Claire Brindis, Dr. P.H. University of California, San FranciscoAmerican Public Health Association- Annual MeetingNovember 10, 2004

Adolescent Health: Adolescent Health: Promising Directions for the Promising Directions for the 2121stst Century Century

Adolescents & Young Adults – Adolescents & Young Adults – A Time of DevelopmentA Time of Development

Critical period of life, major transition from childhood to adulthood.

Some common behaviors (e.g., alcohol and tobacco use, nutrition, physical activity) which start during adolescence, contribute to leading health problems as adults.

Opportunity to promote positive development and a lifetime of healthy behaviors.

Adolescents & Young Adults –Adolescents & Young Adults – WhoWho are They? are They?

By 2020, there will be 42 million young people ages 10-19 in the US, which represents 13% of the total population Increase from 35 million in 1990

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1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050

US Population, Ages 10-19, 1980-2050

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Young people are a diverse group – racial/ethnic diversity among youth exceeds that of adult population.

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White-NH Hispanic Black-NH A/PI-NH AI/AN-NH Other

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Ages 10-19

Race/Ethnicity of US Population vs. Ages 10-19, 2000

Adolescents & Young Adults –Adolescents & Young Adults – WhoWho are They? are They?

The racial/ethnic diversity among young people will increase: The White, non-Hispanic youth population will decrease

by 21% between 2000 and 2040.

Race/Ethnicity of Adolescents Ages 10-19, 2000 & 2040

62.9

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15.6

27

14.5 13.7

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White/NH Hispanic Black/NH A-PI/NH AI-AN/NH

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Adolescents & Young Adults –Adolescents & Young Adults – WhoWho are They? are They?

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Underlying PhilosophyUnderlying Philosophy

Reducing behaviors that jeopardize health and safety and improve health outcomes are important–but not enough.

Fostering healthy youth development is integral to improving adolescent and young adult health.

Critical to create a healthy environment, and not focus exclusively on changing individuals to assure health outcomes.

Adopting a Lifespan, Developmental Adopting a Lifespan, Developmental Approach from Middle Childhood to Approach from Middle Childhood to

Young Adulthood (Ages 6-24)Young Adulthood (Ages 6-24)

A societal commitment is critical for creating a positive environment that supports healthy youth development and promotes healthy behaviors.

The involvement of diverse organizations and institutions is necessary for success.

Who Needs to Be Involved? Who Needs to Be Involved?

Recognize involvement of all societal sectors influencing health:

Adolescents & Young Adults

GovernmentAgencies

Employers

Post-SecondaryInstitutions

Media

Faith-basedOrganizations

CommunityAgencies

Health Care Providers

Schools

Parents & Families

Special ChallengesSpecial Challenges

Expanding definition of what constitutes health, including well-being.

By most traditional markers, healthy indicators.

Most significant threats pertain to risky behavior.

Focus on individual health problems, but increased emphasis on positive development and environmental influences on health.

Many health problems are inter-related and have common etiologies –yet our approaches tend to be narrow in focus.

Policy and Research Analyses and Policy and Research Analyses and Direction Across the LifespanDirection Across the Lifespan

Recognize special populations and how programs and policies are shaped for each:

Demographically-defined,

Legally-defined (incarcerated, foster care, migrant groups),

Chronic conditions (physical, emotional),

Other populations (unique qualities, such as homeless, pregnant and parenting).

Future Directions - ResearchFuture Directions - Research

Need for population-based research focusing on:

Trends and policies that affect environmental influences and healthy development – from family policies to community-interventions at the individual, family, peer, school, community, media, and policy levels.

Future Directions - ResearchFuture Directions - Research

Collect data on indicators of well-being, ways that societal institutions contribute to health, preventive services, coordinated care.

Research supports young people need to navigate transitions successfully (from childhood into adolescence; adolescence into young adulthood).

Conduct further research of the role of families, youth-serving organizations, faith-based institutions and other community influences on adolescent behaviors to develop more effective prevention interventions.

Future Directions - PolicyFuture Directions - Policy

Transition readiness – what policies, programs, etc. are needed to assure smooth transitions (for example, school readiness)?

Influence of youth development, supportive environment on adolescent risk-taking behaviors.

Need developmental and environmental indicators to supplement the current focus on individual health status.

Create a National Agenda for Create a National Agenda for Young PeopleYoung People

Identify priorities.

Networks of interest groups.

Data collection to monitor comprehensive health status (resiliency; protective indicators).

Analyze extent to which policies and programs are developed and sustained.

Developmentally appropriate.

Inclusive of special populations within each age group.

EXAMPLE:EXAMPLE:The National Initiative to Improve The National Initiative to Improve

Adolescent Health by the Year 2010Adolescent Health by the Year 2010 & & 2010 Guide2010 Guide

What is the National Initiative?What is the National Initiative?

A collaborative effort to improve the health, safety, A collaborative effort to improve the health, safety, and well-being of adolescents and young adults and well-being of adolescents and young adults (ages 10-24).(ages 10-24).

Launched in a unique partnership of two federal Launched in a unique partnership of two federal agencies: Centers for Disease Control and agencies: Centers for Disease Control and Prevention’s Division of Adolescent and School Prevention’s Division of Adolescent and School Health Health (CDC-DASH)(CDC-DASH) & Health Resources and & Health Resources and Services Administration’s Maternal and Child Services Administration’s Maternal and Child Health Bureau’s Office of Adolescent Health Health Bureau’s Office of Adolescent Health (HRSA-MCHB-OAH) and other National Partners(HRSA-MCHB-OAH) and other National Partners..

Grounded in Healthy People 2010Grounded in Healthy People 2010

A comprehensive set of national A comprehensive set of national disease prevention and health disease prevention and health promotion objectives that measure promotion objectives that measure the nation’s progress over time the nation’s progress over time

Two overarching goals of Healthy Two overarching goals of Healthy People 2010: People 2010: Increase quality and Increase quality and

years of lifeyears of life Eliminate health Eliminate health

disparitiesdisparities

www.healthypeople.gov

National Initiative GoalsNational Initiative Goals

21 Critical Health Objectives for Adolescent & 21 Critical Health Objectives for Adolescent & Young Adult Health:Young Adult Health: Include individual health outcomes (injury, disease & Include individual health outcomes (injury, disease &

death) as well as related behaviors (e.g., substance death) as well as related behaviors (e.g., substance abuse, physical activity, safety belt use).abuse, physical activity, safety belt use).

21 Objectives fall into six general areas:21 Objectives fall into six general areas: Mortality,Mortality, Unintentional Injury,Unintentional Injury, Violence,Violence, Mental Health and Substance Abuse,Mental Health and Substance Abuse, Reproductive Health,Reproductive Health, Chronic Disease Prevention.Chronic Disease Prevention.

Goals:Goals:Beyond the 21 ObjectivesBeyond the 21 Objectives

Reduce disparities among adolescents and young adults.

Increase adolescents’ and young adults’ access to quality health care, in areas including:

Comprehensive general health,

Oral health,

Mental health, and

Substance abuse prevention and treatment.

Improving the Health of Improving the Health of Adolescents and Young AdultsAdolescents and Young Adults

One of the Healthy People 2010One of the Healthy People 2010 “Companion Documents”“Companion Documents”

Also available:Also available: Healthy Campus 2010: Healthy Campus 2010:

Making It HappenMaking It Happen Healthy People 2010: Healthy People 2010:

Reproductive HealthReproductive Health Rural Healthy People Rural Healthy People

2010: A Companion2010: A CompanionDocument for RuralDocument for RuralAreasAreas

http://www.healthypeople.gov/Implementation/compdocs.htm

PurposePurpose

To help guide state and local agencies and organizations in: Community coalition building Needs-and-assets assessment Priority Setting, Program Planning,

Implementation, and Evaluation

To build national efforts for improving adolescent health

ResourcesResources National Initiative to Improve Adolescent Health by the

Year 2010http://www.cdc.gov/HealthyYouth/NationalInitiativehttp://nahic.ucsf.edu/nationalinitiative

2010 Guide/Companion Document

Order It! http://www.cdc.gov/HealthyYouth/NationalInitiative/order/

Download it!

http://nahic.ucsf.edu/2010guide

Partner Resources

National Initiative Core Partners Resources and Activities – a searchable database, coming soon on NAHIC web site!