BACKGROUND:
Accelerated transitions into adult roles among adolescents remain insufficiently examined as a factor influencing population health inequalities. This study assessed how early assumptions about adult economic and caregiving responsibilities shape life-course trajectories in a rural Ghanaian community.

METHODS:
The study employed qualitative research methods. Data were generated through in-depth interviews with adolescents and key informants. Analysis followed an inductive thematic approach, drawing on social-ecological and life-course perspectives.

RESULTS:
Findings indicate that accelerated adulthood is embedded in household survival strategies and in structurally constrained rural contexts. Non-nuclear family arrangements redistributed adult responsibilities to adolescents, while limited educational and occupational mobility restricted opportunities to delay adulthood. Weak infrastructure, dependence on inherited livelihood pathways, and low institutional support narrowed life options and reduced adolescents’ capacity to accumulate human capital. These interacting conditions shortened adolescence and shaped early transitions with implications for health, well-being, and socioeconomic outcomes across the life course.

CONCLUSIONS:
Accelerated adulthood emerged as a population-level adaptation to inequality rather than an expression of individual choice. From a public health perspective, this process represents an upstream determinant of intergenerational disadvantage. Addressing it requires policy coherence across adolescent health, education, labour, and rural development sectors. Population health strategies that focus narrowly on risk behaviours without engaging structural drivers risk limited impact. Integrating social protection, livelihood expansion, and rural investment into youth policy is necessary to reduce life-course inequities and improve long-term population health outcomes.