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A generation at risk.

Among the 31 million adolescents between ten and eighteen years old in the U.S., one in seven had no health insurance in 1988; one in three poor adolescents had no Medicaid coverage. Those who do have access to care rarely deal with providers who have any special training in or commitment to working with young people. To assess the state of adolescent health care, the Office of Technologhy. Assessment looked not only to statistics and policy reports, but invited comment from a panel of ten- to nineteen-year-old consultants as well.

Issues of parental consent, confidentiality, and the lack of appropriately trained providers raise special obstacles for older children and teenagers, according to the report released in April by the OTA (Adolescent Health. Vol. 1. Summary and Policy Options, U.S. Government Printing Office). And while all adolescents face similar difficulties, those who are poor and members of ethnic or racial minorities are doubly vulnerable, at higher risk for health problems and less likely to have access to care.

The OTA offers several strategies for improving health care for the nation's young people, recommending especially the development of school-linked or community-based centers to offer comprehensive health and related services. Such centers can offer early intervention for free or at low cost, by staff knowledgeable about and committed to helping adolescents, during realistic evening and weekend hours. Involving adolescents in designing and managing services can increase the effectiveness of school- or community-based clinics.

Adolescent Health also recommends that Congress improve adolescents' legal access to health services, perhaps by drafting model legislation on consent and confidentiality to guide state statutes, or by conditioning federal monies on states drafting appropriate statutes. Similarly, the report urges increased federal support for training health care providers to work with young people.

As Congresswoman Pat Schroeder (D-Col.) remarked, "With this report, OTA is issuing us a warning -- adolescence may be hazardousd to our children's health. We must heed the warning . . ."
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Title Annotation:report on state of adolescent health care and health insurance coverage from the Office of Technology Assessment recommends improvements
Author:Crigger, Bette-Jane
Publication:The Hastings Center Report
Date:May 1, 1991
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