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December 1996

Health Status of Well vs Ill Adolescents

Author Affiliations

From the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (Drs Starfield, Forrest, Riley, and Ensminger); and the Department of Psychology, The Johns Hopkins University (Dr Green), Baltimore, Md; and Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY (Dr Ryan).

Arch Pediatr Adolesc Med. 1996;150(12):1249-1256. doi:10.1001/archpedi.1996.02170370027003

Background:  Accountability of health services in meeting needs and assessing outcomes is hampered by the absence of tools to assess health, especially in children and youth. Because it is no longer adequate to assess health by a narrow focus on biological and physiological measurers, instruments that assess functional status, person-focused general health status, and overall well-being in a more comprehensive way are needed.

Objective:  To examine whether a health status instrument we have developed discriminates between teenagers in schools and teenagers attending clinics for acute or chronic conditions.

Methods:  Teenagers (aged 11-17 years) in schools and in general medical and specialty clinics completed a questionnaire The Child Health and Illness Profile-Adolescent Edition (CHIP-AE), comprehensively covering aspects of health in 6 domains: discomfort, satisfaction with health, disorders, achievement of social expectations, risks, and resilience.

Results:  Acutely ill teenagers reported more physical discomfort, minor illnesses, and lower physical fitness; chronically ill teenagers reported more limitations of activity, long-term medical disorders, dissatisfaction with their health, and less physical fitness than teenagers in the school samples. Age, sex, and social class did not explain the differences. Teenagers within the acutely and chronically ill clinic populations differed substantially in their health status.

Implications:  Availability of a comprehensive instrument (CHIP-AE) to assess adolescent health provides a means of documenting health needs and outcomes in populations of teenagers with acute or chronic illness. The heterogeneity within these groups provides support for a person-focused (rather than a disease-focused) approach to assessing both needs for care and the influence of care on promoting health.Arch Pediatr Adolesc Med. 1996;150:1249-1256