Adolescents Deserve Special Attention in SCHIP Outreach Programs Public health program administrators and health care policy makers should consider treating adolescents as a distinct group that requires age-specific policies and practices and tailored outreach, benefits and services strategies, according to the National Academy for State Health Policy (NASHP). In its recent Briefing on SCHIP and Adolescents, NASHP noted that adolescents are more likely to be uninsured than younger children and have distinct needs. As has been frequently noted, adolescents are more likely to engage in high-risk behaviors as they get older, and some of those behaviors can affect their health and safety. Additionally, an estimated $700 billion is spent annually on preventable adolescent health problems, particularly with: • Pregnancy • Sexually transmitted infections • Motor vehicle injuries • Substance abuse • Unintentional injuries, and • Mental health problems. According to the U.S. Census Bureau, about 13 percent of adolescents ages 12 through 17 were uninsured in 2006, compared to 11 percent 11 years old or younger. The statistic is even more striking for young people in poverty, the briefing noted. Adolescents also seek office-based health care less frequently than other age groups. As they gain a sense of autonomy, the Academy said, they need to be able to participate more in health care decisions. But, according to the Academy, little is known about how the State Children's Health Insurance Program (SCHIP) particularly serves adolescents, helping them overcome barriers to care. One of the few published studies found that "after uninsured adolescents enrolled in SCHIP, they had increased access to care and improved quality of care, leading to fewer unmet health needs." SCHIP-enrolled adolescents also were more likely to have a single source for health care such as a family physician -- important to receiving preventive services. SCHIP also is associated with reducing racial and ethnic disparities in access to care. The briefing paper outlines some "best ways" to reach youth and their parents, including: partnering with community sites adolescents frequent, such as schools and malls; training hotline operators and others to answer questions likely to come from adolescents; targeting special populations, such as the homeless, runaways, and minorities; streamlining enrollment procedures, and advertising coverage especially tuned for the needs of adolescents. Confidentiality is crucial, the authors note, as many adolescents will seek health care on the condition that their privacy will be honored. SCHIP programs should take into account the state laws that allow adolescents to consent for their own care under specific circumstances. Because SCHIP incorporates both the program components and flexibility needed to reach and enroll adolescents, it has shown some success in serving adolescents during its first decade. More effort, the report urges, would be effective. The State Health Policy Briefing may be found at http://www.nashp.org/Files/shpbriefing_adolescents.pdf. |
