Puberty, Developmental Processes, and Health Interventions

Excerpt

Adolescence is increasingly recognized as a critical period in the life course, a time when rapid development of the brain, body, and behaviors opens a window of opportunity for interventions that may affect health throughout life.

Puberty results in very rapid somatic growth, brain development, sexual maturation, and attainment of reproductive capacity. It is accompanied by final maturation of multiple organ systems and major changes in the central nervous system and in psychosocial behavior (Patton and Viner 2007). The discovery of continued brain development through adolescence is one of the great advances of neuroscience in the past 20 years. A dramatic spurt in brain development begins during adolescence and continues until the mid-20s, with marked development of both cortical and subcortical structures (Goddings and others 2012).

This rapid development in the body and brain interacts with social changes, including increasing individuation and new peer groups, to facilitate transitions important for individuals to function as productive adults (World Bank 2006). A range of social determinants of health arise in adolescence, with peers, schools, and eventually the workplace becoming strong determinants of health and well-being as the influence of the family wanes (Viner and others 2012). These social changes are apparent even in traditional or more sociocentric cultures. More than half of the top 10 risk factors identified in the Global Burden of Disease study (GBD 2013 Risk Factors Collaborators 2015) are largely determined during adolescence.

Adolescence is also a time when young people may modify or alter the pathways to adult health or illness (Viner and others 2012). Early life experiences may reinforce both good and poor trajectories. Similarly, resilience during adolescence may improve outcomes for young people born into adversity. The transfer from primary to secondary school, sexual debut, and entry into the labor market may be critical points for preventing the accumulation of health risk (Viner and others 2012).

This chapter outlines the key dynamics of adolescent development and examines how they provide opportunities for intervention. Definitions of age groups and age-specific terminology used in this volume can be found in chapter 1 (Bundy and others 2017).