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By Lisa Gillespie
Young people with health problems left uncared for in adolescence face higher risks of leading unhealthy lives as adults, a new study finds.
A study of 14,800 people found that the odds of adverse adult health conditions were 13 to 52 percent higher among those who reported unmet health needs as adolescents than for those who did not have unmet needs as teens but who were otherwise comparable. The study was conducted first in 1994-95 when many subjects were in their mid-teens, and again in 2008 when many were in their late 20s.
An article about the study was published Monday in Pediatrics, the journal of the American Academy of Pediatrics.
This isn’t the first study to find a link between health services for adolescents and better adult health, but past research relied on country-level data from sources such as the World Bank. The latest study is the most extensive one using individual data, said lead researcher Dougal Hargreaves, a research fellow at Boston Children’s Hospital.
Teenagers with depression whose needs were unmet then were one and a half times more likely to have depressive symptoms in adulthood than counterparts who received help in adolescence. Similarly, poor general health, functional impairment, missed work or thoughts of suicide in a person’s early years – if not addressed – are a predictor for those issues in later life, researchers said.
The study compared people who had reported unmet health needs in adolescence with subjects with similar adolescent health issues, insurance coverage and socioeconomic backgrounds but no unmet health needs.
There could be two reasons for unresolved teenage problems that carry into adulthood, the study’s authors wrote. One explanation might be that health care not provided in adolescence exacerbates a condition in adulthood – although they said they did not study that specifically. Another possibility is teenagers who don’t take care of their health follow the same habit as adults, the authors speculated.
Adolescence is a time when people begin to form attitudes about health and seeking help when it’s needed that stick with them for life. “Adult behavior may be influenced by experiences in childhood as well as adolescence,” the Pediatrics article said.
Adolescent subjects in the study often didn’t perceive their health needs as important. That was the most common reason those needs were not met. Cost was the least common reason, the authors wrote. Other reasons cited were teens’ fear of negative consequences if they sought help and their lack of confidence that their privacy would be protected.
“Oftentimes, we’re worried about financial access problems. But for adolescents, often the access challenge isn’t related to the ability to pay, but the ability to understand the importance of treating problems now and to find a trusted provider who can offer care in a nonjudgmental way,” said Matthew Davis, a professor of pediatrics at the University of Michigan.
Scott Benson, a child psychiatrist for 35 years in Pensacola, Fla., said the study reported in Pediatrics affirmed the stigma he sees many teen patients come in with. Many have no idea they have depression and wonder why they are sad. While many teens had depression symptoms in the study, he said outcomes could have gotten worse because they were not addressed early.
Hargreaves’ takeaway was that teens need to use services more easily, and get around the stigma of getting help, especially for mental illness. They should be able to talk with health professionals about subjects awkward to them, he said.
This story originally appeared in Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.