Sir.—Health issues facing adolescents have changed dramatically over the last several decades.1 Twenty years ago, adolescent morbidity and mortality were associated predominantly with natural causes. Adolescents today, however, are endangered predominantly by their own behaviors. Drinking, tobacco and drug use, pregnancy, sexually transmitted diseases, and injuries take a major toll on youth and place them at risk of developing disease as adults. Because these health risks do not lend themselves to traditional models of medical intervention, greater emphasis is needed on prevention as a way to improve the health and well-being of adolescents.
The process of identifying and implementing a broad prevention startegy has gained momentum with the recent release of two documents by the US Public Health Service (PHS):—Healthy People 2000: The National Health Promotion and Disease Prevention Objectives2 and the Guide to Clinical Preventive Services.3 Unfortunately, pediatricians and other health care professionals treating