This brief summarizes the contributions of Kaiser Permanente Research since 2007 on the topic of adolescent health. Although this topic encompasses a wide array of health conditions, this brief will focus on a small number of specific issues affecting youth, including mental health disorders, high-risk behaviors, injuries and accidents, and issues related to the development of chronic illnesses in adulthood (such as obesity, exercise, and nutrition).
Adolescence is widely considered to be a period of ideal physical health. However, the rapid physical, cognitive, and social changes teens experience can be associated with the onset of significant health problems.
Poor nutrition1 and inadequate exercise2 are common problems that contribute to obesity3 and place youths at risk for type 2 diabetes, cardiovascular disease, and other serious health problems.4
Mental health conditions are also a concern for adolescents. The symptoms of mental health conditions, including depression and anxiety, often begin during the teen years. Approximately 1 in 8 adolescents and young adults in the United States live with depression,5 and suicide is one of the most common causes of death in this age group.6;7 Anxiety disorders affect approximately one-third of teens,8 and attention-deficit/hyperactivity disorder and eating disorders are common in adolescence.9;10
Mental health disorders and other health issues may result from adverse childhood experiences (such as traumatic events, economic hardship, or parental separation or divorce), which affect 45% of American youths.11 More recently, the COVID-19 pandemic, with its associated physical and social isolation, lockdown measures, social unrest, and various economic and other stressors, has had an adverse effect on both the physical and mental well-being of adolescents.
In many youth populations, rates of depression, anxiety, stress, suicidal ideation and behavior, and unhealthy substance use have increased,12 as has utilization of emergency and other medical services for mental health problems.13;14
Moreover, as youth transition into the increased autonomy and independence of adulthood, they are more likely to engage in high-risk behaviors. Although use of alcohol, tobacco, and most illicit drugs among American teens has declined in recent years, marijuana use has increased among 10th graders, and the National Institute on Drug Abuse has reported a substantial increase in the use of tobacco and marijuana vaping products.15 Moreover, recent surveys suggest that adolescents’ perceptions of the risks of marijuana use have declined steeply.15
High-risk sexual behavior among teens also remains common. According to the Centers for Disease Control and Prevention, 27.4% of U.S. high school students in 2019 reported having had sexual intercourse in the prior 3 months. Of these, nearly half had not used a condom, and 21.2% had used drugs or alcohol prior to intercourse.16 About 11% of students reported having been forced to engage in sexual behavior against their will, including unwanted kissing and touching, or being forced to have intercourse.16 As a consequence of risky sexual behavior, nearly 150,000 infants were born to teen mothers in 2021,17 and half of new cases of sexually transmitted infections (including 21% of new HIV diagnoses18) occur in adolescents and young adults.19
Finally, accidental deaths and injuries, primarily associated with driving, cycling, and walking,20 represent the leading cause of death among teens.21
Adolescent health is an active area of study for Kaiser Permanente Research. Scientists across the organization have used our rich, comprehensive, longitudinal data to advance knowledge in the areas of understanding risk, improving patient outcomes, and translating research findings into policy and practice. We have published nearly 730 articles related to adolescent health since 2007; together, these articles have been cited more than 22,000 times.22
These articles are the product of observational studies, randomized controlled trials, meta-analyses, and other studies led by Kaiser Permanente scientists. Our unique environment — a fully integrated care and coverage model in which our research scientists, clinicians, medical groups, and health plan leaders collaborate — lets us contribute generalizable knowledge on adolescent health and many other research topics.