adolescent health: robert wm. blum, md, mph, phd center for adolescent health & development who...
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Adolescent Health:
Robert Wm. Blum, MD, MPH, PhDCenter for Adolescent Health & Development
WHO Collaborating Centre on Adolescent Health
University of Minnesota
New Directions for a New Millennium
Youth Support ConferenceLondon, England24 October 2002
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When we talk about adolescent health, what is it that we picture?
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A Picture of Youth Health
PhysicallyHealthy
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
EducatedorLiterate
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
EducatedorLiterate
Safe & free of abuse
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
EducatedorLiterate
Safe & free of abuse
FullParticipation
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
EducatedorLiterate
Safe & free of abuse
FullParticipation
SpirituallyHealthy
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A Picture of Youth Health
PhysicallyHealthy
MentallyHealthy
SexuallyHealthy
EducatedorLiterate
Safe & free of abuse
FullParticipation
SpirituallyHealthy
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Today, 30% of the world’s population is between the ages of 10-24 years
1.5 billion young people;Over the next decade the number will
increase;In industrialized countries young people
represent 13% of the population;In developing nations it is 20-25%.
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There is a deepening North/South divide between economically rich & poor nations
85% of young people live in economically impoverished nations;
The changing opportunity structure for young people: away from agriculture toward the factory some will compete in the information age.
80% of young people are unemployed.
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0
200
400
600
800
1000
1200
1990 2000 2025
RuralUrban
Population of Young People in Developing Countries by Urban & Rural Areas 1990-2025
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Social Trends
Global homogenization of youth culture and the impact of global media
The rise in religionChanges in traditional practices:
Female Genital Mutilation Abuse
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Births before marriageAIDS orphansDivorceMultiple household families
The Changing Structure of the Family
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Our Understanding of what InfluencesAdolescent Health has Changed
Deviance ModelClustering of risk behaviorsRisk and protective factorsAn ecological modelPositive youth development
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Shifting Models/Shifting Approaches
TeenTeen
Knowledge(just know)
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Shifting Models/Shifting Approaches
TeenPeer Influence
(peer education)Teen
Knowledge(just know)
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Shifting Models/Shifting Approaches
Teen
Risk Behaviors Linked(comprehensive strategy)
Peer Influence
(peer education)Teen
Knowledge(just know)
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Shifting Models/Shifting Approaches
Teen
Resistance Skills(just say no)
Risk Behaviors Linked(comprehensive strategy)
Peer Influence
(peer education)Teen
Knowledge(just know)
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Shifting Models/Shifting Approaches
Teen Environmental Factors(mentorship)
Resistance Skills(just say no)
Risk Behaviors Linked(comprehensive strategy)
Peer Influence
(peer education)Teen
Knowledge(just know)
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Shifting Models/Shifting Approaches
Teen
Family Factors(family involvement)
Environmental Factors(mentorship)
Resistance Skills(just say no)
Risk Behaviors Linked(comprehensive strategy)
Peer Influence
(peer education)Teen
Knowledge(just know)
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Priorities for the Next Decade
Foster basic research; Understanding social contexts and
their impact on youth health and development;
Strengthen informal networks and parental supports;
Operationalize positive youth development;
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Priorities for the Next Decade
Shift supports from social protection to social capital;
Broaden our framework from healthy people to healthy communities;
Establish new collaborations; Move from demonstration to
replication.
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#1 Basic Research
Neurodevelopment through puberty and adolescence into adulthood;
Neuroendocrinology of puberty and adolescence;
The interface of genetics and behavior.
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#2 Social Contexts
The role of social contexts in the lives of young people
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Do social epidemics work like infectious disease epidemics?
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A non-linear relationship between a number of adolescent health problems and the environment in which young people live.
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Probability of Black Teenagers Dropping Out of School as a Function of Percentage of High-Status Workers in Big-City Neighborhoods
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
5 10 15 20 25 30
PercentCrane, J. Am J. Soc. 1991, 96(5):1226-1259
— Males— Females
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If this is true for other issues, other groups and other settings, it means that small environmental shifts can have big effects.
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School Climate Research
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School Environment Counts
School connectedness protects against every health risk studied;
School connectedness does not depend on: Class size; Years of teacher experience; Academic preparation of teachers.
School connectedness depends on: Caring adults; Social integration; School size; Classroom management.
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#3 Strengthen Informal Networks and Parenting Supports
Resilience research consistently shows that informal social networks are highly protective in the lives of adolescents as well as adults: Neighbors Friendship networks Adults Teachers/coaches
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Strengthening Families
While we know that families are important, much less is known about policies or programs that most effectively support parents of adolescent children.
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Strengthening Families
How do we strengthen the human resources in a neighborhood so they can better support young people?
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#4 Operationalize Positive Youth Development
Positive youth development is defined as participation in prosocial behaviors and avoidance of health compromising and future jeopardizing behaviors.
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Key Elements of Positive Youth Development
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Successful Interventions
Build strong adult-youth relationships;Have a clear, well articulated
philosophy about youth;Build interventions on a theory of youth
development grounded in research;Recognize the strengths of youth and
build upon those strengths;
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Successful Interventions
Recognize the human resources in the community;
Actively involve young people;Link young people with pro-social
adults;Provide life skills;Provide opportunities for young
people to contribute.
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To identify the protective factors in the lives of young people that transcend culture and setting;
To identify successful interventions at the individual and community level that support and strengthen the protective factors in the lives of young people.
The Challenges for the Next Decade
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#5 Shift From Social Protection to Social Capitol
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Social Capitol
Social capital: Environmental resources that are people
specific (e.g., family stability) that support human development. These factors are also protective. These factors are sometimes viewed as assets. Others refer to them as components of resilience.
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Factors Associated with Social Capital
Two parents;Fewer siblings;Fewer changes in schools attended;Regular attendance at religious services;Mother’s expectations for her children’s
educational attainment.
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#6 Broaden our Perspective from Healthy People to Healthy Communities
Social capital;Positive youth development;Informal networks;Social contexts.
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#7 Develop New Teams and Collaborations
Education, health and development as core, integrated elements;
Youth as a critical team player;Link economic development and health
domestically.
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#8 Move from Demonstration to Replication then to Scale
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Center for AdolescentHealth and Development
www.allaboutkids.umn.edu