Introduction by Croakey: In the second of a series of essays from the 2024 National Public Health Student Think Tank Competition, Rebecca Raeside examines efforts to support participation of young people in decisions that impact their health and wellbeing.
“Active participation in decision-making can improve the health and wellbeing of young people, including those from priority populations,” Raeside writes below.
Students were invited to address the following prompt: Considering the need for an inclusive public health system in Australia, propose an innovative strategy to amplify marginalised voices to address the public health challenges of today.
Rebecca Raeside writes:
With a growing mental health crisis, issues with health systems, environmental pollution, the climate crisis, and increasing rates of non-communicable diseases, the young people of today face an uncertain future.
Without action on these issues they will bear the greatest impacts of the public health challenges we all currently face. Their voices are crucial in addressing the challenges of today for a better future for all.
In Australia, health disparities exist between urban, rural, and remote areas, across the socioeconomic gradient, for First Nations people, and those from culturally and linguistically diverse backgrounds. The rapid digitalisation of society without consideration of the social determinants of health is also set to increase these disparities over time.
These growing challenges require us to reflect on our current approaches and think differently about solutions to improve the health and wellbeing of people living in Australia today and for generations to come, particularly those from priority populations.
Young people, typically those aged 10-24 years old, are left out of critical discussions that impact them.
To amplify voices of all young Australians, systems need to be established to enable them to engage with critical public health issues. This includes that young people from all backgrounds and communities are embedded into policy and guideline development and reform, research, and decision-making.
The Engage! Strategy was launched by the Federal Government in 2024 and has the opportunity to include young people from diverse backgrounds and priority populations in government decision-making. The strategy outlines three priority areas:
- Recognising and listening to young people
- Empowering young people to advocate and engage with government
- Supporting government to work with young people
In a discussion paper for the strategy, a young person said, “prioritising the voices of underrepresented youth can lead to more inclusive and well-informed policies that address a broader range of people’s needs”.
The strategy will report each year to measure their progress in engaging young people with government. However, no reporting or evaluation is available yet, and it is unclear how this will be achieved.
A good example of youth engagement and evaluation is the Health Advisory Panel for Youth at the University of Sydney (HAPYUS).
This ongoing model allows 16 diverse young people from across New South Wales to engage in chronic disease prevention research. The evaluation demonstrated that they increased their leadership and life skills over 12 months, and participants felt empowered, actively contributed and felt they had influence.
Researchers also shared key reflections on this youth engagement model which included the importance of redefining power dynamics, having a flexible working style, and challenging traditional structures to support young people as co-researchers.
Triple dividend
Young people are going through a rapid developmental period, where their health and wellbeing are influenced by psychological and social factors.
According to the World Health Organization, investing in adolescent health and wellbeing will bring a ‘triple dividend’ of benefits – ensuring the health and wellbeing of today’s young people, enhancing their prospects to thrive and reach their full potential within their lifetime and improve outcomes for generations to come.
Thus, their engagement in public health policy and guideline development and reform, research, and decision-making is critical to improve health and wellbeing globally.
The UN Convention of the Rights of the Child (CRC) was ratified by Australia in 1990, yet many of the articles of the CRC are yet to be attained. To be able to achieve these, young people – including those from priority populations – must be given a seat at the table to be able to voice their concerns and be able to contribute effectively to decision-making.
Currently, young people are often stereotyped and dismissed when they do speak up, and this is especially true for those from priority populations.
Giving young people from priority populations a platform to share their concerns will ensure that all youth voices are heard. Adult-centred institutions must be held accountable to invest in effective youth engagement by sharing power with young people and having adaptable systems and structures.
The Lansdown-UNICEF Framework was developed to define different modes of youth engagement, and each mode can be appropriate in different contexts namely:
- No or unethical participation
- Consultative participation
- Collaborative participation
- Adolescent-led participation.
To determine if engagement is effective, there is a need to focus on the outcomes of youth participation. These include a sense of self-worth, self-esteem and self-efficacy, being taken seriously, making decisions, and public and civic engagement.
The collective impact of improving these individual outcomes has the potential to cause population-level change to improve health and wellbeing and cause societal change.
Leading change
As the largest generation of young people in history, campaigns to achieve better health and wellbeing outcomes are gaining traction globally and locally.
The 1.8 Billion Young People for Change campaign captured the views of young people globally on what action is required to support and improve their health and wellbeing, and included high participation from low-and-middle income countries. An agenda for action has now been developed which is fed back to decision-makers so that policies, investments and action across priority areas can be made.
Locally, we can look at the example of as School Strike 4 Climate – a movement of diverse young people from across Australia demanding politicians act on climate change.
Given there are disproportionate impacts of climate change on First Nations young people, there are also organisations such as Seed Mob. This First Nations youth-based network is empowering young people to lead change in their communities.
The Office for Youth is running Youth Advisory Groups as part of the Engage! Strategy. These groups work with government agencies to develop policies and programs that matter to young people. Areas of focus for 2025 include First Nations Youth, Climate Change and Civic Engagement.
Transparency and evaluation
Young people are being given more opportunities to make their voices heard. Active participation in decision-making can improve the health and wellbeing of young people, including those from priority populations.
Change makers are coming to the table to co-create policies and decisions with young people that represent diverse groups of needs.
It is important to ensure that these opportunities are not tokenistic and the voices of young people from priority populations are heard. This requires transparency and thorough evaluation of outcomes, including around young people’s self-worth, self-esteem and self-efficacy, and whether they are being taken seriously, and making decisions.
Ensuring effective engagement of young people, including those from priority populations, has potential to cause population-level change to ensure a more inclusive public health system in Australia now and for generations to come.
About the author
Rebecca Raeside studied a Masters in Public Health and is a Research Associate and PhD candidate at the University of Sydney, who submitted her thesis in September 2024. Her vision is to harness the benefits of digital technologies to improve adolescents’ health. Throughout her PhD, she has conceptualised and led a nationwide clinical trial to test the efficacy of Health4Me, a novel digital intervention for adolescents aiming to improve shared risk factors for physical and mental health. She actively works alongside adolescents to inform all aspects of her research. She currently sits on national and international committees relating to her research, including as a board director for the Australian Association for Adolescent Health.
Bookmark this link to follow the 2024 Think Tank series, and see Croakey’s archive of articles on youth health
