Accessing Health Care

Adolescence is a time when youth begin making independent choices concerning their own health and health care, considering physical, mental and dental issues. Their experiences can have lifelong effects, so it is important that the care they receive is timely, appropriate, easily accessible and affordable. Because most adolescents are generally physically healthy, we tend to take their health for granted. However, adolescents do have particular health needs. Adolescent health concerns include skin conditions, weight and nutrition, vision concerns, dental and orthodontia concerns (see Chapter VIII), conditions of the spine, reproductive issues, common viral diseases such as infectious mononucleosis and meningitis and access to immunization services. They also commonly need services for mental health, substance abuse and social development issues. Health promotion and injury prevention services are critical during this phase of development.

These behaviors are commonly initiated during adolescence. Unfortunately, if not prevented, these behaviors initiated during adolescence often extend into adulthood and have serious consequences for long-term health status. Virtually every early death in adolescence is preventable, and many adult chronic health conditions find their genesis in these preventable adolescent risk behaviors. If adolescents have a regular source of health care, a “medical home”, they are more likely to receive preventive services as well as guidance for a healthy lifestyle.

A medical home approach, as opposed to receiving health care through an emergency room or urgent care facility will offer an opportunity where a person can form a relationship with a health provider. Teens will likely feel more comfortable with a health care provider who knows their situation and respects their choices.

This will build their confidence in the health care system so they can access care in a timely and appropriate manner. Because teens are changing so rapidly in their physical, social and emotional development, health experts recommend that adolescents (up to age 21) have an annual, routine preventive visit. These regular visits to a health practitioner are opportunities to detect potential health problems early on, especially if there is a family history of poor health or chronic disease.

Equally as important, they offer opportunities for preventive counseling to the adolescent and his or her family. However, adolescents are the group of children who are least likely to be insured and most likely to “under-use” primary and preventive health services. They face substantial barriers in entering and using the health care system, often missing opportunities to improve their health. The major barrier is cost. Other factors impeding access include geography and lack of transportation, a shortage of providers trained in adolescent specialties and limited provider participation in subsidized care.