THERE IS GROWING recognition that teenagers have healthcare needs that are distinct to their own age group—needs that pediatricians and primary care physicians are not always equipped to handle.

Physicians who treat teenagers must be ready to deal with hard-to-talk-about issues, such as obesity, alcohol, drugs, sexual behavior and violence.

"Teens are the healthiest age group as far as organic diseases," says Robert T. Brown, MD, president of Society of Adolescent Medicine (SAM) and chief of the section of adolescent health at Children's Hospital in Columbus, Ohio. "At the same time, they have relatively high rates of mortality and morbidity. That comes from behavior, and that's what makes them different."

Nearly 1,000 doctors have been certified in the subspecialty of adolescent medicine since 1994, according to SAM, a multi-disciplinary organization of health professionals.

MHE Executive view

It's hard to get through to the teen population, especially when it comes to health issues, Dr. Brown says. But it is important to get teens to manage their health and, if they contract a disease, manage that disease. It begins with communication.

That communication centers on the idea that creating a healthy lifestyle in a person's formative years can directly impact that person's health later in life.

"There is a greater urgency to learn how to take care of yourself and protect your body from the damages of disease early on, because that damage will accumulate over time," says Andrew Baskin, MD, national medical director for program support for Aetna. "If you do a better job at a young age, you can prolong your life and allow yourself a better quality of life."

Jim King, MD, president-elect of the American Academy of Family Physicians (AAFP), says people are being diagnosed with chronic conditions earlier in life, calling attention to teen health issues.

Dr. King, who is also managing partner of Prime Care Medical Center in Seller, Tenn., says there are more cases of young adults being diagnosed with diabetes and hypertension—two illnesses that can directly be attributed to teen obesity.

He says he recently diagnosed hypertension in a 14-year-old male and that more people in the 20- and 30-year-old range are being diagnosed with adult-onset diabetes. "Usually, this type of diabetes is not diagnosed until a person is in the 40- to 60-year-old range," he says.

Fast food, an unhealthy diet and a sedentary lifestyle are to blame for obesity, which is the cause for the early onset of adult diabetes, Dr. King says. "It's based on being overweight for years," he notes. "If their weight was better under control, these problems wouldn't present themselves until later in life."

THE LINES OF COMMUNICATION

Health plans have responded by adding teen health initiatives to their disease management programs.

Aetna's disease management program identifies more than 34 illnesses and diseases, ranging from cystic fibrosis to asthma, that could possibly effect members of all ages, including teenagers.

Nurses are trained to engage teenagers by finding out their interests and using those interests as a springboard to a dialogue, says Meg Dee, RN, director of disease management operations for Aetna. "Every teen is different," she points out. "It is not a cookie-cutter approach. It may take multiple conversations, but we don't have a time limit. That's the nature of the business and the nature of teens."

It's also the nature of teens to play video games. In fact, playing video games, instead of participating in physical activities, is one reason why many teens live that sedentary lifestyle.

HopeLab, a Palo Alto, Calif.-based nonprofit organization, has turned what many consider to be a negative—video games—into a positive by helping teenagers who have been diagnosed with cancer deal with the disease.