Adolescent and young adult male health receives little attention, despite the potential for positive effects on adult quality and length of life and reduction of health disparities and social inequalities. Pediatric providers, as the medical home for adolescents, are well positioned to address young men’s health needs. This review has 2 primary objectives. The first is to review the literature on young men’s health, focusing on morbidity and mortality in key areas of health and well-being. The second is to provide a clinically relevant review of the best practices in young men’s health. This review covers male health issues related to health care access and the Centers for Disease Control and Prevention’s Healthy 2020 objectives for adolescents and young adults, focusing on the objectives for chronic illness, mortality, unintentional injury and violence, mental health and substance use, and reproductive and sexual health. We focus, in particular, on gender-specific issues, particularly in reproductive and sexual health. The review provides recommendations for the overall care of adolescent and young adult males.
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September 2013
State-of-the-Art Review Article|
September 01 2013
Adolescent and Young Adult Male Health: A Review
David L. Bell, MD;
aDepartment of Pediatrics, Department of Population and Family Health, Columbia University Medical Center, New York, New York;
Address correspondence to David L. Bell, MD, MPH, Medical Director, The Young Men’s Clinic, Center for Community Health & Education, 60 Haven, B3, New York, NY 10032. E-mail: [email protected]
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David J. Breland, MD;
David J. Breland, MD
bDivision of Adolescent Medicine, Seattle Children's Hospital, Seattle, Washington; and
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Mary A. Ott, MD
Mary A. Ott, MD
cSection of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Address correspondence to David L. Bell, MD, MPH, Medical Director, The Young Men’s Clinic, Center for Community Health & Education, 60 Haven, B3, New York, NY 10032. E-mail: [email protected]
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2013) 132 (3): 535–546.
Article history
Accepted:
June 20 2013
Connected Content
A correction has been published:
Bell et al. Adolescent and Young Adult Male Health: A Review. Pediatrics. 2013;132(3):535–546
Citation
David L. Bell, David J. Breland, Mary A. Ott; Adolescent and Young Adult Male Health: A Review. Pediatrics September 2013; 132 (3): 535–546. 10.1542/peds.2012-3414
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Comments
Distinction between transfusion refusal ethical versus management issues
I disagree with the fundamental premise of the article by Ukachi et al that this is a case about medical ethics. The case report involves an 18 year old woman who is a Jehovah's Witness with life threatening anemia who refuses transfusion. The case raises important management but not ethical issues. It is firmly established that competent adults may refuse life sustaining treatment against medical advice.1 This right to refuse life sustaining treatment is not absolute and courts recognize exceptions in circumstances for "(1) the preservation of life; (2) the protection of interests of innocent third parties; (3) the prevention of suicide; and (4) the maintenance of the ethical integrity of the medical profession."2 None of these exceptions apply in this case. As the reviewers point out, the case illustrates the importance for pediatric providers to recognize and anticipate the transition of their patients from being children with surrogate decision makers to becoming competent adults. Dr. Morrison's premise that implied consent is given for a procedure in the absence of a written refusal or changing physicians is problematic. A Michigan court in a similar case regarding blood transfusion of a Jehovah's Witness patient pointed out that the refusal of treatment needed to be contemporaneous.3 The reviewers' comments on the importance of pursuing alternative treatments cannot be overstated. It is unclear why this patient was not discharged on hormonal therapy to suppress her menses and remove at least one contributing factor to her anemia.
1. Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990)
2. Commissioner of Correction v. Myers, 379 Mass. 255, 261-262 (1979)
3. Werth v. Taylor, 475 N.W. 2d 426 (Mich. App. 1991)
Conflict of Interest:
None declared