Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, March 17, 1993 TAG: 9303170388
SECTION: EDITORIAL PAGE: A7 EDITION: METRO
SOURCE: TOM ROBERTSON
DATELINE: LENGTH: Long
IN PARTNERSHIP FOR TEEN HEALTH
ROANOKE'S 11,000 adolescents need our help. Their physical and mental health is in a state of neglect.Their access to health-care providers is sadly lacking. Many simply have no way to get to where the care is offered. Others have no way to pay for medical services.
Over the past 30 years, adolescents have been the only population group in the United States not to see an improvement in health status. Injury and illness due to societal, environmental and behavioral factors have left 10- to 19-year-olds at greater risk than ever before.
Poor nutrition, lack of exercise, abuse of illegal drugs and alcohol, smoking, sexual activity, and delinquent and violent behavior can threaten or shorten the life of adolescents.
By age 15, about a quarter of all adolescents are engaged in behaviors that are harmful or dangerous to themselves or others. The consequences are increases in depression and other mental disorders, early pregnancy and childbirth, sexually transmitted diseases, abortion, homelessness, failure at school, injury, disease and death.
Our health-care system is not meeting the needs of many adolescents. Consider these disturbing statistics:
One of seven adolescents has no health insurance. One of three poor adolescents is not covered by Medicaid.
Adolescents visit physicians' offices less than any age group, though they have a higher rate of acute conditions.
One in five adolescents has at least one serious health problem. Five to 10 percent have a chronic disease or disability. Five percent are obese and 25 percent are overweight.
Violence and injury account for three of every four adolescent deaths. In Roanoke, homicide was the leading cause of death among 15- to 19-year-olds in 1990. That same year, juvenile offenses of all types totaled more than 3,600, a 20 percent increase since 1980. The number of violent crimes involving juveniles increased 13 percent since 1980 to nearly 500 incidents per year.
More adolescents are experimenting with drugs at younger ages, especially before age 15. Smoking and drug use are on the rise, especially among middle-school students.
In a survey of middle- and high-school students in Roanoke, young adolescents reported more use of beer, cigarettes, wine coolers, liquor and marijuana than their peers nationwide. Students in Roanoke also found it easier to obtain beer, marijuana and cocaine than students nationwide.
Nearly 1 million adolescents become pregnant each year. In 1990, the pregnancy rate among Roanoke adolescents (more than 92 for every 1,000 teens) was nearly twice the state average. There were 536 adolescent pregnancies in Roanoke in 1991.
Every year, 2.5 million adolescents become infected with sexually transmitted diseases. In Roanoke in 1991, more than 400 had a sexually transmitted disease.
Mental disorders affect 634,000 adolescents and account for 32 percent of adolescent disabilities. In a national survey, more than half of adolescents reported feeling sad and hopeless, 45 percent reported difficulty coping with home and work, 34 percent had thought about suicide and 14 percent had attempted suicide. Over the past 30 years, adolescent suicide rates have tripled.
Poverty increases the risk of poor health among adolescents. Of the approximately 6,300 students enrolled in Roanoke's middle schools and high schools, 51 percent are classified as economically disadvantaged.
One obvious way to improve the health of Roanoke's adolescents is to bring health care directly to them - in the communities where they live and the schools they attend.
The Roanoke Adolescent Health Partnership seeks to overcome barriers to adolescent health care by building on two existing programs - the Teen Health Center in the Hurt Park community and the school health program of the Roanoke Health Department and Roanoke city schools.
The Roanoke Adolescent Health Partnership was formed in 1992 to provide community-based and school-based health-care services to adolescents. Members of the partnership believe a key to improving adolescent health is accessibility.
The partnership has developed a pilot project that will expand services at the Teen Health Center, now open only one afternoon a week. It also will establish comprehensive health-care services at Patrick Henry High School and Ruffner Middle School for the next two school years.
The project is being funded with a $400,000 grant from Carilion Health System. Carilion is making this commitment because part of its mission is to work with other groups to improve the health status of the communities it serves. Other members of the partnership are Roanoke city schools, the Roanoke Health Department and the Roanoke Redevelopment and Housing Authority.
The Roanoke Adolescent Health Project will work with resources at the schools, the Health Department and at other human-service agencies in the area so treatment of students is well-coordinated and as comprehensive as possible. These resources include school nurses, guidance counselors, substance-abuse counselors, public-health nurses and social workers. Referrals will be made to other agencies whenever appropriate.
Basic services will include physical exams, health screenings, treatment of acute conditions, immunizations and nutrition counseling. Other services include mental-health counseling, drug and alcohol counseling, health education, family-planning information and referral, and limited laboratory testing. Students must have written parental permission to obtain services.
Roanoke is woefully short of the goal established by the General Assembly of one school nurse for every 1,000 students. Its school nurse-to-student ratio is approximately 1 to 4,000. Most nurses in the city serve elementary students. One part-time nurse serves students at four of the city's six middle schools. The city's two high schools must rely on Health Department nurses who visit the schools only one or two hours a week.
Late last year, the Roanoke School Board voted to improve the ratio of school nurses by adding four nurses each year over the next three years. The partnership believes its project will complement that effort and strengthen access to health-care services for adolescents, giving them more of an opportunity to build a better future.