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Many teens face serious health threats from risk-taking behaviors such as unprotected sex and drug use, including alcohol and tobacco. In addition, a growing number of teens are developing medical conditions once thought to afflict only adults. Overweight and obesity have become widespread, contributing to a steady rise in high blood pressure and diabetes among children and adolescents.

Teens smoke, drink or commit violence for many reasons, including peer pressure, the need to assert their independence, to relieve stress and to satisfy their curiosity. However, risk-taking behavior initiated during adolescence often extends into adulthood and can contribute to serious illnesses, such as cardiovascular disease and cancer-the top two leading causes of death in U.S. adults. . Through routine medical exams, health care professionals can screen teens for risk-taking behaviors, identify early stages of physical or emotional disorders and provide information and counseling to both teens and parents.

Below is an overview of major teen health risks and suggestions for minimizing them. The health screening guidelines will help you know what to expect during teen health Checkups in the years ahead.

TEEN HEALTH RISKS

Preventable Accidents. In 2003, more than 70 percent of all deaths among U.S. youth between the ages of 10 and 24 were from four causes: motor vehicle crashes, other types of accidents, homicide and suicide. To help keep your teen safe, insist that your teen uses seat belts in cars, drives sober and doesn't ride with friends who drive while under the influence of drugs or alcohol. Remind your teen to wear a helmet when biking, skateboarding and skiing. Be alert to signs of depression in your teen. Also, talk about the dangers of handling guns.

Sexually Transmitted Infections/Unwanted Pregnancy. Each year, there are approximately four million cases of sexually transmitted diseases among youth between the ages of 15 and 19, and 900,000 adolescent girls become pregnant. Be sure to talk to your teen about sex, relationships and the health risks involved with early sexual activity. Numerous resources are available to help you start these conversations. If your teen is engaging in sexual activity, encourage him or her to use condoms. Like it or not, the facts are that 47 percent of teens have had sexual intercourse, and 37 percent of sexually active teens did not use a condom the last time they had sex.

Substance Abuse. In 2005, 43 percent of high school students had drunk alcohol, and 54 percent had tried cigarette smoking at some point. And a 2004 survey conducted by the U.S. Department of Justice revealed that 34.3 percent of high school seniors reported using marijuana in the last year, and 19.9 percent reported using it in the last 30 days. Review the dangers of drug abuse and encourage open conversations with your teen about drug use. As a parent, always use alcohol responsibly and, if you smoke, quit.

High Blood Pressure. Since 1988, blood pressure levels in children and teenagers have risen significantly, partially due to overweight and obesity. In adulthood, high blood pressure is a major risk factor for heart disease and the chief risk factor for stroke. The National Heart, Lung and Blood Institute (NHLBI) has revised its guidelines on high blood pressure (hypertension) in children and adolescents. The guidelines establish a prehypertension category so children at risk can make dietary or other changes. Ask your health care professional for information about normal, prehypertensive and high blood pressure ranges in teens and have your child's blood pressure checked regularly.

Obesity. In the past two decades, obesity rates have more than doubled among children and adolescents. This trend is strongly related to non-active lifestyles and a national craving for foods high in refined carbohydrates and fats. Be a good role model for your teen. If you enjoy healthful foods and physical activity, your child is more likely to follow your example. And don't be judgmental if you think your child may be overweight; discuss the situation with his or her pediatrician.

Insulin Resistance and Type 2 Diabetes. Research shows an increase in Type 2 diabetes among children and adolescents. Obesity plays a key role--it is a risk factor for insulin resistance, which frequently leads to diabetes. Family history is also a major risk factor for developing diabetes. If you're concerned about your teen's weight or diabetes, ask your health care professional for guidance.

Eating Disorders. Eating disorders usually develop in women between the ages of 12 and 25. Anorexia nervosa and bulimia are potentially life-threatening--they can lead to heart failure and death. Anorexic girls perceive themselves as overweight, regardless of how emaciated they become. Teens with binge-eating disorders can develop high blood pressure, high cholesterol and Type 2 diabetes. Periodically, engage your teen in discussions about the unrealistic body images the media portrays. Be supportive of physical changes your child is experiencing during adolescence and seek medical attention if you suspect your child is suffering from an eating disorder.

PREVENTIVE SCREENING GUIDELINES

Many health care organizations have developed guidelines for teenage checkups. For example, "Guidelines for Adolescent Preventive Services," published by the American Medical Association, recommends a series of annual health visits between the ages of 11 and 21. These visits typically include:

•	Health guidance for parents
•	Information to teens on their physical and emotional development
•	Advice on injury prevention, diet, exercise, sexual behavior and birth control
•	Pap tests for women 18 or older, or for anyone who is sexually active
•	Immunizations, administered according to federal guidelines
•	Physical exams
•	Screening for:
	- alcohol, tobacco and other substance abuse
	- recurrent or severe depression or risk of suicide
	- high blood pressure
	- sexually transmitted infections, including HIV, when appropriate
	- eating disorders
	- school performance problems

Family history plays an important role in determining whether certain screening tests are needed. If heart disease runs in a patient's family, for example, a blood cholesterol test is warranted. Children with high blood cholesterol levels are likely to become adults with high blood cholesterol levels.

Parents of self-identified gay, lesbian or bi-sexual teens may want to familiarize themselves and their teens with the special health risks these teens may face. If you suspect your child may be struggling with gender issues, ask your health care professional about resources you and your teen may want to consult.

QUESTIONS TO ASK A HEALTH CARE PROFESSIONAL

RESOURCES

American Medical Association
515 N. State Street
Chicago, IL 60610
1-800-621-8335 (toll-free)
www.ama-assn.org
The professional association for U.S. physicians, the AMA also offers a variety of health-related information for adults and children, including physician referral.

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue, NW
Washington, DC 20016-3007
1-800-333-7636
www.aacap.org
Provides information on mental illnesses affecting children, adolescents and their families. Spanish resources available.

American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
1-847-434-4000
www.aap.org
Web site offers free children's health newsletter and general health information for parents of children from birth to age 21.

Gay and Lesbian National Hotline
1-888-THE-GLNH (1-888-843-4564)
www.glnh.org
Provides nationwide toll-free peer counseling, information and referrals.

To view references consulted to develop this article, click here.