Adolescent experiences and exposures: a systematic review of life course outcomes.

Background: Adolescence (ages 10-19) is a critical developmental stage that influences outcomes in adulthood and old age. There is growing policy interest in adolescent interventions that are efficiently targeted, demonstrate long-term returns, and impact various domains of well-being. More data is needed to identify which adolescent experiences and exposures can serve as effective levers to shift developmental trajectories and achieve long-term benefits. Methods: This review examines evidence on the predictive outcomes of adolescent experiences and exposures across the life course. The review is registered in PROSPERO (CRD42023407980). Peer reviewed articles published from March 2010 to July 2025 were included. A framework was adapted to track associations across six core domains of well-being-Agency and Resilience, Connectedness, Family Dynamics, Health and Nutrition, Learning Competence, and Safety-from adolescence through the life course. A systematic search identified relevant studies, followed by a structured descriptive review using the Synthesis Without Meta-Analysis (SWiM) methodology to assess the evidence across domains. Quality was evaluated with an adapted Critical Appraisal Skills Program Checklist. Findings: Of the 244 included papers, 2231 analyses tested associations between adolescent exposures and life course outcomes, covering data from over 2.1 million adolescents. The Health and Nutrition domain was the most studied domain accounting for 60% of all tested associations, of which 42% were statistically significant. In addition to predicting health outcomes, health in adolescence predicts violence exposure, education, and employment in later life. Safety and Supportive Environments, and Agency and Resilience, though less studied, were also robust predictors of a range of adult outcomes with 35% and 48% of tested associations being statistically significant, respectively. Learning Competence and Safety in adolescence strongly predicts economic success and stability in adulthood. No studies reported on intergenerational effects of exposures during adolescence. Interpretation: This review uses a systematic approach to demonstrate that adolescent experiences predict adulthood outcomes beyond the original domain of exposure, with significant cross-domain associations. However, it finds that the evidence is unevenly distributed across domains of well-being. In addition, the results shed light on gaps in research on lower-income settings and across demographic variables including sex and socio-economic status. Funding: This work was supported by Velux Stiftung, Zurich.