Advertisement

Arab Adolescents: Health, Gender, and Social Context

      Abstract

      This article reviews the evidence about adolescent health in the Arab world, against the background of social, economic, and political change in the region, and with a particular focus on gender. For the literature review, searches were conducted for relevant articles, and data were drawn from national population- and school-based surveys and from the Global Burden of Disease project. In some parts of the Arab world, adolescents experience a greater burden of ill health due to overweight/obesity, transport injuries, cardiovascular and metabolic conditions, and mental health disorders than those in other regions of the world. Poor diets, insufficient physical activity, tobacco use, road traffic injuries, and exposure to violence are major risk factors. Young men have higher risks of unsafe driving and tobacco use and young women have greater ill-health due to depression. Several features of the social context that affect adolescent health are discussed, including changing life trajectories and gender roles, the mismatch between education and job opportunities, and armed conflict and interpersonal violence. Policy makers need to address risk factors behind noncommunicable disease among adolescents in the Arab region, including tobacco use, unhealthy diets, sedentary lifestyles, unsafe driving, and exposure to violence. More broadly, adolescents need economic opportunity, safe communities, and a chance to have a voice in their future.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Adolescent Health
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. UNPY. Regional Overview: Youth in the Arab region. New York: United Nations Economic and Social Commission for Western Asia and the United Nations Programme on Youth (UNPY), n.d.

      2. Mirkin B. Population levels, trends and policies in the Arab region: Challenges and opportunities. UNDP: United Nations Development Programme, Regional Bureau for Arab States, Arab Human Development Report Research Paper Series, 2010.

        • UNDP
        Challenges to human security in the Arab countries: Arab human development report 2009.
        United Nations Development Programme (UNDP), Regional Bureau for Arab States, New York2009
        • Lancet
        The Lancet series on adolescent health.
        The Lancet, London2012
        • WHO
        Health for the world's adolescents: A second chance in the second decade.
        World Health Organization, Geneva2014
        • UNFPA
        The power of 1.8 billion: Adolescents, youth and the transformation of the future. State of the world population 2014.
        United Nations Population Fund (UNFPA), New York2014
      3. Institute for Health Metrics and Evaluation. Global Burden of Disease 2010: Data visualization. Available at: http://www.healthdata.org/gbd/data. Accessed December 1, 2014.

        • Institute for Health Metrics and Evaluation
        The global burden of disease: Generating evidence, guiding policy.
        Institute for Health Metrics and Evaluation, Seattle, WA2013
      4. Demographic and Health Surveys. Rockville, MD: ICF International, n.d.

      5. UNICEF. Multiple Indicator Cluster Surveys. New York: UNICEF, n.d.

      6. WHO. Global school-based student health surveys, fact sheets. Geneva: World Health Organization, 2005-2012.

      7. WHO. Global Youth Tobacco Survey fact sheets and country reports: Cairo: World Health Organization, Regional Office for the Eastern Mediterranean and Atlanta, Georgia, USA: United States Centers for Disease Control and Prevention, 2001-2012.

        • Chaaban J.
        Youth and development in the Arab countries: The need for a different approach.
        Middle East Stud. 2009; 45: 33-55
        • UNICEF
        The situation of adolescents and youth in the Middle East & North Africa Region: A desk review of data on current trends and emerging issues.
        UNICEF MENA Regional Office, Jordan2013
        • ASDA'A Burson-Marsteller
        A white paper on the findings of the ASDA'A Burson-Marsteller Arab Youth Survey 2014.
        ASDA'A Burson-Marsteller, Dubai, UAE2014
        • Musaiger A.O.
        • Al-Mannai M.
        • Tayyem R.
        • et al.
        Perceived barriers to healthy eating and physical activity among adolescents in seven Arab countries: A cross-cultural study.
        Scientific World J. 2013; 2013: 1-11
        • Rashad H.
        • Osman M.
        • Roudi-Fahimi F.
        Marriage in the Arab world.
        Population Reference Bureau, Washington, DC2005
        • DeJong J.
        • El-Khoury G.
        Reproductive health of Arab young people.
        BMJ. 2006; 333: 849-851
        • DeJong J.
        • Shepard B.
        • Roudi-Fahimi F.
        • et al.
        Young people's sexual and reproductive health in the Middle East and North Africa.
        Population Reference Bureau, Washington, DC2007
        • Musaiger A.O.
        • Al-Hazzaa H.M.
        Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region.
        Int J Gen Med. 2012; 5: 199-217
        • Afifi R.
        • DeJong J.
        • Bose K.
        • et al.
        The health of young people: Challenges and opportunities.
        in: Jabbour S. Giacaman R. Khawaja M. Public health in the Arab world. Cambridge University Press, Cambridge2012
      8. UNDESA. Definition of youth: A factsheet. New York: United Nations Department of Economic and Social Affairs (UNDESA), n.d.

        • Mokdad A.H.
        • Jaber S.
        • Aziz M.I.
        • et al.
        The state of health in the Arab world, 1990-2010: An analysis of the burden of diseases, injuries, and risk factors.
        Lancet. 2014; 383: 309-320
        • Black R.E.
        • Victora C.G.
        • Walker S.P.
        • et al.
        Maternal and child undernutrition and overweight in low-income and middle-income countries.
        Lancet. 2013; 382: 427-451
        • Ezzati M.
        • Vander Hoorn S.
        • Lopez A.D.
        • et al.
        Comparative quantification of mortality and burden of disease attributable to selected risk factors.
        in: Lopez A.D. Mathers C.D. Ezzati M. Global burden of disease and risk factors. Oxford University Press, New York2006: 241-396
        • El Taguri A.
        • Besmar F.
        • Abdel Monem A.
        • et al.
        Stunting is a major risk factor for overweight: Results from national surveys in 5 Arab countries.
        East Mediterr Health J. 2009; 15: 549-562
        • Galal O.M.
        The nutrition transition in Egypt: Obesity, undernutrition and the food consumption context.
        Public Health Nutr. 2002; 5: 141-148
      9. Aitsi-Selmi A. Addressing the double burden of malnutrition in Egypt: Do conditional cash transfers have a role? Conference proceedings of the International Seminar on Social and Health Policies for Equity: Approaches and Strategies; 2009; London, United Kingdom: The International Union for the Scientific Study of Population Scientific Panel on Health Equity and Policies in the Arab World; 2009.

        • WHO
        Framework for the implementation of the Global Strategy on Diet, Physical Activity and Health in the Eastern Mediterranean Region. Working document.
        World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt2010
        • WHO
        Regional strategy on nutrition 2010-2019.
        World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt2011
        • UNDP
        The report in numbers. Selected data from the Arab Human Development Report 2009: Challenges to human security in the Arab Countries.
        United Nations Development Programme (UNDP), Regional Bureau for Arab States, New York2009
        • Breisinger C.
        • Ecker O.
        • Al-Riffai P.
        Economics of the Arab awakening: From revolution to transformation and food security. Policy Brief 18.
        International Food Policy Research Institute, Washington, DC2011
        • El Mouzan M.I.
        • Al Herbish A.S.
        • Al Salloum A.A.
        • et al.
        Regional prevalence of short stature in Saudi school-age children and adolescents.
        Scientific World J. 2012; 2012: 505709
        • Mirmiran P.
        • Sherafat-Kazemzadeh R.
        • Jalali-Farahani S.
        • et al.
        Childhood obesity in the Middle East: A review.
        East Mediterr Health J. 2010; 16: 1009-1017
        • Ng S.W.
        • Zaghloul S.
        • Ali H.I.
        • et al.
        The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States.
        Obes Rev. 2011; 12: 1-13
        • El Mouzan M.I.
        • Foster P.J.
        • Al Herbish A.S.
        • et al.
        Prevalence of overweight and obesity in Saudi children and adolescents.
        Ann Saudi Med. 2010; 30: 203-208
        • Jildeh C.
        • Papandreou C.
        • Abu Mourad T.
        • et al.
        Assessing the nutritional status of Palestinian adolescents from East Jerusalem: A school-based study 2002-03.
        J Trop Pediatr. 2011; 57: 51-58
        • Mikki N.
        • Abdul-Rahim H.F.
        • Awartani F.
        • et al.
        Prevalence and sociodemographic correlates of stunting, underweight, and overweight among Palestinian school adolescents (13-15 years) in two major governorates in the West Bank.
        BMC Public Health. 2009; 9: 485
        • Nasreddine L.
        • Naja F.
        • Tabet M.
        • et al.
        Obesity is associated with insulin resistance and components of the metabolic syndrome in Lebanese adolescents.
        Ann Hum Biol. 2012; 39: 122-128
        • Hajat C.
        • Shather Z.
        Prevalence of metabolic syndrome and prediction of diabetes using IDF versus ATPIII criteria in a Middle East population.
        Diabetes Res Clin Pract. 2012; 98: 481-486
        • Eapen V.
        • Mabrouk A.
        • Yousef S.
        Metabolic syndrome among the young obese in the United Arab Emirates.
        J Trop Pediatr. 2010; 56: 325-328
        • Mehairi A.E.
        • Khouri A.A.
        • Naqbi M.M.
        • et al.
        Metabolic syndrome among Emirati adolescents: A school-based study.
        PLoS One. 2013; 8: e56159
        • Al-Isa A.
        • Akanji A.O.
        • Thalib L.
        Prevalence of the metabolic syndrome among female Kuwaiti adolescents using two different criteria.
        Br J Nutr. 2010; 103: 77-81
        • Abdulle A.
        • Al-Junaibi A.
        • Nagelkerke N.
        High blood pressure and its association with body weight among children and adolescents in the United Arab Emirates.
        PLoS One. 2014; 9: e85129
        • Musaiger A.O.
        • Al-Roomi K.
        • Bader Z.
        Social, dietary and lifestyle factors associated with obesity among Bahraini adolescents.
        Appetite. 2014; 73: 197-204
        • Musaiger A.
        • Al-Mannai M.
        • Tayyem R.
        Prevalence of overweight and obesity among female adolescents in Jordan: A comparison between two international reference standards.
        Pak J Med Sci. 2013; 29: 678-679
        • Al Junaibi A.
        • Abdulle A.
        • Sabri S.
        • et al.
        The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi, United Arab Emirates.
        Int J Obes (Lond). 2013; 37: 68-74
        • bin Zaal A.A.
        • Musaiger A.O.
        • D'Souza R.
        Dietary habits associated with obesity among adolescents in Dubai, United Arab Emirates.
        Nutr Hosp. 2009; 24: 437-444
        • Al-Dossary S.S.
        • Sarkis P.E.
        • Hassan A.
        • et al.
        Obesity in Saudi children: A dangerous reality.
        East Mediterr Health J. 2010; 16: 1003-1008
        • Washi S.A.
        • Ageib M.B.
        Poor diet quality and food habits are related to impaired nutritional status in 13- to 18-year-old adolescents in Jeddah.
        Nutr Res. 2010; 30: 527-534
        • Musaiger A.O.
        • Al-Mannai M.
        • Tayyem R.
        • et al.
        Prevalence of overweight and obesity among adolescents in seven Arab countries: A cross-cultural study.
        J Obes. 2012; 2012: 981390
        • Ng M.
        • Fleming T.
        • Robinson M.
        • et al.
        Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013.
        Lancet. 2014; 384: 766-781
        • Popkin B.M.
        • Gordon-Larsen P.
        The nutrition transition: Worldwide obesity dynamics and their determinants.
        Int J Obes Relat Metab Disord. 2004; 28: S2-S9
        • Popkin B.M.
        The nutrition transition: An overview of world patterns of change.
        Nutr Rev. 2004; 62: S140-S143
        • Al-Haifi A.R.
        • Al-Fayez M.A.
        • Al-Athari B.I.
        • et al.
        Relative contribution of physical activity, sedentary behaviors, and dietary habits to the prevalence of obesity among Kuwaiti adolescents.
        Food Nutr Bull. 2013; 34: 6-13
        • Al-Hazzaa H.M.
        • Abahussain N.A.
        • Al-Sobayel H.I.
        • et al.
        Lifestyle factors associated with overweight and obesity among Saudi adolescents.
        BMC Public Health. 2012; 12: 354
        • Ali H.I.
        • Ng S.W.
        • Zaghloul S.
        • et al.
        High proportion of 6 to 18-year-old children and adolescents in the United Arab Emirates are not meeting dietary recommendations.
        Nutr Res. 2013; 33: 447-456
        • Ng S.W.
        • Zaghloul S.
        • Ali H.
        • et al.
        Nutrition transition in the United Arab Emirates.
        Eur J Clin Nutr. 2011; 65: 1328-1337
        • Mahfouz A.A.
        • Shatoor A.S.
        • Hassanein M.A.
        • et al.
        Gender differences in cardiovascular risk factors among adolescents in Aseer Region, southwestern Saudi Arabia.
        J Saudi Heart Assoc. 2012; 24: 61-67
        • Musaiger A.O.
        • Bader Z.
        • Al-Roomi K.
        • et al.
        Dietary and lifestyle habits amongst adolescents in Bahrain.
        Food Nutr Res. 2011; 55https://doi.org/10.3402/fnr.v55i0.7122
        • Al Sabbah H.
        • Vereecken C.
        • Abdeen Z.
        • et al.
        Associations of overweight and of weight dissatisfaction among Palestinian adolescents: Findings from the national study of Palestinian schoolchildren (HBSC-WBG2004).
        J Hum Nutr Diet. 2009; 22: 40-49
        • Al-Hazzaa H.M.
        • Abahussain N.A.
        • Al-Sobaye H.I.
        • et al.
        Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region.
        Int J Behav Nutr Phys Act. 2011; 8: 140
        • Allafi A.
        • Al-Haifi A.R.
        • Al-Fayez M.A.
        • et al.
        Physical activity, sedentary behaviours and dietary habits among Kuwaiti adolescents: Gender differences.
        Public Health Nutr. 2014; 17: 2045-2052
        • Chacar H.R.
        • Salameh P.
        Public schools adolescents' obesity and growth curves in Lebanon.
        J Med Liban. 2011; 59: 80-88
        • Musaiger A.O.
        • Al-Mannai M.
        • Al-Lalla O.
        • et al.
        Obesity among adolescents in five Arab countries relative to gender and age.
        Nutr Hosp. 2013; 28: 1922-1925
        • Musaiger A.O.
        Overweight and obesity in eastern mediterranean region: Prevalence and possible causes.
        J Obes. 2011; 2011: 407237
        • Eapen V.
        • Mabrouk A.A.
        • Bin-Othman S.
        Disordered eating attitudes and symptomatology among adolescent girls in the United Arab Emirates.
        Eat Behav. 2006; 7: 53-60
        • Thomas J.
        • Khan S.
        • Abdulrahman A.A.
        Eating attitudes and body image concerns among female university students in the United Arab Emirates.
        Appetite. 2010; 54: 595-598
        • Schulte S.J.
        • Thomas J.
        Relationship between eating pathology, body dissatisfaction and depressive symptoms among male and female adolescents in the United Arab Emirates.
        Eat Behav. 2013; 14: 157-160
        • Mousa T.Y.
        • Mashal R.H.
        • Al-Domi H.A.
        • et al.
        Body image dissatisfaction among adolescent schoolgirls in Jordan.
        Body Image. 2010; 7: 46-50
        • Mousa T.Y.
        • Al-Domi H.A.
        • Mashal R.H.
        • et al.
        Eating disturbances among adolescent schoolgirls in Jordan.
        Appetite. 2010; 54: 196-201
        • Musaiger A.O.
        • Al-Mannai M.
        Association between exposure to media and body weight concern among female university students in five Arab countries: A preliminary cross-cultural study.
        J Biosoc Sci. 2014; 46: 240-247
        • Musaiger A.O.
        • Al-Mannai M.
        • Tayyem R.
        • et al.
        Risk of disordered eating attitudes among adolescents in seven Arab countries by gender and obesity: A cross-cultural study.
        Appetite. 2013; 60: 162-167
        • Mahfouz A.A.
        • Shatoor A.S.
        • Khan M.Y.
        • et al.
        Nutrition, physical activity, and gender risks for adolescent obesity in Southwestern Saudi Arabia.
        Saudi J Gastroenterol. 2011; 17: 318-322
        • Guthold R.
        • Cowan M.J.
        • Autenrieth C.S.
        • et al.
        Physical activity and sedentary behavior among schoolchildren: A 34-country comparison.
        J Pediatr. 2010; 157 (e41): 43-49
        • Al-Nakeeb Y.
        • Lyons M.
        • Collins P.
        • et al.
        Obesity, physical activity and sedentary behavior amongst British and Saudi youth: A cross-cultural study.
        Int J Environ Res Public Health. 2012; 9: 1490-1506
        • WHO
        Road safety in the Eastern Mediterranean Region: Facts from the global status report on road safety 2013.
        World Health Organization, Regional Office for the Eastern Mediterranean, Cairo2013
        • WHO
        Global status report on road safety 2013: Supporting a decade of action.
        World Health Organization, Geneva2013
        • Raman S.R.
        • Ottensmeyer C.A.
        • Landry M.D.
        • et al.
        Seat-belt use still low in Kuwait: Self-reported driving behaviours among adult drivers.
        Int J Inj Contr Saf Promot. 2014; 21: 328-337
        • Al Reesi H.
        • Al Maniri A.
        • Plankermann K.
        • et al.
        Risky driving behavior among university students and staff in the Sultanate of Oman.
        Accid Anal Prev. 2013; 58: 1-9
        • Bener A.
        • Lajunenc T.
        • Ozkand T.
        • et al.
        The effect of mobile phone use on driving style and driving skills.
        Int J Crashworthiness. 2006; 11: 459-465
        • Munk M.D.
        • Carboneau D.M.
        • Hardan M.
        • et al.
        Seatbelt use in Qatar in association with severe injuries and death in the prehospital setting.
        Prehosp Disaster Med. 2008; 23: 547-552
        • Al Turki Y.A.
        How can Saudi Arabia use the Decade of Action for Road Safety to catalyse road traffic injury prevention policy and interventions?.
        Int J Inj Contr Saf Promot. 2014; 21: 397-402
        • Al-Naami M.Y.
        • Arafah M.A.
        • Al-Ibrahim F.S.
        Trauma care systems in Saudi Arabia: An agenda for action.
        Ann Saudi Med. 2010; 30: 50-58
        • Barss P.
        • Al-Obthani M.
        • Al-Hammadi A.
        • et al.
        Prevalence and issues in non-use of safety belts and child restraints in a high-income developing country: Lessons for the future.
        Traffic Inj Prev. 2008; 9: 256-263
        • El-Sadig M.
        • Norman J.N.
        • Lloyd O.L.
        • et al.
        Road traffic accidents in the United Arab Emirates: Trends of morbidity and mortality during 1977-1998.
        Accid Anal Prev. 2002; 34: 465-476
        • Grivna M.
        • Eid H.O.
        • Abu-Zidan F.M.
        Pediatric and youth traffic-collision injuries in Al Ain, United Arab Emirates: A prospective study.
        PLoS One. 2013; 8: e68636
        • Jaffer Y.A.
        • Afifi M.
        • Al Ajmi F.
        • et al.
        Knowledge, attitudes and practices of secondary-school pupils in Oman: II. Reproductive health.
        East Mediterr Health J. 2006; 12: 50-60
        • Jaffer Y.A.
        • Afifi M.
        • Al Ajmi F.
        • et al.
        Knowledge, attitudes and practices of secondary-school pupils in Oman: I. Health-compromising behaviours.
        East Mediterr Health J. 2006; 12: 35-49
        • Alhabdan S.
        • Zamakhshary M.
        • AlNaimi M.
        • et al.
        Epidemiology of traumatic head injury in children and adolescents in a major trauma center in Saudi Arabia: Implications for injury prevention.
        Ann Saudi Med. 2013; 33: 52-56
        • Mamtani R.
        • Al-Thani M.H.
        • Al-Thani A.A.
        • et al.
        Motor vehicle injuries in Qatar: Time trends in a rapidly developing Middle Eastern nation.
        Inj Prev. 2012; 18: 130-132
        • UNICEF
        Progress for children: A report card on adolescents.
        UNICEF, New York2012
        • Maziak W.
        • Nakkash R.
        • Bahelah R.
        • et al.
        Tobacco in the Arab world: Old and new epidemics amidst policy paralysis.
        Health Policy Plan. 2014; 29: 784-794
        • Park H.K.
        • Al Agili D.E.
        • Bartolucci A.
        Factors affecting tobacco use among middle school students in Saudi Arabia.
        Matern Child Health J. 2012; 16: 1828-1836
        • Mandil A.
        • BinSaeed A.
        • Dabbagh R.
        • et al.
        Smoking among Saudi university students: Consumption patterns and risk factors.
        East Mediterr Health J. 2011; 17: 309-316
        • Amin T.T.
        • Amr M.A.
        • Zaza B.O.
        • et al.
        Harm perception, attitudes and predictors of waterpipe (shisha) smoking among secondary school adolescents in Al-Hassa, Saudi Arabia.
        Asian Pac J Cancer Prev. 2010; 11: 293-301
        • Al-Bedah A.M.
        • Qureshi N.A.
        • Al-Guhaimani H.I.
        • et al.
        The global youth tobacco survey–2007. Comparison with the global youth tobacco survey 2001-2002 in Saudi Arabia.
        Saudi Med J. 2010; 31: 1036-1043
        • Al-Makadma A.S.
        • Moynihan M.
        • Dobson S.
        • et al.
        Tobacco use among adolescents in Riyadh Saudi Arabia [e-pub ahead of print].
        Int J Adolesc Med Health. 2014; https://doi.org/10.1515/ijamh-2014-0023
        • Karam E.
        • Kypri K.
        • Salamoun M.
        Alcohol use among college students: An international perspective.
        Curr Opin Psychiatry. 2007; 20: 213-221
        • Karam E.G.
        • Maalouf W.E.
        • Ghandour L.A.
        Alcohol use among university students in Lebanon: Prevalence, trends and covariates. The IDRAC University Substance Use Monitoring Study (1991 and 1999).
        Drug Alcohol Depend. 2004; 76: 273-286
        • Karam E.
        • Melhem N.
        • Mansour C.
        • et al.
        Use and abuse of licit and illicit substances: Prevalence and risk factors among students in Lebanon.
        Eur Addict Res. 2000; 6: 189-197
        • Ghandour L.A.
        • Karam E.G.
        • Maalouf W.E.
        Lifetime alcohol use, abuse and dependence among university students in Lebanon: Exploring the role of religiosity in different religious faiths.
        Addiction. 2009; 104: 940-948
        • Karam E.G.
        • Ghandour L.A.
        • Maalouf W.E.
        • et al.
        A rapid situation assessment (RSA) study of alcohol and drug use in Lebanon.
        J Med Liban. 2010; 58: 76-85
        • Salame J.
        • Barbour B.
        • Salameh P.
        Do personal beliefs and peers affect the practice of alcohol consumption in university students in Lebanon?.
        East Mediterr Health J. 2013; 19: 340-347
        • WHO
        Maternal, child and adolescent mental health: Challenges and strategic directions for the Eastern Mediterranean Region.
        World Health Organization. Regional Office for the Eastern Mediterranean, Cairo2011
        • Al-Balhan E.M.
        The Children's Depression Inventory as a reliable measure for post-Iraqi invasion Kuwaiti youth.
        Social Behav Personal Int J. 2006; 34: 351-366
        • Asal A.R.
        • Abdel-Fattah M.M.
        Prevalence, symptomatology, and risk factors for depression among high school students in Saudi Arabia.
        Neurosciences (Riyadh). 2007; 12: 8-16
        • Mahfouz A.A.
        • Al-Gelban K.S.
        • Al Amri H.
        • et al.
        Adolescents' mental health in Abha city, southwestern Saudi Arabia.
        Int J Psychiatry Med. 2009; 39: 169-177
        • Jaju S.
        • Al-Adawi S.
        • Al-Kharusi H.
        • et al.
        Prevalence and age-of-onset distributions of DSM IV mental disorders and their severity among school going Omani adolescents and youths: WMH-CIDI findings.
        Child Adolesc Psychiatry Ment Health. 2009; 3: 29
        • Ismayilova L.
        • Hmoud O.
        • Alkhasawneh E.
        • et al.
        Depressive symptoms among Jordanian youth: Results of a national survey.
        Community Ment Health J. 2013; 49: 133-140
        • Mahfoud Z.R.
        • Afifi R.A.
        • Haddad P.H.
        • et al.
        Prevalence and determinants of suicide ideation among Lebanese adolescents: Results of the GSHS Lebanon 2005.
        J Adolesc. 2011; 34: 379-384
        • Al-Fayez G.A.
        • Ohaeri J.U.
        • Gado O.M.
        Prevalence of physical, psychological, and sexual abuse among a nationwide sample of Arab high school students: Association with family characteristics, anxiety, depression, self-esteem, and quality of life.
        Soc Psychiatry Psychiatr Epidemiol. 2012; 47: 53-66
        • de Jong J.T.
        • Komproe I.H.
        • Van Ommeren M.
        • et al.
        Lifetime events and posttraumatic stress disorder in 4 postconflict settings.
        JAMA. 2001; 286: 555-562
        • Razokhi A.H.
        • Taha I.K.
        • Taib N.I.
        • et al.
        Mental health of Iraqi children.
        Lancet. 2006; 368: 838-839
        • Karam E.G.
        • Salamoun M.M.
        • Mneimneh Z.N.
        • et al.
        War and first onset of suicidality: The role of mental disorders.
        Psychol Med. 2012; 42: 2109-2118
        • Khamis V.
        Posttraumatic stress and worry as mediators and moderators between political stressors and emotional and behavioral disorders in Palestinian children.
        Int J Psychol. 2012; 47: 133-141
        • Giacaman R.
        • Abu-Rmeileh N.M.
        • Husseini A.
        • et al.
        Humiliation: The invisible trauma of war for Palestinian youth.
        Public Health. 2007; 121 (discussion 572–7): 563-571
        • Kolltveit S.
        • Lange II, N.
        • Thabet A.A.
        • et al.
        Risk factors for PTSD, anxiety, and depression among adolescents in Gaza.
        J Trauma Stress. 2012; 25: 164-170
        • Qouta S.R.
        • Palosaari E.
        • Diab M.
        • et al.
        Intervention effectiveness among war-affected children: A cluster randomized controlled trial on improving mental health.
        J Trauma Stress. 2012; 25: 288-298
        • Espie E.
        • Gaboulaud V.
        • Baubet T.
        • et al.
        Trauma-related psychological disorders among Palestinian children and adults in Gaza and West Bank, 2005-2008.
        Int J Ment Health Syst. 2009; 3: 21
        • Dimitry L.
        A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East.
        Child Care Health Dev. 2012; 38: 153-161
        • Viner R.M.
        • Ozer E.M.
        • Denny S.
        • et al.
        Adolescence and the social determinants of health.
        Lancet. 2012; 379: 1641-1652
        • Assaad R.
        • Roudi-Fahimi F.
        Youth in the Middle East and North Africa: Demographic opportunity or challenge?.
        Population Reference Bureau, Washington, DC2007
        • Kronfol N.M.
        Delivery of health services in Arab countries: A review.
        East Mediterr Health J. 2012; 18: 1229-1238
        • Kronfol N.M.
        Historical development of health systems in the Arab countries: A review.
        East Mediterr Health J. 2012; 18: 1151-1156
        • Kronfol N.M.
        Access and barriers to health care delivery in Arab countries: A review.
        East Mediterr Health J. 2012; 18: 1239-1246
        • Saleh S.S.
        • Alameddine M.S.
        • Natafgi N.M.
        • et al.
        The path towards universal health coverage in the Arab uprising countries Tunisia, Egypt, Libya, and Yemen.
        Lancet. 2014; 383: 368-381
        • WHO
        Adolescent responsive health systems.
        World Health Organization, Geneva2014
        • UNFPA
        Sexual and reproductive health: A core component of universal health coverage.
        UNFPA Arab States Regional Office position paper, New York2014
      10. OECD. Gender, Institutions and Development Database. Available at: http://stats.oecd.org/Index.aspx?DatasetCode=GID2#. Accessed December 1, 2014.

        • UNESCO
        Adult and youth literacy: A fact sheet.
        UNESCO Institute for Statistics (UIS), Montreal, Canada2013
        • ILO
        Rethinking economic growth: Towards productive and inclusive Arab societies.
        International Labour Office (ILO) Regional Office for the Arab States and UNDP Regional Bureau for Arab States, Beirut2013
        • UNDP
        The rise of the south: Human progress in a diverse world. Human development report 2013.
        United Nations Development Progzramme (UNDP), New York2013
      11. Adolescence: A second chance to tackle inequities.
        Lancet. 2013; 382: 1535
        • Courbage Y.
        • Todd E.
        Le rendez-vous des civilisations.
        Seuil, Paris2007
        • Fargues P.
        Changing hierarchies of gender and generation in the Arab world.
        in: Obermeyer C.M. Family gender and population policy in the Middle East. American University of Cairo Press, Cairo1995
      12. Khouri R.G. Lopez V.M. A Generation on the Move: Insights into the conditions, aspirations and activism of Arab youth. Issam Fares Institute for Public Policy and International Affairs, American University of Beirut, Beirut, Lebanon2011
        • Loaiza E.
        • Wong S.
        Marrying too young: End child marriage.
        UNFPA, New York2012
        • Roudi-Fahimi F.
        • Ibrahim S.
        Ending child marriage in the Arab region.
        Population Reference Bureau, Washington, DC2013
      13. ICF International. MEASURE DHS STATcompiler. Available at: www.statcompiler.com. Accessed December 1, 2014.

        • DeJong J.
        • Jawad R.
        • Mortagy I.
        • et al.
        The sexual and reproductive health of young people in the Arab countries and Iran.
        Reprod Health Matters. 2005; 13: 49-59
        • Johns Hopkins University
        Jordanian youth survey: Knowledge, attitudes and practices on reproductive health and life planning.
        Johns Hopkins University, Center for Communication Programs and the National Population Commission, General Secretariat, Baltimore, MD, USA and Amman, Jordan2001
        • Raheel H.
        • Mahmood M.A.
        • BinSaeed A.
        Sexual practices of young educated men: Implications for further research and health education in Kingdom of Saudi Arabia (KSA).
        J Public Health (Oxf). 2013; 35: 21-26
        • Ben Abdalla Senim
        National study on risk behaviors of out-of-school youth in Tunisia.
        ATL, ONFP, UNFPA and UNAIDS, Tunis2010
        • Alquaiz A.M.
        • Almuneef M.A.
        • Minhas H.R.
        Knowledge, attitudes, and resources of sex education among female adolescents in public and private schools in Central Saudi Arabia.
        Saudi Med J. 2012; 33: 1001-1009
        • Schwab P.K.
        • Brende B.
        • Zahidi S.
        • et al.
        The global gender gap report 2013.
        World Economic Forum, Geneva2013
        • Hausmann R.
        • Tyson L.D.
        • Zahidi S.
        The global gender gap report.
        World Economic Forum, Geneva2012
        • Freedom House
        Women’s rights in the Middle East and North Africa 2010.
        Freedom House, Washington DC2010
        • Kelly S.
        Women's rights in the Middle East and North Africa: Recent gains and new opportunities for women's rights in the Gulf Arab States.
        Freedom house, Washington, DC2009
        • Darwazeh N.
        Violence against women: Assessing the situation in Jordan.
        UNFPA Jordan Country Office, Amman, Jordan2009
        • Ghazaleh H.A.
        Arab strategy for combating violence against women 2011-2020.
        Arab Women Organization, Cairo2011
        • NCFA
        Status of violence against women in Jordan.
        National Council for Family Affairs (NCFA), Amman, Jordan2008
        • Alwan A.
        Responding to priority health challenges in the Arab world.
        Lancet. 2014; 383: 284-286
        • Giacaman R.
        • Rabaia Y.
        • Nguyen-Gillham V.
        • et al.
        Mental health, social distress and political oppression: The case of the occupied Palestinian territory.
        Glob Public Health. 2011; 6: 547-559
        • Barber B.K.
        • Schluterman J.M.
        An overview of the empirical literature on adolescents and political violence.
        in: Barber B.K. Adolescents and war: How youth deal with political violence. Oxford University Press, New York2009: 35-60
        • Dewachi O.
        • Skelton M.
        • Nguyen V.K.
        • et al.
        Changing therapeutic geographies of the Iraqi and Syrian wars.
        Lancet. 2014; 383: 449-457
        • Reed R.V.
        • Fazel M.
        • Jones L.
        • et al.
        Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors.
        Lancet. 2012; 379: 250-265
        • Abdirahman H.
        • Fleming L.C.
        • Jacobsen K.H.
        Parental involvement and bullying among middle-school students in North Africa.
        East Mediterr Health J. 2013; 19: 227-233
        • Swahn M.H.
        • Gressard L.
        • Palmier J.B.
        • et al.
        The prevalence of very frequent physical fighting among boys and girls in 27 countries and cities: Regional and gender differences.
        J Environ Public Health. 2013; 2013: 215126
        • WHO, LSHTM, SAMRC
        Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence.
        World Health Organization (WHO) Department of Reproductive Health and Research, London School of Hygiene and Tropical Medicine (LSHTM), South African Medical Research Council (SAMRC), Geneva2013
        • Pinheiro P.S.
        Report of the independent expert for the United Nations study on violence against children.
        United Nations, Geneva2006
        • El-Zanaty F.
        • Way A.
        Egypt demographic and health survey 2005.
        Ministry of Health and Population, National Population Council, El-Zanaty and Associates, and ORC Macro, Cairo2006
        • Kulczycki A.
        • Windle S.
        Honor killings in the Middle East and North Africa: A systematic review of the literature.
        Violence Against Women. 2011; 17: 1442-1464
        • PRB
        The World's youth: 2013 data sheet.
        Population Reference Bureau, Washington, DC2013
        • Eisner M.
        • Ghuneim L.
        Honor killing attitudes amongst adolescents in Amman, Jordan.
        Aggress Behav. 2013; 39: 405-417
        • Population Council
        Survey of young people in Egypt.
        Population Council, West Asia and North Africa Office, Cairo2011
        • Sawyer S.M.
        • Afifi R.A.
        • Bearinger L.H.
        • et al.
        Adolescence: A foundation for future health.
        Lancet. 2012; 379: 1630-1640
        • Abdul Rahim H.F.
        • Sibai A.
        • Khader Y.
        • et al.
        Non-communicable diseases in the Arab world.
        Lancet. 2014; 383: 356-367

      Linked Article

      • Adolescent and Young Adult Health in the Arab Region: Where We Are and What We Must Do
        Journal of Adolescent HealthVol. 57Issue 3
        • Preview
          Throughout much of the world, the popular impression of the Arab region is of desert, turmoil, instability, and a lack of security. But to those more familiar with the region and its people, the impression is of the fundamental importance and value of family, tradition, generosity, and religion. Although the political upheavals that the region has witnessed in recent years are concerning to all, adolescents and young adults may have the most at stake. The region has a youthful population, with about 20% of the population aged 10–19 years and about 60% aged younger than 25 years [1].
        • Full-Text
        • PDF