Comprehensive Guidelines Needed for Young Adult Preventive Care

Health care reform changes likely to magnify problem

By Juliana Bunim

With no specific clinical preventive care guidelines targeting young adults, health care providers are missing key opportunities to improve the health of this population through preventive screening and intervention.

Elizabeth Ozer, PhDElizabeth Ozer, PhD

Yet a new study from the University of California, San Francisco (UCSF) shows that when the ages of 18-26 years are carved out of existing professional guidelines across specialty groups, there are a broad number of evidence-based recommendations that can inform the care of young adults. 

The transition from adolescence to young adulthood can be a challenge often associated with greater engagement in health damaging behaviors, with the highest rates of mental health problems, substance abuse and sexually transmitted infections.

Because these health problems largely are preventable, primary care visits can present a key opportunity to improve the health of young adults, with evidence supporting the efficacy of preventive services.  But this group also is the least likely to be insured, seek outpatient care or have a primary care physician, according to researchers.

“This is really a key time to intervene,” said lead study author Elizabeth Ozer, PhD, an associate professor of pediatrics in the UCSF Division of Adolescent Medicine. “Yet even when young adults use primary care, they infrequently receive preventive health care”.

The study, “Young Adult Preventive Health Care Guidelines: There But Can’t be Found,” is available in the March 2012 issue of Archives of Pediatrics and Adolescent Medicine. The research team conducted a careful analysis of existing guidelines for adolescents and adults and identified preventive care guidelines relevant to young adults.

According to the authors, the expansion of health insurance to young adults up to age 26 years through the 2010 Affordable Care Act (ACA) creates an urgent need for specific guidelines for young adult preventive care. While the ACA provides an “unprecedented opportunity,” to improve the health of young adults, it also will create an influx of this population seeking services, thus increasing the demands on the health care system, and the need to provide preventive services, the team states.

Recent data from the National Health Interview Survey (NHIS) found that in the first quarter of 2011, approximately 2.5 million more young adults had health insurance compared to the previous year. 

“The good news is that there is no need to reinvent the wheel when developing comprehensive preventive services for young adults.  Existing evidence based guidelines can inform this process,” said Ozer.  “This review is an important first step in moving forward to create guidelines for young adult health care that outline a core set of preventive services that will better enable clinicians and young adults to talk full advantage of the primary care opportunity.”

Co-authors are John T. Urquhart, BA; Claire D. Brindis, DrPH; M. Jane Park, MPH; and Charles E. Irwin Jr, MD, all with the UCSF Division of Adolescent and Young Adult Medicine, Department of Pediatrics. Ozer also is affiliated with the UCSF Office of Diversity and Outreach. Brindis is affiliated with the UCSF Philip R. Lee Institute for Health Policy Studies.

The study was supported by grants from the US Department of Health and Human Services.

Young Adult Preventive Health Care Guidelines: There But Can’t be Found
Archives of Pediatrics and Adolescent Medicine, March, 2012