Introduction
National security has traditionally been understood in terms of protecting a state’s territorial integrity, preserving political stability, and safeguarding citizens from external aggression and internal threats (see Wu, 2025). However, contemporary security discourse has expanded beyond military defence to incorporate the concept of human security, which recognises that the health, well-being, and resilience of a nation’s population are fundamental pillars of national security (Biswas & Murai, 2024). Increasingly, governments and security institutions acknowledge that emerging threats such as pandemics, substance abuse, mental health disorders, cybercrime, and demographic vulnerabilities have the potential to undermine national development and weaken state capacity just as significantly as conventional security threats (Andrews & Obi, 2024; UNOWAS, 2025).
Ghana is often celebrated for its youthful population, with people between the ages of 15 and 35 constituting a substantial proportion of the country’s labour force and future leadership (see Ghana Statistical Service, 2021). This demographic advantage presents enormous opportunities for economic growth, innovation, and national development. Yet it also presents significant challenges when large segments of the youth engage in behaviours that compromise their physical, psychological, and social well-being. While discussions surrounding youth behaviour frequently focus on morality and social values, there is a growing need to examine these issues from a national security perspective. A nation whose young population is increasingly affected by preventable diseases, substance dependence, mental health disorders, gambling addiction, and avoidable fatalities risks weakening the very human capital upon which its future depends.
This article argues that the rise in youth health-risk behaviours represents an emerging human security challenge in Ghana. Drawing on recent empirical evidence, it examines four interrelated issues: the rise of hookup culture and its implications for sexually transmitted infections, particularly HIV/AIDS; increasing drug abuse, alcoholism, and unhealthy lifestyle practices; the growing mental health crisis associated with gambling and substance dependence; and road traffic fatalities involving commercial motorcycle (Okada) riders. It further argues that unless these issues are addressed through coordinated public health, educational, economic, and security interventions, they will continue to erode Ghana’s human capital and undermine national security.
The Rise of Hookup Culture and Sexual Health Risks
Hookup culture refers to casual, non-committed sexual relationships that occur without expectations of emotional attachment or long-term commitment (Garcia et al., 2012). Although the concept originated largely from studies of youth relationships in Europe and North America, it has increasingly gained relevance in African societies where changing social norms, urbanization, and economic pressures have transformed patterns of intimacy. Within the African context, hookup culture often overlaps with transactional sexual relationships in which intimacy is exchanged for financial assistance, accommodation, gifts, or other material benefits (Masvawure, 2010; Ntim, 2022). In Ghana, intimate relationships among young people have undergone significant transformation over the past decade. Courtship practices that traditionally emphasized family involvement, commitment, and marriage are increasingly giving way to more casual and less formal relationship arrangements, particularly within urban centres such as Accra and Kumasi (Karen, 2026). Social media has accelerated this cultural shift by exposing young people to global dating practices while simultaneously normalising casual sexual relationships through music, comedy skits, influencers, and lifestyle content. Digital platforms such as TikTok, Snapchat, Instagram, Facebook, and X (formerly Twitter) have created virtual environments where hookup culture is often portrayed as fashionable, entertaining, and financially rewarding. Consequently, transactional relationships, popularly described as “hookups,” “sponsors,” or “soft life” relationships, have become part of everyday conversations among sections of urban youth.
Empirical evidence suggests that early sexual initiation is becoming increasingly common among Ghanaian youth. Studies conducted by Asante (2018) and Klu et al. (2024) indicate that a considerable proportion of Ghanaian adolescents become sexually active during their teenage years. By the age of twenty, many young women have already experienced their first sexual intercourse, demonstrating that sexual activity forms part of the lived experiences of many Ghanaian youth long before marriage. While sexual activity itself is not inherently problematic, early sexual debut combined with multiple partnerships, inconsistent condom use, peer influence, and transactional relationships substantially increases vulnerability to sexually transmitted infections (STIs), unintended pregnancies, unsafe abortions, and psychological distress.
Despite decades of public health interventions, HIV/AIDS continues to pose a significant challenge globally, particularly among adolescents and young adults. Young people aged between 10 and 24 years experience profound biological, psychological, and social transitions that often increase their susceptibility to risky sexual behaviours. However, these unique vulnerabilities remain inadequately addressed within many national HIV prevention programmes (Pettifor et al., 2018). Globally, approximately 260,000 adolescents and young adults aged 15–24 acquired HIV in 2016, with young women experiencing infection rates approximately 44 per cent higher than their male counterparts (Pettifor et al., 2018). Sub-Saharan Africa remains the epicentre of the HIV epidemic, accounting for nearly 71 per cent of all new infections worldwide. Within West Africa, young women between the ages of 15 and 24 account for approximately 22 per cent of newly reported HIV infections, reflecting persistent gender inequalities, economic vulnerability, and unequal power relations within sexual relationships (Bell, 2024).
Although Ghana’s overall HIV prevalence remains comparatively lower than several countries in Southern and Eastern Africa (Boah et al., 2023), emerging trends suggest that adolescents and young adults continue to bear a disproportionate share of new infections. According to the Ghana AIDS Commission (2023), approximately 18,000 new HIV infections were recorded nationwide in 2022, with individuals aged 15–24 accounting for more than one-quarter of these new cases. These statistics suggest that while considerable progress has been made in reducing overall HIV prevalence, young people remain one of the populations at greatest risk. The implications extend beyond HIV infection alone. Studies have shown that casual and transactional sexual relationships also increase exposure to other sexually transmitted infections such as gonorrhoea, chlamydia, syphilis, hepatitis B, and human papillomavirus (see Onoya et al., 2012; Konlan, P., & Ganle, 2025). Many of these infections remain untreated due to stigma, limited access to sexual health services, or lack of awareness, thereby increasing long-term reproductive health complications among young adults. Furthermore, unintended pregnancies resulting from unprotected sexual encounters continue to contribute to unsafe abortions, school dropout among adolescent girls, financial hardship, and social exclusion. These outcomes reduce educational attainment and labour market participation, ultimately weakening the country’s human capital.
From a human security perspective, these health outcomes should not be viewed merely as private or individual matters. Rising HIV infections, sexually transmitted diseases, and reproductive health complications impose significant economic costs through increased healthcare expenditure, reduced labour productivity, and long-term dependency on public health services. A country whose economically productive population increasingly suffers from preventable diseases experiences diminished economic competitiveness and reduced national resilience.
Drug Abuse, Alcohol Consumption and Emerging Lifestyle Diseases
Substance abuse has emerged as one of the most pressing public health concerns confronting Ghanaian youth. Alcohol remains the most widely consumed psychoactive substance, and it is widely advertised on both traditional and social media (Mayrhofer & Naderer, 2019). A recent survey revealed that for many young people, drinking begins in seemingly harmless social settings such as birthday parties, university programmes, concerts, clubs, funerals and festivals. Excessive alcohol consumption is frequently portrayed as a symbol of enjoyment, confidence and social acceptance. Unfortunately, what begins as occasional drinking may gradually develop into alcohol dependence, exposing young people to impaired judgement, violence, road traffic accidents, risky sexual behaviour and chronic health conditions.
Similarly, shisha smoking has experienced a rapid rise in popularity among senior high school students, university students and young professionals (GhanaWeb, 2024; Darko & Glozah, 2025). Many users perceive shisha to be safer than cigarette smoking because of its pleasant flavours and the misconception that water filters harmful substances. Scientific evidence, however, suggests otherwise (Badran & Laher, 2020). The World Health Organization has consistently warned that a single shisha session may expose users to significantly larger quantities of smoke, nicotine, carbon monoxide and toxic chemicals than smoking a cigarette. These substances increase the risk of cardiovascular diseases, respiratory illnesses, lung cancer and nicotine addiction.
Beyond alcohol and shisha, Ghana has witnessed growing abuse of prescription drugs such as tramadol, codeine and other opioids (see Baaladong, 2025; Kivoame, 2025). While substance use has long existed within Ghanaian society, its scale, accessibility and normalization among young people have become increasingly alarming. Reports by the Narcotics Control Commission (NACOC) and the Food and Drugs Authority have repeatedly highlighted the misuse of pharmaceutical drugs among young people, often driven by peer influence, curiosity, perceived enhancement of sexual performance, or attempts to cope with emotional stress (Armah, 2025; GhanaWeb, 2024). The widespread availability of these substances through illegal markets continues to undermine efforts aimed at controlling drug abuse.
Economic conditions further stress the problem. Ghana continues to face persistent youth unemployment and underemployment despite increasing levels of educational attainment. The Ghana Statistical Service in 2023 revealed that unemployment remains disproportionately high among young adults. Many graduates struggle to secure stable employment, while others remain trapped in precarious informal jobs with limited opportunities for upward mobility. Feelings of frustration, hopelessness and economic uncertainty create fertile conditions for substance abuse as some young people seek temporary escape from daily pressures.
The Mental Health Authority has also warned that substance abuse is becoming a significant contributor to psychiatric disorders among young people. According to the Authority, outpatient cases involving mental disorders associated with psychoactive substance use increased from approximately 4,155 in 2019 to more than 5,554 cases in 2023, with the age group between 20 and 34 years recording the highest number of cases. In addition, cases have also been reported among children aged between 10 and 14 years, suggesting that exposure to addictive substances is beginning much earlier than previously observed (Mohammed, 2024). Substance abuse has consequences that extend beyond addiction itself. Young people under the influence of alcohol or drugs are more likely to engage in violent behaviour, unsafe sexual practices, criminal activities and dangerous driving (Majee et al., 2024). Drug dependence also reduces educational performance, workplace productivity and family stability, thereby creating wider social and economic burdens.
Emerging Lifestyle Diseases Among Ghanaian Youth
Equally concerning is the growing prevalence of unhealthy lifestyle practices among Ghanaian youth. Studies have revealed that urban lifestyles increasingly encourage the excessive consumption of highly processed foods, sugary beverages, energy drinks and instant meals while simultaneously reducing levels of physical activity (see Ameye et al., 2025; Yi et al., 2025). Energy drinks have become particularly popular among students, commercial drivers, artisans and young professionals who consume them to combat fatigue or improve concentration (Kobik, & Aryee, 2024). However, many of these beverages contain extremely high levels of caffeine and sugar. Excessive consumption of energy drinks has been linked to elevated blood pressure, cardiac arrhythmias, anxiety, insomnia and cardiovascular complications (Mandato et al., 2025).
The increasing dependence on processed foods and fast-food diets has also contributed to rising cases of obesity, hypertension, diabetes, chronic kidney disease and liver complications among younger populations (Babalola et al., 2025; Lestari, 2023). Diseases like hypertension once associated primarily with old age are now being diagnosed among individuals in their twenties and thirties (Ambolley, 2025). This epidemiological transition reflects changing lifestyles characterised by sedentary behaviour, poor nutrition and chronic stress (Bosu & Bosu, 2021).
The implications for Ghana’s healthcare system are significant. Non-communicable diseases require long-term treatment, increase public healthcare expenditure and reduce workforce productivity. As these conditions become increasingly common among economically productive age groups, they threaten the country’s future labour force and economic competitiveness.
Gambling, Betting and the Growing Mental Health Crisis
Mental health remains one of the least understood dimensions of health within Ghanaian society. Unlike physical illnesses, whose symptoms are often immediately observable, mental health disorders frequently develop gradually and remain undetected until they significantly impair an individual’s social, educational or occupational functioning. Consequently, many young people continue to suffer in silence due to stigma, misinformation and limited access to professional mental healthcare.
One of the fastest-growing contributors to psychological distress among Ghanaian youth is gambling. The rapid expansion of digital technology, mobile money services and internet access has transformed gambling from an occasional recreational activity into an everyday practice accessible through smartphones. Sports betting, casino games and virtual betting platforms such as Aviator have become particularly popular among young people seeking quick financial rewards.
Several factors explain the increasing attraction of gambling. Persistent unemployment, financial insecurity, rising living costs and the widespread promotion of instant wealth through social media have created an environment in which betting appears to offer an alternative pathway to economic success. For many unemployed young people, placing multiple bets each day has become normalized despite the extremely low probability of financial gain.
Research consistently demonstrates that gambling addiction is associated with numerous adverse mental health outcomes. Boateng (2020) found that excessive sports betting contributes to anxiety, depression and emotional distress among Ghanaian youth. More recent evidence further strengthens these concerns. A 2024 study published in BMC Public Health by Manu et al., found a strong relationship between gambling severity and psychological distress among Ghanaian youth. The study reported that approximately 84 per cent of participants exhibited moderate to problematic gambling behaviour. Furthermore, 68.8 per cent experienced symptoms of anxiety, 43.6 per cent reported depression and 31.1 per cent experienced significant stress. Participants with severe gambling problems consistently demonstrated poorer psychological outcomes than non-problem gamblers. These empirical findings are reflected in lived experiences. During a YouTube interview hosted by Nana Aba Anamoah in November 2024, a young Ghanaian openly described how gambling addiction had resulted in overwhelming financial losses, severe emotional distress and significant strain on his marriage. His testimony illustrates that gambling addiction extends far beyond financial loss; it affects family relationships, emotional stability and social functioning.
Okada Riding and the Loss of Young Lives
Commercial motorcycle transportation, popularly known as Okada, has become one of the fastest-growing sources of informal employment in Ghana. Thousands of young men, particularly those unable to secure formal employment, have entered the commercial motorcycle transport sector because it offers relatively low entry costs and immediate income opportunities. While Okada services have significantly improved transportation in many underserved communities, they have also introduced serious public health and safety concerns.
Many commercial motorcycle riders operate without formal rider training, valid licences or adequate protective equipment. Excessive speeding, dangerous overtaking, overloading, poor motorcycle maintenance and limited compliance with traffic regulations significantly increase the likelihood of road crashes. In many instances, both riders and passengers fail to wear protective helmets, thereby increasing the severity of injuries sustained during accidents.
Road traffic injuries have become one of the leading causes of death among economically active young adults. According to the National Road Safety Authority (NRSA), approximately 2,000 people lost their lives through road crashes between January and August of 2025 alone, with nearly three-quarters of the fatalities being males (GhanaWeb, 2025). Although not all road traffic accidents involve commercial motorcycles (4,186 out of a total of 16,348 accidents), young male riders constitute one of the most vulnerable groups because of prolonged exposure to road risks and economic pressure to maximise daily earnings. Every preventable death or permanent disability resulting from motorcycle crashes represents a loss of productive human capital. Families lose breadwinners, communities lose economically active citizens and the nation loses part of its future workforce.
Health-Risk Behaviours as an Emerging National Security Challenge
The discussion above demonstrates that the health challenges confronting Ghanaian youth are not isolated public health concerns. Rather, they are interconnected social phenomena that collectively threaten the country’s human capital, economic productivity, institutional capacity and national resilience. Contemporary security thinking increasingly recognises that national security extends beyond defending territorial borders. A state’s strength is equally determined by the health, productivity and psychological resilience of its population. Consequently, the deterioration of youth health should be understood as an emerging human security challenge with significant implications for Ghana’s national security.
Human capital remains one of Ghana’s most valuable national assets. Young people constitute the country’s future workforce, entrepreneurs, researchers, teachers, healthcare professionals, military personnel, police officers and political leaders. Any factor that weakens their physical or psychological well-being inevitably weakens national development.
The rise in HIV infections among young adults, increasing cases of substance abuse, gambling addiction, mental health disorders and road traffic fatalities collectively reduce the quality of Ghana’s labour force. Individuals living with untreated illnesses or addiction often experience reduced educational attainment, lower productivity, unstable employment and diminished earning potential. Over time, these outcomes translate into slower economic growth, declining national productivity and increasing dependency on public support systems.
Countries invest substantial resources in educating young people from primary school through tertiary education. When preventable illnesses, addiction or premature death remove these individuals from productive economic participation, the nation loses both its financial investment and future developmental capacity.
Implications for National Defence and Security Institutions
Perhaps the most direct connection between youth health and national security is its impact on recruitment into Ghana’s security services. The Ghana Armed Forces, Ghana Police Service, Ghana Immigration Service, Ghana National Fire Service and Ghana Prisons Service all rely on physically fit, psychologically resilient and medically healthy young people. Recruitment into these institutions involves rigorous medical examinations precisely because national security depends upon the physical and mental preparedness of personnel.
Evidence presented by the Minister for the Interior, Hon. Mohammed-Mubarak Muntaka, illustrates the seriousness of the challenge. Speaking during an interview on Pan African Television on 23 May 2025, the Minister disclosed that more than 100,000 applicants reached the medical screening stage of the 2025/2026 security services recruitment exercise. However, over 4,000 applicants failed mandatory drug screening tests, while more than 2,000 others were disqualified because of mental health conditions. These figures are significant for several reasons.
- First, they demonstrate that thousands of otherwise eligible young Ghanaians were unable to serve their country because of preventable health conditions. This represents a substantial reduction in the pool of qualified recruits available for national service.
- Second, the statistics suggest that substance abuse and mental health disorders may be more widespread among sections of the youth population than previously recognised. If over 6,000 applicants fail basic health assessments during one recruitment exercise, it raises important questions regarding the broader health profile of Ghana’s economically active population.
- Finally, declining physical and psychological fitness among young people may affect Ghana’s long-term defence preparedness. National resilience depends upon maintaining a sufficient reserve of healthy citizens capable of serving in times of national emergency, disaster response or military mobilisation.
The concept of human security emphasises that national stability ultimately depends upon the security of individuals. Citizens who enjoy good health, meaningful employment, quality education and psychological well-being are more likely to contribute positively to national development than those experiencing chronic illness, addiction or social exclusion. The interconnected nature of Ghana’s current youth challenges illustrates this principle clearly. Youth unemployment increases vulnerability to gambling and substance abuse. Addiction contributes to deteriorating mental health. Poor mental health weakens educational achievement and labour productivity. Reduced productivity increases economic hardship, which may encourage criminal behaviour or deepen dependence on addictive coping mechanisms. This cycle gradually weakens both individual well-being and national resilience. Breaking this cycle requires recognising youth health as a strategic national security priority rather than solely a medical or social welfare issue.
Conclusion and Policy Recommendations
Ghana’s youthful population represents one of the country’s greatest comparative advantages. However, the increasing prevalence of risky sexual behaviour, substance abuse, unhealthy lifestyles, gambling addiction, mental health disorders and preventable road traffic fatalities presents an emerging human security challenge with significant implications for national development and national security. These behaviours collectively erode human capital, reduce labour productivity, increase healthcare expenditure and weaken the pool of physically and psychologically fit citizens available for national service. The disqualification of more than 6,000 applicants during the 2025/2026 security services recruitment exercise due to drug use and mental health conditions underscores the urgency of treating youth health as a strategic national security concern rather than solely a public health issue.
Addressing these challenges requires coordinated action across government, civil society and the private sector.
- The Government of Ghana should strengthen comprehensive sexuality education and youth-friendly reproductive health services to reduce HIV and other sexually transmitted infections.
- Mental health services should be expanded in schools, universities and communities, while stricter regulation of gambling advertisements, alcohol marketing and access to illicit drugs should be prioritised.
- Investment in youth employment and entrepreneurship programmes is equally critical to addressing the structural conditions that drive substance abuse, risky behaviours and psychological distress.
- The Ministries of Health, Education, Youth Development, Interior and National Security should establish an inter-agency framework that recognises youth health as a core component of Ghana’s national security strategy.
A country whose future leaders, innovators, security personnel and professionals are increasingly affected by preventable diseases, addiction and mental health challenges risks undermining its own development and security. Protecting the health of Ghana’s youth is therefore not only an investment in individual well-being but also a strategic investment in the resilience, stability and future prosperity of the nation.
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