Access To Physical Health Services

Access to regular health care services helps support healthy development in adolescence. Teens should have a physical checkup once a year and a dental checkup twice a year.[1],[2] Physicals should include immunizations, time alone with a clinician, and information about health-promoting (and damaging) behaviors. Most adolescents receive recommended annual physical checkups and at least one dental checkup a year.[3] However, barriers, such as lack of insurance or trained clinicians, prevent some from accessing care.[3][4] Adolescents with special needs (such as physical and mental health disorders) may have even less access to necessary health care services.[5] The Affordable Care Act addresses several of these aspects by expanding primary care services to reach adolescents who are newly eligible for health insurance coverage.[6] For example, preventative services—including yearly physical examinations—will be covered at no cost to families.

Annual Checkup Components

  1. Conduct physical examinations & immunizations
  2. Screen for physical problems (e.g., vision & hearing screening, selected laboratory tests)
  3. Record history & key developments since last visit
  4. Monitor development through medical examination and general discussion
  5. Observe parent-youth interaction
  6. Discuss the following priority issues and areas:
Priority Issue Areas
Physical growth and development Physical and oral health; body image; healthy eating
physical activity
Social and academic competence Connectedness with family, peers, and community
interpersonal relationships; school performance
For ages 18-19: Job Performance
Emotional well-being Coping, mood regulation and mental health; sexuality
Risk reduction Use of tobacco, alcohol or other drugs; pregnancy, STDs
Violence and injury prevention Safety belt and helmet use; guns; bullying
For ages 11-14: Substance abuse and riding in a vehicle; interpersonal violence (fights)
For ages 15-17: Driving (graduated license) and substance abuse; interpersonal violence (dating violence)
For ages 18-19: Driving and substance abuse; interpersonal violence (dating violence, stalking)

*Source: Hagan, J. F., Shaw, J., & Duncan, P. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents: American Academy of Pediatrics. Retrieved March 27, 2015 from http://brightfutures.aap.org/pdfs/Guidelines_PDF/18-Adolescence.pdf.

The Adolescent Health Library has additional resources on access to physical health services.


[1] Hagan, J. F., Shaw, J., & Duncan, P. (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents: American Academy of Pediatrics. Retrieved May 4, 2016, from https://brightfutures.aap.org/materials-and-tools/guidelines-and-pocket-guide/Pages/default.aspx.
[2] American Academy of Pediatric Dentistry. (2013). Guideline on periodicity of examination, preventive dental services, anticipatory guidance/counseling, and oral treatment for infants, children, and adolescents: Washington, DC: American Academy of Pediatric Dentistry. Retrieved May 4, 2016, from http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf.
[3] Bloom, B., Jones, L.I., Freeman, G. (2013). Summary health statistics for U.S. children: National Health Interview Survey, 2012. Washington, D.C.: Centers for Disease Control and Prevention, National Center for Health Statistics. Retrieved August 3, 2016, from http://www.cdc.gov/nchs/data/series/sr_10/sr10_258.pdf.
[4] National Research Council and Institute of Medicine. (2009). Adolescent health services: Missing opportunities. Washington, DC: The National Academies Press. Retrieved May 4, 2016, from http://www.nap.edu/read/12063/chapter/1.
[5] Child and Adolescent Health Measurement Initiative; The Data Resource Center for Child and Adolescent Health. (2010). National Survey of Children with Special Health Care Needs. Portland, OR: Child and Adolescent Health and Measurement Initiative; The Data Resource Center for Child and Adolescent Health. Retrieved May 4, 2016, from http://childhealthdata.org/browse/survey/results?q=1624&r=1&g=86.
[6] English, A. (2010). The Patient Protection and Affordable Care Act of 2010: How does it help adolescents and young adults? San Francisco, CA: National Adolescent Health Information and Innovation Center. Retrieved May 4, 2016, from http://nahic.ucsf.edu/downloads/HCR_Issue_Brief_Aug2010_Final_Aug31.pdf.
Last updated: August 11, 2016