Everybody knows babies and the elderly often have to battle for survival. Nobody thinks of adolescence, with its youthful vitality, as hazardous to health.
But millions of adolescents do suffer serious health problems, the Office of Technology Assessment, an arm of Congress, reports, and they face "formidable barriers" to basic health care.Adolescence is defined in the report as ages 10 to 18.
About one in five of America's 31 million adolescents has at least one serious health problem - defined as a condition that would be covered by health insurance. Those in their second decade of life suffer from everything from hay fever to mental disorders. About a million adolescents become pregnant annually, and half give birth.
More troubling are the barriers adolescents face in obtaining medical care. A variety of obstacles - ranging from a lack of insurance to parental consent laws - keep young people from getting health care, researchers found.
But when the report made the evening news last week, you could almost hear America changing the channel. We have been bombarded by news of the plight of children for some time.
This time, though, there was reason for people to stay tuned.
What made the report by the Office of Technology Assessment different is that it does more than ask for sympathy. This report, requested by Congress, spells out why it's in the national interest to care about adolescent health and offers a series of policy options for Congress.
It makes sense to improve the health of the younger generation if for no other reason than as an investment in the future economy.
And yet, one in seven adolescents lacks health insurance. One in three poor kids is not covered by Medicaid.
While impoverished youths who are members of racial or ethnic minorities are most at risk of health problems, the report found "today's white, middle-class adolescents are also at high risk of developing problems and not having access to needed health services."
Adolescents have among the lowest overall death rates of any age group, but they are more likely than those younger or older to die of injuries, suicide and homicide, the report said. That's partly because adolescents are more likely to engage in risky behavior. Also, the suicide rate among adolescents has tripled since the 1950s.
Some of the proposals to improve health are likely to be controversial - and costly. The report recommends that Congress expand Medicaid to cover all poor kids and that it require employers to provide health benefits to all who work 30 hours or more weekly and their families. Congress also could close the loophole that allows employers not to cover prenatal and maternity care for the daughters of employees.
These changes would not solve the problem of adolescents who are reluctant to tell their parents they are sexually active. The report also calls on Congress to support school-linked or community-based health clinics that would provide free comprehensive services to adolescents once parents have signed blanket permission.
Students who have used school-linked health clinics say they did so because they felt they could trust the center because it was at school, that it was easy to get to and that the staff cared, the report says.
But Congress may be reluctant to get into the school clinic debate.
The health of adolescents has not been a federal priority, largely because no one has been aware of the problems.