Adolescents and Inequality: Rising Wealth, Improving Health?

There is a wealth of evidence that the growing gap between rich and poor is bad for our collective health. A small but growing body of research makes it clear that the origins of these disparities begin at an early age.

In a commentary in The Lancet, John Santelli, chair of the Heilbrunn Department of Population and Family Health at Columbia’s Mailman School, discusses a study of socioeconomic inequalities in adolescents by Frank Elgar and colleagues published in the same issue of the journal. The article points to widening health disparities between rich and poor adolescents in 34 countries across Europe and North America. Young people from the poorest socioeconomic groups had worse health outcomes in areas like obesity and physical activity.

"Adolescents are typically overlooked in the health sector because of their relative health," said Santelli. "However, health behaviors developed in adolescence often manifest later in life, including in the form of non-communicable diseases such as diabetes, cardiovascular disease, and cancer."

Santelli and co-authors Wendy Baldwin and Jennifer Heitel argue the main drivers of adolescent health sit largely outside the health system. While schools can help close the gap in social disparities, they can’t do so alone. Also needed are public health, political leadership, economic development, empowered communities, and youth themselves. The Lancet Commission on Adolescent Health and Wellbeing, on which Santelli and Baldwin serve, they say, is one attempt to orchestrate these efforts.

"To improve health and reduce health disparities across the lifespan, a focus should be on social factors that affect the health and wellbeing of young people… Investment in youth now could pay huge dividends in health outcomes and reduce health disparities in later years," the authors conclude.