Caring For Those in the Second Decade of Life

There are more than 42 million adolescents between the ages of 10-19 in the United States. Worldwide one in six people is a teenager. As recently noted by the World Health Organization, “Promoting healthy practices during adolescence, and taking steps to better protect young people from health risks are critical for the prevention of health problems in adulthood, and for countries’ future health and social infrastructure.” In other words, if we want to keep our communities healthy, teen health is essential.

Since the mid-20th century, the health field has recognized the unique needs of adolescents and their right to developmentally appropriate services that openly address the health and behavioral realities of teen life. Today, adolescent medicine is an established field as a sub-specialty of pediatrics. MDs with training in pediatrics, family medicine, or internal medicine can enter adolescent medicine fellowship programs.

Mount Sinai Adolescent Health Center, today one of the largest adolescent-specific health centers in the country, was founded in 1968 with the belief that adolescents needed safe, nurturing, and non-judgmental health services. The Mount Sinai Adolescent Health Center respects each patient’s right to confidentiality and privacy, and services are provided through a personal relationship-based dynamic that takes into account each adolescent’s “voice” and integrates medical, sexual and reproductive, dental and mental health, as well as health education.

As they have throughout time, adolescents face many challenges. In the U.S. more than half of high school students engage in two more risk behaviors, and nearly a quarter engage in four or more. Today, in the U.S. almost two-thirds of teenagers are sexually active by grade 12 yet only 59 percent of those report using a condom. Forty one percent of U.S. teens text or email while driving; 41 percent spend three or more hours a day on the computer; 29 percent report persistent sadness and 14 percent have seriously considered suicide. Behavioral patterns established during the second decade of life influence not only the current health status of adolescents but their health throughout adulthood. Yet while adolescents represent roughly 14 percent of the population of the US, their proportion of medical and mental health visits is far lower than that. In the U.S. adolescents and young adults as a group are the population least insured, with black adolescents 40 percent more likely to be uninsured and Latino adolescents 300 percent more likely to be uninsured than white counterparts.

Sustained intervention by health care providers and public health messaging can be effective – as long as young people also have access to developmentally-appropriate, high quality health care that continues to evolve to meet their changing needs. At Mount Sinai Adolescent Health Center, we provide free, comprehensive services without barriers to more than 11,000 patients annually. Ninety-eight percent are poor, 92 percent are young people of color and 70 percent are uninsured; most have experienced violence and trauma. Yet they have significantly better outcomes across multiple measurements, including lower pregnancy and school drop-out rates, and higher vaccination rates, than others from a similar demographic in New York City. They also access health care services much more frequently, providing the opportunity for ongoing health education.

Adolescents are the barometer by which we can measure the health of our society. Ensuring their health is essential and must be a priority if we are to have a population with life-long health and social well-being. When a young person understands the link between their choices and their health, then they can make sound decisions that keep them healthier throughout life. Healthy teens mean healthy communities in the future. When adolescents do well, society does well.

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Angela Diaz, MD, MPH

Director, Mount Sinai Adolescent Health Center

Jean C. and James W. Crystal Professor of Pediatrics and Preventive Medicine at the Icahn School of Medicine

Angela Diaz, MD, MPH, is the Director of the Mount Sinai Adolescent Health Center (MSAHC) and the Jean C. and James W. Crystal Professor of Pediatrics and Preventive Medicine at the Icahn School of Medicine at Mount Sinai. Dr. Diaz is an internationally recognized leader in the field of adolescent health whose work and life mission as a physician, teacher, researcher and advocate has reduced health disparities and improved health outcomes for adolescents around the globe.

Sources:

World Health Organization, “Health for the World’s Adolescents”, May 2014

http://apps.who.int/adolescent/second-decade

National Adolescent Health Information Center 2011

YRBS 2013 Report

http://www.cdc.gov/mmwr/pdf/ss/ss6304.pdf

National Alliance to Advance Adolescent Health, 2010

 

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