Health Maintenance, 18- to 21-Year-Old

SCHOOL PERFORMANCE

After high school completion, the young adult may be attending college, technical or vocational school, or entering the military or the work force.

SOCIAL AND EMOTIONAL DEVELOPMENT

The young adult establishes adult relationships and explores sexual identity. Young adults may be living at home or in a college dorm or apartment. Increasing independence is important with young adults. Throughout adolescence, teens should assume responsibility of their own health care.

IMMUNIZATIONS

Most young adults should be fully vaccinated. A booster dose of Tdap (tetanus, diphtheria, and pertussis, or "whooping cough"), a dose of meningococcal vaccine to protect against a certain type of bacterial meningitis, hepatitis A, human papillomarvirus (HPV), chickenpox, or measles vaccines may be indicated, if not given at an earlier age. Annual influenza or "flu" vaccination should be considered during flu season.

TESTING

Annual screening for vision and hearing problems is recommended. Vision should be screened objectively at least once between 18 and 21 years of age. The young adult may be screened for anemia or tuberculosis. Young adults should have a blood test to check for high cholesterol during this time period. Young adults should be screened for use of alcohol and drugs. If the young adult is sexually active, screening for sexually transmitted infections, pregnancy, or HIV may be performed. Screening for cervical cancer should be performed within 3 years of beginning sexual activity.

NUTRITION AND ORAL HEALTH

  • Adequate calcium intake is important. Consume 3 servings of low-fat milk and dairy products daily. For those who do not drink milk or consume dairy products, calcium enriched foods, such as juice, bread, or cereal, dark, leafy greens, or canned fish are alternate sources of calcium.

  • Drink plenty of water. Limit fruit juice to 8 to 12 ounces per day. Avoid sugary beverages or sodas.

  • Discourage skipping meals, especially breakfast. Teens should eat a good variety of vegetables and fruits, as well as lean meats.

  • Avoid high fat, high salt, and high sugar foods, such as candy, chips, and cookies.

  • Encourage young adults to participate in meal planning and preparation.

  • Eat meals together as a family whenever possible. Encourage conversation at mealtime.

  • Limit fast food choices and eating out at restaurants.

  • Brush teeth twice a day and floss.

  • Schedule dental exams twice a year.

SLEEP

Regular sleep habits are important.

PHYSICAL, SOCIAL, AND EMOTIONAL DEVELOPMENT

  • One hour of regular physical activity daily is recommended. Continue to participate in sports.

  • Encourage young adults to develop their own interests and consider community service or volunteerism.

  • Provide guidance to the young adult in making decisions about college and work plans.

  • Make sure that young adults know that they should never be in a situation that makes them uncomfortable, and they should tell partners if they do not want to engage in sexual activity.

  • Talk to the young adult about body image. Eating disorders may be noted at this time. Young adults may also be concerned about being overweight. Monitor the young adult for weight gain or loss.

  • Mood disturbances, depression, anxiety, alcoholism, or attention problems may be noted in young adults. Talk to the caregiver if there are concerns about mental illness.

  • Negotiate limit setting and independent decision making.

  • Encourage the young adult to handle conflict without physical violence.

  • Avoid loud noises which may impair hearing.

  • Limit television and computer time to 2 hours per day. Individuals who engage in excessive sedentary activity are more likely to become overweight.

RISK BEHAVIORS

  • Sexually active young adults need to take precautions against pregnancy and sexually transmitted infections. Talk to young adults about contraception.

  • Provide a tobacco-free and drug-free environment for the young adult. Talk to the young adult about drug, tobacco, and alcohol use among friends or at friends' homes. Make sure the young adult knows that smoking tobacco or marijuana and taking drugs have health consequences and may impact brain development.

  • Teach the young adult about appropriate use of over-the-counter or prescription medicines.

  • Establish guidelines for driving and for riding with friends.

  • Talk to young adults about the risks of drinking and driving or boating. Encourage the young adult to call you if he or she or friends have been drinking or using drugs.

  • Remind young adults to wear seat belts at all times in cars and life vests in boats.

  • Young adults should always wear a properly fitted helmet when they are riding a bicycle.

  • Use caution with all-terrain vehicles (ATVs) or other motorized vehicles.

  • Do not keep handguns in the home. (If you do, the gun and ammunition should be locked separately and out of the young adult's access.)

  • Equip your home with smoke detectors and change the batteries regularly. Make sure all family members know the fire escape plans for your home.

  • Teach young adults not to swim alone and not to dive in shallow water.

  • All individuals should wear sunscreen that protects against UVA and UVB light with at least a sun protection factor (SPF) of 30 when out in the sun. This minimizes sun burning.

WHAT'S NEXT?

Young adults should visit their pediatrician or family physician yearly. By young adulthood, health care should be transitioned to a family physician or internal medicine specialist. Sexually active females may want to begin annual physical exams with a gynecologist.