Health care reform and adolescents-an agenda for the lifespan: a position paper of the Society for Adolescent Medicine.

New opportunities now exist in the United States to achieve significant health care reform. The Society for Adolescent Medicine believes that health care reform must address the needs of everyone, whatever their age, race, national origin, income level, social circumstance, or health care needs. To achieve reforms that are meaningful for all, it is essential to address the specific needs of adolescents. Many aspects of health care reform that are needed for adults and for younger children will also help adolescents. However, adolescents require special attention and services to promote healthy development and a safe transition to adulthood. Adolescence provides a unique opportunity to prevent health conditions and behaviors with life-long implications for individual young people and for society. The second decade of life is a unique period, with significant growth and development on a scale matched only during infancy. Many adolescents experiment with ‘‘adult’’ behaviors and are increasingly independent in personal habits. These behaviors and habits—such as tobacco and alcohol use, other substance use and abuse, diet, exercise, sexual behavior, and driving—have significant implications for health. Indeed, the major causes of adult morbidity and mortality, such as heart and lung disease, diabetes, or cancer, are linked to these behaviors and habits, many of which have their onset during the second decade of life, and become ingrained in the early twenties. Health care services can play a key role in primary prevention of health problems and in enabling those with chronic conditions to manage their health effectively as they transition to adulthood. Ensuring adolescents’ access to high-quality, developmentally appropriate, affordable health care services lays the foundation for a lifetime of good health and health habits, and prepares adolescents to be productive, engaged citizens through their young adult years and beyond. This statement outlines principles to ensure that health care reform is meaningful for adolescents and also for young adults.