Exam Update - Teenage health problems

  • Adolescence is a critical period for engaging the population in health because new health behaviours are laid down that track into adulthood.
  • The UK has the second highest teenage pregnancy rate in the developed world.
  • The £150 million campaign to reduce teenage pregnancies has failed - there has been a rise in the number of 14-year-olds becoming pregnant.
  • For teenagers, key public health indicators in priority areas such as obesity, smoking, STIs and teenage pregnancy have actually shown adverse trends or no change in the past 20 years (BMJ 2005; 330: 901).

What is the evidence?

- Recent concern in the UK has focused on issues such as continued high levels of smoking by young women, binge drinking and associated antisocial behaviour by young people in general, and higher levels of cannabis use in adolescents than in most European countries (BMJ 2005; 331: 393-6).

- The specific health needs of young people are often neglected by primary care because it is believed that adolescents are on the whole a healthy group who rarely present to their GP (BMJ 2005; 330: 465).

- Improving services to allow young people to engage with their health will result in short- and long-term population health gains (BMJ 2005; 330: 901).

- To maximise the impact of services in promoting sexual health in adolescents, more innovative means of offering advice and promoting sexual health will be needed (BMJ 2005; 330: 107).

- A report has found that women under the age of 18 who live in more deprived areas of Britain have higher rates of conception than women in wealthier areas, but are less likely to opt for an abortion (BMJ 2004; 329: 14).

Implication for practice

- An efficient future health service should be built on adolescents' engagement with their own health, but there is much to be done to achieve this goal.

Available guidelines

- The DoH has recently updated guidance that clarifies the duty of confidentiality, care, and good practice in providing advice to young people under the age of 16 (Teenage Pregnancy Unit, DoH).

- The government has decided not to introduce mandatory reporting of under-age sexual activity. All cases of sexually-active under-age patients should be documented and GPs should record detailed reasons for not sharing information.

Useful websites

www.dfes.gov.uk/ teenagepregnancy - Teenage Pregnancy Unit

www.jrf.org.uk - A matter of choice? Explaining national variations in teenage abortion and motherhood.

- Dr Louise Newson is a GP in the West Midlands and author of 'Hot Topics for MRCGP and General Practitioners', Pas Test 2006

KEY POINTS
- Sexual health is important.
- Teenage pregnancy rates are still high.
- Teenage health is often neglected.
- GPs should be providing better healthcare for teenagers.

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