Supplement article
Reasons to invest in adolescents

https://doi.org/10.1016/S1054-139X(02)00486-XGet rights and content

Abstract

Purpose

To discuss the frequent failure of the United States (and other countries) to make the types of investment in youth that would increase the future prospects of youth from high-risk backgrounds. I argue that these investments are worth making, and describe the types of research and knowledge dissemination that will be necessary to promote such investments

Approach

I begin with a framework for thinking about and working with adolescents. I review theories of youth development, the developmental tasks of adolescence, risk and resilience, and the strong tendency of current approaches to address single problems and symptoms rather than underlying conditions. A conceptual framework is presented that combines known elements of risk and protective factors, such as antecedents, system markers of current or potential difficulties, risk behaviors, and outcomes. I briefly review what we know about youth risk behavior and outcomes in various domains, including combined prevalence and patterning. I then examine what we know about the payoffs that we can expect from investing in activities that promote adolescent health. I end with a set of recommendations for researchers and practitioners, and discuss the information that they need to put these recommendations into practice.

Section snippets

Need for future health and productivity

In 1996, youth made up about one in every seven people in the U.S. population, whether the focus is on the younger end of the age spectrum (10- to 19-year-olds comprise 14.3%) or the older end (14- to 24-year-olds comprise 13.8%). These are the individuals on whom the future of this country depends. A strong argument can be made that we need all of our youth to develop into productive adults, with skills and attitudes ready to cope with 21st-century work, politics, and community and

Problem-focused versus holistic programming

Our society may need youth, but it has not been too successful at knowing how to help many of them reach a productive adulthood. The programs that do exist to serve adolescents, and the types of attention that adolescents usually do receive when they receive any, too often are focused on specific problem behaviors after the behaviors are fairly well entrenched. Prevention programs are relatively scarce; what happens instead can be called “tertiary attention”—trying to fix something after it is

Theories of youth development and their implications

Adolescence was once viewed as a life stage that, by its very nature, involved serious conflict and upheaval as individuals tried to sever their connections with childhood dependence and struggled to achieve an independent adult identity 3, 4. The troubles of adolescents were seen as typical or to be expected during this life stage, rather than as a sign that something was seriously wrong. However, more recent thinking sees much less necessary difficulty with the process and much more

Circumstances and needs of American youth

This section briefly summarizes the conditions of youth that point to potential difficulties in achieving successful adulthood, focusing on the right half of Table 1. It looks at education, health and reproductive health, substance abuse, and criminal behaviors. Its basic focus is on identifying how many youth have futures threatened by problems during adolescence.

What payoffs can we expect from investing in activities that promote adolescent health?

One way to think about the importance of attending to adolescent health issues, and attending to them in a holistic and comprehensive way, is to consider what the consequences will be if we do not make these investments. A number of studies try to assess the personal or societal costs of adolescent risk behaviors with respect to a variety of topics including youth smoking and substance abuse, teenage pregnancy and childbearing, lack of educational completion, and juveniles likely to become

What evidence do we have that a holistic approach works?

In deciding what to do to assist youth, past efforts have focused largely on youth who have already exhibited behaviors considered undesirable by society (e.g., dropping out of school, engaging in illegal activities, engaging in violent activities, having babies without being able to support them, and abusing alcohol and other drugs). Programs addressing these issues typically work with youth to try to stop them from continuing these behaviors and to reduce the consequences of these behaviors.

Summary and conclusions

The view of adolescence presented in this paper has important implications for how we should work with adolescents. First, it is critically important to develop coordination among different parts of the service and support system so that the needs of adolescents can be addressed in a holistic and coordinated way. Even if health is the major focus of a program, it is still necessary to address the needs of youth to earn money, help their family, or learn how to deal with its difficulties, and

Acknowledgements

This paper was prepared at the request of the Maternal and Child Health Bureau, U.S. Department of Health and Human Services, for presentation at “Health Futures of Youth II: Pathways to Adolescent Health,” held September 14–16, 1998, in Annapolis, Maryland. The views expressed are mine and should not be attributed to the Urban Institute, its trustees, or its funders, or to the U.S. Department of Health and Human Services.

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