Social inputs on health care: Money woes stress out young adults; children more at risk around guns

Recently, Dr. Eric Sigel, professor of pediatrics at the University of Colorado School of Medicine and adolescent medicine specialist at Children’s Hospital Colorado, revealed new research showing that kids who report potential access to guns — it’s easy to get guns, they know where to get guns, or have friends with guns — saw higher rates of mental-health issues and violent tendencies.

“That combination can lead to a lethal situation,” Sigel said.

Kids who report having emotional issues such as anxiety, depression or eating disorders and have increased access to guns are in a very vulnerable situation.

“If you are a parent, adult or health-care provider, you need to be really cognizant of that,” Sigel said. “We need to have a conversation as a society about this potential lethal interaction, to really make sure that kids do not have access to guns.”

The study was conducted only in two neighborhoods in Denver so it’s not representative of the whole population, or to upper-middle-class people living in Boulder necessarily, but the lessons apply to everyone.

“We do know that statistics show the safest home for a kid is a home with no guns,” Sigel said. “Recognizing that people do possess firearms for hunting, protection or target shooting, the next-best scenario is that they are locked up unloaded and the ammunition is locked away in a separate place. Make sure the kids don’t know the keycode.”

Establishing a better understanding of youth and guns is a newer construct because there isn’t a lot of comparison, as there has been a ban on federal funding of research focused on firearms. Sigel notes that the motor-vehicle accident rate had been cut in half during that same time period because of research.

Tech trouble

Technology can really compromise the health of youth in many ways. Too much screen time is associated with a whole host of issues — sleep deprivation, increased aggression, not attending to a general expectation with chores, losing levels of social skills and a decreased attention span. Online peer bullying has become an epidemic, which takes a dangerous toll on the young minds of the bullied.

“Communication and interaction might truly be changed by our tech age,” Sigel said. “When a kid can’t call a friend to say, ‘Hey what’s up’ or ‘I have an issue I need to talk about,’ like we used to, it creates a void. Now kids just text emojis for communication. That’s not a good replacement.”

Those at higher risk

One population of youth that faces enhanced physical and mental-health risks is the GLBTQ community.

“We have come a long way, but still a long way to go,” Sigel said. “In general, there is a much healthier acceptance, but GLBTQ kids, especially transgender, are at a higher risk for any adolescent issue — more depression, more risk of suicide and substance abuse, more sexual experimentation with STD risk.”

Sigel says there is extensive training at Children’s Hospital, and the residents have become accustomed to working with GLBTQ youth. He would like to see “more and more and more” providers who are sensitized and aware of the particular physical and emotional health needs of the GLBTQ community.

Protecting all youth

A preemptive strike is crucial when it comes ensuring quality youth health.

“The key is recognizing that intervention is really critical, and there’s a lot that can be done if society continues to support health care,” Sigel said. “If kids get engaged in primary care and have access to services early on, a lot of the morbidities related to adolescent and adult health can be averted. One of the critical things we are understanding on a societal level is that the stressors that kids are exposed to really contribute to life-long health.”

Adverse childhood experiences such as food insecurity, exposure to parental mental-health issues, emotional or sexual abuse, alcoholic or incarcerated parents — accumulate, and kids have mental issues: depression, anxiety, post-traumatic stress. This all converts to having major physical health issues. Stressors cause inflammation, hypertension, obesity and diabetes, as well as other health issues.

“If we can really improve adolescent and young adult health,” Sigel said. “We can avert most of these things down the road and make us all healthier.”

Wayfinding woes

As 20-somethings fly the coop, they are finding that “adulting” is legitimately stressful, which sometimes can cause mental anxiety. Josh Johnson, 20, lives in Longmont and works as an assistant manager at a local tire shop. While he admits that he makes better money than some of his peers, he still falls behind on his bills. He said he feels pressure to “do better,” but comes up short when facing an issue bigger than himself: It’s really expensive to live in the Boulder Valley. The average monthly rent in the region is around $1,500 to $1,700.

For young adults in much of Colorado along the Front Range, it seems nearly impossible to make a decent living and have a basic home without working themselves practically to death.

Johnson works well over 40 hours a week on his feet. It’s physically and mentally exhausting. And what bothers him the most is that after all the hard works he puts in, he still doesn’t have proper health insurance.

“Health care that I can afford is crappy,” Johnson said, adding that he wakes up every morning between 4 and 5 a.m. to work out at the gym before heading to work as one measure to maintain optimum health. He tries to eat healthy as much as possible, but it’s challenging to do that when money is tight.

“If I can figure out how to treat myself when I’m sick or minorly injured, I’m going to save my money and skip the doctor,” he said.

Coming together

All of these social determinants that contribute to the compromised health of young people cannot be solved by one person, Sigel pointed out. Additionally, there are political forces at hand threatening to thwart the effort within the medical community to improve preventive care and other methods of integrated health care.

From Sigel’s view, “The Affordable Care Act has done wonders for access to health care, particularly among the population I work with. The threat of having that removed makes lots of people worried. $800 billion proposed to be slashed from Medicaid would create a disaster for the state of Colorado as well as the nation.”

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