Improve the healthy development, health, safety, and well-being of adolescents and young adults (AYAs).
Adolescents (ages 10 to 17) and young adults (ages 18 to 25) make up 22% of the United States population.1 The behavioral patterns established during these developmental periods help determine young people’s current health status and their risk for developing chronic diseases during adulthood.2
Although adolescence and young adulthood are generally healthy times of life, some important health and social problems either start or peak during these years.3 Examples include:
- Mental disorders
- Substance use
- Smoking/nicotine use
- Nutrition and weight conditions
- Sexually transmitted infections, including human immunodeficiency virus (HIV)
- Teen and unintended pregnancies
- Academic problems and dropping out of school
- Motor vehicle collisions
Because they are in developmental transition, adolescents and young adults (AYAs) are particularly sensitive to influences from their social environments.4 Their families, peer groups, schools, and neighborhoods can either support or threaten young people’s health and well-being.5 Societal policies and cues, such as structural racism and media messages, can do the same.5 Older adolescents and young adults, including those with chronic health conditions, may face challenges as they transition from the child to the adult health care system, such as changes in their insurance coverage and legal status and decreased attention to their developmental and behavioral needs.6 Bolstering the positive development of young people facilitates their adoption of healthy behaviors and helps ensure a healthy and productive adult population.7, 8
Why Is Adolescent and Young Adult Health Important?
Adolescence is a critical transitional period9, 10 that includes the biological changes of puberty and developmental tasks such as normative exploration and learning to be independent.4, 11 Young adults who have reached the age of majority also face significant social and economic challenges with few organizational supports at a time when they are expected to take on adult responsibilities and obligations.12
There are significant disparities in outcomes among racial and ethnic groups. In general, AYAs who are African American, American Indian, or Latino, especially those living in poverty, experience worse outcomes in a variety of areas such as obesity,13 teen and unintended pregnancy,14 tooth decay,15 and educational achievement,16 compared to AYAs who are Caucasian or Asian American. In addition, sexual minority youth have a higher prevalence of many health risk behaviors.17
The financial burdens of preventable health problems are large and include the long-term costs of chronic diseases resulting from behaviors begun during adolescence and young adulthood. For example, the annual adult health–related financial burden of cigarette smoking, which usually starts during these years, was calculated as $289 billion for 2009–2012.18
There are many examples of effective policies and programs19 that address AYA health issues:
- Access to health care20
- School-based health care services21
- State graduated driver licensing programs22
- Prevention of alcohol,23, 24 marijuana,25 and tobacco use26, 27
- Violence prevention28, 29, 30
- Delinquency prevention31, 32, 33, 34
- Mental health and substance use interventions23, 35, 36
- Teen pregnancy prevention37, 38, 39, 40
- HIV prevention41, 42
Understanding Adolescent and Young Adult Health
The leading causes of illness and death among AYAs are largely preventable,3 and health outcomes are frequently both behaviorally mediated43 and linked to multiple social factors. This is shown by the following empirical examples:
- Adolescents who have good communication and are bonded with a caring adult are less likely to engage in risky behaviors.44
- Parents who supervise and are involved with their adolescents’ activities are promoting a safe environment for them to explore opportunities.44, 45- Photos Made Easy Passport Youtube Easiest Photoshop
- The children of families living in poverty are more likely to have health conditions and poorer health status, as well as lower access to and use of health care services.46, 47, 48
- Student health and academic achievement are linked.49 Healthy students are more effective learners.50
- Academic success and achievement strongly predicts overall adult health outcomes. Proficient academic skills are associated with lower rates of risky behaviors and higher rates of healthy behaviors.51
- High school graduation leads to lower rates of health problems52, 53 and risk for incarceration,54, 55 as well as enhanced financial stability and socio-emotional well-being during adulthood.12, 56, 57, 58, 59
- The school social environment affects student attendance, academic achievement, engagement with learning, likelihood of graduation, social relationships, behavior, and mental health.60, 61, 62Ec; Summons Standard News On Sunita Business May Voter Up Delhi Kejriwal Court Id 3 Hearing Row, 63, 64
- AYAs growing up in distressed neighborhoods with high rates of poverty are at risk for exposure to violence and a variety of negative outcomes, including poor physical and mental health, delinquency, and risky sexual behavior.65, 66
- AYAs exposed to media portrayals of violence, smoking, and drinking are at risk for adopting these behaviors.67
- Although social media use offers important benefits to AYAs, such as health promotion, communication, education, and entertainment, it also increases risks for exposure to cyberbullying, engagement in “sexting,” and depression.12Creating Account Test - A Sage Paypal ,68, 69, 70
Emerging Issues in Adolescent and Young Adult Health
Three important issues influence how the health of AYAs will be approached in the coming decade:
- The AYA population is becoming more ethnically diverse, with rapid increases in the numbers of Latino and Asian American youth. The growing ethnic diversity will require cultural responsiveness to health care needs as well as sharpened attention to disparate health, academic, and economic outcomes.71
- The mental health of AYAs has a profound impact on their physical health, academic achievement, and well-being.72 About 50% of lifelong mental disorders begin by age 14 and 75% begin by age 24.73 Suicide is a leading cause of death among AYAs74 and suicide rates climbed significantly for these age groups between 1999 and 2014.75, 76 Trauma associated with common adverse childhood experiences (ACEs) contributes to mental and behavioral health issues for many youth77, 78, 79 as well as negative adult outcomes.80 Fortunately, at least some ACEs can be prevented and their effects improved.81, 82
- Positive youth development (PYD) interventions are intentional processes that provide all youth with the support, relationships, experiences, resources, and opportunities needed to become competent, thriving adults.83 Their use is growing for preventing AYA health risk behaviors.84 An expanding evidence base demonstrates that well-designed PYD interventions can lead to positive outcomes, including the prevention of AYA health risk behaviors. Additional evaluation is necessary to learn how to tailor successful interventions to meet the needs of different groups of AYAs.85, 86, 87, 88, 89
1 U.S. Census Bureau. Annual estimates of the resident population by sex, age, race, and Hispanic origin for the United States and states: April 1, 2010 to July 1, 2014. 2014 Population Estimates. Available from: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk
2 Lawrence RS, Gootman JA, Sim LJ, eds., and the Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development, National Research Council and Institute of Medicine of the National Academies. Adolescent health services: Missing opportunities. Washington, DC: National Academies Press; 2009. Available from: https://www.nap.edu/catalog/12063/adolescent-health-services-missing-opportunities
3 Park MJ, Scott JT, Adams SH, Brindis CD, Irwin CE. Adolescent and young adult health in the United States in the past decade: Little improvement and young adults remain worse off than adolescents. J Adolesc Health. 2014;55(1):3–16. doi: 10.1016/j.jadohealth.2014.04.003.
4 Sawyer SM, Bearinger LH, Blakemore SJ, Dick B, Ezeh A, Patton GC. Adolescence: A foundation for future health. Lancet. 2012;379:1630–40. Available from: http://www.thelancet.com/journals/lancet/issue/vol379no9826/PIIS0140-6736(12)X6017-3
5 Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, Currie C. Adolescence and the social determinants of health. Lancet. 2012;379:1641–52. doi: 10.1016/S0140-6736(12)60149-4. Available from: http://www.thelancet.com/journals/lancet/issue/vol379no9826/PIIS0140-6736(12)X6017-3
6 Bonnie RJ, Stroud C, Breiner H, eds., and the Committee on Improving the Health, Safety, and Well-Being of Young Adults, Institute of Medicine and National Research Council of the National Academies. Investing in the health and well-being of young adults. Washington, DC: The National Academies Press; 2014. Available from: http://www.nap.edu/catalog/18869/investing-in-the-health-and-well-being-of-young-adults
7 McNeely C, Blanchard J. The teen years explained: A guide to healthy adolescent development. Baltimore: Johns Hopkins Bloomberg School of Public Health, Center for Adolescent Health; 2009. Available from: https://www.jhsph.edu/research/centers-and-institutes/center-for-adolescent-health/_docs/TTYE-Guide.pdf
8 Nagaoka J, Farrington CA, Ehrlich SB, Heath RD. Foundations for young adult success: A developmental framework. Concept paper for research and practice. Chicago, IL: The University of Chicago Consortium on Chicago School Research; 2015. Available from: https://consortium.uchicago.edu/sites/default/files/publications/Foundations%20for%20Young%20Adult-Jun2015-Consortium.pdf
9 Johnson MK, Crosnoe R, Elder GH. Insights on adolescence from a life course perspective. J Res Adolescence. 2011;21(1):273-80. doi: 10.1111/j.1532-7795.2010.00728.x. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3072576
10 Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: A Lancet commission on adolescent health and wellbeing. Lancet. 2016;387:2423-2478. doi: 10.1016/S0140-6736(16)00579-1. Available from: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)00579-1.pdf
11 McNeely C, Blanchard J. The teen years explained: A guide to healthy adolescent development. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health, Center for Adolescent Health; 2009. Available from: https://www.jhsph.edu/research/centers-and-institutes/center-for-adolescent-health/_docs/TTYE-Guide.pdf
12 IOM (Institute of Medicine) and NRC (National Research Council). Investing in the health and well-being of young adults. Washington, DC: The National Academies Press; 2014. Available from: http://www.nap.edu/catalog/18869/investing-in-the-health-and-well-being-of-young-adults
13 Frederick CB, Snellman K, Putnam RD. Increasing socioeconomic disparities in adolescent obesity. Proc Natl Acad Sci U S A. 2014;111(4):1338–1342. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910644
14 Romero L, Pazol K, Warner L, Cox S, Kroelinger C, Besera G, et al. Reduced disparities in birth rates among teens aged 15–19 Years — United States, 2006–2007 and 2013–2014. MMWR. 2016;65(16):409-414. Available from: http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6516a1.pdf
15 Dye BA, Li X, Thornton-Evans G. Oral health disparities as determined by selected Healthy People 2020 oral health objectives for the United States, 2009-2010. NCHS Data Brief, No 104. Hyattsville, MD: National Center for Health Statistics; 2012. Available from: http://www.cdc.gov/nchs/data/databriefs/db104.pdf
16 National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education. The nation’s report card: Math and reading assessments, 2015. Available from: http://www.nationsreportcard.gov/reading_math_2015/#?grade=8 and http://www.nationsreportcard.gov/reading_math_g12_2015/#reading and http://www.nationsreportcard.gov/reading_math_g12_2015/#mathematics
17 Kann L, Olsen EO, McManus T, Harris WA, Shanklin SL, Flint KH, et al. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9–12 — United States and selected sites, 2015. MMWR Surveill Summ. 2016;65(SS-9):1-202. Available from: https://www.cdc.gov/mmwr/volumes/65/ss/ss6509a1.htm
18 U.S. Department of Health and Human Services. The health consequences of smoking—50 years of progress: A report of the Surgeon General. Atlanta, GA: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention; 2014. Available from: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf
19 Catalano RF, Fagan AA, Gavin LE, Greenberg MT, Irwin CE, Ross DA, Shek DTL. Worldwide application of prevention science in adolescent health. Lancet. 2012;379:1653-64. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60238-4/fulltext
20 Larson K, Cull WL, Racine AD, Olson LM. Trends in access to health care services for U.S. children 2000-2014. Pediatrics. 2016;138(6):e20162176. doi: 10.1542/peds.2016-2176.
21 The Guide to Community Preventive Services 2015. Promoting health equity through education programs and policies: School-based health centers. Task Force Finding and Rationale Statement. Available from:
22 Zhu M, Zhao S, Long L, Curry AE. Association of graduated driver licensing with driver, non-driver, and total fatalities among adolescents. Am J Prev Med. 2016;51(1):63-70. Available from: https://dx.doi.org//10.1016/j.amepre.2016.02.024
23 U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Washington, DC: HHS; 2016. Available from: http://www.surgeongeneral.gov/library/reports/ OR https://addiction.surgeongeneral.gov
24 Harding FM, Hingson RW, Klitzner M, Mosher JF, Brown J, Vincent RM, et al. Underage drinking: A review of trends and prevention strategies. Am J Prev Med. 2016;51(4Suppl2):S148-S157. doi: 10.1016/j.amepre.2016.05.020.
25 American Academy of Pediatrics. The impact of marijuana policies on youth: Clinical, research and legal update. Pediatrics. 2015;135(3):584-587. doi: 10.1542/peds.2014-4146.
26 United States Department of Health and Human Services. Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012. Available from: http://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf
27 United States Department of Health and Human Services. The Surgeon General’s report on youth/young adults and e-cigarettes. Atlanta, GA: United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016. Available from: http://www.surgeongeneral.gov/library/reports
28 David-Ferdon C, Simon TR. Preventing youth violence: Opportunities for action. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2014. Available from: https://www.cdc.gov/violenceprevention/youthviolence/pdf/opportunities-for-action.pdf
29 David-Ferdon C, Simon TR. Taking action to prevent youth violence: A companion guide to preventing youth violence: Opportunities for action. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2014. Available from: https://www.cdc.gov/violenceprevention/youthviolence/pdf/opportunities-for-action-companion-guide.pdf
30 National Academies of Science, Engineering, and Medicine. Preventing bullying through science, policy, and practice. Washington, DC: The National Academies Press; 2016. doi: 10.17226/23482. Available from: http://www.nap.edu/catalog/23482/preventing-bullying-through-science-policy-and-practice
32 Center for the Study and Prevention of Violence. Blueprints for healthy youth development. Boulder, CO: University of Colorado Boulder, Institute of Behavioral Science, Center for the Study and Prevention of Violence. Available from: http://www.blueprintsprograms.com
33 Hawkins JD, Oesterle S, Brown EC, Abbott RD, Catalano RF. Youth problem behaviors 8 years after implementing the Communities That Care prevention system: A community-randomized trial. JAMA Pediatrics. 2014; 168(2):122-129. doi: 10.1001/jamapediatrics.2013.4009.
34 Spoth R, Redmond C, Shin C, Greenberg M, Feinberg M, Schainker L. PROSPER community-university partnership delivery system effects on substance misuse through 6½ years post baseline from a cluster randomized controlled intervention trial. Prev Med. 2013;56(3):190-196. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23276777
35 Jones TM, Hill KG, Epstein M, Lee JO, Hawkins JD, Catalano RF. Understanding the interplay of individual and socio-developmental factors in the progression of substance use and mental health from childhood to adulthood. Dev Psychopathology. 2016;28(3):721-741. doi: 10.1017/SO954579416000274. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5011437/
36 O'Connell ME, Boat T, Warner KE, eds., and National Research Council and Institute of Medicine, Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Preventing mental, emotional and behavioral disorders among young people: Progress and possibilities. Washington: National Academies Press; 2009. Available from: http://books.nap.edu/catalog.php?record_id=12480
37 U.S. Department of Health and Human Services. Teen pregnancy prevention evidence review. Available from: http://tppevidencereview.aspe.hhs.gov/EvidencePrograms.aspx
38 Brindis CD, ed. Implementing community-wide teen pregnancy prevention initiatives. J Adolesc Health. 2017;60(3, Supplement):S1-S68. Available from: http://www.jahonline.org/issue/S1054-139X(17)X0003-7
39 Treadwell HM, Satcher D, Batliner TS, Borrell LN, eds. Preventing teen pregnancy. Supplement to AJPH. 2016;106(S1):S1-S139.
40 Beltz MA, Sacks VH, Moore KA, Terzian M. State policy and teen childbearing: A review of research studies. J Adol Health. 2015;56(2):130-138. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25620298
41 Centers for Disease Control and Prevention. The guide to community preventive services: Preventing HIV/AIDS, other STIs, and teen pregnancy: Group-based comprehensive risk reduction interventions for adolescents. Recommended June 2009. Available from: http://www.thecommunityguide.org/hiv/riskreduction.html
42 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention. Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Atlanta, GA: Centers for Disease Control and Prevention; 2016. Available from: http://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html
43 Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, Currie C. Adolescence and the social determinants of health. Lancet. 2012;379:1641-52. doi: 10.1016/S0140-6736(12)60149-4. Available from: http://www.thelancet.com/journals/lancet/issue/vol379no9826/PIIS0140-6736(12)X6017-3
44 Moore KA, Whitney C, Kinukawa A. Exploring the links between family strengths and adolescent outcomes. Child Trends Research Brief 2009. Publication # 2009-20. Available from: http://www.childtrends.org/wp-content/uploads/2013/03/Child_Trends-2009_04_16_RB_FamilyStrengths.pdf
45 Aufseeser D, Jekielek S, Brown B. The family environment and adolescent well-being: Exposure to positive and negative family influences. Washington: Child Trends; and San Francisco: National Adolescent Health Information Center, University of California, San Francisco; 2006. Available from: http://nahic.ucsf.edu/wp-content/uploads/2011/02/2006-FamEnvironBrief.pdf
46 Pascoe JM, Wood DL, Duffee JH, Akno A, et al. Mediators and adverse effects of child poverty in the United States. Pediatrics. 2016;137(4):e20160340. doi: 10.1542/peds.2016-0340.
47 Chaudry A, Wimer C. Poverty is not just an indicator: The relationship between income, poverty, and child well-being. Academic Pediatrics. 2016;16(3,Supplement):S23-S29. doi: 10.1016/j.acap.2015.12.010.
48 Racine AD. Child poverty and the health care system. Academic Pediatrics. 2016;16(3,Supplement): S83-S89. doi: 10.1016/j.acap.2015.12.002.
49 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. Health and academic achievement. 2014. Available from: http://www.cdc.gov/healthyschools/health_and_academics/pdf/health-academic-achievement.pdf
50 Basch CE. Healthier students are better learners: A missing link in efforts to close the achievement gap. New York, NY: Columbia University; 2010. Available from: http://files.eric.ed.gov/fulltext/ED523998.pdf. Also in J School Health. 2011;81(10):591-662. Available from: http://onlinelibrary.wiley.com/doi/10.1111/josh.2011.81.issue-10/issuetoc
51 Lee JO, Kosterman R, Jones TM, Herrenkohl TI, Rhew IC, Catalano RF, Hawkins JD. Mechanisms linking high school graduation to health disparities in young adulthood: A longitudinal analysis of the role of health behaviours, psychosocial stressors, and health insurance. Public Health. 2016;139:61-69. doi: 10.1016/j.puhe.2016.06.010.
52 Commission to Build a Healthier America, Robert Wood Johnson Foundation. Education matters for health, Issue brief 6: Education and health. September 2009. Available from: http://www.commissiononhealth.org/PDF/c270deb3-ba42-4fbd-baeb-2cd65956f00e/Issue%20Brief%206%20Sept%2009%20-%20Education%20and%20Health.pdf
53 Cutler DM, Lleras-Muney A. Education and health: Evaluating theories and evidence. Working Paper 12352. Cambridge, MA: National Bureau of Economic Research; 2006. Available from: http://www.nber.org/papers/w12352
55 Sum A, Khatiwada I, McLaughlin J. The consequences of dropping out of high school: Joblessness and jailing for high school dropouts and the high cost for taxpayers. Boston: Center for Labor Market Studies, Northeastern University; 2009. Available from: https://www.issuelab.org/resource/the-consequences-of-dropping-out-of-high-school-joblessness-and-jailing-for-high-school-dropouts-and-the-high-cost-for-taxpayers.html
56 Edelman PB, Holzer HJ. Connecting the disconnected: Improving education and employment outcomes among disadvantaged youth. IZA Policy Paper No. 56; April 2013. Available from: http://ftp.iza.org/pp56.pdf
57 Kearney MS, Levine PB. Income inequality, social mobility, and the decision to drop out of high school. Brookings Papers on Economic Activity; Spring 2016. Available from: https://www.brookings.edu/wp-content/uploads/2016/03/kearneytextspring16bpea.pdf
58 Hale DR, Bevilacqua L, Viner RM. Adolescent health and employment: A systematic review. Pediatrics. 2015;136(1):128-140. doi: 10.1542/peds.2014-2015.
59 Lee JO, Herrenkohl TI, Kosterman R, Small CM, Hawkins JD. Educational inequalities in the co-occurrence of mental health and substance use problems, and its adult socioeconomic consequences: A longitudinal study of young adults in a community sample. Public Health. 2013;127(8):745-753. doi: 10.1016/j.puhe.2013.04.005.
60 Balfanz R, Byrnes V. The importance of being in school: A report on absenteeism in the nation’s public schools. Baltimore: Johns Hopkins University, School of Education, Center for Social Organization of Schools; 2012. Available from: https://eric.ed.gov/?id=EJ1002822
61 Farrington CA, Roderick M, Allensworth E, Nagaoka J, Keyes TS, Johnson DW, Beechum NO. Teaching adolescents to become learners: The role of noncognitive factors in shaping school performance: A critical literature review. The University of Chicago Consortium on Chicago School Research; 2012. Available from: http://www.raikesfoundation.org/sites/default/files/SA-Rec-Reading-CCSR-Noncog-RF-Full-Report-Revision-%281.14%29.pdf
62 The Future of Children. Social and emotional learning. Woodrow Wilson School of Public and International Affairs at Princeton University and the Brookings Institution. Volume 27(1), Spring 2017. Available from: www.futureofchildren.org/publications
63 Child Trends Data Bank. High school dropout rates. November 2015. Available from: http://www.childtrends.org/wp-content/uploads/2014/10/01_Dropout_Rates.pdf
65 Galster GC. How neighborhoods affect health, well-being and young people’s futures. MacArthur Foundation Policy Research Brief, How Housing Matters; 2014. Available from: https://www.macfound.org/media/files/HHM_-_Neighborhoods_Affect_Health_Well-being_Young_Peoples_Futures.pdf
66 Coley RL, Leventhal T, Lynch AD, Kull M. Relations between housing characteristics and the well-being of low-income children and adolescents. Dev Psychol. 2013;49(9):1775-89. doi: 10.1037/a0031033. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766502/
67 Strasburger V, Council on Communications and Media, Academy of Pediatrics. Children, adolescents, substance abuse, and the media. Pediatrics. 2010;126(4):791-799. Available from: http://pediatrics.aappublications.org/content/pediatrics/126/4/791.full.pdf
68 Harris SK, Aalsma MC, Weitzman ER, Garcia-Huidobro D, Wong C, Hadland SE, et al. Research on clinical preventive services for adolescents and young adults: Where are we and where do we need to go? J Adolesc Health. 2017;60(3):249-260. Available from: http://www.jahonline.org/article/S1054-139X(16)30401-3/fulltext
69 Romer D, ed. Adolescents in the digital age: Effects on health and development. Media Commun. 2016;4(3):1-94. ISSN: 2183-2439. doi:10.17645/mac.v4i3.659. Available from: http://www.cogitatiopress.com/mediaandcommunication/issue/view/44
70 O’Keefe GW, Clarke-Pearson K, Council on Communications and Media Academy of Pediatrics. Clinical report – The impact of social media on children, adolescents, and families. Pediatrics. 2011; 127(4):800-804. Available from: http://pediatrics.aappublications.org/content/pediatrics/127/4/800.full.pdf
71 Ozer EM, Park MJ, Paul T, et al. America's adolescents: Are they healthy? San Francisco, CA: University of California-SF, National Adolescent Health Information Center; 2003. Available from: http://nahic.ucsf.edu/downloads/AA_2003.pdf
72 National Research Council and Institute of Medicine, Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education, O'Connell ME, Boat T, Warner KE, eds. Preventing mental, emotional and behavioral disorders among young people: Progress and possibilities. Washington, DC: National Academies Press; 2009. Available from: http://books.nap.edu/catalog.php?record_id=12480
73 Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatr. 2005;62(6):593-602.
74 Heron M. Deaths: Leading causes for 2013. National Vital Statistics Reports; vol 65 no 2. Hyattsville, MD: National Center for Health Statistics; 2016. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_02.pdf
75 Sullivan EM, Annest JL, Simon TR, Luo F, Dahlberg LL. Suicide trends among persons aged 10-24 years – United States, 1994-2012. MMWR. 2015;64(08):201-2015. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6408a1.htm
76 Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999-2014. NCHS Data Brief, no 241. Hyattsville, MD, National Center for Health Statistics; 2016. Available from: https://www.cdc.gov/nchs/products/databriefs/db241.htm
77 McCauglin KA, Greif GJ, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of United States adolescents. Arch Gen Psychiatry. 2012;69(11):1151-1160. doi: 10.1001/archgenpsychiatry.2011.2277. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766502/
78 Rehkopf DH, Headen I, Hubbard A, Deardoff J, Kesavan Y, Cohen AK, et al. Adverse childhood experiences and later life adult obesity and smoking in the United States. Ann Epidemiol. 2016;26(7):488-492. doi: 10.1016/j.annepidem.2016.06.003. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966898/
79 Bethell CD, Newacheck P, Hawes E, Halfon N. Adverse childhood experiences: Assessing the impact on health and school engagement and the mitigating role of resilience. Health Aff. 2014;33(12):2106-15. doi: 10.1377/hlthaff.2014.0914.
80 Giovanelli A, Reynolds AJ, Mondi CF, Ou S-R. Adverse childhood experiences and adult well-being in a low-income, urban cohort. Pediatrics. 2016;137(4):e20154016. doi: 10.1542/peds.2015-4016.Fake Templates psd License Driving Files
81Thanks Recognition Facial The Technology From Phony No More Ids Dmv To Improved Catalano RF, Fagan AA, Gavin LE, Greenberg MT, Irwin CE, Ross DA, Shek DT. Worldwide application of prevention science in adolescent health. Lancet. 2012; 379:1653-64. doi: 10.1016/S0140-6736(12)60238-4. Available from: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60238-4/fulltext
82 Verbitsky-Savitz N, Hargreaves MB, Penoyer S, Morales N, Coffee-Borden B, Whitesell E. Preventing and mitigating the effects of ACEs by building community capacity and resilience: APPI cross-site evaluation findings. Washington, DC: Mathematica Policy Research; 2016. Available from: https://www.mathematica-mpr.com/our-publications-and-findings/publications/final-report-preventing-and-mitigating-the-effects-of-aces-by-building-community-capacityAhead Improvements Exciting Mcgrady Chuck
83 Bernat DH, Resnick MD. Healthy youth development: Science and strategies. J Public Health Manag Pract. 2006;12(suppl 6):S10-S16. Available from: http://journals.lww.com/jphmp/Fulltext/2006/11001/Healthy_Youth_Development
84 Roth, JL, Brooks-Gunn J. Evaluating youth development programs: Progress and promise. Appl Develop Sci. 2015;20(3):188-202. doi:10.1080/10888691.2015.1113879.
85 Gavin LE, Catalano RF, Markham CM. Positive youth development as a strategy to promote adolescent sexual and reproductive health. J Adolesc Health. 2010;46(3S):S1-S6. Available from: http://www.jahonline.org/article/S1054-139X(09)00701-0/fulltext
86 Scales PC, Benson PL, Oesterle S, Hill KG, Hawkins JD, Pashak TJ. The dimensions of successful young adult development: A conceptual and measurement framework. Appl Dev Sci. 2016;20(3):150-174.
87 Tolan P, Ross K, Arkin N, Godine N, Clark E. Toward an integrated approach to positive development: Implicatons for intervention. Appl Dev Sci. 2016;20(3):214-236.
88 Tolan P. Future directions for positive development intervention research. J Clin Child Adolesc Psychol. 2014;43(4):686-694. doi: 10.1080/15374416.2014.936604.
89 Williams JL, Deutsch NL. Beyond between-group differences: Considering race, ethnicity, and culture in research on positive youth development programs. Appl Dev Sci. 2016;20(3):202-213. doi: 10.1080/10888691.2015.113880.