Wednesday, 4 September 2013

What to do about young men?

This is somewhat out of my normal comfort zone of infections, but a recent review in Pediatrics looks at the subject of health in adolescent boys and young men, and makes some suggestions about activities that might be undertaken to improve their health through screening and other measures.

The paper itself is American, and does not necessarily translate directly to a UK or European setting, but much of it does.  The list of conditions that young men might suffer is quite extensive, and in addition to the various medical conditions there are many other issues such as violence and suicide that while they may differ in degree, are definitely issues for many young men.  The other really interesting issues are those surrounding sexuality and the role of men in society.  This struck me because many of the regular drama programmes in the UK (particularly EastEnders) have a really negative image of men, they all seem to be crooks, emotionally unstable, or generally not very nice.  While this is only drama, the drip, drip, drip effect of negativity may be significant.

One of my jobs here in the College is to run the HIV Course, and the assignment for this includes planning a health education intervention.  A lot of the students decide to target gay men; but when asked how they will access them they only seem to know about gay men in terms of those who go to nightclubs and bars.  Now while many gay men do, I am pretty sure there are many who don't frequent nightclubs and bars, so how best to access them?  The same problem occurs with young men, how do you access them, and when you do what interventions actually work?

Since writing the NICE Fever Guidelines, and being a fully paid up convert to the idea of traffic light tables, maybe one idea might be to do a traffic light for young men.  What characteristics are indicative of low, intermediate and high risk of morbidity?  I know they have limitations, they are either too sensitive or too specific........but they are a start, and they do make people think about what we know, and more importantly what we don't, what is the level of uncertainty and where does it lie?

One particularly fascinating idea is the concept of the positive development approach, where one acknowledges and promotes the young persons strengths and assets rather than problems and weaknesses.  It seems obvious, but actually we don't often do that, indeed the NHS in the UK often referred to as the National Sickness Service rather than the National Health Service.  Then it struck me, promoting strengths and assets, and being positive; wouldn't it be nice if we could do that to everyone?

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