Expert Perspectives on Health Needs of Adolescents and Young Adults in This Moment
Adolescents experience rapid physical, mental and emotional growth. As a result, their health needs evolve along with their engagement with the health care system. Young adults, too, are often engaging with the health care system in new ways, independently navigating systems and coverage for the first time. And they deserve care that meets their needs.
Recent federal policy changes will impact health coverage and the care landscape. Even though most of these changes do not explicitly target adolescents and young adults, the changes will have implications for their health and well-being into adulthood.
Research helps us know how to best support adolescents’ health and well-being. In this post, ten PolicyLab experts lift up what works, offering important considerations for adolescents and young adults in the context of the federal health policy changes.
Keeping adolescents and young adults covered
Young adults (age 19-24) are more likely to be uninsured than any other age group. Three in ten have Medicaid coverage. And research shows that young people struggle with administrative processes, can have variable work schedules and are likely to change addresses regularly. These factors will impact young adults’ ability to demonstrate and maintain eligibility with Medicaid’s forthcoming work reporting requirements and increased eligibility checks.
Here’s how two of our experts—who investigate what we can do to support adolescents and young adults’ transition from pediatric to adult care—are thinking about the impact of these coverage changes for youth with complex care needs:
Dr. Emma Edmondson examines how to improve engagement with care for young people with diabetes as they age out of pediatric care.
“Young adults with diabetes face significant risks during the transition to adult care. If they fall through the cracks of our health systems and fail to establish care with an adult provider, we leave them vulnerable to grave consequences like cardiovascular disease, renal failure and irreversible vision loss.”
Dr. Daniel Zheng, who works with young cancer survivors, has shown that nearly 30% of patients reported delaying or missing care because they didn’t know what their plans covered.
"Follow-up care for cancer survivors is important for survivors’ long-term health. Insurance carriers can and should do more to help young people understand how to use their health plans. Adding even more red tape, such as work requirement reporting, will mean that more young cancer survivors could lose coverage simply because they don't understand, or keep up with, the paperwork. "
Ensuring access to behavioral health care
Nearly one-third of adolescents accessed mental health treatment in 2023. As the leading payor of behavioral health care, Medicaid covered much of this care. Moving forward, state Medicaid programs will likely receive less federal funding and may need to make difficult decisions that will impact adolescents’ and young adults’ access to behavioral health care, as the youth mental health crisis persists.
Federal funding reductions are also changing the availability of some community health resources that currently support youth mental health, such as school mental health grants established through the Bipartisan Safer Communities Act.
Here are two PolicyLab researchers on what is needed to support young people’s mental health and wellness:
Dr. Polina Krass researches mental health risks among youth in pediatric emergency departments.
“Helping children get mental health support before they experience a crisis includes investments in pediatric mental health care financing and in community supports. Adolescents are experiencing a mental health crisis, and barriers to accessing evidence-based outpatient care have already resulted in increasing Emergency Department visits for mental health conditions.”
Dr. Gwen Lawson develops and tests ways to deliver mental health interventions through schools.
“K-12 schools are an important setting to foster youth mental health, given they are where youth spend much of their time. At the same time, schools are tasked with many responsibilities with limited resources, so we need to make sure that they have adequate support and effective mental health intervention available.”
Ensuring inclusion for adolescents and young adults
Different groups of adolescents have unique experiences. National surveillance offers crucial insight into how adolescents are doing—with an eye to specific populations. Data provide an opportunity to monitor the well-being of youth, help validate interventions and identify emerging needs.
With changes to national data collection and funding, including the Youth Risk Behavior Surveillance System, we will lose important insight. And changes to specialized resources, such as the LGBTQ+ services offered through 988 (national suicide prevention and mental health crisis hotline) create a gap in services.
Three PolicyLab experts reflect on the opportunities to enhance and tailor interventions and supports to meet the specific needs of adolescents and young adults:
Dr. Renata Arrington Sanders leads research on how psychosocial factors (e.g., co-existing substance use, unstable housing and mental health) impact an adolescent’s health and contribute to health in adulthood.
“Surveillance systems are the only method that we have to identify and monitor an adolescent’s health needs. These allow providers, educators, researchers, and community members to know when and how to address key gaps in adolescent health at the national, regional, and local level. It helps us identify risk behavior, vulnerable populations, and periods of life that may need additional support. Without it, we will be creating interventions that are a shot in the dark; approaches that do not align with areas, populations and communities with the most needs.”
Dr. Scott Jelinek works to advance the health and well-being of LGBTQ+ youth and their families.
“When data systems protect privacy, they protect trust—the foundation of care for young people navigating identity and belonging—and they equip policymakers and providers to respond to the real needs of youth, not assumptions about them. As policies shift, reliable and inclusive data ensure that LGBTQ+ youth don’t disappear from the story of our nation’s health. Collecting accurate sexual orientation and gender identity data allows us to see and affirm LGBTQ+ youth within the health system, but it must be done with the highest standards of confidentiality and respect.”
Dr. Joey Whelihan has explored how support from families can be protective of LGBTQ+ youth’s mental health.
“We know that with increasing acceptance, especially from families, we can improve the mental health of LGBTQ+ youth, who experience higher rates of mental health concerns compared to their cisgender, heterosexual peers. These disparities are driven by lack of acceptance and often times, families benefit from behavioral health support to accomplish these changes. In this environment, funding and therefore access to these supports wanes.”
Maintaining confidential sexual and reproductive health care
Access to confidential and comprehensive sexual and reproductive health care is key for adolescents' well-being. It is also shifting, as PolicyLab colleagues explain. Research shows that adolescents are uniquely impacted by changes to this care landscape, and they continue to experience high rates of sexually transmitted infections and unintended pregnancy.
Three of our experts weigh in on why confidential sexual and reproductive health care matters so much to adolescents and young adults:
Dr. Sarah Green explores how to increase adolescents’ access to contraception.
“Free, confidential, and same-day reproductive health services are vitally important for young people. In this changing environment, it is more important than ever to tune into the needs of this population because barriers to accessing reproductive health disproportionately affect adolescents."
Bevin Gwiazdowski conducts research related to youth experiencing and at risk of sexually transmitted infections.
“Access to sexual health care services is a key component of addressing rising STI rates, which is particularly important as young people ages 15 to 24 account for 25% to 50% of new sexually transmitted infections or STIs each year. High-quality sexual health care that reaches adolescents and young adults means accessible hours and competent staff—something that may become difficult for providers to sustain.”
Dr. Shelby Davies works with youth living in poverty to identify opportunities to advance menstrual health equity.
"Progress has been made in recent years to elevate menstrual health as a basic human right and reduce stigma and disparities. At least 1 in 4 youth already face barriers in accessing menstrual supplies—which can impact adolescents’ participation in school and related activities and their health. Limiting access to essential reproductive health services and supplies will increase the challenges that young people are facing."
As the research shows, adolescents and young adults have unique health needs that may be impacted by the shifting health policy landscape. PolicyLab researchers will continue to build the evidence base to improve the systems that young people need to thrive.
