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Health Needs of Adolescents Not Being Met, UCSF Expert Says

By Robin Hindery

Mary-Ann Shafer

As the Obama administration and Congress begin to tackle national health care reform, one of the top priorities must be improving access to and quality of care for adolescents – a group that is currently woefully underserved, according to a prominent UCSF adolescent health specialist. “Taking care of young people is really at the forefront of where the field of medicine needs to be going, and we’re at a critical time right now,” said Mary-Ann Shafer, MD, a professor and vice chair of faculty development in the UCSF Department of Pediatrics, and associate director in the Division of Adolescent Medicine. The United States is home to about 42 million youths age 10 to 19, according to the Centers for Disease Control and Prevention (CDC). While the majority of deaths in that age group are caused by motor vehicle accidents and firearm-related injuries, adolescents are at increasing risk of long-term health problems linked to obesity and lack of physical activity. Over the past 30 years, the percentage of adolescents considered overweight or obese has more than tripled, the CDC reports. Health professionals face numerous challenges when it comes to providing quality, customized health care to adolescents, a patient population whose needs fit neither the adult nor the child health care model, Shafer said. Those challenges include the high number of uninsured adolescents and a shortage of qualified adolescent medicine practitioners, she said. In addition, a recent study led by UCSF researchers found that the majority of adolescents in the United States do not obtain the appropriate level of preventive health care services. Out of a nationwide group of nearly 8,500 youths age 10 to 17, only 38 percent had a preventive doctor visit in the previous year, the study found. Addressing those problems will require close collaboration among physicians, mental health and other health professionals, parents, teachers, and community health organizations, Shafer said. “Health is a much broader concept than medicine,” she said. “We need to have a very holistic approach to preparing adolescents to be healthy, productive adults. That means not only immunizations, but also safer neighborhoods with recreational facilities, training to enter the job market, and healthy food choices in schools and even at local fast food restaurants.” Shafer now has a national platform from which to promote adolescent health care reform. She was recently elected president of the Society for Adolescent Medicine (SAM), the nation’s premier, multidisciplinary organization of adolescent health professionals, with members from 30 countries. The SAM is the only US-based organization dedicated exclusively to advancing the health and well-being of adolescents, which it does through advocacy, clinical care, research, health service delivery and professional development. Shafer’s appointment took effect at the SAM annual meeting on March 27 in Los Angeles. She has had a long history of involvement with the organization, and in 2007 was awarded the SAM Visiting Professorship in Adolescent Medicine, traveling to China and Japan to assist local professionals in establishing the field of adolescent health in their respective countries. Shafer sees the SAM as a national leader in the effort to improve health care for young people and to attract qualified health professionals to the field of adolescent medicine and health. She said she also will promote the widespread use of technology to enhance continuing education opportunities for health professionals; to develop web-based resources for teens, parents and their providers; and to help make doctor-patient communications more effective and more appealing to tech-savvy tweens, teens and young adults. “When it comes to health care delivery, we’re moving more and more toward e-communication,” she said. “For teens and young adults especially, we want to branch out away from traditional doctor visits and make better use of technologies, such as email and text messaging, to communicate important health promotion messages.” Reforming adolescent health care – both domestically and around the world – will have benefits that extend far beyond a healthier population, Shafer said. “There’s a quote from the World Health Organization that I really think says it all,” she said. “They said the most important commitment a country can make for future economic, social and political progress and stability is to address the health and development needs of its adolescents.” In addition to her other roles at UCSF, Shafer is director of the Fellows College, a professional development program in the Department of Pediatrics. Her specific areas of interest include eating disorders, fatigue and pain syndromes, medical gynecology, and complex, chronic illness among adolescent males and females. Photo by Susan Merrell

Related Links:

UCSF Division of Adolescent Medicine

Society for Adolescent Medicine