2.9 Social determinants of adolescent health: advertising and marketing

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Global Adolescent Health

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The University of Melbourne

Global Adolescent Health

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This course will explore the dynamic factors affecting the health and wellbeing of young people around the world, and how important it is for individuals, communities and nations that we improve the health and life chances of this important population group. With over 25% of the world’s population aged between 10 and 24 years, today’s generation of young people is the largest in human history. As the future leaders and drivers of growth, productivity and innovation, young people are our greatest assets, and investment in their health and wellbeing has social, economic and other benefits that continue across the lifespan and into the next generation. In this course we will adopt a life-course framework to take a holistic view of youth health and wellbeing. We will explore changing patterns of adolescent health and development, including why adolescence is starting earlier and ending later; how puberty and adolescent brain development may shape future health; and how what happens in adolescence can affect the start to life for the next generation. We’ll also look at the major health and social issues affecting young people and ways of addressing these through policy, practice and programming. COURSE FORMAT: This course comprises short video lectures and interviews, required and recommended readings, online discussion, quizzes and written assignments. There is no required text for this course and all readings are provided. DO I HAVE TO PAY FOR THIS COURSE? No- you may access 100% of material in this course for free. You are also welcome to do as much or as little of the course as you like, including all (or none!) of the assessment tasks- it all depends on your learning goals. The option to pay for this course is there for those who wish to receive a Course Certificate as evidence of completion (which does require you to attempt and successfully pass the assessment tasks). WHO IS THIS COURSE FOR? This course will be relevant for anyone with an interest in the health and wellbeing of young people. You do not need to be of any particular personal or professional background to benefit from this course, but having some basic undergraduate study experience will be helpful to your learning (particularly if in a health related field). WHAT IS THE MOST INTERESTING THING I'LL LEARN IF I TAKE THIS COURSE? You’ll learn how so much of what happens during adolescence can impact not only the future health of individuals, but the health of the next generation as well. You’ll develop a greater understanding of the key factors impacting upon youth health and learn how to be a better advocate for the health and wellbeing of young people. View the MOOC promotional video here: http://tinyurl.com/z5l4mod

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Week 2 - Introduction to adolescent health: developmental and ecological perspectives (Part II)

This week we return to our conceptual framework and unpack the key concepts of social determinants of health and risk and protective factors. We explore what these terms mean and how they influence and shape adolescent health and development. We also begin to apply this knowledge at a practical level in terms of the interventions and actions we can take to improve or maintain health and wellbeing during the adolescent and young adult years, or prevent problems from happening in the first place.

2.1 Revisiting the framework6:43

2.2 Risk and protective factors: concepts9:43

2.3 Risk and protective factors: implementation11:57

2.4 Risk and protective factors: peer relationships6:04

2.5 Risk and protective factors: families, education and communities8:10

2.6 Social determinants of adolescent health: economic factors8:16

2.7 Social determinants of adolescent health: human rights and gender13:58

2.8 Social determinants of adolescent health: population displacement8:42

2.9 Social determinants of adolescent health: advertising and marketing9:33

2.10 Socially disadvantaged adolescents5:27

Interview with Prof Craig Jeffrey (UK/Aus) 22:40

Interview with Prof Rima Afifi (Lebanon/USA) 22:47

Interview with Baroness Susan Greenfield (UK) 21:06

Rencontrer les enseignants

Professor Susan Sawyer
Chair of Adolescent Health
Department of Paediatrics
Professor George Patton
Professorial Fellow
Adolescent Health Research

The last group of social determinants I want to review are those that relate from

increasing advertising and marketing to young people, the rise of consumer

culture and the contribution of social media to young people's health.

And I've put together this collage here that I think George had also used last

week to really highlight some of these influences that we'll now go through.

The first I want to highlight is the notion of unhealthy products.

I would have liked to have put up here a set of immediately recognisable global

brands, relating to tobacco, alcohol, hamburgers, or sugar-rich drinks,

such as McDonalds or Coca-Cola, as it's these brands that so well reflect

the extent of globalisation of advertising and marketing across the world.

However, for copyright purposes, we can't, so

I want you to imagine the slide full of branded images.

But let's start on the left by thinking about tobacco, because this is, I think,

a really important example to consider.

And we'll come back to tobacco later on in our course,

as well, in terms of thinking about policy responses to the tobacco epidemic.

Tobacco is a legal product that, despite very clearly defined health consequences,

continues to be sold commercially due to the extent of advertising and

marketing, and in the context of nicotine dependence.

The tobacco industry disproportionately sets out to target and

recruit young smokers, because once young smokers are dependent

on nicotine, adults then typically have decades of smoking ahead of them.

Interestingly, as ever tighter laws are brought into play

that are successfully reducing the rate of smoking in high income countries,

so the tobacco industry has increasingly moved to create new markets,

firstly in middle income countries, and increasingly,

as well, in low income countries, through advertising and marketing.

And young people across the world are highly susceptible to such advertising

with its allure of social success,

as can be seen by the dramatic increase in the rates of smoking in young people,

in countries that historically had very low smoking rates.

For example, over the past few years, Indonesia

is a country that has experienced some of the highest per capita increases in

the repulsion of young people who now smoke, with previous gender norms that had

functioned to protect women from smoking, also being increasingly broken down.

Growing marketing of alcohol across the world is having similarly

devastating effects on the health of populations, including adolescents.

With alcohol being a significant contributor to interpersonal violence

within families, and within individuals obviously, a contributor to road

traffic accidents, and also to poorer sexual health outcomes.

And one only has to be aware of the outcry from high energy food and

beverage marketers that gives some indication of the extent of their

concerns about how possible taxation of added fat or

sugar to food and drinks, might significantly limit their income.

Yet, clearly the extent of overweight in obesity in adolescents across the globe

is extremely worrying in terms of young people's health currently,

as well as their future health, in terms of the risk of non-communicable diseases.

So, for example, Type II Diabetes was hardly ever seen in adolescents,

even a few decades ago.

But sadly, it's now just all too common place in very overweight adolescents,

with a future health risks of adolescent obesity being really quite profound.

But marketing and advertising is not just around unhealthy products,

but is also around unhealthy attitudes, unhealthy gender norms.

For example, unhealthy attitudes to the body can create

quite unrealistic expectations about appearance and

sexual attraction, not just for young women, as has historically long been

the case in high-income countries, but increasingly for young men as well.

And I draw your attention to the image in the middle here, the shadowed image,

that you or I might guess is highly modified in terms of

the waist shape of this woman that's air brushed away almost to nothing.

But for adolescents who don't have the sophistication of interpreting such

images, take at face value these types of images

as role models, for which they would like their own bodies to replicate.

Now, many of these attitudes have distinct consequences for health.

Some relate to the use of specific products by adolescents,

such as the application of skin whitening agents, or protein supplement

drinks by young men, with an expectation of bulking up their musculature.

Other attitudes can result in behaviours with more explicit health risks.

For example, body image dissatisfaction leads to dieting behaviours

with increasing risks for eating disorders, while the increasing demand for

plastic surgery to, for example, reduce the sizes of women's noses in

the Middle East, or to change the appearance of the eyes of Asian women,

carry with them distinct surgical risks.

Now we know that social media provides an important opportunity

to connect young people to each other, an important opportunity

to reach the young in terms of health promotion.

But it also brings with it, risks to health.

Due to the unprecedented reach, and in particular the speed with which

new ideas can be promoted or promulgated within particular groups of young people.

As a community, we are still clearly in our infancy when it comes to understanding

both the opportunities provided by social media for health,

let along the challenges to health that can also result.

The notion of social contagion is an interesting one for us to think about.

It's long been understood in relationship to the phenomena of what's now described

as copycat suicide, a phenomena that was first described by Goethe in the 1700s.

And this is where a highly publicised death of a celebrity

is followed by an increased rate of suicide using the same means.

And this phenomena, or copy cat phenomena social contagion, has been similarly

invoked to explain the dramatic increases we've seen in young people with

very diverse behaviours impacting upon health, ranging from bulimia nervosa,

to self harm by cutting, the sewing of lips together by asylum seekers.

And even school shootings, a phenomena that was previously only seen within

the United States of America, but is now sadly seen much more widely.

In all these cases, one can appreciate how social engagement,

whether at a face-to-face level,fuelled but particularly fuelled by social media,

can dramatically increase the uptake of certain ideas, which have

unprecedented reach when compared to old forms of media and communication.

I was in Istanbul in 2013 for the International Association

of Adolescent Health Conference, which happened to coincide with the protests at

Taksim square, where many young people were demanding their democratic

rights in relationship to transparency of government.

In that case, social media was being very overtly used to bring protesters together,

so overtly used that in its anger, the government jammed the Twitter feed.

And increasingly, the up cry from the young meant this stance was

unable to be sustained by the Turkish government.

However, the development of social media sites such as Grindr are interesting.

Grindr uses GPS to connect strangers who wish to have sex,

one with another in the same vicinity.

And already,

this would appear to be linked to increasing rates of sexually transmitted

infections in those individuals who access such sites and services.

Do you think such sites should be more strongly promoting

safer sex messages as well?

Something to perhaps think about.

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