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Problem Behavior of Adolescents

The health problems of adolescents have recently become the focus of new and unprecedented attention by public health officials and physician organizations. By traditional outcome measures of morbidity and mortality, the health status of adolescents in the United States is excellent. Outpatient physician use and hospital discharge rates for the age group 11 to 20 years remain the lowest of any age cohort.¹ Because of these low frequency utilization rates and apparent excellent health status, the pediatrician has a major challenge: how to identify emergent problems in his or her preadolescent and adolescent patients.

These data concern primarily short-term, medical outcomes and provide little information about rates of chronic medical and psychologic disability, rates of change of behaviors during the second decade of life, and, most important, behavior-related problems, which often have their onset during adolescence. A different picture of adolescent health emerges when the causes of mortality are assessed. In 1986, 80% of the deaths in this age group were from accidents, homicides, and suicides—an increase from 51% in 1950. Furthermore, when the rate of change of mortality is evaluated during the second decade, there is a 200% increase, the largest in any single decade of the lifespan.² Although hospitalization rates are low in this age group, leading discharge diagnoses, excluding pregnancy-related causes, are injuries and poisonings.

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				A. Valadez-Meltzer, T. J. Silber, A. A. Meltzer, and L. J. D'Angelo Will I Be Alive in 2005? Adolescent Level of Involvement in Risk Behaviors and Belief in Near-Future Death Pediatrics, July 1, 2005; 116(1): 24 - 31. [Abstract] [Full Text] [PDF]