are responsible for delivering health care to adolescents have to resolve this paradox. They need to address the health conditions that require immediate attention while also preparing young people to adopt practices that can help improve their future health status and prevent unhealthy behaviors. They need to recruit adolescents who are difficult to reach and engage them in health care settings that often are not tailored to the sensitivities or concerns of adolescents. And as this list also suggests, health care providers need to be sensitive to the interactions between adolescents’ health and their life circumstances, developing strategies that can incorporate health care in a broad array of settings—schools, neighborhoods, community centers, and social services—that interact with vulnerable adolescents and their families.

For all adolescents, health and health care can be complicated by developmental changes, questions about confidentiality, relationships with families and peers, and other factors specific to this stage of life. For especially vulnerable populations, such as adolescents who are disabled, homeless, incarcerated, in foster care, or who live in poverty, health issues can be far more complicated. The needs of adolescents vary by gender, race and ethnicity, and other factors. Many of the challenges of adolescence are not medical but reflect larger social issues, such as poverty, crime, and the prevalence of violence. Nevertheless, lack of comprehensive health coverage, severely dysfunctional families, and the lack of many supports that other adolescents may take for granted can mean disconnection from the health care system and serious deficiencies in the care these young people receive. Insufficient health care affects not just the health of individual adolescents as they are growing up, but their lifelong health status as well.

The Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development was formed by the National Academies in May 2006, with funding from The Atlantic Philanthropies, to study adolescent health care services in the United States and highlight critical health care needs, promising service models, and components of care that may strengthen and improve health care services, settings, and systems for adolescents and contribute to healthy adolescent development. Committee members brought to this task expertise in the areas of adolescent health, general pediatrics, health care services, adolescent development, school-based health services, health care finance, mental health, alcohol, tobacco, and drug use, sexual health, oral health, nursing, public policy, statistics and epidemiology, preventive medicine, program evaluation, injury research, law, and immigrant and minority adolescents.

The committee was charged with exploring the following questions:

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