1. Claire Brindis, Dr. P.H. University of California, San Francisco American Public Health Association- Annual Meeting November 10, 2004 Adolescent Health: Promising Directions for the 21 st Century

2. Adolescents & Young Adults – A 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.

3. Adolescents & Young Adults – Who 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 US Population, Ages 10-19, 1980-2050 # in thousands

4.   Young people are a diverse group – racial/ethnic diversity among youth exceeds that of adult population. Race/Ethnicity of US Population vs. Ages 10-19, 2000 Adolescents & Young Adults – Who are They?

5.  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 Adolescents & Young Adults – Who are They? # in thousands

6. Underlying 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.

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

8. Who Needs to Be Involved? Recognize involvement of all societal sectors influencing health: Adolescents & Young Adults Government Agencies Employers Post-Secondary Institutions Media Faith-based Organizations Community Agencies Health Care Providers Schools Parents & Families

9. Special 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.

10. Policy and Research Analyses and Direction 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).

11. Future 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.

12. Future 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.

13. Future 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.

14. Create a National Agenda for Young 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.

15. EXAMPLE: The National Initiative to Improve Adolescent Health by the Year 2010 & 2010 Guide

16. What is the National Initiative?  A collaborative effort to improve the health, safety, and well-being of adolescents and young adults (ages 10-24).  Launched in a unique partnership of two federal agencies: Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) & Health Resources and Services Administration’s Maternal and Child Health Bureau’s Office of Adolescent Health (HRSA-MCHB-OAH) and other National Partners.

17. Grounded in Healthy People 2010  A comprehensive set of national disease prevention and health promotion objectives that measure the nation’s progress over time  Two overarching goals of Healthy People 2010:  Increase quality and years of life  Eliminate health disparities www.healthypeople.gov

18. National Initiative Goals  21 Critical Health Objectives for Adolescent & Young Adult Health:  Include individual health outcomes (injury, disease & death) as well as related behaviors (e.g., substance abuse, physical activity, safety belt use).  21 Objectives fall into six general areas:  Mortality,  Unintentional Injury,  Violence,  Mental Health and Substance Abuse,  Reproductive Health,  Chronic Disease Prevention.

19. Goals: Beyond 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.

20. Improving the Health of Adolescents and Young Adults  One of the Healthy People 2010 “Companion Documents”  Also available:  Healthy Campus 2010: Making It Happen  Healthy People 2010: Reproductive Health  Rural Healthy People 2010: A Companion Document for Rural Areas http://www.healthypeople.gov/Implementation/compdocs.htm

21. Purpose   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

22. Resources   National Initiative to Improve Adolescent Health by the Year 2010   http://www.cdc.gov/HealthyYouth/NationalInitiative   http://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!