Significant Health Problem Facing California - Case Study Example

Health Policy Research Brief Adolescent Health: A Social Imperative for California’s Future One major component of a sound society is the sound health of its adolescents; the sound health of its future. It is of paramount importance that adequate mechanism must be in place to address this important issue, which determines the well being of the society at large. The health and well-being of California teens has a major impact on the overall social and economic health of our state. Today’s teens are tomorrow’s workforce, parents, and leaders, and their future is shaped by the opportunities we create for them today. Most parents make significant personal investments in their children’s future. Yet as a society, we are not making adequate investments necessary to ensure the health and well-being of all of our youth. During adolescence, young people confront new issues that affect their physical and mental health. These could be attributed to a number of varying factors. Similarly, young adults continue to experience many of the same challenges to their health and well-being. The health issues of teens and young adults are easy to overlook because they are not, for the most part, acute illnesses or chronic diseases. Instead, they are largely behavioral and social issues. Unlike the issues related to general health conditions that confront the society at large, adolescent’s health problems relate more to the lacuna in the societal interventions. Adolescents confront health issues that have multi-dimensional characteristics and implications. Addressing these issues requires change at multiple levels—from service delivery, to funding priorities, to community resources and environments, and, more fundamentally, to the behavior and attitudes of California’s adults. The World Health Organization’s definition can be taken as the standard in all areas of public health. According to the World Health Organization, health is defined as more than just the “absence of disease,” but rather a state of “complete physical, mental, and social well-being.” This broad definition has a lot of significance to adolescent health. Adolescent health encompasses not only the prevention and treatment of disease and disability. It features behavioral and social issues on an equal scale. Issues of safety, social relationships, self-esteem, education and skill development all figure into good health of adolescents. Thus, to make progress in improving adolescent health, a combination of perspectives and approaches is needed. Besides the disease components, interventions must address societal and behavioral issues. California’s adolescent population is growing at a very fact pace. It is estimated that between 1995 and 2005, the number of youth ages 10 to 19 in California will grow from 4.4 to 6.0 million—a 34% increase. By contrast, this age group will grow by only 13% nationally. This is an alarming rate of growth for a particular segment of population. California’s adolescent population, already among the most ethnically diverse in the nation, will become even more diverse. While the number of white youth will grow by 16%, the number of African American youth will grow by 22%, Asian youth by 45%, and Latino youth by 61% (Figure 1). The Native American youth population will grow by only 2%. Because the sheer number of adolescents in the state is increasing, we can anticipate growing demands on the service system. Furthermore, the increase in population in a particular population segment is equally alarming. and because this increase is greater among groups that often have poorer health outcomes and less access to health care, Growth in California’s Adolescent Population: Figure 1 Source: California Department of Finance, Race/Ethnic Population With Age and Sex Detail, 1970-2040 This tremendous increase in demography is equally matched by an alarming risky health status of youth. As against the major diseases and risky lifestyles that plague the adults in the society, deaths among youth are primarily caused by inadequate healthcare interventions. An analysis of the leading cause of death among adolescents depict that all of them are preventable (Figure 2). Source: California Department of Health Services, Vital Statistics, 1998 The Challenge The tremendous social, economic, and demographic changes that lie ahead place our state at an important crossroads. We are at a very important juncture where the decision we make today is going to affect the present and future well being of our state. The challenge is to ensure that all of California’s teens have the supports they need for healthy development and a smooth transition to adulthood. Meeting this challenge will require significant improvements in infrastructure, service systems, and community-level supports. Continuing past policies and approaches that often ignore the multidimensional needs and assets of youth is unlikely to produce significant changes. However, if we combine forces, and begin to seriously address the social, cultural and economic factors that shape adolescent health, there is tremendous potential to improve the health of our teens and our society. Recommendations: Throughout the state, there is a significant amount of work taking place to improve the health and well-being of adolescents. This work includes broad initiatives, policy reforms, and service programs, as well as informal and personal efforts. In addition, a number of strategic plans have laid out priorities for various specific issues in adolescent health. However, we must tread with caution. We must table all viable alternatives for in-depth reviews, consultations and discussions. All policy alternatives must be properly studied before deciding on any one of them. Furthermore, in developing a comprehensive adolescent health strategic plan, it was important that the plan be consistent with existing strategies, but also that it has added value, rather than simply repackaging the same messages under a new cover. Thus, efforts must be geared towards addressing the factors that are common to many adolescent health issues. Rather than picking up some unique cases, policy directive must target those issues which are generating substantial social and economic burden. The five core recommendations have been outlined as follows to direct a viable and appropriate policy toward this end: 1. Making youth a policy priority: Generally, providing decision making capacity to the ultimate beneficiaries has proved effective in various initiatives. Involving young people in the policy process is a critical step toward the creation of public policy that supports adolescent health. Young people have firsthand knowledge of their school, family, and community environments which should form the basis of policies that impact youth. They can conduct youth outreach and collect data in ways that adults cannot. Moreover, youth often provide practical and fresh perspectives that challenge the traditional thinking. Their desire to look beyond traditional platforms and their ability to give a firsthand account of the issues make youth effective in taking charge of their own health issues, besides attracting the attention of policymakers and the media towards this end. 2. Improving services and access to service: Involving youth in the design of services and delivery can greatly enhance the usage of medical, health education and other services. Youth have a better knowledge of their own critical requirements and can play a very important role in the design and delivery of critical services. Recent approaches include involving teens as peer health educators, and as members of planning groups. However, although the involvement of peers as staff or educators has been successful, it does not appeal to all teen patients. Some teens are more comfortable with people whom they are less likely to see in other settings. There are also a host of societal influences and implications associated with youth themselves providing the services. Efforts must be geared towards promoting comprehensive, high-quality health care, and improving the skills of adolescent health providers. Healthcare should be made easy and comfortable for all teens to access and adolescents must be involved in the planning and delivery of health services. They must be empowered to make decisions for themselves thereby generating the most effective health outcomes of the state directed health policies. 3. Design schools to promote health and development: Schools are important environments for the growth and development of teens. Schools should provide youth with academic and vocational skills, a secure environment that facilitates healthy choices, comprehensive health education, and opportunities to make a contribution to the school and community. This would foster good health among the adolescents and, thereby, ensure healthy development of youth. 4. Build stable families that can support teens: The family is a critical determinant of adolescent health. The role of families in assuring a successful transition through adolescence into adulthood is well established. The family often serves as one of the most important elements in an adolescent’s life, creating the initial environment in which they receive emotional, social, and economic support. Adolescents spend maximum of their time with their families and the domestic environment play a critical role in determining their social and emotional health. Supportive family relationships protect youth against many different kinds of health risks, including emotional distress and suicidal thoughts and attempts, use of addictive and harmful substances, violent behavior, and early sexual activity. 5. Build strong public support for investment in youth: Adolescents require requires consistent health and social support. This is an area where public policy support plays a major role. Political will to make these investments and to prioritize the needs of youth is often lacking. Controversy over adolescent behaviors, especially early sexual activity and substance use, makes it difficult to reach a consensus on how to approach some of these issues. As a result, it is challenging to develop a strong, unified public position in support of youth. Although progress will come incrementally by improving service delivery and prevention strategies, the impact of these efforts can be magnified many times if we, as a society, begin to think differently about our youth. The public generally supports programs and policies that support youth, such as education and after-school programs. This type of public support must be strengthened to create the political will needed for long-term commitment to investing in youth. This commitment is critical to the success of all of the recommendations stated above. References California Youth Authority. Population Movement Summary: Fiscal Year 1997-98. Retrieved 11/10/99 from the World Wide Web: http://www.cya.ca.gov/facts/pop_move_9798.html Hedberg, V., Bracken, A., & Stashwick, C. (1999). Long-term consequences of adolescent health behaviors: Implications for adolescent health services. Adolescent Medicine: State of the Art Reviews, 10(1). Greene, J., Ringwalt, C., Kelly, J., Lachan, R., & Cohen, Z. (1995). Youth with Runaway, Throwaway, and Homeless Experiences: Prevalence, Drug Use, and Other At-risk Behaviors. Washington, DC: U.S. Department of Health and Human Services, Agency on Children, Youth and Families. Irwin, C. E., Jr., Igra, V., Eyre, S. (1997). Risk-taking behavior in adolescents: The paradigm. Annals of the New York Academy of Sciences, 817, 1-35. McGinnis J. M., & Foege, W. H. (1993). Actual causes of death in the United States. Journal of the American Medical Association, 270(18), 2207-2212. National Adolescent Health Information Center. (1998). Assuring the Health of Adolescents in Managed Care. San Francisco, CA: University of California, San Francisco, National Adolescent Health Information Center. U.S. Department of Health and Human Services. (1989). Reducing the Health Consequences of Smoking: 25 years of Progress: A Report of the Surgeon General (DHHS Publication No. (CDC) 89-8411. 4004859897). Washington, DC: U.S. Government Printing Office. Read More