Review article
Adolescent and Young Adult Health in the United States in the Past Decade: Little Improvement and Young Adults Remain Worse Off Than Adolescents

https://doi.org/10.1016/j.jadohealth.2014.04.003Get rights and content

Abstract

Adolescence and young adulthood are unique developmental periods that present opportunities and challenges for improving health. Health at this age can affect health throughout the lifespan. This review has two aims: (1) to examine trends in key indicators in outcomes, behaviors, and health care over the past decade for U.S. adolescents and young adults; and (2) to compare U.S. adolescents and young adults on these indicators. The review also assesses sociodemographic differences in trends and current indicators. Guided by our aims, previous reviews, and national priorities, the present review identified 21 sources of nationally representative data to examine trends in 53 areas and comparisons of adolescents and young adults in 42 areas. Most health and health care indicators have changed little over the past decade. Encouraging exceptions were found for adolescents and young adults in unintentional injury, assault, and tobacco use, and, for adolescents, in sexual/reproductive health. Trends in violence and chronic disease and related behaviors were mixed. Review of current indicators demonstrates that young adulthood continues to entail greater risk and worse outcomes than adolescence. Young adults fared worse on about two-thirds of the indicators examined. Differences among sociodemographic subgroups persisted for both trends and current indicators.

Section snippets

Methods and Presentation of Data

Selecting indicators and data sources for this review involved an iterative process. As shown in Figure 1, two sources guided identification of potential indicators: the 2009 review article [1] and the Healthy People 2020 Core Health Outcome Indicators for Adolescents and Young Adults [17]. These Healthy People indicators span seven domains which were adapted into eight categories for this review: overall health, function, and mortality; injury; violence; mental health; substance use; sexual

Overall health, function, and mortality

General measures of overall health and function changed little. The vast majority of adolescents and young adults continued to be endorsed as being in excellent, very good, or good health, overall and among subgroups. Similarly, rates of limitations in activity (e.g., daily physical and social tasks, including household chores or visiting friends) remained stable and low, with adolescents having higher rates than young adults and no notable subgroup differences in trends or current measures.

Discussion

This review shows little or no progress on most key measures of adolescent and young adult health. Exceptions include encouraging trends in unintentional injury for both age groups and sexual and reproductive health for adolescents. Decreased tobacco use and assault rates and increases in exercise are also encouraging. Most other areas showed little change or unhealthy trends. The review also showed that young adulthood continues to entail greater risk than adolescence, with young adults faring

Summary and Implications

This review revealed improvements in monitoring data compared with 2009, including increased access through online databases and data specific to young adults. Many limitations remain, however, notably disparate age groupings across data sets [76]. The relative lack of easily accessible data for young adults remains a challenge. Despite the similarity in health issues, monitoring systems for adolescents and young adults remain fairly separate, making direct comparisons difficult. Available data

Acknowledgments

The authors gratefully acknowledge Elizabeth Ozer for her review of an earlier manuscript and Linda Ha for her assistance in preparing the manuscript for publication.

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