While the health of children and older people has improved considerably, young people have fallen through the gap in targeted services, argues Dr Russell Viner, the UK's only consultant in adolescent medicine.
Mortality rates for adolescents from injury and suicide have increased fivefold over the last century - rising from 11% of total deaths for 15-19 year olds in 1901-10, to 57% in 2003. Rates of obesity, sexually transmitted infections, smoking and teenage pregnancies among adolescents have also increased or shown no improvement over the last twenty years.
"Adolescence is a critical period for engaging the population in health" says Dr Viner, as behaviour and attitudes towards health are maintained into adulthood. Yet current strategies do not target young people appropriately, and do not engage them with their own healthcare. Existing policies also ignore health inequalities - which have a considerable influence on adolescent health, he argues.
Young people must be recognised as a distinct group in devising public health policies, says Dr Viner, and staff must be properly skilled to address their health needs. The exclusive focus on one issue or target - such as teenage pregnancy - misses the other influencing factors in adolescent behaviours, so approaches must be developed which cross education, social services and the justice system.
At the age of 14-15 adolescents should also be "re-registered" with general practitioners, allowing them to establish a relationship with their GP outside of the family context, says Dr Viner. New health services designed for and by young people - including sexual health and counselling services - should also be developed in urban areas.