The Doctor is In

BY TERENCE O’ROURKE, JR. M.D. – MEDICAL DIRECTOR, STUDENT HEALTH

re the years of age from 18 to 25 the unhealthiest years? In the Feb. 2015 edition of the Journal of Adolescent Health, a commentary summarized the latest research on health quality in late adolescents and young adults: people your age. The main, somewhat surprising finding, was that young adults were much less healthy than those under 18 and those over 25.

As young people get more autonomy at college or living on their own for the first time, they often continue to show the penchant for poor judgment we associate with teenagers. The article says young adults are generally less likely to eat breakfast, exercise regularly, go to the doctor or dentist for preventative care and they are more likely to eat fast food, contract sexually transmitted diseases, smoke cigarettes, use marijuana, hard drugs and binge drink than teenagers and those over the age of 25. Their risk for motor vehicle crashes and firearm associated homicides is also higher than the age groups above and below, and they are part of the epidemic of obesity in the young.

Behavioral health in this age group was also a big concern of the commentary’s authors, who said: “Nearly two-thirds of the burden in disability in young adults in the United States is associated with either mental health or substance use disorders. Young adulthood marks the peak in substance use and the typical age of onset of the most serious mental health conditions – psychotic disorders.” They are also more likely to contemplate and complete suicide. Only a small percentage of these young adults, 25 percent, receive appropriate behavioral health care, according to the Journal of Adolescent Health, and this group is also the most likely to abandon treatment.

One attempt to right this ship is the portion of the Affordable Care Act that allowed youngest adults to stay on their parents’ health insurance through the age of 25. Still, once in the system, the care is often inadequate. The Institute of Medicine released a report in 2014 titled “Investing in the Health and Well-Being of Young Adults.” Its major recommendation was for young adults to be treated as a special, at risk, population.

According to the commentary, its underlying recommendations included improving the transition from pediatric to adult medicine and more research and work on preventive care for young adults. This author will point out family medicine providers are perfectly suited to deal with the transition, though this author is as guilty as some at not emphasizing enough the benefits of prevention with young adult patients. We assume young adults to be naturally healthy: they are beyond the age of onset of childhood diseases and not old enough for most of the worst chronic adult diseases.

The articles and studies mentioned made the usual calls for more research and effective protocols, but there is not much money set aside for or interest in young adult health in the scientific community.

The good news is Susquehanna and the Student Health Center are very interested in your health and trying to get all of you on the right path for your long-term health while you are here. We hope you will avoid the pitfalls that affect so many young adults who get caught up in drug and alcohol abuse, risky behaviors and bad health habits all while feeling the robustness of youth going to waste. We do share the concluding sentiments of the commentary: “Healthy, productive and skilled young adults are crucial for the nation’s workforce, global competitiveness, public safety, national security and, because many are parents, to the healthy development and well-being of the next generation. Supporting all young adults in their efforts to achieve a successful and healthy transition to adulthood can benefit not only the young adults themselves but also our broader society.”