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Dear Editor:
With regard to the publication by Bonilla-Aldana et al. (1) in the journal Iatreia, on the need for an integrative approach to SARS CoV2 infection, which represents the most serious public health threat of the 21st century; it is useful to pick up on the point of “strengthening countries’ public health systems by integrating an understanding the relationships among the animal-host, human-susceptible and environment, unique interdisciplinary management, good communication and coordination, and robust public health policies” (1).
This letter is a reflective contribution of health professionals in relation to the Young population, which has been affected in their individual and social life, compromising their mental health as a result of isolation, confinement, inactivity, deterioration of interpersonal relationships, loneliness, stressful feelings such as uncertainty, fear and limitation of leisure time, among others (2). Health professionals, as part of their work, are interested in the search for alternatives to the problems that currently affect the population, including living in the context of a pandemic.
Currently, the COVID-19 pandemic, caused by a new type of coronavirus called SARS-CoV-2, declared by the WHO as a public health emergency of international concern (30 January 2020) has affected 170,472,291 people, adding up to 3,544,186 fatalities, since its appearance until May 2021 (3). Faced with this scenario, the priority of governments has been to save lives, protect health, promote solidarity and looking for cooperation between nations. In this sense, one of the transcendental axes has been to strengthen strategies and actions from Primary Health Care, aimed at different age groups according to the degree of exposure, either by associated morbidities or by behavioral factors, as is the case with the young population (4).
Young people, in the analysis of public health problems, are resistant to morbid processes; their attitude and vision of the world can lead them to believe that they are immune to these risks (5). However, this group should be of particular interest, as they are characterized by a physical and psychological developmental stage in a changing and complex socio-cultural environment that conditions them to take risks.
Globally, the number of obese people aged 5-19 years has multiplied in the last 4 decades, from 11 million in 1975 to 124 million in 2016 (6). Suicides and accidental deaths due to self-harming behavior were the second leading cause of death in young people aged 15-29 years in 2018, with nearly 67,000 deaths (6). In Europe and South-East Asia, this condition is the first or second leading cause of death. In the Americas, around 80,000 adolescents (10-19 years) and 150,000 young people (15-24 years) die each year, especially from causes such as homicide, suicide and land transport accidents (6). In Colombia, 48.5% of attempted suicide cases in 2017 were among 15-24-year-old (7).
In 2019, homicide and suicide ranked first and third in mortality from external causes (7).
In addition, with the current SARS-coV-2 (COVID-19) pandemic young people have also been affected, and although they tend to be asymptomatic or have mild symptoms, it confers a high risk of infecting others. According to statistics for the month of March -2020 - in the United States, of the 100% of users hospitalized for the disease, approximately 20% were young people; while Colombia for July -2020 - had more than 58,000 confirmed cases in young people between 20 and 29 years of age (8).
Analyzing these aspects within the framework of the pandemic and public health, leads to taking on challenges such as those posed by Barrientos-Gutiérrez et al (9), who suggest that the approach to young people should be based on the empowerment of strengths, capacities and especially of resilience. This análisis becomes important when considering the Sense of Coherence (SOC) as a possibility to face these problems, a concept introduced by Antonovsky, as an element of the salutogenic model -public health based on health promotion-; which puts the focus on the resources, conditions and factors that can make people move in the direction of health, beyond the pathogenic model (10).
This perspective enables young people to see life in a coherent, structured, understandable, manageable and meaningful way, so that it helps to express the degree of confidence they have in internal and external stimuli and their ability to see them as positive, structured and explainable, which enables them to understand and strengthen (10):
The organization of their life and position in the world.
The ability to understand other people’s situations, control one’s own thoughts, emotions and establish harmonious relationships with the environment.
The resources they need for their survival, whether they are under their control or that of others.
The feeling of one’s own life oriented towards goals they wish to achieve.
Obstacles seen as valuable life challenges.
The above calls for health professionals to analyze the impact of the pandemic on the biological, psychological and social dimensions of young people. In this way, resignifying the ways of “doing” to lead interdisciplinary work from the different areas, whose focus is the Sense of Coherence (SOC) with its motivational component and coping capacity, in a globalized world that requires being prepared to provide solutions and responses to fluctuating, different and adverse situations, as well as to assume the responsibilities and demands of society, family, the educational and labor system.
