Reforms Needed in Health Care Services for Adolescents, Including Greater Coordination of Care and Better Training for Providers

WASHINGTON -- Current health services for adolescents are fragmented and poorly designed to meet the health needs of all of the nation's adolescents, says a new report from the National Research Council and Institute of Medicine.

Although most U.S. adolescents are healthy, many engage in risky behavior, develop unhealthy habits, and have physical and mental conditions that can jeopardize their immediate and future health. Health care providers need better training in how to meet the specific health needs of those aged 10 to 19, said the committee that wrote the report.

"Adolescents have unique health care needs, and our health system should not approach their care the same way it does children or adults," said committee chair Robert S. Lawrence, CLF director and professor of environmental health sciences and health policy at the Johns Hopkins Bloomberg School of Public Health. "As policymakers discuss how to restructure the way health care is delivered in the U.S., the distinct problems faced by adolescents -- such as risky behavior -- deserve particular attention. And because adolescence is a critical period for developing habits that build a strong foundation for health throughout one's entire life, services need to focus on promoting healthy behaviors, preventing disease, and managing health conditions."

Some young people, particularly those who are uninsured or underinsured, have little or no access to mainstream primary care services; they rely largely on "safety-net" settings, such as hospitals, community centers, and school-based health centers for their care, the report says. In fact, adolescents are in the age group most likely to rely on emergency departments for routine health care.

The various services and providers that are needed and used by adolescents are often fragmented, resulting in gaps in care, the report says. For example, specialty services in mental health, sexual health, oral health, and substance abuse treatment are not accessible to most adolescents.

The full report is available from the National Academies web site.