Chronic Disease

A chronic disease is a condition lasting at least three months that may worsen over time.¹ Chronic diseases comprise the leading causes of death and disability in the United States; they are also leading drivers of annual health care costs.² More than 40% of school-aged children and adolescents in the United States have at least one chronic disease, and this may vary by region.³

Several risk factors cause many preventable chronic diseases. These risk factors include poor nutrition (including consumption of ultraprocessed foods), physical inactivity, smoking/tobacco use, alcohol misuse, and exposure to environmental chemicals, among others.⁴ At home and at school, parents and teachers can help adolescents manage and prevent chronic disease.

Below, explore management and prevention strategies to support adolescents with chronic diseases: asthma, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), cancer, diabetes, epilepsy, human immunodeficiency virus (HIV), hypertension, inflammatory bowel disease (IBD), and obesity. These examples are not an exhaustive list. For any chronic condition, an adolescent’s healthcare provider is the best source of information about management, prevention, and treatment.

Asthma

Managing Asthma at Home

• Limit exposure to asthma triggers: Triggers like dust mites and tobacco smoke can cause asthma episodes.⁵
• Develop an asthma action plan: Work with medical professionals to develop a plan for managing your adolescent’s asthma episodes.
• Prioritize overall health: Maintaining a healthy lifestyle can help with managing asthma symptoms. Help your adolescent maintain a healthy weight, eat heart-healthy foods like fruits and vegetables, exercise regularly, manage his or her stress, prioritize good quality sleep, and avoid smoking/tobacco use.⁷
• Get support: Participate in the Asthma and Allergy Foundation of America (AAFA) Support Community.⁸

Managing Asthma at School

• Create a safe environment: Collaborate with administrators and staff, including school nursing services. Reduce asthma triggers at school. Design physical education activities for students with asthma. Measure and evaluate program effectiveness.⁹
• Support students with asthma: Identify students with asthma and the support they need, such as quick access to their prescribed inhalers. Ensure students take their medicines. Educate students with asthma and their families.¹⁰
• Connect with medical professionals: Collaborate with medical professionals when providing care.¹¹

Attention Deficit/Hyperactivity Disorder (ADHD)

Managing ADHD at Home

• Consult with a healthcare provider: Your adolescent’s healthcare provider can develop a treatment plan based on your adolescent's age and needs.¹²
• Help your adolescent stay organized: Encourage a predictable routine and consistent habits. Help your adolescent break complex tasks into manageable steps. Communicate clearly. Present limited, specific choices when asking your adolescent to make decisions.¹³
• Encourage good health: Healthy food, exercise, and sleep can all help your adolescent manage his or her ADHD symptoms.¹⁴

Managing ADHD at School

• Support students with clear communication and tailored coursework: Give students positive feedback, clearly signal when changing topics or altering a routine, and ensure that students with ADHD have support when shifting focus from an activity they have been concentrating on. When assigning work, consider giving students options for how they demonstrate their knowledge, offering shorter assignments, and building in breaks and time for students to move through the day. Help students focus by minimizing distractions and promoting use of organizational tools.¹⁵
• Work with trained staff: Trained teachers, counselors, or psychologists can support students’ positive classroom behavior and teach organizational skills.¹⁶
• Provide education services and accommodations in accordance with the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973: Provide students with Individualized Education Programs (IEPs) or alter learning environments based on a 504 Plan.¹⁷

Autism Spectrum Disorder (ASD)

Managing ASD at Home

• Explore treatment options with a healthcare provider: Treatments for ASD include behavioral, developmental, educational, social-relational, pharmacological, psychological, and complementary and alternative approaches. Your adolescent’s healthcare provider can recommend the treatment(s) that best suit your adolescent’s needs.¹⁸
• Encourage good overall health: Ensure your adolescent eats healthily, exercises, stays hydrated, and gets enough sleep. Find healthcare providers able to meet the specific needs of patients with ASD. Remember that behavioral changes can be due to physical issues, including those your adolescent may have trouble describing.¹⁹
• Prepare for milestones: Create a plan for when your adolescent will start communicating directly with his or her healthcare provider. Plan ahead for educational and career-related decisions; aim to have these plans in place by the time your adolescent is 14 years old and no later than when he or she is 16 years old.²⁰

Cancer

Preventing Cancer at Home

• Avoid sunburn: Encourage your adolescent to avoid sunburn by staying in the shade; wearing hats, sunglasses, and clothes that cover their arms and legs; and applying broad spectrum sunscreen with a sun protection factor (SPF) of 15 or higher.²¹
• Help your adolescent maintain a healthy weight: By preventing and managing obesity through physical activity and a healthy diet, your adolescent can reduce his or her risk of cancer.²²
• Protect your adolescent from firsthand and secondhand smoke: Educate your adolescent about the risks associated with smoking/tobacco use. Do not expose your adolescent to secondhand smoke.²³
• Reduce exposure to environmental toxins: Per- and Polyfluoroalkyl Substances (PFAS)²⁴ and other toxins²⁵ may lead to increased risk of cancer. Steps toward limiting exposure to PFAS can include contacting your local water utility to learn about how they address risk, avoiding serving fish caught in waterways impacted by PFAS, consulting the Consumer Product Safety Commission’s website to learn about products containing PFAS, and, if your family uses a well, to regularly test well water.²⁶

Diabetes

Preventing Type 2 Diabetes at Home

• Prioritize a healthy diet: Prioritize healthy choices like whole grains, lean meats, fruits and vegetables, and water instead of sugary drinks. Teach your adolescent to read nutrition labels and prepare healthy meals.²⁷
• Stay active as a family: Encourage your adolescent to get at least 60 minutes of activity per day. Limit his or her screen time. Plan outdoor activities like walking, hiking, and biking.²⁸

Managing Type 1 Diabetes at Home

• Understand type 1 diabetes: Learn about taking insulin; checking for high and low blood sugar and ketones; preparing items like glucagon, gels, and drinks to manage low blood sugar; and identifying signs of low blood sugar.²⁹
• Expect change: Your adolescent may want to take more responsibility for managing his or her diabetes. Prepare your adolescent so he or she will be ready to eventually take more responsibility for managing his or her diabetes. Your adolescents’ health needs may also change during puberty, when blood sugar can be more difficult to manage.
• Stay connected: Communicate with your adolescent, his or her health care providers, and support groups.³⁰

Managing Diabetes at School

• Develop a diabetes medical management plan: Involve a student’s parents and doctor in creating a plan to manage his or her diabetes. The plan should include the services that the school will provide, ways to recognize high and low blood sugar levels, steps to take in case of an emergency, and up-to-date emergency contact information.³¹
• Support students with diabetes: Make sure students with diabetes are comfortable monitoring their own blood sugar or know when and where a trained school employee will help them. Have a glucagon emergency kit ready for emergencies due to low blood sugar.³²
• Encourage healthy habits: Support students in eating a healthy diet and staying active.³³

Epilepsy

Preventing Epilepsy at Home

• Take precautions against traumatic brain injury: Make sure your adolescent wears a seatbelt in a car and a helmet when riding a bike or as needed when playing sports. Make sure your adolescent does not drive under the influence of drugs or alcohol.³⁴
• Reduce risk of stroke: Since stroke can cause epilepsy, healthy habits for diet and exercise can reduce risk of stroke, as can avoiding alcohol use and smoking/tobacco use.³⁵
• Encourage good hygiene to avoid cysticercosis infection: Handwashing, food preparation safety, and drinking clean water can reduce risk of cysticercosis infection (a tapeworm infection), which can lead to epilepsy.³⁶

Managing Epilepsy at Home

• Encourage healthy habits: Encourage your adolescent to get enough sleep, exercise, eat a healthy diet, and avoid tobacco, alcohol, and illegal drugs.³⁷
• Prioritize mental health: Help your adolescent manage stress.³⁸
• Understand epilepsy: Learn about the condition and your adolescent’s treatment plan. Ensure your adolescent takes his or her medicines as prescribed.³⁹
• Manage seizures: Help your adolescent track his or her seizures and recognize patterns.⁴⁰

Managing Epilepsy at School

• Educate staff: Ensure school nurses and personnel understand epilepsy and that school administrators understand legal protections for students with disabilities.⁴¹
• Support students with epilepsy: Help students take medication as directed and avoid seizure triggers such as flashing lights. Provide supports as needed, monitor for related conditions like depression, and prevent bullying of students with epilepsy.⁴²
• Manage seizures: Follow the student’s seizure action plan in case of emergency. Help students with uncontrolled seizures seek medical support.⁴³

Human Immunodeficiency Virus (HIV)

Preventing HIV at Home

• Talk to your adolescent about causes of HIV: Educate your adolescent about the causes of HIV and how to avoid risk behaviors.

Managing HIV at Home

• Begin treatment: Antiretroviral therapy (ART) reduces the amount of virus in a patient’s body, lowering it to a point where tests cannot detect it. Maintaining an undetectable viral load is the most important step for managing HIV.⁴⁴
• Prevent opportunistic infections: Certain illnesses, such as herpes simplex virus, tuberculosis, and pneumonia, occur more frequently and with greater severity in people with HIV. Talk to your adolescent’s healthcare provider about how to reduce risk of exposure to opportunistic infections and how to treat them. Before traveling, ask his or her healthcare provider about specific precautions to take. Ensure your adolescent takes his or her HIV medicine as prescribed: this is the best way to protect his or her immune system.⁴⁵
• Maintain a healthy lifestyle: A healthy diet and regular exercise strengthen an immune system.⁴⁶
• Avoid smoking/tobacco use: Smoking/tobacco use is linked to poorer response to treatment for HIV and increases risk of cancer, pneumonia, chronic obstructive pulmonary disease, and heart disease.⁴⁷

Hypertension

Preventing and Managing Hypertension at Home

• Prioritize physical activity and a healthy, low-sodium diet: Encourage your adolescent to get about 30 minutes of physical activity five days a week. Prioritize a healthy diet, including by limiting sodium. Take steps to manage and prevent diabetes and obesity, both of which can increase risk of hypertension.⁴⁸
• Manage stress: Depression, anxiety, stress, and post-traumatic stress disorder can contribute to hypertension.⁴⁹
• Avoid substance misuse: Talk to your adolescent about risks associated with alcohol misuse and smoking/tobacco use, which can increase risk of hypertension.⁵⁰
• Inform healthcare providers about risk factors: Talk to your adolescent’s healthcare provider about any family history of hypertension or any other risk factors.⁵¹

Inflammatory Bowel Disease (IBD)

Managing IBD at Home

• Track inflammatory foods and eating patterns: Help your adolescent keep a food diary to track what he or she ate and when he or she experienced inflammation. If a type of food seems connected to digestive problems, your adolescent can test the connection by avoiding the food for a few weeks and then trying it again.⁵²
• Identify foods that your adolescent can eat and foods that he or she should avoid: Soft, bland foods spaced out in smaller portions every two to four hours tend to be least inflammatory. The most inflammatory foods are usually greasy, fibrous, spicy and/or milk heavy; the most inflammatory beverages are usually caffeinated, carbonated, and/or alcoholic.⁵³
• Prioritize mental health: Encourage your adolescent to structure his or her day for predictability, including rest time and activities that he or she enjoys. Help your adolescent cope with stress and remind him or her to prioritize mental health.
• Stay healthy: Hydration, sleep, and exercise can help with IBD. Smoking/tobacco use and alcohol misuse can worsen it.⁵⁴

Obesity

Preventing and Managing Obesity at Home

• Maintain a healthy diet: Encourage your adolescent to make healthy choices for meals and snacks.⁵⁵
• Stay active: Find ways to stay active as a family.⁵⁶
• Encourage a consistent sleep schedule: Encourage your adolescent to go to sleep and wake up at the same time every day.⁵⁷

Preventing and Managing Obesity at School

• Take a comprehensive approach: Make nutrition and physical activity a routine part of the school day. Provide healthy meal options in the cafeteria. Encourage good health habits that last before, during, and after school. Support all students without singling out any.⁵⁸
• Coordinate with families and health care professionals: Take a collaborative approach to promoting health.⁵⁹

Resources

Coping with Chronic Stress: Healthy Strategies for Young Changemakers (Youth Generated Content)
Chronic stress can take a real toll on young minds and bodies, but it doesn’t have to control their lives. This article by a YE4C Editorial Board member breaks down healthy, realistic coping strategies young changemakers can use to manage stress, set boundaries, and protect their well-being while still working toward their goals.

The Hidden Impact of Chronic Stress: What You Should Know (Youth Generated Content)
Stress is a normal part of life, but when it becomes constant, it can seriously affect young bodies, minds, and overall well-being. This article by a YE4C Editorial Board member helps young people understand what chronic stress is, how it shows up in everyday life, and why recognizing the signs early matters.

Make America Healthy Again (MAHA) Report (PDF, 73 pages)
This report from the Make America Health Again (MAHA) Commission provides data on child health trends and examines the root causes of child health issues.

Children and Adolescents with Diabetes: How Can You Help? (PDF 2 pages)
This resource from the U.S. Department of Health and Human Services’ (HHS) Centers for Disease Control and Prevention (CDC) describes ways for schools, parents, and healthcare providers to work together to support adolescents with type 1 and type 2 diabetes.

Living with a Chronic Condition
This webpage from the CDC provides advice for managing chronic conditions.

Preventing Chronic Diseases: What You Can Do Now
This webpage from the CDC identifies risk factors that can lead to chronic diseases and offers guidance on how to avoid and mitigate those risks.

Healthy Schools
This webpage describes CDC partnerships with schools. These partnerships include programs promoting nutrition, physical activity, health education, and more.

What Works in Schools
This CDC webpage describes a school-based health program that improves health education, connects young people to health services, and makes school environments safer.

General Supports for Youth with Chronic Conditions & Disabilities and Their Families
This webpage from the HHS Office of Population Affairs (OPA) describes how to coordinate care for youth with disabilities and how to manage health care transitions as youth age.

Youth with Chronic Conditions and Disabilities
This webpage from the OPA offers information about chronic conditions and disabilities and how they affect youth in particular.

References