2 February 2000
Report Advises How States Can Improve Health of Millions of Adolescents
States should take full advantage of the nationwide state Children's Health Insurance Program to improve the health of millions of low-income and at-risk adolescents, according to a report reviewed yesterday in Washington, DC.
The report was released by the Association of Maternal and Child Health Programs (AMCHP); the National Adolescent Health Information Center (NAHIC) at UCSF, and the Policy Information and Analysis Center for Middle Childhood and Adolescence (the Policy Center), also at UCSF.
The report was reviewed February 1 at a briefing for Capitol Hill health policy experts. State and federal health professionals who have initiated successful strategies in several states to improve care for adolescents joined the study's authors to urge recognition that a special focus is needed to meet the health needs of this age group.
The report, Adolescents and the State Children's Health Insurance Program (SCHIP): Healthy Options for Meeting the Needs of Adolescents, analyzes strategies tested in 12 states to use the SCHIP program to improve health care. SCHIP provides federal funding that enables states to expand health insurance coverage for low-income children from birth to age 18. It extends coverage to children and adolescents whose families cannot afford private health insurance, including working families and those trying to get off welfare.
"SCHIP represents an unprecedented opportunity for states to expand health insurance for children of all ages, but particularly the under-served population of adolescents," said Claire Brindis, DrPH, co-author of the report and UCSF professor of pediatrics and health policy in the Division of Adolescent Medicine and the Philip R. Lee Institute for Health Policy Studies.
In a 1999 study, Brindis and colleagues found that one in seven youth between the ages of 10 and 18 are uninsured. Even as teens have been added to public insurance programs, the number and proportion of adolescents covered by private insurance has declined. In a study of the demographics of adolescent health, Brindis found that teens are increasing as a percentage of the overall population for the first time in 20 years. It is estimated that the number of young people ages 10-19 will increase by 13 percent between 1995 and 2005. In California, the most populous state, teen numbers will rise by 34 percent.
"Adolescents have unique needs - they are neither big children nor little adults," said Catherine Hess, executive director of AMCHP. "Our report documents how the states are beginning to tailor their new or expanded health insurance programs to address their special needs. There is much more we could be doing though, and this report also provides some pointers."
Brindis and Hess welcomed the renewed national interest in covering more of the uninsured and called for bipartisan support to help more youth and families. One example is President Clinton's proposal, announced January 19, to offer insurance as well to the parents of children covered by SCHIP and Medicaid, and to include young adults through age 20. "More than 4 million children aged 10 to 17 are not insured," Brindis said. "Coverage is even lower in the 18 to 20 group, and among families with young parents. These are the children and young adults least likely to get regular health care or to get the preventive care and counseling that saves lives and protects them from illness and injury."