Teenagers represent a large proportion of the population and have the
potential for considerable morbidity because of high smoking rates and
unwanted teenage pregnancy. The government intends to reduce the inci
dence of this important morbidity, but there is no coherent strategy f
or attaining these improvements. Research in this area is limited in t
he United Kingdom, but research from elsewhere has clarified teenagers
' attitudes. There have also been some intervention studies resulting
in improvements in specific aspects of teenage health. A worrying them
e which emerges from this research is of a new inverse care law. Teena
gers with low self-esteem and less hope for their own future are more
likely to lead lifestyles which put them at risk and are less likely t
o ask for advice in relation to their health or lifestyle. Thus, it ma
y be more difficult to alter behaviour in these patients; overall popu
lation based improvements may be difficult to achieve. Teenagers' own
concerns appear to be at variance with the goals dictated by governmen
t and health professionals. It is suggested that the only method of me
eting the needs of teenagers and at the same time aiming to reduce mor
bidity in this age group is to foster an atmosphere of patient centred
ness in dealings with adolescent patients and for further research in
this important health gain area.