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Risky health behaviors, rather than infectious or chronic diseases, are the leading causes of morbidity among adolescents.1-7 Most morbidity results from 3 risky behaviors initiated in early to middle adolescence: substance use, sexual activity, and motor/recreational vehicle use. These 3 behaviors tend to covary. For example, substance use plays a major role in motor vehicle crashes. Use of substances is associated with sexual behavior, often placing adolescents at risk for acquisition of sexually transmitted infections and unintended pregnancy.1


The primary diagnosis for adolescent emergency room visits is injuries. Trauma-related disorders are also a leading reason for outpatient provider visits as well as inpatient hospitalization for both males and females.5 Sexually transmitted infections are the most common reported infectious diseases in adolescents, and childbirth and complications related to pregnancy are the leading cause of inpatient hospitalizations for female adolescents.7,8


Additional causes of morbidity are related to chronic conditions or special health care needs.8 Mental health disorders affect between 10% and 20% of adolescents; anxiety disorders are the most common diagnosis, followed by depression (see Chapter 72).9,10 Asthma is a major chronic illness: About 16% of adolescents are reported to have lifetime asthma, and 10% to 15% reported to have current asthma.11 Diabetes is another common chronic illness. In 2004, there were 2.29 cases per 1000 adolescents among younger adolescents (ages 10–14 years) and 3.35 cases per 1000 older adolescents (ages 15–19 years), indicating that diabetes increases throughout adolescence.12 The prevalence of both asthma and diabetes has increased in recent years.


The number of adolescents who are overweight and obese is of increasing concern. The percentage of overweight adolescents has more than tripled over the past 25 years, with 17% of adolescents ages 12 to 19 considered overweight in 2004. The health consequences for adolescents can include diabetes, metabolic syndrome, high cholesterol, and hypertension; and overweight adolescents have a 70% chance of becoming overweight or obese adults (see Chapter 32).13,14


Approximately 6% of adolescents have a chronic disease that interferes with general functioning.6,15-17 The most common causes of chronic illness include mental health disorders and diseases of the respiratory and musculoskeletal systems. Younger male adolescents living in poverty are the group most impaired by chronic disease. Most adolescents suffer no major problem in their psychosocial functioning as a result of chronic disease.


Common medical problems for which adolescents seek medical care include acne, reproductive health problems resulting from variants of normal physiological maturation and initiation of sexual activity; and specific disorders of the skeletal system such as Osgood-Schlatter disease, idiopathic scoliosis, and common sports injuries; and mental health disorders.6 Reproductive health problems are discussed in Chapters 74, 75, 76, 77, and 78, skeletal disorders are discussed in Chapters 210, 211, 212, 213, 214, ...

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