Unmet healthcare need in adolescence linked to poor adult outcomes

1. Almost one in five adolescents report unmet healthcare needs for a variety of reasons, the most common of which is perceived low importance or non-financial access problems.

2. Unmet healthcare need in adolescence was associated with an increased odds of fair/poor general health, functional impairment, depressive symptoms, and suicidal ideation in adulthood.

Evidence Rating Level: 2 (Good)    

Study Rundown: Adolescence is a period of time fraught with transitions and formative experiences that have effects into adulthood. Country-level data has shown an association between accessible healthcare experiences in adolescence and future positive health outcomes. There is also evidence that points to poor outcomes in adolescents with unmet healthcare needs. Until now, the data has only been investigated in a broader scope. This study investigated the effects of unmet healthcare needs in adolescence using individual-level data. Using adolescents’ reports of healthcare need, the study authors followed the cohort and analyzed self-reported healthcare outcomes 13 years later. They found that almost 20% of adolescents reported unmet healthcare needs. Of these, one third reported that this was due to “perceived low importance” and another third reported “non-financial access problems.” Those with unmet healthcare needs had a significantly increased odds of fair/poor general health, functional impairment, depressive symptoms, and suicidal ideation in adulthood. While this study uniquely addresses this significant question, it is limited by non-specific and self-reported variables. Nonetheless, these results showed the individual effects of poor access on one’s future health, highlighting the importance of creating strategies that engage teens in advocating for and accessing healthcare.

Click to read the study published today in Pediatrics

Relevant Reading: Adolescence: a foundation in future health

Study Author, Dr. Dougal S. Hargreaves, MBBChir, MD, talks to 2 Minute Medicine: UCL Institute of Child Health, Division of General Pediatrics, Department of Medicine, and Population, Policy and Practice Programme.

“Many people are worried about how health care systems can be sustainable in the future – for example, due to an ageing population and growing use of expensive medical technologies. Although further research is needed, our study suggests that delivering high-quality, accessible health services for adolescents has the potential to make long-term improvements to the health of those individuals and reduce their need for health services as adults.”

In-Depth [prospective cohort study]: Data was taken from Waves I (1994-1995) and IV (2008) of the Add Health study, with a 78.2% retention rate at Wave IV (n= 14,800). The mean age in Wave I was 15.9 years (53.3% white and 46.8% male )and 29.6 years in Wave IV. Dependent variables were 5 self reported health outcomes: general health, functional impairment, missed any work/school for health reasons, depressive symptoms, and suicidal ideation. Wave I participants were asked if they ever thought they needed access to health care, but did not access it, and why. In Wave I, the prevalence of unmet healthcare need was 19.2%. Thirty-seven percent of adolescents with unmet needs cited “perceived low importance” while 32% described “nonfinancial access problems.” There was no significant association between reasons for unmet need and health outcomes. Adolescents with unmet healthcare needs in Wave I, had increased odds of fair/poor general health, functional impairment, depressive symptoms and suicidal ideation in Wave IV (OR= 1.27 [95% CI 1.00-1.60], 1.52 [95% CI 1.23-1.87], 1.36 [95% CI 1.13-1.64], 1.30 [95% CI 1.03-1.68], respectively).

Image: PD

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