INTERVIEW. Reading time: 3 min

Lourdes Cantarero Arevalo

Public health across disciplines: “We need to look at the commercial determinants of health because they impact every decision we’re making and certainly also among adolescents.”

An interview with Professor Michal Molcho, sociologist of Health and Director of MSc in Adolescent Health at the University of Galway, Ireland

Michal has a PhD in Sociology, researching social inequalities in adolescents’ injuries and founded the “Children Studies Discipline at the University of Galway, Ireland. Professor Molcho leads a new master's degree, MSc in Adolescent Health, and is the Program Director. She is also a longstanding member of the International Health Behaviour in School Children (HBSC), WHO multicountry collaborative study. You can meet Michal next November at the EUPHA conference in Dublin.

Michal has been interested in researching and understanding social inequalities among children and adolescents since her PhD studies when she investigated social inequalities in injuries. Her sociology background allows her to see beyond individual factors and understand the role of neighbourhoods and social structures in child and adolescent health and well-being. “Nowadays, we need to look at the commercial determinants of health because they impact every decision that we’re making and certainly also among adolescents”, argues Michal, when discussing the effect that exposure to SoMe has on adolescents' health. Sure enough, it is worrying what recent statistics tell us about the increase in eating disorders in adolescents across several European countries. “The need to fit within a very strict and narrow box makes it difficult for adolescents to thrive. There are too strict ways of seeing the bodies and how a body should look, and SoMe and its algorithms are reifying these images”. Michal is especially concerned about SoMe and its commercial interests because “adolescents are less happy as they feel they need to fit in and neglect their identities and needs”.

As public health professionals, how will we change the impact that SoMe have on adolescent mental well-being?

When asked this question, Professor Molcho proposes to use, as in many other areas related to public health (traffic, alcohol, tobacco), to control what adolescents are exposed to through regulation. “It is not yet regulated because it is not perceived as dangerous, but actually, it is”.

Do we have the expertise and transformative capacity to tackle the challenges SoMe poses? Do we need other disciplines? Other stakeholders?

“Public health is interdisciplinary, so there is much potential, but we need ways to work together. We must also work more with children. They are key experts who can tell us what we are dealing with.”

Another interesting topic for Michal is the well-being of minority children and adolescents.

“Discrimination does have a biological impact, especially among children and adolescents. The stress caused by discrimination and its consequent hormonal disruption affects children's and adolescents' brains in ways that we cannot yet fully understand. Fortunately, the neuroplasticity of adolescents’ brains gives hope, but what is going on in a young brain?”. This is the time to ensure that every adolescent gets a second chance; therefore, the need for a specific master's in Adolescent health. There is more we need to learn about adolescents’ developmental capacity.

LGBTQ+ adolescents across Europe seem to thrive less than cisgender adolescents. What can be done so that they have the same chances to express themselves and thrive?

“It is hard to be different, and it takes time to recognise one's differences, identify one's needs, and develop an identity. The problem is that LGBTQ+ adolescents have fewer people they can relate to and fewer people who inspire them to think. It is ok to me, there are other than me, and the others like me are doing ok. Gender and Sexual minority adolescents need role models as beckons of hope. We do have role models for minorities nowadays in popular culture that are non-binary, but we need more”.