A new Johns Hopkins study confirms something those familiar with youth health may have already observed: as teens enter young adulthood, their annual checkups with their primary care doctor often fall by the wayside.
Researchers at the Johns Hopkins Children’s Center led a study of adolescents and young adults between the ages of 15 and 23. They found that many young people skip their yearly wellness visits as they reach high school and transition into adulthood.
Published Dec. 19 in the “Journal of Adolescent Health,” the study’s findings highlight the “critical period of vulnerability” for this age group as they begin serious relationships, start new jobs, and enter new environments. Young people who skip these wellness visits are missing out on opportunities for preventative care, especially during a period of their lives in which riskier behavior related to drug use, sexual activity, and other areas tend to start or intensify.
“These life changes can have physical and mental health impacts. Attending yearly wellness visits is an opportunity to screen and provide care for risky or dangerous behavior, including drug use,” said Dr. Arik V. Marcell, a Johns Hopkins Children’s Center pediatrician and adolescent medicine specialist, in a statement.
Marcell co-led the study with Children’s Center fellow Morayo Akande. In addition to tracking how often teens and young adults attend yearly health checkups, the Hopkins researchers also examined what factors contribute to young people continuing or not continuing to go to these appointments.
While a majority of both male and female subjects were engaged with attending their annual wellness visits, that level of engagement faded over time; more than 30% of males and nearly 20% of females became disengaged as they got older, according to the study.
The study points to a couple possible explanations for why the decline in young people attending visits with a primary care provider.
Young people, who have relied on parents to make their appointments for them, sometimes do not assume that responsibility for themselves when they go off to college. Although they may be more inclined to visit a specialized physician for specific complaints, they may mistake those appointments as a replacement for their annual checkup, the study suggests.
The researchers did find that during the seven years of tracking, 13% of girls and young women became “gradually reengaged” and went back to their primary care provider.
Concerns about topics such as menstrual cycles, birth control, pregnancy create more health “touchpoints” for girls and young women that encourage them to attend checkups, compared to boys and young men, according to the study.
The study recommends for parents to teach their children about the importance of annual checkups. It also recommends that primary care providers do more to reach out to teen and young adult patients.
In addition to Marcell and Akande, the study’s authors included Kathryn Van Eck, Xingyun Wu, Elianna Perrin, Lingxin Hao and Pamela Matson with Johns Hopkins and Elizabeth Ozer with the University of California, San Francisco.
The study was funded by the U.S. Health Resources & Services Administration Maternal and Child Health Bureau, and used data from the NEXT Generation Health Study which was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
