A study conducted by researchers at Johns Hopkins Children's Center has provided new information on the patterns of annual wellness visit attendance among adolescents and young adults (AYAs) aged 15 to 23. The research, published in the Journal of Adolescent Health, indicates that many individuals in this age group begin to skip yearly checkups as they transition from high school to adulthood.
The analysis was based on data collected over seven years from the NEXT Generation Health Study, which followed both male and female AYAs. The study found that while a majority continued with regular wellness visits, more than 30% of males and nearly 20% of females disengaged from preventive care as they grew older.
"This is very concerning since these young people will have fewer opportunities to get preventive care, especially during a period when engaging in riskier behaviors begins or escalates, including behaviors related to drug use and sexual activity," said Marcell, one of the lead researchers.
Researchers pointed out several factors contributing to the decline in primary care visits. One reason is that after leaving home for college or work, parents are no longer responsible for making appointments. Additionally, some adolescents may turn exclusively to specialists for specific health issues—such as girls seeing gynecologists—and may not view these visits as substitutes for comprehensive primary care.
The study also observed that about 13% of females "gradually reengaged" with primary care over time. According to Marcell, "Girls and young women have more health-related concerns and 'touchpoints' that may lead them to make a wellness appointment—including changes in menstrual cycles, the need for birth control, or concerns about pregnancy—than do boys and young men."
Another finding showed that boys and young men with chronic health conditions were more likely to maintain regular wellness visits. In contrast, females experiencing mental health symptoms were less likely to stay engaged with routine checkups.
These findings build upon previous research led by Marcell showing similar trends: from middle childhood through late adolescence, only about half maintained annual wellness visits. For boys specifically, attendance dropped significantly after age five—when school-required vaccinations are typically completed—and remained lower compared to girls through age seventeen.
Marcell emphasized the importance of preventive care: "All parents and AYAs need to understand the value of the annual preventive care wellness visit," he said. He also recommended teaching children how to schedule their own appointments as part of learning essential life skills.
The researchers suggest further studies using longitudinal data like those from the NEXT dataset could help healthcare providers identify which populations are missing out on preventive services and develop targeted outreach strategies.
Other contributors included Kathryn Van Eck, Xingyun Wu, Elianna Perrin, Lingxin Hao and Pamela Matson from Johns Hopkins University; Elizabeth Ozer from University of California San Francisco; with funding support from several federal agencies such as the U.S. Health Resources & Services Administration Maternal and Child Health Bureau and multiple institutes within the National Institutes of Health.
