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Adolescent Health Services: Missing Opportunities
access to and utilization of health services is explored more fully in Chapter 3.) Moreover, this chapter addressed differences in how need matters, as some segments of the adolescent population, defined by biology as well as behavior, have health needs that require particular attention in health systems.
A recent analysis of the 21 Critical Health Objectives for Adolescents and Young Adults, a subset of the objectives of the Centers for Disease Control and Prevention’s (CDC’s) Healthy People 2010, highlights how little progress has been made in the overall health status of adolescents (Park et al., 2008; U.S. Department of Health and Human Services, 2006a). Of these 21 objectives, the only ones that have shown improvement since 2000 are unintentional injury-related behavior, pregnancy and sexually related behavior, and tobacco use (see Table 2-1). Moreover, several areas have worsened, including deaths caused by motor vehicle crashes related to alcohol use, which have risen, and obesity/overweight, which has increased along with a decrease in reported physical activity (Park et al., 2006).
With these and many other findings in mind, this chapter explores available evidence on the health status of adolescents as defined by traditional measures (mortality rates, incidence of disease, prevalence of chronic conditions, and use of health services). The chapter also offers a more complex and complete picture of health status by reviewing behaviors that may adversely affect health status not only during adolescence, but also in adulthood. Finally, the chapter highlights the current health status of various subpopulations of adolescents who are especially likely to be affected by several co-occurring health challenges, including those who behave in more than one risky way at the same time. Data on adolescents’ use of health services are discussed in Chapter 3.
As discussed in Chapter 1, the committee focused this study on health services and policies for adolescents between the ages of 10 and 19, and where appropriate and possible, broke this population down into the two subsets of early adolescence (ages 10–14) and adolescence (ages 15–19). Throughout this chapter, health status is described for the adolescent population, and where data are available, is distinguished for these two subsets, adhering as closely as possible to these specific age ranges. Moreover, at some points in the chapter, the health status of those transitioning from adolescence to adulthood (those aged approximately 20–24) is included in the discussion because (1) the data do not always break off at exactly age 19, and (2) health problems in adolescence can have implications for adult health, and the progression of these problems is important to note.
Finding:Most adolescents are considered healthy as defined by traditional medical measures of current health status, such as mortality