Health Insurance for Children 117 www.futureofchildren.org The Unique Health Care Needs of Adolescents Claire D. Brindis, Madlyn C. Morreale, and Abigail English H ealth insurance coverage plays a key role in meeting adolescents’ needs by increasing their access to health care, yet adolescents are more likely to lack coverage than younger children. 1 One in seven adolescents ages 10 to 18 has no form of public or private insurance. 2 Even higher rates of uninsurance are found among low- income, black, and Hispanic adolescents. For low- income adolescents, insurance through public programs such as Medicaid and the State Children’s Health Insur- ance Program (SCHIP) is particularly important. Like younger children without coverage, adolescents without insurance use fewer health services, receive care less fre- quently, return for fewer follow-up appointments, and are more likely to seek care in an emergency room. 3,4 While most adolescents are healthy by traditional med- ical standards, a significant number of young people experience some serious physical or mental health prob- lems or concerns. For example, approximately one in five adolescents suffers from at least one serious health problem, such as chronic conditions, asthma, or depres- sion; and about one in four is believed to be at risk for early unprotected sexual intercourse or substance abuse. 5 Moreover, many health problems occur disproportion- ately among adolescents who are Medicaid and SCHIP eligible. Low-income adolescents, especially those of color, have higher rates of death, illness, and health risk behaviors in almost every category studied. 6 In addition, other subgroups of adolescents face special, heightened health risks and are more likely to have acute and com- plex health care needs. These groups include youth who have chronic physical or mental health conditions; live in foster or group homes; are homeless or have run away from home; are undocumented, migrant, or new immi- grants; have limited English language skills; are incarcer- ated or involved in the juvenile justice system; or are pregnant or parenting. 7 Making adolescent health a priority is especially timely because significant demographic changes are occurring in the United States. While adolescents will represent a smaller proportion of the overall population, the num- ber of adolescents ages 10 through 19 is expected to grow from 39.8 million in 2000 to 42.3 million in 2020, a 6.4% increase. 8 Moreover, adolescent population pro- jections anticipate far greater numbers of young people of color, who are more likely to live in poverty, be unin- sured, and underutilize primary and preventive health care services. 9 This article describes the particular health care needs of adolescents and explores the extent to which public Claire D. Brindis, Dr.P.H., is a professor of pediatrics and health policy with the Division of Adolescent Med- icine and the Institute for Health Policy Studies at the University of California, San Francisco. Madlyn C. Morreale, M.P.H., is deputy director of the Center for Adolescent Health & the Law. Abigail English, J.D., is director of the Center for Adolescent Health & the Law.