Jointly released by UCSF and the California Adolescent Health Collaborative (CAHC), the 100-page plan represents 18 months of intensive investigation, research and deliberation by leading organizations dedicated to the welfare of youth. "Investing in Adolescent Health: A Social Imperative for California's Future," outlines a spectrum of short- and long-term strategies to ensure the health of tomorrow's workforce, parents and leaders.

"Statistics on illness, death and risky behavior among teens provide clear evidence that we need to improve our approach to adolescent health issues," says Claire Brindis, DrPH, UCSF professor of pediatrics in the Division of Adolescent Medicine and member of UCSF's Center for Health and Community. "Almost all adolescent death, illness and disability are preventable -- this plan is one of the most important steps toward addressing that crisis."

Every week in California, eight teens are murdered, nine die in motor vehicle crashes, two commit suicide and 1,139 become mothers. Brindis points out that not enough has been done to steer adolescents toward positive and healthy choices.

And while California is grappling with these issues, the state is undergoing a "youthquake," marked by a projected 34 percent climb in the teen population in the period between 1995 and 2005. By contrast, this age group will grow only 13 percent nationally.

"Our health service system for youths is already frayed," admits Margie Fites Seigle, CEO of the Los Angeles-based California Health Council. "As the teen population continues to mushroom, we'll continue to fall short, leaving the next generation of California's leaders and our greatest statewide resource increasingly at risk."

The Collaborative has engaged in a wide range of partners that it believes will have the capacity to create change at the state and community levels. The Plan outlines eight recommendations for a complete strategy to shore up what it sees as a woefully inadequate system for providing teens with key services and opportunities.

Adolescents currently have the lowest use of health services of any age group. The plan calls for expansion of health services that are "youth-friendly" and located where teens will actually use them.

Although health care is an important aspect of the strategic plan, it is only one component of a comprehensive approach to improving adolescent health. To create strong relationships with caring adults that reduce teens' likelihood of engaging in risky behaviors, the plan calls for expanding state-funded programs, as well as efforts by businesses, religious organizations and individuals to connect youth with adults and community organizations, and provide mentoring and after-school activities.

"We must incorporate teens into the fabric of society," says Brindis. "Rather than marginalizing them, we need to give them a role in shaping policies that affect them."

The plan calls on cities, state boards, health programs and media outlets to establish youth advisory councils and to train youths so that they can weigh in on policy matters that affect them.

"Investing in Adolescent Health" is a comprehensive and far-reaching document, but the CAHC insists that implementation can begin immediately. Some of the immediate actions recommended include: enrolling all eligible teens in existing public insurance programs, inviting a youth member to sit on every school board and city council, and using part of the state's budget surplus to fund after-school programs.

"It's not like we are starting from scratch," says Fites Seigle. "There's a lot of exciting work already taking place. It's a matter of building on this work, developing a unified vision of how we can invest in youth and creating the political will to get there."

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