Published online by Cambridge University Press: 11 August 2009
Introduction
Adolescence is commonly viewed as a healthy time of life with little need for medical care. Although there is some truth to this belief, individual adolescents may suffer from a wide variety of illnesses and injuries (Council on Scientific Affairs, 1990; Feinstein et al., 1998), which can have immediate and, in many cases, lifetime effects. Many teenagers coming to detention also have deferred medical needs because of barriers to access (Council on Scientific Affairs, 1990), including absent or limited insurance, lack of parental involvement (Hein et al., 1980), chaotic lives and limited understanding of medical care requirements. Incarceration provides the best chance to meet the medical and dental needs of this particularly vulnerable group (Hein et al., 1980; American Academy of Pediatrics, 1989; Society for Adolescent Medicine, 2000). In addition, the act of detaining citizens removes their ability to seek care voluntarily thus placing a legal and moral imperative on the detaining authority to provide care that meets community standards (Costello & Jameson, 1987). Resources expended on youth provide a cost-effective intervention because this prevents more serious sequellae requiring greater expenditures in the future. Lastly, rehabilitation of delinquent youth proceeds most smoothly when the youth is free of disease, pain, and disability.
This review is divided into four sections: medical problems that may predispose to delinquent behavior; medical illness and injury likely to result from delinquent behavior; health concerns for all adolescents; and health maintenance issues.
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