Finding: Certain subpopulations of adolescents defined by selected demographic characteristics and other circumstances—such as those who are poor or members of a racial or ethnic minority; in the foster care system; homeless; in a family that has recently immigrated to the United States; lesbian, gay, bisexual, or transgender; or in the juvenile justice system—have higher rates of chronic health problems and may engage in more risky behavior relative to the overall adolescent population.


Most adolescents are healthy as defined by traditional measures of mortality, morbidity, and use of health services. Even though these traditional indicators give reason for optimism, behavioral indicators of health status continue to show little improvement in the overall well-being of adolescents. The health problems of adolescents are primarily behavioral and environmental in origin, dominated by interpersonal violence, motor vehicle crashes, substance (including tobacco and alcohol) use and abuse, problems associated with risky sexual behavior, risky eating behavior, inadequate physical activity, and mental disorders. These behaviors not only affect adolescents’ immediate health, but also have a significant impact on their health as adults. It is important as well to provide health services that are attentive and responsive to the needs of specific subpopulations of adolescents with certain characteristics, such as being low-income, a racial/ethnic minority, in the foster care system, homeless, living in an immigrant family, LGBT, or in the juvenile justice system, since evidence shows that these young people often have higher rates of chronic health problems, may engage in more risky behavior, and may live in social environments that place them at greater risk relative to the overall adolescent population. Looking at these data, the committee is struck by the need for a focus on prevention; on behavioral health issues; on mental health issues; on oral health issues; and on disparities in health status that derive from income, race, and special circumstances. Available health services for adolescents and the extent to which they respond to these needs are explored in subsequent chapters.


Adam, M., McGuire, J., Walsh, M., Basta, J., and LeCroy, C. (2005). Acculturation as a predictor of the onset of sexual intercourse among Hispanic and white teens. Archives of Pediatrics and Adolescent Medicine, 159, 261–265.

Akinbami, L. J. (2006). The state of childhood asthma, United States, 1980–2005. Vital Health Statistics, 381, 1–24.

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