Teens and tweens are basically healthy, but they still face to steep risks that call for regular medical checkups. Too many aren't getting that care.
The roughly 40 million Americans ages 10 to 19 are basically healthy most of the time. But they're also more likely than most other age groups to die from accidents, homicide and suicide and at high risk for sexually transmitted diseases, drug abuse and eating disorders.
Parents may assume that their teens will go online or to peers for health guidance before turning to almost any adult. Besides, the expectation is that few teens want to see a doctor unless they're sick.
But a recent survey on perceptions of teen health suggests those assumptions are wrong.
On behalf of the National Foundation for Infectious Diseases, market research firm Harris Interactive surveyed youths ages 13 through 17, parents of teens in that age group, and health providers -- slightly more than 2,300 in all.
In general, the teens said when they worry about something, they mainly turn to parents (67 percent of the time) and friends (59 percent of the time). But 43 percent said they consider health care providers to be their most trusted source for health information. Still, 40 percent also said they don't like talking to doctors or other health providers, and 50 percent of the teens do go online for health information.
Only 28 percent of parents thought their teens worry much about their health; but 66 percent of the teens say they "worry a lot" about staying healthy. And while doctors say teens need annual medical checkups as much as younger children do, just 61 percent of the parents felt screening visits were necessary.
Other surveys done by the U.S. Department of Health and Human Services and the Census indicate at least a third of teens are not getting annual health screenings.
Physicians in the NFID survey, which was backed financially by the drug firm Pfizer Inc., also noted that teens and parents are more likely to ask about weight, sexual health, vaccines and mental health issues during a routine checkup than during a sick visit.
Parents' and teens' ambivalent attitudes about checkups are just part of the problem. A 2008 report from a committee set up by the Institute of Medicine noted that the nation's office-based system of primary care doctors is ill-equipped to deal with many health needs of adolescents, particularly those related to mental health or substance abuse.
Many teens rebel at continuing to see a pediatrician. And it's hard for them to get appointments with other primary-care doctors without missing school or other activities.
And a 15-minute office visit offers little chance for probing teen concerns about their bodies and what they're doing with them. Several recent studies have shown that primary-care doctors often don't know what to do about substance abuse problems in patients of any age, even if they identify them.
Another national survey published earlier this month by the University of Michigan and the W.K. Kellogg Foundation found that only 30 percent of adults who work and volunteer with children and teens think their community has "lots of availability" in mental health care for those age groups.
Many teens seek care from "safety net" providers like school clinics, community health centers or emergency rooms. A quarter of the teens in the NFID survey said they've gone to adults in their school -- such as a nurse, guidance counselor or a teacher -- for health information and advice.
While experts say it's better if teens are comfortable enough with their parents to talk about health problems, having any caring adult on their side is a plus. But patients of all ages are generally better off having a steady relationship with a health professional.