By Angela Diaz, MD, PhD, MPH, Director
One in six people alive in the world today are teenagers, but our health care system is still designed with adults in mind.
Adolescence is a unique—and uniquely important—time in a person’s life. Adolescents have specific medical, psychological and social needs. Adolescent medicine specialists handle issues related to development, reproductive health and sexuality, mental health and more. When we ignore these specific challenges, young people pay the price. For example, only 63% of teen girls and 50% of teen boys have gotten the HPV vaccine—partly because many medical providers feel uncomfortable talking about sex. That’s a much lower rate than that of other immunizations like Tdap and meningococcus.
Despite the importance of adolescent health, there is a shortage of adolescent medicine physicians. Instead of seeing physicians trained to meet their needs, teens and young adults often stick with their pediatrician or start seeing an internal or family medicine physician.
Society gives lip service to the idea that young people are the future. But young people are also the present. In order to grow into healthy, successful adults, teens need a health system that works for them and meets them where they are.
At Mount Sinai Adolescent Health Center, we’ve pioneered an integrative model of care for young people. Anyone 10-22 years old can walk through our doors and receive the care they need, completely free of charge. We are a one-stop shop for primary care and optical, dental, mental health, reproductive health, and nutrition and wellness services. Additionally, our special programs meet the needs of LGB and transgender youth, teen parents, human trafficking and trauma survivors, youth living with HIV, and more. We are a non-judgmental, safe space where teens get the care and learn the coping skills they need to thrive.
But this quality care needs to be accessible to young people across the country—not just in NYC.
This International Youth Day, let’s renew our commitment to keeping young people healthy. Here are 5 things we need to create a health system that works for teens.
Young people deserve access to high-quality, comprehensive health services, regardless of their ability to pay or where they live.
Income-based health disparities in the USA are worse than in every developed country but Chile and Portugal. This is unconscionable. In a teen-friendly health system, every young person receives the same high-quality services regardless of their ability to pay.
These inequities also play out along geographical divisions. In some areas, young people may not be able to physically get to the services they need—or only be able to access them with the knowledge and permission of their caregivers.
A health care system that works for teens provides confidential care to young people. When teens know that their health care visits are confidential, they ask important questions about sex, relationships and their body that they might otherwise avoid. They get tested and treated for sexually transmitted infections (STIs). They access birth control.
But when teens don’t understand that their visits are confidential, they do not access these essential services, putting them at risk for unplanned pregnancy, STIs and abusive relationships.
We talk more about the importance of confidentiality here.
Teens are often stereotyped as lazy, inconsiderate, manipulative, and downright terrible. But young people are perceptive. If they sense that their health care provider is judging them or their behavior, they won’t be honest with their provider. They may also be less likely to seek the care they need in the future. In extreme cases, health care providers who judge their patients may deny young people important health services: “You’re too young to be on birth control.”
This is why non-judgmental providers are a key part of a teen-friendly health care system.
(P.S.—Teens aren’t terrible. They’re strong and resilient.)
Every young person deserves the same high-quality health care, no matter their gender, sexual orientation, race, ability, or immigration status.
This means that transgender youth have access to the appropriate transition-related care, such as hormone blockers, hormone replacement therapy, and more. A young, bi person of color doesn’t have to worry about finding a doctor that’s not biphobic OR racist. Sex education is inclusive of all bodies and identities.
In a health system that works for teens, young people access all the care they need—primary, mental health, reproductive, dental and optical—in one place. This makes managing their own care easier, and makes it more likely that they’ll actually access the services they need.
Comprehensive health care also addresses the social needs of adolescents. Can their family afford nutritious food? Do they have a safe, stable home?
Healthy adolescents grow into healthy, successful adults. This International Youth Day, let’s recognize the strength and resilience of young people—and commit to providing them with a health system that works for them.
Angela Diaz, MD, PhD, MPH has led the Mount Sinai Adolescent Health Center for more than 25 years, overseeing its growth into the largest center of its kind in the United States. Dr. Diaz has long been a leading figure in public health advocacy in New York as well as nationally and internationally, advancing policies that break down the economic and social barriers to high-quality health and wellness care for young people. As a young immigrant from the Dominican Republic, Dr. Diaz was once a patient at MSAHC herself. She earned her medical degree from Columbia University College of Physicians and Surgeons in 1981. She also earned a Master’s in Public Health from Harvard University and a Ph.D. in epidemiology from Columbia University.
The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.