Toward a One Health Framework for Understanding Adolescents’ Mental Well-Being in Europe

Elisa Benedetti, Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (CNR-IFC)
Gabriele Lombardi , University of Florence
Rodolfo Cotichini, Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (CNR-IFC),
Sonia Cerrai, Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (CNR-IFC)
Marco Scalese, Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (CNR-IFC)
Sabrina Molinaro, Epidemiology and Health Research Lab, Institute of Clinical Physiology of the Italian National Research Council (CNR-IFC)

Adolescent mental health and well-being have declined over the past two decades, with disproportionate impacts observed among females and socio-economically disadvantaged groups, particularly following the COVID-19 pandemic. Despite growing recognition of the interconnectedness of human, animal, and environmental health, research in this area often focuses narrowly on individual-level determinants, overlooking broader ecological and socio-economic influences. Furthermore, cross-national evidence remains limited due to methodological heterogeneity across studies. Using nationally representative samples of 16-year-old students from 33 countries (n = 98,430) collected in 2024 through the European School Survey on Alcohol and Other Drugs (ESPAD), this study examines cross-country variations in adolescent subjective mental well-being. Employing a One Health framework, we investigate how individual, emotional, socio-economic, and environmental factors interact to shape mental health outcomes. Country-level indicators included GDP, Gini Index, Gender Inequality Index, public health expenditure, Life Evaluation Index, greenhouse gas emissions, urbanisation, biodiversity, and forest coverage. Preliminary multilevel analyses reveal persistent gender disparities, with girls reporting lower well-being, and counterintuitive associations between inequality measures and individual well-being, warranting further investigation of potential ecological fallacies. Findings highlight the multifactorial nature of adolescent mental health and highlight the need for integrated, multidisciplinary strategies involving schools, families, and health services. Interventions for enhancing adolescent well-being require addressing modifiable risk factors, leveraging protective influences, and fostering supportive environments that build resilience, emotional competence, and coping skills amid socio-economic and ecological pressures.

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 Presented in Session 23. Mental Health, Cognition and Wellbeing