Unmet Health Care Need in US Adolescents and Adult Health Outcomes
Abstract
BACKGROUND: Adolescence is a formative period when health care services have a unique opportunity to influence later health outcomes. Unmet health care need in adolescence is known to be associated with poor contemporaneous health outcomes; it is unknown whether it predicts poor adult health outcomes. METHODS: We used nationally representative data from 14 800 subjects who participated in Wave I (mean age: 15.9 years [1994/1995]) and Wave IV (mean age: 29.6 years [2008]) of the National Longitudinal Study of Adolescent to Adult Health. Logistic regression models were used to estimate the association between unmet health care need in adolescence and 5 self-reported measures of adult health (fair/poor general health, functional impairment, time off work/school, depressive symptoms, and suicidal ideation). Models were adjusted for baseline health, insurance category, age, gender, race/ethnicity, household income, and parental education. RESULTS: Unmet health care need was reported by 19.2% of adolescents and predicted worse adult health: fair/poor general health (adjusted odds ratio [aOR]: 1.27 [95% confidence interval (CI): 1.00–1.60]); functional impairment (aOR: 1.52 [95% CI: 1.23–1.87]); depressive symptoms (aOR: 1.36 [95% CI: 1.13–1.64]); and suicidal ideation (aOR: 1.30 [95% CI: 1.03–1.68]). There was no significant association between unmet health care need and time off work/school (aOR: 1.13 [95% CI: 0.93–1.36]). Cost barriers accounted for only 14.8% of unmet health care need. The reason for unmet need was not significantly related to the likelihood of poor adult health outcomes. CONCLUSIONS: Reported unmet health care need in adolescence is common and is an independent predictor of poor adult health. Strategies to reduce unmet adolescent need should address health engagement and care quality, as well as cost barriers to accessing services.
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Unmet health care needs highly impact adolescents and young adults' physical and mental health outcomes in adulthood.
“Unmet health care needs highly impact AYAs’ physical and mental health outcomes in adulthood [16].”
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- Authors
- Hargreaves, D. S., Elliott, M. N., Viner, R. M., Richmond, T. K., & Schuster, M. A.
- Affiliations
- University College London (GB)
- RAND Corporation (US)
- Boston Children's Hospital (US)
- Harvard University (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2015-09-01
- Volume
- 136
- Issue
- 3
- Pages
- 513-520
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2170367623
- Cited by
- 111
- References
- 27
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 15 · 2023: 6 · 2022: 12 · 2021: 12 · 2020: 12 · 2019: 14 · 2018: 10 · 2017: 2 · 2016: 9 · 2015: 1
- FWCI
- 16.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- UNICEF
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- adolescents, adult health outcomes, functional disability, depressive symptoms, suicidal ideation, health status, financial barriers to care, health care access, adolescent to adult transition, Add Health
- MeSH terms
- Absenteeism, Adolescent, Adult, Depression, Health Services Needs and Demand, Health Status, Humans, Longitudinal Studies, Socioeconomic Factors, United States, Prevalence, Adolescent Health Services, Insurance Coverage, Young Adult, Suicidal Ideation
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