The health, social and economic implications of risk-taking in adolescence over the life-course: a data linkage study of the Raine cohort

Risk-taking is part of normal adolescent development, but much youth and young adult morbidity, mortality, and social adversity arises from risky behaviour in adolescence. No systematic way exists to distinguish those with high probability of serious adverse outcomes, limiting our capacity to screen and intervene.

Using data from the Western Australian Pregnancy Cohort (Raine) Study, linked to routinely collected health and welfare data, we will identify participants who have experienced significant negative health and social outcomes through to late adolescence and young adulthood. We will then characterise the pathways to these outcomes, from the prenatal period through adolescence, which differentiate these vulnerable young people. Instead of the standard approach of measuring outcomes only in single health domains (e.g. sexual health or substance use), arising from risky behaviours only in those individual domains, we will explore relationships across multiple domains, including different types of risk behaviours clustered in individuals, to single and clustered outcomes.

We will apply the distributions of the predictors, mediators, and outcomes determined from the statistical analysis of the linked Raine data in a novel microsimulation health economic model (MSM). Using a basefile representative of the Australian population, the MSM will be used to calculate Australian health system expenditures and labour market effects as far into the future as 2040. We will then conduct virtual experiments in the MSM by simulating and comparing competing interventions to provide quantitative analysis of their implications. In this way, we can capture a complete picture of the health and social impacts of risky behaviour in adolescence and potential benefits of investment in this age group.