National statistics show health standards for children and young people are in rapid decline, with the population getting fatter and sexually transmitted infections becoming growing threats. Jennifer Taylor examines what is being done to combat these menaces.

The full scale of the health problems facing today's young people is made apparent by new national statistics, and it makes chilling reading.

Sexually transmitted infections in under-20s have doubled between 1991 and 2001, while children are getting fatter and exercising less, and mental health problems show no signs of improvement.

The numbers are staggering, with sexually transmitted infections in under-20s increasing from just under 670,000 in 1991 to more than 1.3 million in 2001.

Melissa Dear, spokeswoman for fpa (formerly The Family Planning Association), says young people are aware of some infections, like chlamydia, but "translating that knowledge to the behavioural change to use condoms is the challenge".

Infections have increased dramatically partly because people start having sex younger, have more casual sexual partners and more concurrent partners.

In 1990, the average age at first sex was 17 but it fell to 16 in 2000.

Exposure to risk

Another reason for the increase could be the focus on pregnancy. Anna Martinez, co-ordinator of the Sex Education Forum, says: "Young people may be more aware of protecting themselves from getting pregnant, not realising that even though they are taking the pill they are still exposed to sexually transmitted infections."

She says there is still a mentality that "STIs happen to other people and not me". The challenge for campaigns is to get the message through that everyone who has unprotected sex could be at risk.

The figures for obesity are equally worrying. In 2000, 20 per cent of boys and 27 per cent of girls aged two to 19 years were overweight. This is an increase of two percentage points for boys and three for girls since 1995.

Brigid McKevitch, nutrition scientist at the British Nutrition Foundation, says: "We're seeing type two diabetes in children and adolescents, whereas in the past we associated that kind of diabetes with people who are older and overweight."

McKevitch says everyone needs to be involved in tackling the issue. "We're not trying to point the finger at any one person or section of society but we have to realise that we have a problem and we can all help make a difference."

Making it easier for children to be physically active is one priority, since the proportion of school children spending less than one hour each week on physical education increased from five per cent in 1994 to 18 per cent in 1999.

Mental health problems in children seem to be at a fairly stable level.

About one in 10 children aged five to 15 years have a clinically recognisable mental disorder (11 per cent of boys and eight per cent of girls).

The children most at risk of psychiatric disorder are looked-after children, homeless children and young offenders.

Lee Miller, consultancy and training manager for child mental health charity YoungMinds, says these children tend to have more risk factors for mental health disorders, such as parental conflict, family breakdown and abuse.

Kathy Dunnett, a designated nurse for looked-after children and chair of Champions for Children and Young People in Care, a special interest group of the Community Practitioners' and Health Visitors' Association, says work with looked-after children needs to consider the wider issues of mental health.

She says: "I think sometimes people assume that mental health is mental illness, which is CAMHS' (Child and Adolescent Mental Health Services) responsibility and has nothing to do with them."

Crossing boundaries

Children who have parents with unskilled jobs have three times the risk of mental health problems than those in professional families - 15 per cent compared to five per cent. Poor housing, poverty and environment all contribute.

And there is a strong link between mental disorder and rates of smoking, drinking and cannabis use.

"Some young people with mental health problems try to self-medicate and drink or smoke cannabis to get relief from their problems," says Miller.

However, prolonged cannabis use could increase the risk of mental illness.

But Miller says new funding is emphasising multi-agency working and linking drug and alcohol workers with mental health services. "Traditionally, young people would go to one service or the other but now there are posts that cross those boundaries."

KEY POINTS

- The figures come from The Health of Children and Young People, which was published by the Office for National Statistics on 30 March

- It describes the health of under-20s in the UK during the period 1990 to 2001

- www.statistics.gov.uk/children.