Adolescent health and youth development: turning social policy into public health practice.

The blueprint for improving the health of Americans, Healthy People 2010, contains eight measurable leading health indicators for adolescents and young adults, with six targets directed at morbidity and mortality. These are reduction of (1) deaths caused by motor vehicle crashes, (2) homicides, (3) proportion of youth engaging in binge drinking of alcoholic beverages, (4) past-month use of illicit substances, (5) tobacco use, and (6) proportion of youth who are overweight or obese. In addition, there are two targets directed at wellness, increasing the proportion of youth who (1) abstain from sexual intercourse or use condoms if currently sexually active and (2) engage in vigorous physical activity. Although each of these targets is related to potentially modifiable adolescent behaviors, traditional medical approaches have largely failed to reach them. Even public health approaches have predominantly been deficitbased, insofar as they tend to measure the reduction in morbidity or mortality, rather than improvements in health (including 75% of health indicators mentioned above). Moreover, an Institute of Medicine report recently expressed concern about the crumbling infrastructure of public health in America and noted the need to determine the best strategies to ensure the health of the public in the 21st century. Thus, specialists in public health and in adolescent healthcare have begun to recognize the promise of a more positive, asset-based approach to improve the health of our youth by focusing on healthy youth development (YD). The details of the YD approach are explored by several articles in this supplement of the Journal of Public Health Management and Practice and offer innovative alternatives to approaches that have failed largely because they did not include the target population in their design or implementation in meaningful ways. Although not intentionally designed as a public health strategy, attention to positive YD nonetheless