Nearly one in five teens has specific health care needs that are not receiving attention, and this may set them up for poorer physical and mental health in adulthood, a new study contends.
“Previous research had shown that lack of medical care in this age group is associated with poor health and higher risk behaviors at the time. But, it wasn’t known that these poor health outcomes persisted into adulthood,” said lead author Dr. Dougal Hargreaves, a pediatrician and health services researcher at University College London, England, and at Boston Children’s Hospital.
The study was published online Aug. 17 in the journal Pediatrics.
The researchers analyzed data from 14,800 participants in a long-term U.S. study of teen and adult health. The teens first answered questions in 1994-1995 when they were, on average, 16 years old. Then they responded in another questionnaire in 2008 when they were about 30 years old.
In the teenage questionnaire, 19 percent reported they had some kind of health care need that did not get treatment.
“Teenagers have the same broad range of health needs as other age groups,” Hargreaves said. These include acute infections, skin problems or headaches, and long-term conditions such as asthma, diabetes or epilepsy. Teen needs also include mental health problems and preventive care, such as immunizations and obesity prevention.
“Some health problems are particularly common in adolescence,” Hargreaves said. “For example, anxiety, depression and other mental health problems often start in adolescence and early adulthood, but many young people experience long delays in getting the help they need.”
The researchers focused on five areas of health problems when the teens reached adulthood: having overall poor health, difficulty with everyday activities, taking extra time off work or school, depression symptoms, and suicidal thoughts.
Those who had unmet health needs in adolescence were more likely to experience all of these negative adult experiences except taking more time off work.
“Attitudes to health and health care are often established in adolescence and young adulthood,” Hargreaves said. “Our study found that individuals who didn’t get in the habit of accessing health care appropriately as adolescents continued not to access the care they needed as adults.”
Adults whose teenage health issues weren’t addressed had 52 percent greater odds of having difficulty doing everyday activities, such as moving furniture, going bowling, or walking a short distance, compared to the other study participants.
The adults with unmet needs as teens also had 27 percent greater risk of having only fair or poor health, 36 percent greater odds of depression symptoms and 30 percent greater odds of suicidal thoughts.
The reasons teens were not getting the care they needed was varied, but only 15 percent cited cost.
Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, Calif., said, “The most surprising finding in this study was that the unmet health needs existed across all socioeconomic groups.
“Teen health issues are important even if there is no obvious functional impairment,” Fisher explained. “Adolescents sometimes seek to hide destructive behaviors, and other times they ask for help.”
While the study only found an association rather than a cause-and-effect link, there are several possible reasons why these teens with unmet health needs have a harder time in adulthood, Hargreaves said. It may be that a serious or long-term health condition becomes worse when it’s not addressed early on. Or teens may get into a habit of not seeking health care when they need it.
Hargreaves suggested three ways to better address teens’ health needs. One is ensuring that high-quality, confidential health care services exist for young people. Another is for policymakers, insurance companies and care providers to make sure all teens have access to this care.
“Thirdly, many young people miss out on medical care due to embarrassment, lack of engagement with their health or lack of knowledge about when a health problem might be serious,” Hargreaves said. “This is a wider issue which needs to be addressed by parents, community groups, charities, schools and media organizations, as well as by health care professionals.”
The U.S. Centers for Disease Control and Prevention has more about adolescent health.