State Policies that Support Adolescent Health and Well-Being
This report, written by Susan Wile Schwarz and Yumiko Aratani from the National Center for Children in Poverty (NCCP), looks at how well the United States is currently meeting the health and development needs of all adolescents and particularly of disadvantaged youth.
For policymakers, adolescence presents an invaluable opportunity to ensure that all young people can access the high-quality services and supports they need to improve their odds of becoming successful, healthy, productive adults. At an historic moment when the provisions and breadth of health care reform are under vigorous debate, it is important to know whether the states meet the health and development needs of adolescents. This report presents information from NCCP’s Improving the Odds for Adolescents project about state policy choices that affect the health and well-being of adolescents.
For adolescents whose family income is up to 200 percent of the federal poverty line (FPL), almost every state offers public health insurance coverage through the Children’s Health Insurance Program (CHIP), and about a third offer coverage through Medicaid. Variability exists among states’ choices to extend coverage to different groups of vulnerable youth. Only about one-fifth of states do not terminate Medicaid enrollment for juvenile justice-involved youth.
Most states recognize the key role schools play in promoting the health and well-being of their students. However, there has been noticeably less agreement in how integrated and extensive this role should be and whether it should include health services provision. More than half of states have specific health-related curricula requirements, including physical education requirements, and about a third fund direct health services offered by school-based health centers. Health curricula in nearly two-thirds of states must cover prevention of HIV, sexually transmitted infections, and pregnancy. Yet, only one-fifth require schools to provide any services related to this prevention.
Nearly all states may allow adolescents to consent to a variety of reproductive health and family planning services, with the exception of abortion services, but very few have policies explicitly dictating who can and cannot consent to services and whether confidentiality will be maintained. Lack of clarity about the right to consent and confidentiality can cause confusion among service providers and especially among adolescents in need of care.