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Adolescent Health Services: Missing Opportunities
To implement this recommendation, federal agencies would need to adopt consistent age brackets that cluster data by ages 10–14 and 15–19 and consistent identifiers of socioeconomic status, geographic location, gender, and race and ethnicity. Also needed are consistent identifiers of specific vulnerable adolescent populations, including those in the foster care system; those who are homeless; those who are in families that have recently immigrated to the United States; those who are lesbian, gay, bisexual, or transgender; and those in the juvenile justice system. Important as well is to track emerging disparities in access to and utilization of health services, with attention to specific components of health care, such as screening, assessment, and referral, as well as an emphasis on racial and ethnic differences. Finally, longitudinal studies are needed on the effects of both health-promoting and health-compromising behaviors that often emerge in the second decade of life and continue into adulthood.
While the gaps and problems in the health services used by young people discussed in this report are not unique to this age group, a compelling case can be made for improving health services and systems both to support the healthy development of adolescents and to enhance their transitions from childhood to adolescence and from adolescence to adulthood. Current interest in restructuring the way health care is delivered and financed in the United States—and defining the content of care itself more broadly—is based on a growing awareness that existing health services and systems for virtually all Americans have important and costly shortcomings. In the midst of these discussions, the distinct deficits faced by adolescents within the health system deserve particular attention. Their developmental complexities and risky behavior, together with the need to extend their care beyond the usual disease- and injury-focused services, are key considerations in any attempt to reform the nation’s chaotic health care system—especially if adolescents are to benefit. Even if the larger systemic issues of access to the health system were resolved, more would likely need to be done to achieve better health for adolescents during both the adolescent years and the transition to adulthood.