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June 26, 1987, Vol 257, No. 24 >
ARTICLE | June 26, 1987

Contemporary Threats to Adolescent Health in the United States FREE

Robert Blum, MD, PhD
[+] Author Affiliations

Reprint requests to the Adolescent Health Program, Box 721, University of Minnesota Hospital and Clinic, Harvard Street at East River Road, Minneapolis, MN 55455 (Dr Blum).


JAMA. 1987;257(24):3390-3395. doi:10.1001/jama.1987.03390240096031
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References

Over the past 30 years, adolescents have been the only population in the United States who have not experienced improvement in their health status. Violence has replaced communicable diseases as the primary cause of juvenile mortality and, currently, over 77% of adolescent deaths are caused by accidents, suicide, and homicide. Increasingly, poverty, life-style, and risk-taking behaviors are influencing the morbidities of youth, with associated sequelae of trauma, adolescent pregnancy, substance abuse, physical/sexual abuse, and most other major health problems of adolescents. Clinicians seem to be interested in addressing the shifting nature of adolescent morbidity, yet are insufficiently trained to be effective. The physician must go beyond traditional clinical medicine and address the social, environmental, and behavioral factors that underlie current morbidity.

(JAMA 1987;257:3390-3395)

REFERENCES

1 +
Kovar M:  Some indicators of health-related behavior among adolescents in the United States . Public Health Rep 1979;;94:109-118.
2 +
Burke V: Poor Children: A Study of Trends and Policy, 1968-1984 . Subcommittee on Public Assistance and Unemployment Compensation, Committee on Ways and Means, House of Representatives, Congressional Research Service, 1986;.
3 +
Select panel for the Promotion of Child Health, Better Health for Children: A National Strategy, publication 79-55071. Government Printing Office, 1981, vol 2.
4 +
Select Panel for the Promotion of Child Health, Better Health for Children: A National Strategy, publication 79-55071. Government Printing Office, 1981, vol 3.
5 +
Halpern S, Bass J, Mehta K, et al:  Unintentional injuries among adolescents and young adults: Review and analysis . J Adolesc Health Care 1983;;4: 275-281.
6 +
Withers B, Baker S:  The epidemiology and prevention of injuries . Emerg Med Clin North Am 1984;;2:702-709.
7 +
Robertson L:  Crash involvement of teen drivers when driver education is eliminated from high school . Am J Public Health 1980;;70:599-603.
8 +
Chilton L:  Potential benefit versus risks of current attempts in health education among adolescents . J Pediatr 1977;;90:163-164.
9 +
 Homicide among young black males—United States, 1970-1982 . MMWR 1985;;34:629-633.
10 +
Parker R, Smith M:  Deterrents, poverty and type of homicide . Am J Sociol 1979;;85:614-624.
11 +
Williams K:  Economic sources of homicide: Reestimating the effects of poverty and inequality . Am Sociol Rev 1984;;49:283-289.
12 +
Garfinkel B, Froese A, Hood J:  Suicide attempts in children and adolescents . Am J Psychiatry 1982;;139:1257-1261.
13 +
Tonkin R:  Suicide methods in British Columbian adolescents . J Adolesc Health Care 1984;;5:172-177.
14 +
Hendricks L, Fullilore R:  Locus of control and the use of contraception among unmarried black adolescent fathers and their control . J Youth Adolesc 1983;;12:225-233.
15 +
Health Status of Youths Age 11-19 . Washington, DC, National Center for Health Statistics, 1981;.
16 +
Westoff C, Calot G, Foster A:  Teenage fertility in developed nations . Fam Plann Perspect 1983;;15: 105-108.
17 +
Tietze C: Induced Abortion: A World Review, 1983 , ed 5. New York, The Population Council, 1983;.
18 +
Hayes L. Crovitz E:  Adolescent pregnancy . South Med J 1979;;31:869-874.
19 +
Hollingsworth D, Kreutner K:  Teenage pregnancy . N Engl J Med 1980;;303:516-518.
20 +
Zuckerman D, Alpert J, Dooling E, et al:  Neonatal outcome: Is adolescent pregnancy a risk factor? Pediatrics 1983;;71:489-493.
21 +
Teenage Pregnancy: The Problem That Hasn't Gone Away . New York, Alan Guttmacher Institute, 1981;.
22 +
Hardy J, Welcher D, Stanley J, et al:  Longrange outcome of adolescent pregnancy . Clin Obstet Gynecol 1978;;21:1215-1221.
23 +
Mott F, Marsiglio W:  Early childbearing and the completion of high school . Fam Plann Perspect 1985;;17:234-237.
24 +
Burt M: Estimating the Public Costs of Teenage Child Bearing . Washington, DC, Center for Population Options, 1986;.
25 +
Johnston L, O'Malley P, Bachman J, et al: Use of Illicit Drugs by American High School Students, 1975-1984 . US Dept of Health and Human Services, 1985;.
26 +
Johnston L, Bachman J, O'Malley P:Highlights From Drugs and the Class of '84: Behaviors, Attitudes and Recent National Trends . Rockville, Md, National Institute on Drug Abuse, 1985;.
27 +
Blum R:  Diagnostic and treatment issues in adolescent substance abuse . Pediatr Clin North Am 1987;;34:523-537.
28 +
Donovan J, Jessor R, Jessor S:  Problem drinking in adolescence and young adulthood: A followup study . J Stud Alcohol 1983;;44:109-137.
29 +
Remington P, Forman M, Gentry E, et al:  Current smoking trends in the United States: The 1981-1983 behavioral risk factor surveys . JAMA 1985;;253:2975-2978.
30 +
Hunter S, Croft J, Burke G, et al:  Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: The Bogalusa heart study . Am J Public Health 1986;;76:193-195.
31 +
Smoking and Health , publication (PHS) 79-50066. US Dept of Health, Education, and Welfare, 1979;.
32 +
Guggenheimer J, Zullo T, Kruper D, et al:  Changing trends of tobacco use in a teenage population in western Pennsylvania . Am J Public Health 1986;;76:196-197.
33 +
Greer R, Poulson T:  Oral tissue alterations associated with the use of smokeless tobacco by teenagers . Oral Surg Oral Med Oral Pathol 1983;;56:275-284.
34 +
Christen A, Swanson B, Glover E, et al:  Smokeless tobacco: The folklore and social history of snuffing, sneezing, dipping and chewing . J Am Dent Assoc 1982;;105:821-829.
35 +
The Health Consequences of Using Smokeless Tobacco , US Dept of Health and Human Services publication (NIH) 86-2874. Public Health Service, 1986;.
36 +
Kandel D, Logan J:  Patterns of drug use from adolescence to young adulthood: I. Period of risk for initiation, continued use, and discontinuation . Am J Public Health 1984;;74:660-667.
37 +
Yamaguchi K, Kandel DB:  Patterns of drug use from adolescence to young adulthood: II. Sequences of progression . Am J Public Health 1984;;74:668-672.
38 +
Yamaguchi K, Kandel DB:  Patterns of drug use from adolescence to young adulthood: III. Predicators of progression . Am J Public Health 1984;;74: 673-681.
39 +
Halikas J, Lyttle M, Morse C, et al:  Proposed criteria for the diagnosis of alcohol abuse in adolescence . Compr Psychiatry 1984;;25:581-585.
40 +
Hampton L, Newberger E:  The epidemiology of abuse in childhood and adolescence . Am J Public Health 1985;;75:56-59.
41 +
Blum R, Runyan C:  Adolescent abuse: The dimensions of the problem . J Adolesc Health Care 1980;;1:121-126.
42 +
Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;.
43 +
Newacheck P, Budetti P, McManus P:  Trends in childhood disability . Am JPublic Health 1984;;74: 232-236.
44 +
Garell D:  Beyond survival of the fittest: Children with chronic illness in the 21st century . Read before the Health Futures of Adolescent National Invitational Conference, Daytona Beach, Fla, April 4, 1986 .
45 +
Zeltzer L, Kellerman J, Ellenberg L, et al:  Psychological effects of illness in adolescence: II. Impact of illness in adolescence—crucial issues and coping styles . J Pediatr 1980;;97:132-138.
46 +
Offer D, Ostrove E, Howard K:  Body image, self-perception and chronic illness in adolescence , in Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;, pp 59-74.
47 +
Nelson R:  Political and financial issues that affect the chronically ill adolescent , in Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;, pp 1-16.
48 +
Blum R:  The adolescent with spina bifida . Clin Pediatr 1983;;22:331-335.
49 +
Brunswick A, Josephson E:  Adolescent health in Harlem . Am J Public Health 1972;;62 ( (suppl) ):7-62.
50 +
Sternlieb J, Munan A:  A survey of health problems, practices and needs of youth . Pediatrics 1972;;49:177-186.
51 +
Parcel G, Nader P, Meyer M:  Adolescent health concerns, problems and patterns of utilization in a tri-ethnic urban population . Pediatrics 1977;;60: 157-164.
52 +
Radius S, Dillman T, Becker M, et al:  Adolescent perspectives on health and illness . Adolescence 1980;;15:375-384.
53 +
Benedict V, Lundeen K, Moor B:  Self-assessment by adolescents of their health status and perceived health needs . Health Values 1981;;5: 239-245.
54 +
Green J, Walker L, Hickson G, et al:  Stressful life events and somatic complaints in adolescents . Pediatrics 1985;;75:19-27.
55 +
Marks A, Malizio J, Hoch J, et al:  Assessment of health needs and willingness to utilize health care resources of adolescents in a suburban population . J Pediatr 1983;;102:456-460.
56 +
Levenson P, Morrow P, Pfefferbaum B:  Attitudes toward health and illness . J Adolesc Health Care 1984;;5:254-260.
57 +
Blum R:  Physician assessed competitiveness in adolescent health care . J Med Educ 1987;;62: 401-407.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Kovar M:  Some indicators of health-related behavior among adolescents in the United States . Public Health Rep 1979;;94:109-118.
2 +
Burke V: Poor Children: A Study of Trends and Policy, 1968-1984 . Subcommittee on Public Assistance and Unemployment Compensation, Committee on Ways and Means, House of Representatives, Congressional Research Service, 1986;.
3 +
Select panel for the Promotion of Child Health, Better Health for Children: A National Strategy, publication 79-55071. Government Printing Office, 1981, vol 2.
4 +
Select Panel for the Promotion of Child Health, Better Health for Children: A National Strategy, publication 79-55071. Government Printing Office, 1981, vol 3.
5 +
Halpern S, Bass J, Mehta K, et al:  Unintentional injuries among adolescents and young adults: Review and analysis . J Adolesc Health Care 1983;;4: 275-281.
6 +
Withers B, Baker S:  The epidemiology and prevention of injuries . Emerg Med Clin North Am 1984;;2:702-709.
7 +
Robertson L:  Crash involvement of teen drivers when driver education is eliminated from high school . Am J Public Health 1980;;70:599-603.
8 +
Chilton L:  Potential benefit versus risks of current attempts in health education among adolescents . J Pediatr 1977;;90:163-164.
9 +
 Homicide among young black males—United States, 1970-1982 . MMWR 1985;;34:629-633.
10 +
Parker R, Smith M:  Deterrents, poverty and type of homicide . Am J Sociol 1979;;85:614-624.
11 +
Williams K:  Economic sources of homicide: Reestimating the effects of poverty and inequality . Am Sociol Rev 1984;;49:283-289.
12 +
Garfinkel B, Froese A, Hood J:  Suicide attempts in children and adolescents . Am J Psychiatry 1982;;139:1257-1261.
13 +
Tonkin R:  Suicide methods in British Columbian adolescents . J Adolesc Health Care 1984;;5:172-177.
14 +
Hendricks L, Fullilore R:  Locus of control and the use of contraception among unmarried black adolescent fathers and their control . J Youth Adolesc 1983;;12:225-233.
15 +
Health Status of Youths Age 11-19 . Washington, DC, National Center for Health Statistics, 1981;.
16 +
Westoff C, Calot G, Foster A:  Teenage fertility in developed nations . Fam Plann Perspect 1983;;15: 105-108.
17 +
Tietze C: Induced Abortion: A World Review, 1983 , ed 5. New York, The Population Council, 1983;.
18 +
Hayes L. Crovitz E:  Adolescent pregnancy . South Med J 1979;;31:869-874.
19 +
Hollingsworth D, Kreutner K:  Teenage pregnancy . N Engl J Med 1980;;303:516-518.
20 +
Zuckerman D, Alpert J, Dooling E, et al:  Neonatal outcome: Is adolescent pregnancy a risk factor? Pediatrics 1983;;71:489-493.
21 +
Teenage Pregnancy: The Problem That Hasn't Gone Away . New York, Alan Guttmacher Institute, 1981;.
22 +
Hardy J, Welcher D, Stanley J, et al:  Longrange outcome of adolescent pregnancy . Clin Obstet Gynecol 1978;;21:1215-1221.
23 +
Mott F, Marsiglio W:  Early childbearing and the completion of high school . Fam Plann Perspect 1985;;17:234-237.
24 +
Burt M: Estimating the Public Costs of Teenage Child Bearing . Washington, DC, Center for Population Options, 1986;.
25 +
Johnston L, O'Malley P, Bachman J, et al: Use of Illicit Drugs by American High School Students, 1975-1984 . US Dept of Health and Human Services, 1985;.
26 +
Johnston L, Bachman J, O'Malley P:Highlights From Drugs and the Class of '84: Behaviors, Attitudes and Recent National Trends . Rockville, Md, National Institute on Drug Abuse, 1985;.
27 +
Blum R:  Diagnostic and treatment issues in adolescent substance abuse . Pediatr Clin North Am 1987;;34:523-537.
28 +
Donovan J, Jessor R, Jessor S:  Problem drinking in adolescence and young adulthood: A followup study . J Stud Alcohol 1983;;44:109-137.
29 +
Remington P, Forman M, Gentry E, et al:  Current smoking trends in the United States: The 1981-1983 behavioral risk factor surveys . JAMA 1985;;253:2975-2978.
30 +
Hunter S, Croft J, Burke G, et al:  Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: The Bogalusa heart study . Am J Public Health 1986;;76:193-195.
31 +
Smoking and Health , publication (PHS) 79-50066. US Dept of Health, Education, and Welfare, 1979;.
32 +
Guggenheimer J, Zullo T, Kruper D, et al:  Changing trends of tobacco use in a teenage population in western Pennsylvania . Am J Public Health 1986;;76:196-197.
33 +
Greer R, Poulson T:  Oral tissue alterations associated with the use of smokeless tobacco by teenagers . Oral Surg Oral Med Oral Pathol 1983;;56:275-284.
34 +
Christen A, Swanson B, Glover E, et al:  Smokeless tobacco: The folklore and social history of snuffing, sneezing, dipping and chewing . J Am Dent Assoc 1982;;105:821-829.
35 +
The Health Consequences of Using Smokeless Tobacco , US Dept of Health and Human Services publication (NIH) 86-2874. Public Health Service, 1986;.
36 +
Kandel D, Logan J:  Patterns of drug use from adolescence to young adulthood: I. Period of risk for initiation, continued use, and discontinuation . Am J Public Health 1984;;74:660-667.
37 +
Yamaguchi K, Kandel DB:  Patterns of drug use from adolescence to young adulthood: II. Sequences of progression . Am J Public Health 1984;;74:668-672.
38 +
Yamaguchi K, Kandel DB:  Patterns of drug use from adolescence to young adulthood: III. Predicators of progression . Am J Public Health 1984;;74: 673-681.
39 +
Halikas J, Lyttle M, Morse C, et al:  Proposed criteria for the diagnosis of alcohol abuse in adolescence . Compr Psychiatry 1984;;25:581-585.
40 +
Hampton L, Newberger E:  The epidemiology of abuse in childhood and adolescence . Am J Public Health 1985;;75:56-59.
41 +
Blum R, Runyan C:  Adolescent abuse: The dimensions of the problem . J Adolesc Health Care 1980;;1:121-126.
42 +
Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;.
43 +
Newacheck P, Budetti P, McManus P:  Trends in childhood disability . Am JPublic Health 1984;;74: 232-236.
44 +
Garell D:  Beyond survival of the fittest: Children with chronic illness in the 21st century . Read before the Health Futures of Adolescent National Invitational Conference, Daytona Beach, Fla, April 4, 1986 .
45 +
Zeltzer L, Kellerman J, Ellenberg L, et al:  Psychological effects of illness in adolescence: II. Impact of illness in adolescence—crucial issues and coping styles . J Pediatr 1980;;97:132-138.
46 +
Offer D, Ostrove E, Howard K:  Body image, self-perception and chronic illness in adolescence , in Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;, pp 59-74.
47 +
Nelson R:  Political and financial issues that affect the chronically ill adolescent , in Blum R (ed): Chronic Illness and Disabilities in Childhood and Adolescence . New York, Grune & Stratton, 1984;, pp 1-16.
48 +
Blum R:  The adolescent with spina bifida . Clin Pediatr 1983;;22:331-335.
49 +
Brunswick A, Josephson E:  Adolescent health in Harlem . Am J Public Health 1972;;62 ( (suppl) ):7-62.
50 +
Sternlieb J, Munan A:  A survey of health problems, practices and needs of youth . Pediatrics 1972;;49:177-186.
51 +
Parcel G, Nader P, Meyer M:  Adolescent health concerns, problems and patterns of utilization in a tri-ethnic urban population . Pediatrics 1977;;60: 157-164.
52 +
Radius S, Dillman T, Becker M, et al:  Adolescent perspectives on health and illness . Adolescence 1980;;15:375-384.
53 +
Benedict V, Lundeen K, Moor B:  Self-assessment by adolescents of their health status and perceived health needs . Health Values 1981;;5: 239-245.
54 +
Green J, Walker L, Hickson G, et al:  Stressful life events and somatic complaints in adolescents . Pediatrics 1985;;75:19-27.
55 +
Marks A, Malizio J, Hoch J, et al:  Assessment of health needs and willingness to utilize health care resources of adolescents in a suburban population . J Pediatr 1983;;102:456-460.
56 +
Levenson P, Morrow P, Pfefferbaum B:  Attitudes toward health and illness . J Adolesc Health Care 1984;;5:254-260.
57 +
Blum R:  Physician assessed competitiveness in adolescent health care . J Med Educ 1987;;62: 401-407.

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