Millions of US Teens May Be Missing Out on Annual Checkups


Approximately one-third of teens may be missing annual checkups according to data from the US Department of Health and Human Services and the US Census. Teens often encounter social, emotional, and physical issues that may include eating disorders and obesity, substance abuse, and sexually transmitted infections. While experts agree that teens should get annual medical checkups to be screened for health risks and discuss important health-related matters, perceptions exist that may contribute to millions of teens missing out on yearly visits.

To better understand perceptions about teen health, the National Foundation for Infectious Diseases (NFID), in collaboration with, and with support from Pfizer Inc, conducted a national survey, fielded by Harris Interactive, of more than 2,000 parents of teens, teens, and healthcare professionals.

A key finding was that about one in four parents surveyed said that teens’ lifestyle choices today won’t affect their health in the future, and one in five teens surveyed agreed. The disconnect among parents and teens between today’s choices and future impacts on health contrasts with medical thinking that health behaviors in the teen years can have a long-term impact on health in adulthood.

“NFID has long been an advocate of preventive health. With the drop in annual checkups during the teen years, we wanted to take a look at the attitudes and behaviors of the people closest to teen health to see if we can better understand the reason for the decline,” said Susan J. Rehm, MD, NFID medical director.

“There’s a valley in our healthcare continuum, and two out of three teens surveyed said they have at least one reason for not getting an annual checkup. If we understand why, we may be better equipped to address those perceptions.”

The survey revealed a number of misperceptions and potential missed opportunities, including:

•About 60 percent of teens surveyed identified at least one reason for not getting an annual checkup; of those, about one-third believe that they only need to see a doctor when sick.

•When teens are joined by a parent in the exam room, it can restrict the conversation, according to 84percent of physicians surveyed.

•About half of physicians surveyed assumed teens’ friends were a most trusted source for health information, teens surveyed (43 percent) actually listed healthcare providers as their most trusted source for health information.


Checkups are not just for babies

Parents of infants and young children are accustomed to regularly visiting a pediatrician for their child’s checkups. But when children reach the teen years, these annual checkups may fall off the radar. While 85 percent of parents polled say an annual checkup is very important for those zero to five years, there was a 24 percent drop in the percentage who believe the same is true for teens (61 percent).

Professional societies, including the Society for Adolescent Health and Medicine (SAHM) and the American Medical Association (AMA), recommend annual checkups for teens. In addition, the Affordable Care Act allows teens and young adults to remain under their families' health coverage up to age 26, which can help ensure that they have access to preventive health care, including checkups.

Annual checkups can be an important opportunity for positive health discussions. Physicians polled report that teens and their parents are more likely to ask about a number of health topics, including weight, sexual health, vaccines, and stress-related conditions, during an annual checkup than at a sick visit.

“Teens are smart, but they’re just like the rest of us: overscheduled and overwhelmed. It’s normal to have an ‘it won’t happen to me’ attitude,” said Aria Finger, chief operating officer of, a large social change nonprofit in the United States. “It’s about changing the consciousness of teens and those who care for them. Everyone wants what’s best. Making the annual checkup part of the norm during teen years sets young people up to take charge and get ahead of the curve about their own health.”


Teens worry about health

Nearly all parents, teens, and physicians surveyed (94, 96, and 97 percent, respectively) agree that teens should have a say in decisions about their own health. And the survey shows being healthy can be top of mind for many; two out of three teens surveyed say they worry a lot or a great deal about staying healthy. However, only 28 percent of parents reported that they believe their teens worry a lot or a great deal about their health.

While teens may trust doctors, they don’t necessarily like talking with them. Almost 40 percent of teens surveyed say they don’t like talking with doctors or other health care providers. Fifty percent of teens surveyed turn to the Internet for health information. Parents surveyed report that when they are in the room, only half of the conversation is directed solely toward the teen. Furthermore, as noted, having a parent in the teen’s exam room during an annual checkup can restrict the conversation, according to 84 percent of physicians.

“The information and communication dynamic among teens, parents, and doctors is an important one,” said Leslie Walker, MD, immediate past-president of SAHM and division chief of adolescent medicine and professor of pediatrics at University of Washington School of Medicine and Seattle Children’s Hospital. “It’s appropriate for teens to be able to talk to their doctor alone. Establishing this one-on-one relationship between patient and physician encourages independence and responsibility for one’s own health.”


It takes a village

Teens may also turn to other adults in their lives. One in four teens surveyed said they may turn to school-based professionals (teachers, guidance counselors and school nurses) for health information.

“Teens are social beings,” said Finger. “The adults and peers in their lives model behaviors and influence attitudes about health and well-being. Engaging these audiences or equipping them to positively influence teens can go a long way.”