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Health Equity for Adolescents

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What is Health Equity?

Health equity is a component of the AAP Strategic Plan. Health equity is defined as “equity in health related to ethical and social justice issues in that is seeks to reduce health inequities between social groups – usually groups that have more and less privilege in society.” (Horn, 2004)

Horn I, Beal A. Child Health Disparities: Framing a Research Agenda, Ambulatory Pediatrics 2004; 4:269-275

Review the AAP Agenda for Children 2008-09, as it relates to the universal principle of Health Care Equity. (AAP members only)

Although health equity (and also the parallel concept of health disparities) is often viewed in terms of ethnic and racial groups, the adolescent developmental period includes some unique ethical and social justice issues that are not as prominent in other pediatric age groups.

What are specific health equity issues that relate to all adolescents?

  • Communication techniques that build trust
  • Confidentiality
  • Cultural competence that encompasses both youths' and their parents'/caregivers' views - family-centered care
  • Teen friendly offices

Special populations of adolescents who may have more disparities:

  • Racial and ethnic groups
  • Recent immigrant youth (especially first generation US citizens/immigrants)
  • Gay, lesbian, bisexual, transgender and questioning youth
  • Homeless youth
  • Youth in foster care
  • Youth in juvenile detention/legal system
  • Youth that have dropped out of school
  • Young males

AAP Resources

Health literacy a cornerstone of quality pediatric care
By: O. Marion Burton, MD, FAAP, AAP News 2011; 32; 6

Promoting Health Equity in Adolescent Care: A 2-part Web Cast Series
This archived Web cast series, sponsored by the AAP Adolescent Health Partnership Project, and held in July and August 2009, helps participants understand the health disparities that adolescents face and provides practical approaches to reframe how adolescent care is provided.

AAP Policy Statements:
Culturally Effective Pediatric Care: Education and Training Issues
Enhancing the Diversity of the Pediatric Workforce
Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy

The AAP Community Pediatrics Web pages also provide resources related to cultural competence and health equity:

“Creating a Healthy Physician-Patient Relationship with Adolescents from Diverse Backgrounds”
Roger Apple, MA, printed in Section on Adolescent Health Newsletter, Winter 2008 (access available only to AAP SOAH members.)

HIPPA and Adolescent Privacy in a Nutshell

Gotlieb EM.
In: Aten CB, Gotlieb EM, eds. Caring for Adolescent Patients
Elk Grove Village, IL: American Academy of Pediatrics; 2006: 843

Office-Based Care of Adolescents: Part 1
Creating a Teen-Friendly Office

Rainey DY.
Adolescent Health Update, Vol 16, No 1, October 2003

Other Important Resources

Teen Bill of Rights
New York Chapter 3, Committee on Adolescence developed the “New York State Teen’s Health Care Bill of Rights,” which became available in 2005 and was reprinted in 2007.  This project was written up in the Section on Adolescent Health Newsletter, Winter 2008. Contact: Jessica Geslani, NY District II Coordinator, jgeslani@aap.org, 516-326-0310.

Minors’ Access Cards
The Physicians for Reproductive Choice and Health has developed short summaries of the reproductive health laws in 11 states.

Guttmacher Institute
The Guttmacher Institute publishes information about state's policies regarding minor's consent laws and adolescent access to certain sexual health services.

Self-Assessment Exercise on Cultural Competence
(Developed by T. Goode, Georgetown University Child Development Center-UAP. Adapted from Promoting Cultural Competence and Cultural Diversity in Early Intervention and Early Childhood Settings and Promoting Cultural Competence and Cultural Diversity for Personnel Providing Services and Supports to Children with Special Health Care Needs and Their families (June 1989, revised 1993; revised 1996; October 1997; September 1999; July 2000).