimilation, they have lost touch with their identity lost touch with their spirituality and have engaged in risky behaviour, e.g. smoking, excessive alcohol consumptionSocioeconomic factorsSocioeconomic statusIndividuals with lower socioeconomic status develop unhealthy diet habits. This is common in y.p. due to lower paying jobsDevelops an anti-work ethic, which may result in the development of poor mental health (strategy) schools place more emphasis on developing a stronger work ethic e.g. compulsory work placementLower incomes forces y.p to take risky behaviours, e.g. driving faulty carsEmploymentMany young people, either while they are still in full-time study or after leaving school, take on relatively unskilled jobs in fast-food outlets, service industries or as machine operators. potential for accidents and in some there is a risk of serious injury. Food outlets are often open late, which means the chance of fatigue-related accidents is increased. Education: The reduction of PDHPE classes limit education on risky behaviours such as smoking, substance abuseEnvironmental factors Geographic locationReduced employment opportunities in country areas means that many y.p either remain unemployed and economically disadvantaged, or are forced to travel long distancesY.p. in rural or remote areas are sometimes exposed to harsher environments (extremes of temperatures, drought or floods) rural work can be dangerous and forces them to work outside higher risk of developing skin cancersAccess to health servicesMany y.p do not seek treatment or discuss health problems as readily as y.p. in the cities due to less health care services in the country areas poor uptake of health promotion and self-care messagesLess health care services less access to specialist services (like STI clinics) Use of technology:Using technology has led to a reduced level of physical activity obesity and decline of fitness levels of y.p in generalY.p. may become detached from society and unable to effectively communicate face-to-face due to long amounts of time spent on the internet affect mental and social healthDevelopmental aspects that affect the health of young people AspectDefinitionPositive exampleNegative ExampleEffect on Health - LINK TO DETERMINANTSRevising roles in relationshipsVaries according to age, gender, attitudes, expectations, and type of personality. It has a permanent influence and may be positive, nurturing, or negative and abusive. May take an equal role, dominant or submissive.Parents might provide their child with opportunities to take on responsibility, such as borrowing the family car.Certain friendships or romantic relations may encourage risky behaviour that may have bad health consequences, activities including smoking, drinking etc. P = by being provided with the opportunity to become responsible, young people are enabled to trust those who they have relationships, improving social health. One’s emotional sense of self becomes positive as an outcome of making trusting relationships.N = participating in risky behaviour can position y.p. to put their physical health at risk; smoking habits potentially leading to cancer or excessive drinking leading to poisoning.Clarifying self-identityDuring the transition from childhood to adulthood young people are concerned with ‘who they are’. An important developmental task for young people is establishing a sense of self.A woman describing herself as a mother, sister, wife, and captain of a sporting team.Some young people may devalue their abilities or see themselves as worthless for various reasons, for example, lack of employment or poor family relationships.P = knowing your identity can provide a sense of fulfillment and satisfaction, and enhance self-esteem and confidence, improving mental health.N = lack of identity can promote a negative self-perception, and can lead to depression Developing self-sufficiency and autonomyBeing autonomous means that individuals are trusted to undertake tasks without guidance from someone in authority.Securing a part-time job, learning to drive, buying a car and taking responsibility for educational and employment pathways. Achieving autonomy enhances self-confidence and self-esteem, and a young person’s sense of identity becomes more complete. They become responsible for making important decisions about their work, diet and health. The frustration of not having any autonomy leads to some young people, and their families, living with high levels of stress. P = The mental health of a young person is enhanced when they are able to achieve self-sufficiency and autonomy. For many young people this marks their ‘rite of passage’ to the adult world. N = Not having self-sufficiency and autonomy can hinder their ability to be independent.Establishing education, training and employment pathwaysEducation includes high school, tertiary schooling (TAFE, university, etc).Involves learning stuff, starting from a young age in primary school.→ TAFE traineeships enable a young person to learn on the job and earn a small income.→ Australian School-based Apprenticeships allow years 11 and 12 students to start an apprenticeship at school.→ Part-time work allows young people to develop job skills that are transferable to other areas of employment.Unemployment is a genuine fear for some young people who lack employment experience or formal training.A solid education can provide the foundation for obtaining employment and achieving personal potential and positive self-esteem. The wide range of options available creates flexibility in education, reducing the stress for young people, promotes greater self-confidence and enables young people to have a clearer pathway and be more prepared for work.Establishing personal support structuresParents older siblings, grandparents, teachers and parents can all assist young people by listening to their fears and concerns, offering advice, providing guidance and supporting their decisions.Personal support structures enable a person to cope with stress, allow them to have time out if needed and provide someone to turn to for advice. Adolescents who are in a rush to achieve independence risk leaving unresolved conflicts with the family, which can damage their personal support structures. Should their personal support structures fail, they need to seek alternative support through government agencies, community groups or professionals. Because of the high demand for these services, there are limits to the depth and length of support they can offer. The family has the most to gain by promoting the good health of its members. A good personal support structure is a two-way communication based on mutual respect, trust and shared responsibility supporting young people financially, emotionally, physically and mentally. Providing personal support structures in the following ways can either hinder or enhance one’s health.Determining behavioural boundariesLearning what is acceptable and what is not. Each family establishes its own behavioural boundaries, and these are often based on cultural and religious beliefs. Often have consequences if boundaries are broken. Boundaries protect the safety of the young person, for example, in schools, behavioural boundaries are necessary to ensure all students are able to learn in a safe and supportive environment, and forbid behaviour such as smoking on school premise. For some young people, questioning the boundaries results in illegal activities, such as theft, violence and drug and alcohol abuse.Boundaries can protect the health of young people and prevent them from participating in unsafe behaviour, for example, parents implementing a curfew can protect the y.p. from the dangers of the night (rapists, pedos, kidnappers, etc). This reduces the risk of death and harm.Without boundaries, the y.p. is able to participate in unsafe behaviour, for example, y.p. are able to smoke and drink without boundaries, consequently resulting in increased chances of developing liver disease (from drinking) or lung cancer (from smoking)The major health issues that impact on young peopleMental health problems and illnessesNature:“Mental illness” when someone experiences significant changes in their thinking, feelings or behaviour affects how the person functions or causes distress to themselves and others“Mental health” mental wellbeing, good mental functioning“Mental health problem” interferes with how a person thinks, feels and behaves, but to a lesser extent than a mental illnessCan be categorised as psychotic or non-psychotic:Psychotic illnesses: causes a person to lose touch with reality, e.g. schizophrenia or bipolar disorder.Might see, hear and feel a world very different from othersMight display extreme emotions, false beliefs or hallucinationsE.G. Bipolar disorder experiences extreme mood swings; periods of deep depression alternating with episodes of manic Non-psychotic illnesses: occurs when people’s emotions become overwhelming and interfere with their ability to cope with daily tasksSymptoms include exaggerated feeling such as depression, anxiety and fearE.g. phobias, depression and OCDE.G. Depression persistently depressed mood or loss of interest in activities, causing significant impairment in daily lifeExtent:Almost 1 in 7 of children and adolescents aged 4-17yrs have been assessed with having a mental illness – AIHWAbout 14% of children and adolescents aged 4-17yrs experience mental health disorders from 2012-23 (AMA)Rates of depression are higher in women (17%) than in males (10%)12.5% of young Australians aged 15-24 died of suicide in 2015Suicide in the leading cause of death for young AustraliansRisk factorsGenetic factors increases risk of child developing mental illness if it has hereditary linksBiomedical factors illnesses such as depression and bipolar disorder occur when a chemical imbalance is present within the brain. Schizophrenia, however, occurs when there are abnormalities in various neurotransmitters, which affect nerve cells.Stress stressful incidents can cause mental illnesses such as relationship breakdowns, unemployment or death of a loved onePersonality people with certain personality traits might be more likely to experience bouts of depression, e.g. perfectionists, extremely stubborn or heavily dependent on othersLifestyle people who use drugs have an increased risk of mental illnessTraumatic events sexual abuse can lead to self-harm, for exampleIssues of sexuality Protective factors:Personal skills assertiveness, resilience, coping, decision making, problem solving and conflict resolutionStrong support network open communication that function in both good and bad times, e.g. family and friendsAccess to services and the development of health literacy schools allowing mental health services to educate students, e.g. Batyr, promoting the use of services, school counsellorsCompletion of year 12 or other educational qualification leads to employment and can improve socioeconomic status, leading to better/healthier lifestyleDeterminants:SocioculturalSocioeconomicEnvironmentalChanging family structure is also a factor. Family breakdown ending in divorce reduces the strong relationship support offered by the family and provides a traumatic experience that can trigger an episode of mental illness.In Aboriginal communities, mental illness may remain undetected as people often consult elders rather than a health professional.People who have had a falling out with peers or have been exposed to bullying are more at riskPeer expectations can lead to poor self-perception and can lead to self-harm/eating disordersSocial causes of mental illness include a lack of employment prospects can lead to increased stress levels among young people and the long term unemployed.Those who are socio-economically disadvantaged might experience more stressful circumstances linked to their poorer financial situation and are more likely to engage in high levels of substance abuse.Low level of education lower levels of health literacyRural young males are at a higher risk of suicide than urban young males due to differences in access to support and job prospectsDistant access to servicesDistant access to the latest technology Groups at risk:Those with a family historyIndigenous malesThose who are frequently exposed to a stressful environmentThose who have experienced significant trauma in their livesThose with certain personality types (e.g. perfectionists)Elderly peopleYoung gay and lesbian peoplePeople who talk about ending their lives.People with a physical illness, particularly a terminal illness.Road Safety NatureExtentRisk and Protective factorsRisk FactorsProtective FactorsAlcohol consumption (particularly for drivers of motor vehicles)Drug use (e.g. cannabis)Lack of driving practice and experienceDriver fatigueBadly constructed/designed roads (e.g. no traffic lights at a busy intersection)Geographic location (e.g. rural areas have higher speed limits and dirt roads)Risk taking behaviour (e.g. not wearing a seatbelt)Socioeconomic status (e.g. a low socioeconomic status means drivers aren’t able to purchase cars with safety features, such as airbags)Disobeying road rulesDeveloping personal skills around assertiveness (e.g. decision making and problem solving)Abiding laws regarding licensing, speed limits and alcohol consumptionAcquiring driving knowledge through education programs (e.g. U turn the Wheel)Improving society and cultural norms by developing curfews and promoting alcohol free behaviourGovernment initiatives (e.g. double demerit points)Improvement in road structures (e.g. speed cameras and roundabouts)Improvement in car safety features (e.g. air bags and brakes)DeterminantsSocioculturalSocioeconomicEnvironmentalPeer influence → peers may pressure the y.p. to speed or drink drive to look coolPopular youth culture that encourage risk taking, e.g. burnouts, donuts, street racing, etcMovies promoting risky behaviour (media stereotypes), e.g. The Fast and the Furious → makes y.p. think they’re cool by participating in the same behaviourSubstance consumption with friends → drug and alcohol consumption with friends → increase likelihood of crashes and accidents when driving as their mind isn’t functioning wellY.p. with lower socioeconomic status may not be able to purchase adequate driving education (lessons, driving schools and programs), increasing their likelihood to drive unsafely Y.p. need transport for their jobs → may be trying to earn a lot of money → can lead to fatigue from overworking → fatigue on the road and increasing the risk of crashes and accidentsMore programs in school educate y.p. of road safety, e.g. RYDA → increases their knowledge of the risks and decreases their chances of participating in risky behaviourWeather conditions may cause crashes and accidents and as y.p. may not have enough experience, they may not know how to safely handle it, e.g. rain creates a more slippery surface, and y.p may not take the necessary precautions to ensure safety due to lack of experience (e.g. slowing down)Improvements of road surfaces and design → increases road safety, e.g. roundabouts → they allow a flow in traffic to prevent collisions → protecting the physical health of y.p. and others on the road if utilised in harmony. Geographic location → more crashes and accidents likely to occur to y.p who live in rural areas as road surface is rougher or animals can jump out in front of the car → y.p may not be able to safely react due to lack of experienceGroups most at riskGroups of young people most at risk of road injuries are: Young males are more likely than young females to be involved in road trauma, especially if they exhibit risk-taking factors.Males, especially in rural areasIndividuals with limited driving experienceDrivers of high-performance vehiclesIndividuals affected by alcohol or cannabisIndividuals who work late at night or are affected by fatigueIndividuals from low socioeconomic backgrounds who cannot afford to maintain their vehicle properly females, generally as passengers. ................
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