Global policy can be influential in gaining serious commitment or buy-in from countries such as around the United Nations Convention on the Rights of a Child or the Framework Convention on Tobacco Control. As previously discussed, to be effective laws and regulations require enactment by nations and states, and local implementation. This lecture reviews some of the approaches that can be taken to improve adolescent health through using regulatory approaches. In democratic nations, many laws are enacted with the goal of protecting citizens. This is particularly the case for children and young people. Legislation that affects adolescents and their health include laws around the minimum age of legal employment for children. Laws also function to limit unsafe behavior such as those that render certain substances illegal, or that limit access to other drugs, such as alcohol and tobacco. There are many laws around sexual behaviors, such as laws about the minimum age for heterosexual intercourse, and the legality and minimum age of homosexual activity. There are laws about the minimum age of marriage, laws about the sex of who you can marry, laws about the age that one can consent to sexual and reproductive health services, including HIV testing and abortion. And legal responses to sexual violence and transactional sex. As we can appreciate with some of these laws, they can be seen as much to control young people's sexuality, as they can also be viewed to protect young people from potential harms. Clearly, as we have discussed earlier, laws need to balance the need to protect young people with their human right to participate in society as autonomous individuals. Commensurate with their maturity according to the United Nation Convention of the Rights of the Child. Thus, while laws enable young people in most countries to, for example, vote at the age of 18 years, given young people's capacities to make decisions at a younger age there is every reason to consider lowering the voting age. And while there are also laws about judicial responses to criminal activities which render young people under 18 less criminally responsible for their actions. As we've described in earlier lectures I think you can appreciate that there may be reasons to think about how the law should continue to respond differently to young people, even those over 18 years of age, given the extent of neurodevelopmental vulnerabilities in many young people within the youth justice system. You may be interested in this brief online article in the conversation that discusses some of these tensions about neurodevelopmental challenges for young people within the youth justice system, and what that system could consider doing differently in response. Given that road traffic accidents, the major cause of death in adolescence, we will now turn to consider the opportunities of road safety regulations in reducing road mortality. This graph depicts the number of road traffic deaths in Australia from 1925 to 2005. The red solid line shows that since the 1970s, the number of road fatalities has decreased significantly. What is especially notable is that this has occurred despite the increase in car ownership over the same time, as shown in the dotted blue line. And as we can see here, there has been a steady decrease in road deaths per 10,000 registered vehicles since 1925. This is about a ten-fold reduction in the number of road deaths per 10,000 vehicles over that time. What factors might be responsible for this? You may wish to pause and consider this for a minute. Australia is a country with a particularly strong record in road safety public policy and has experienced an enviable reduction in road traffic deaths over the years. Legislation has made a very important contribution to this reduction of deaths. One element has been improvements to roads, including pedestrian and railway crossings. Improvements to vehicles is another area, including technological improvements, brakes, tires, lights, and head restraints, for example. Other elements relate to more specific aspects such as the quality of safety belts and children's restraints. In most countries, it is the car industry, not governments, that has been responsible for such technological improvements. However, it is governments that can ensure that there are minimum safety standards around each of these. Laws to promote road safety include mandatory wearing of safety belts, which Australia was the first country to introduce. And also laws about mandatory helmets for motorbikes and bicycles. Other legislative initiatives in Australia have focused on alcohol and drink driving. This includes the introduction of .05% blood alcohol legislation, random breath testing, and strong penalties for drink driving including cancellation of licenses. In addition to such legislative changes, other elements include enhanced police enforcement, and intensive public education. All of these elements are considered to be part of Australia's success at reducing its high burden still from road traffic accidents. Young people are disproportionately more likely to die on roads than older, more experienced drivers. They are also more likely to be injured as shown by these data from the United States, with a highest injury rate in the youngest of drivers. The United States, Canada, Australia, and New Zealand have a system of graduated learning and licenses for novice drivers. These have the goal of enabling novice drivers to obtain necessary driving skills under conditions of lower risk, before moving on to more challenging driving tasks, especially those in which research has identified they are more likely to be involved in a collision, such as driving at night or with other young passengers. Graduated licenses allow drivers to gain driving experience and also mature physically, psychologically, and socially before receiving a completely unrestricted driving license. Different countries attach colored plates to a car to signal the presence of a learner driver with an adult supervisor. The yellow plate on the top left that I've shown here is from Australia and New Zealand, while a plain red plate is from the UK. The green one comes from Spain, while the bottom right plate is from Hong Kong, with a Chinese character meaning to learn. Learner drivers generally have to demonstrate that they have accrued a minimum number of hours of supervised, on-road driving. For example in Victoria, the Australian state that I live in, learner drivers have to demonstrate that they have been supervised for 120 hours, and I must say that personally I can attest to the fact that this is quite a lot of hours. In Australia there are now two types of probationary licenses. One for the first year, and the other for the next three years. Unlike those with a full license, P platers, as they are known here, are not allowed any alcohol in their system, and are not allowed to drive with more than one passenger age 16 to 22 years who is not their sibling or spouse. This is in recognition of the greater likelihood of accidents when other young people are in the car, presumably an effect of hot cognitions. P platers are also unable to drive high-powered vehicles. The Japanese V shaped sign on the right, known as the Shoshinsha or Wakaba mark, was introduced in 1972. And I like the fact that in addition to it being mandatory for Japanese drivers to display the sign on their cars for one year, drivers who are not confident are still able to display that sign beyond the first year. In Australia, as a result of this continued policy focus on road safety regulations, we continue to see downward and disproportionate trends in road traffic deaths in the young. For example over the past decade there was a 7% decline in annual deaths in 17 to 25 year olds, as can be seen here, In comparison to only a 1% decline in 40 to 64 year-olds. It appears that many of Australia's road safety policies are disproportionately benefitting young drivers. Now, in the UK one in five 17-24 year old drivers, has an accident within the first year of obtaining their license. This is a remarkably high ratio. The U.K. is one country that does but does not yet have graduated licenses. There proponents of introducing graduated licenses believe that they would see at least a 20% reduction in casualties involving young drivers were they simply to introduce a graduated drivers license system. They also believe that introducing a wider legislative package could reduce overall fatalities by as much as 60%.
