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Provision of health care to the young.

T H E W O R L D H E A L T H O R G A N I Z A T I O N ( W H O ) recently published a report (1) showing, in large measure, that health is a function of the distribution of wealth and opportunity, which medicine cannot change. Medical care, however, can reach more of the young if physicians insist on the appropriateness of direct, unimpeded provision of care. The report defines young people as those between the ages of 10 and 24. It states that unemployment and underemployment are the most serious problems confronting young people today, that every health problem has a social component, and that effective health care delivery systems require prior consultation with the intended young recipients. In this way, services can be designed that are practical and reflect the behaviors and preferences of the young. Successful health centers all use multiservice approaches to the needs of the young, have easily accessible and comfortable environments, and respect the privacy and protect the confidentiality of shared information. The result of adequate planning is that the young are encouraged to assume greater responsibility for their health needs. In a country in which teenage pregnancy, substance abuse, suicide, and accidents present ever-growing threats to the health of young people, it is critical to recognize that the causes of the health problems of the young lie at the intersection of social, economic, and social welfare policy. In outlining the appropriate stages of development for healthy young people, the report comments that impoverished socioeconomic and cultural conditions can act against appropriate intellectual and emotional development. In an impoverished culture, the report warns, children may never achieve their intellectual potential as adults, acquire a sense of community, or refine their potential for engaging in productive occupations. This country shelters specific traditional communities of poverty within a larger, technologically sophisticated, modern society. In urban ghettos and rural areas, the young face the same bleak existence that their parents experienced and the same dismal future as in underdeveloped countries. This report makes clear that the health of our nation's young people is not just the business of medicine. The health of young people is also, and primarily, a matter of social and economic justice. Clearly, health care profes-