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For example, McGinnis and Foege (1993) and more recently Mokdad and colleagues (2004) have shown that half of deaths among adults are due to health-related behaviors that for many people have their onset during adolescence. Many adolescents behave in risky ways or live in environments that not only affect their immediate health, but also have a significant impact on their health as adults. This chapter explores how timing matters-how adolescence is a critical time for health promotion. According to data from the Behavioral Risk Factor Surveillance System, 91 percent of those aged 18вЂ“24 consider themselves to be in good, very good, or excellent health (McCracken, Jiles, and Michels Blanck, 2007). According to the National Survey of Child Health, approximately 83 percent of adolescents aged 12вЂ“17 are in either excellent or very good health as reported by their parents, regardless of whether they live in urban or rural areas (Maternal and Child Health Bureau, 2005a,b).

Most adolescents are considered healthy as defined by the traditional medical measures of health status, such as mortality rates, incidence of disease, prevalence of chronic conditions, and use of health services. These adolescents are also at increased risk of unprotected sex and pregnancy, and have higher rates of severe mental health problems and substance use. Adolescents in foster care face more health challenges and chronic health issues-such as asthma, anemia, neurological abnormalities, emotional and behavioral problems, chronic physical disabilities, birth defects, and developmental delays-than those not in foster care.

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