Saturday, December 3, 2011

Adolescent Health

Goal

Improve the healthy development, health, safety, and well-being of adolescents and young adults.


Overview

Adolescents (ages 10 to 19) and young adults (ages 20 to 24) make up 21 percent of the population of the United States. The behavioral patterns established during these developmental periods help determine young people's current health status and their risk for developing chronic diseases in adulthood.
Although adolescence and young adulthood are generally healthy times of life, several important public health and social problems either peak or start during these years. Examples include:
  • Homicide
  • Suicide
  • Motor vehicle crashes, including those caused by drinking and driving
  • Substance use and abuse
  • Smoking
  • Sexually transmitted infections, including human immunodeficiency virus (HIV)
  • Teen and unplanned pregnancies
  • Homelessness
Because they are in developmental transition, adolescents and young adults are particularly sensitive to environmental—that is, contextual or surrounding—influences. Environmental factors, including family, peer group, school, neighborhood, policies, and societal cues, can either support or challenge young people’s health and well-being. Addressing the positive development of young people facilitates their adoption of healthy behaviors and helps to ensure a healthy and productive future adult population.

Why Is Adolescent Health Important?

Adolescence is a critical transitional period that includes the biological changes of puberty and the need to negotiate key developmental tasks, such as increasing independence and normative experimentation.
There are many examples of effective policies and programs that address adolescent health issues. They include:
  • State graduated driver licensing programs
  • Teen pregnancy prevention programs
  • Violence prevention programs
  • Delinquency prevention programs
  • Mental health and substance abuse interventions
  • HIV prevention interventions
The financial burdens of preventable health problems in adolescence are large and include the long-term costs of chronic diseases that are a result of behaviors begun during adolescence. For example, the annual adult health-related financial burden of cigarette smoking, which usually starts by age 18, is $193 billion.
There are significant disparities in outcomes among racial and ethnic groups. In general, adolescents and young adults who are African American, American Indian, or Hispanic, especially those who are living in poverty, experience worse outcomes in a variety of areas (examples include obesity, teen pregnancy,tooth decay, and educational achievement) compared to adolescents and young adults who are white.

Understanding Adolescent Health

The leading causes of illness and death among adolescents and young adults are largely preventable.3 Health outcomes for adolescents and young adults are grounded in their social environments and are frequently mediated by their behaviors. Behaviors of young people are influenced at the individual, peer, family, school, community, and societal levels.
As illustrated by the following examples of research findings, health outcomes are linked to multiple environmental factors.

Family

  • Adolescents who perceive that they have good communication and are bonded with an adult are less likely to engage in risky behaviors.
  • Parents who provide supervision and are involved with their adolescents' activities are promoting a safe environment in which to explore opportunities.
  • The children of families living in poverty are more likely to have health conditions and poorer health status, as well as less access to and utilization of health care.

School

  • Academic success and achievement are strong predictors of overall adult health outcomes. Proficient academic skills are associated with lower rates of risky behaviors and higher rates of healthy behaviors.
  • High school graduation leads to lower rates of health problems and risk for incarceration,as well as enhanced financial stability during adulthood.
  • The school social environment affects students' attendance,academic achievement, and behavior.A safe and healthy school environment promotes student engagement and protects against risky behaviors and dropping out.

Neighborhoods

Adolescents growing up in distressed neighborhoods characterized by concentrated poverty are at risk for a variety of negative outcomes, including poor physical and mental health, delinquency, and risky sexual behavior.

Media Exposure

Adolescents who are exposed to media portrayals of violence, sexual content, smoking, and drinking are at risk for adopting these behaviors.

Emerging Issues in Adolescent Health

Two important issues influence how adolescent health will be approached in the coming decade. First, the adolescent population is becoming more ethnically diverse, with rapid increases in the numbers of Hispanic and Asian American youth. The growing ethnic diversity will require cultural responsiveness to health care needs and sharpened attention to disparate health and academic outcomes, which are correlated with poverty, especially among adolescents from minority racial and ethnic groups.2, 46
The second emerging issue is the increased focus on the use of positive youth development interventions for preventing adolescent health risk behaviors.47, 48 Youth development interventions can be briefly defined as the intentional process of providing all youth with the support, relationships, experiences, resources, and opportunities needed to become successful and competent adults.49 There is growing empirical evidence that well-designed youth development interventions can lead to positive outcomes. Ongoing, rigorous evaluation will determine what works, why it works, and how successful interventions can be applied.49

References

1U.S. Census Bureau. 2008 population estimates: National characteristics, national sex, age, race and Hispanic origin. Washington: 2008. Available from:http://www.census.gov/popest/national/asrh/NC-EST2008-asrh.html
2National Research Council and Institute of Medicine. Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development. Adolescent health services: Missing opportunities. Lawrence RS, Gootman JA, Sim LJ, editors. Washington: National Academies Press, 2009. Available from:http://books.nap.edu/openbook.php?record_id=12063&page=1 External Web Site Policy
3Mulye TP, Park MJ, Nelson CD, et al. Trends in adolescent and young adult health in the United States. J Adolesc Health. 2009;45(1):8-24. Available from: http://download.journals.elsevierhealth.com/pdfs/journals/1054-139X/PIIS1054139X09001244.pdf External Web Site Policy
4National Research Council, Panel on High-Risk Youth, Commission on Behavioral and Social Sciences and Education. Losing generations: Adolescents in high-risk settings. Washington: National Academies Press; 1993. Available from: http://www.nap.edu/openbook.php?record_id=2113&page=1 External Web Site Policy
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