As somebody who keeps an eye on generational issues in health care, I get pretty alarmed by some of the things I see and hear about America's youths. TV series, movies and pop music depict young people indulging in alcohol, drugs and sex at rates that shock even this child of the freewheeling '60s and '70s (though, I admit, the era was perhaps more freewheeling in certain places than it was in rural Pennsylvania where I spent my formative years). And current news is rife with reports of teens and 20-somethings who ping-pong from party to hospital to rehab.
Maybe today's kids should sue the media for defamation of character. As it turns out, recent research indicates they are, by and large, less apt than their parents and grandparents were at their age to take part in certain kinds of self-destructive behavior. And, with a little help, other threats to child and adolescent health are being thwarted.
That's great news for the young people themselves, for the grown-ups who worry about them, and for our already over-stressed health care system.
Here are a few examples:
• In a Feb. 8 Kaiser Health News blog, Shefali S. Kulkarni noted that teen pregnancies are at their lowest rate in 40 years, resulting in fewer abortions and births. Data compiled by the Guttmacher Institute shows that 7 percent of American girls between 15 and 19 years were pregnant in 2008, a decline from the high of more than 11 percent in 1990. The abortion rate among teenage girls was 1.8 percent in 2008, down from the high of 4 percent in 1988. Though the pregnancy and abortion rates have fallen for all ethnic groups, they remain dramatically higher for African-American and Hispanic teens.
Factors that may contribute to this trend: increased education about HIV and STDs; the ability of parents to monitor their children's behavior via cell phone and online social networks; and the availability of contraceptives — though the cost of contraceptives may prevent poorer girls from accessing them.
• In her Feb. 5 New York Times blog, Tara Parker-Pope points to the University of Michigan's Monitoring the Future survey that found marijuana use among high school seniors has dropped; in 1980, 60 percent of seniors had tried it and 9 percent were frequent users, compared with 45.4 percent and 6.6 percent, respectively, today.
Another survey she cites found 40 percent of current high school seniors say they recently consumed alcohol compared with 72 percent in 1980.
• For the first time in years, the overweight epidemic among Americans between 2 and 19 years of age has leveled off. It's still too high, of course, with 17 percent of our kids obese and 32 percent overweight, but let's hope it's the start of a downward trend. Experts say initiatives pushed by Michelle Obama and others to provide healthier food choices on school lunch menus and to encourage kids to exercise seem to be paying off.
And a Kaiser Permanente study last month found that an intervention program involving weekly peer meetings, consultations with primary care providers and separate meetings for parents helped obese teenage girls gain less weight, improve their self-esteem and eat less fast food. The findings were published the journal Pediatrics.
• Children's Hospital Boston reduced emergency department visits by kids with asthma by 68 percent and hospitalizations by 85 percent, thanks to a program targeting 283 children in poor neighborhoods. According to a study, also published in Pediatrics, staff from the hospital's Community Asthma Initiative educated families to correctly use medications and to eliminate factors that trigger attacks, such as contaminated bedding. The program saves $1.46 in hospital care for every $1 spent — a return on investment other hospitals should find attractive.
• One area in which the news remains discouraging is smoking. A report released last week by Surgeon General Regina Benjamin found that nearly one in four high school seniors and one in three adults younger than 26 smoke. She calls it a "pediatric epidemic" fueled by tobacco company marketing, and says that for every three young smokers, one will quit and one eventually will die from tobacco-related causes.
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