Review article
Trends in Adolescent and Young Adult Health in the United States

https://doi.org/10.1016/j.jadohealth.2009.03.013Get rights and content

Abstract

This review presents a national health profile of adolescents and young adults (ages 10–24). The data presented include trends on demographics, mortality, health-related behaviors, and healthcare access and utilization, as well as the most significant gender and racial/ethnic disparities. Although the data show some improvement, many concerns remain. Encouraging trends—such as decreases in rates of homicide, suicide, and some measures of reproductive health—appear to be leveling off or, in some cases, reversing (e.g., birth and gonorrhea rates). Large disparities, particularly by race/ethnicity and gender, persist in many areas. Access to quality healthcare services remains a challenge, especially during young adulthood. Policy and research recommendations to improve health during these critical periods in the lifespan are outlined.

Section snippets

Methods and Presentation of Data

The Healthy People 2010 21 Critical Objectives for Adolescents and Young Adults guided the selection of health topics and age groupings. These objectives were selected by a federally convened panel who chose from the 108 Healthy People 2010 objectives addressing ages 10 to 24 [5]. The objectives span six areas, which we adapt to present the results: mortality; unintentional injury; violence; substance use and mental health; reproductive health; and overweight, exercise, and diet. We also review

Health Status

By traditional measures, adolescents and young adults are healthy. Virtually all adolescents ages 10 to 17 (98.1%) and young adults ages 18 to 24 (96.3%) report being in excellent, very good, or good health [16].

Healthcare Utilization and Access

Adolescents and young adults rely primarily on outpatient care and have low rates of hospitalization. Table 4 provides data on healthcare access and utilization. Most adolescents and young adults saw a clinician and dentist in the past year, although dental visits were fairly low among young adults (60.6%) [16].

Conditions accounting for healthcare visits are fairly similar for adolescents and young adults [46]. Females' reproductive healthcare dominates service utilization. Pregnancy-related

Discussion

Although this review shows improvement in several areas, concerns remain. Encouraging trends appear to be leveling off. Rates of MVA mortality, homicide, and suicide have changed little since the late 1990s. Since 2005, the teen birth rate increased for the first time since 1990. Moreover, these data show continuing disparities in almost all indicators of health. Blacks continue to have the highest homicide rates, and American Indians/Alaskan Natives have the highest suicide and MVA death

Summary and Implications

This review presents a compelling case for strengthening policies, practices, and programs to improve health during these critical periods of the life span. Several national consensus reports call for comprehensive approaches to improve adolescent health [5], [62], [63], [64], [65], [66]. However, many features of the nation's political system—including the categoric nature of funding and the mix of local, state, and federal jurisdiction over different aspects of policy—make it challenging to

Acknowledgments

This research was supported by grants awarded to Dr. Irwin from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (U45MC 00002 and U45MC 00023).

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