Anticipatory guidance for adolescents should include discussions regarding important preventive health issues such as safety, substance abuse, sexual activity, self-esteem, and suicidal ideation. A thoughtful review of these common adolescent concerns stimulates open discussions and instills among youth a feeling of security about having a medical "home." Failure to address these topics may raise unnecessary barriers and provoke a sense of eviction from the health-care system. Teenagers who expect to find help in the pediatrician's office must not feel abandoned at a time when their needs for comprehensive services are greatest. It is our role to identify high-risk behaviors early, arrange for follow-up as indicated, and facilitate a smooth transition to an adult-oriented physician at an appropriate time.

Adolescent Health Statistics

The reasons for addressing these issues are compelling and urgent. Accidents are the leading cause of mortality among adolescents. Each year, an estimated 15 000 to 18 000 deaths occur among teens from automobile-related injuries. Alcohol and other psychoactive drugs are factors in many of these fatalities. There are approximately 6000 adolescent homicide victims annually; gunshot wounds account for many of these deaths. More than 400 youth die from bicycle accidents and more than 50% of all motorcyclists' deaths occur in 15- to 24-year-olds.

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