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Great Transitions: Preparing Adolescents for a New Century

Chapter Two: Old Biology in New Circumstances

The biological changes of puberty are triggered by events in the young person's brain, which instruct the pituitary gland to produce hormones that stimulate the secretion of sex hormones. These hormones, in interaction with external influences, have powerful effects on many tissues of the body, including the brain. They are signified by the dramatic growth spurt and contribute to significant changes in social, emotional, and sexual behavior and in cognitive capacity.

These fundamentals of the adolescent transition are essentially unchanged since ancient times. What is drastically different today is the social context for this series of events. Rapid industrialization, urbanization, technological advances, geographic mobility, and wrenching cultural shifts have profoundly altered the conditions for growing up and for family life. The swiftness of these changes, in historical terms, challenges our understanding and the capacity of our key socializing institutions to meet the basic requirements for healthy child and adolescent development. As a result, many families and their adolescents are not faring as well as they should.

THE CONTEMPORARY CONTEXT FOR ADOLESCENT DEVELOPMENT
Several trends of recent decades have had strong effects on adolescent development.

• The Changing Family. Kinship and neighborhood networks have eroded and divorce has become common. Today, slightly more than half of all American children will spend at least part of their childhood or adolescence in a single-parent family. With one or more parents and other adults in the workplace and otherwise out of the home, adolescents are spending less time in the company of caring adults than they used to. More of their time is spent with peers in age-segregated environments or in front of the television set. A 1988 survey found that about 27 percent of eighth graders spent two or more hours at home alone after school.
• The Shifting Nature of Work. With economic restructuring, the shift to a knowledge-based economy, and the globalization of the marketplace, thousands of high school graduates are now finding themselves relegated to low-status, dead-end jobs. The growing disparity in incomes between college- and high school-educated youths threatens the prospects and morale of many adolescents and their parents. For those who are poor, the material deprivation and job instability they face can give young people a bleak sense of the future.
• The Gap between Early Reproductive Capacity and Adult Roles. While young people are undergoing pubertal changes on average two years earlier than they did a century ago, marriage and the possibility of attaining fully adult status are occurring later. Indeed, the second half of the twentieth century has seen the widest separation ever between the timing of sexual maturation and the formal assumption of adult roles and responsibilities. This long hiatus is, needless to say, the source of much anxiety felt by young people and their parents.
• Dominance of the Media. Television, videocassettes, and music media, along with personal computers, increasingly pervade the lives of both children and adolescents. By mid-adolescence, when television viewing peaks, young people will have spent more time in front of the television set than with their teachers. Television profoundly influences the fears and expectations of adolescents about the future, their values, and their relationships with others.
• Diversity in the Population. The United States has become one of the leading multiethnic nations in the world. One-third of American adolescents today are of non-European descent and come from a wide array of religious, ethnic, and national backgrounds. In many metropolitan areas, disadvantaged minority members constitute a majority in the public schools. By the year 2050, close to 50 percent of the entire American population is projected to be African American, American Indian, Asian/Pacific Islander, and Latino/Hispanic. Learning to live peacefully while respecting diversity will be a major task for youth in the twenty-first century.

All adolescents and their families have been affected by these interrelated social transformations. No segment of the population has been immune, not even more affluent families. Particularly troubling are the worsening trends for younger adolescents. Today, children ten through fourteen are commonly exhibiting many of the very risky behaviors that were once associated with middle and late adolescence. The results for increasing numbers are early foreclosure of opportunity, disability, and even death.

The firearm homicide rate for ten- through fourteen-year-olds more than doubled between 1985 and 1992. In 1992, young adolescents were victims of assault more than any other age group. Altogether, nearly one million adolescents between the ages of twelve and nineteen are victims of violent crimes each year. One-third of eighth graders report the use of illicit drugs, including inhalants. Marijuana use more than doubled between 1991 and 1994. About 15 percent of eighth graders report they have drunk more than five alcoholic beverages in a row in the past two weeks. Among sexually experienced girls thirteen years or younger, over 60 percent have had involuntary intercourse, in many cases with older men. The rate of suicide among ten- to fourteen-year-olds increased 120 percent between 1980 and 1992.

Research shows that, by the time they reach age eighteen, about a quarter of all adolescents have engaged in behaviors that are harmful or dangerous to themselves or others. Another quarter are at moderate risk of engaging in such behaviors. About half of all American adolescents--an estimated 14 million girls and boys--are therefore at high or moderate risk of ruining their life chances through early experimentation in serious problem behaviors. The proportion is higher in distressed communities, where neighborhoods are less likely to furnish jobs that generate sufficient incomes and to have adequate social supports. In these neighborhoods, young people have the least access to good education and health care and the least exposure to role models who can raise their expectations and hopes about the future.

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The problems of adolescence deal with deep and moving human experiences. They center on a fateful time in the life course when poorly informed decisions can have lifelong consequences. The tortuous passage from childhood to adulthood requires our highest attention, our understanding, and a new level of thoughtful commitment.

David A. Hamburg, President, Carnegie Corporation of New York

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TURNING NEW RISKS INTO OPPORTUNITIES
As the nation approaches the twenty-first century, the pace of change will only accelerate, with the pressures on families and adolescents promising to be even more acute. A fundamental task for American institutions, then, is to find innovative ways to adapt to the new conditions in order to ensure that young people's basic developmental needs are met.

In favorable circumstances, adolescents acquire critical adaptive skills in the family, among friends, and in the neighborhood. But there are circumstances in both affluent and economically disadvantaged families in which parents and other adults are unable or unwilling to fulfill their responsibilities to their children. Their work schedules may not allow them to be available when needed. They may be depressed and lacking in hope. They may be hooked on drugs and physically or emotionally neglectful or abusive toward their children.

• Social Support Systems. Although there is no substitute for a deeply caring parent, young people can still thrive if some responsible person or group steps in to meet their developmental needs. To the extent that families and neighborhood resources are not sufficient, specially designed social supports offering family-like care and nurturing, practical services, and firm guidance may be crucial to steer a young person onto a constructive, life-affirming path. Offered by schools and youth organizations as well as social service agencies, such social supports address the factors that predispose a young person to engage in risky behaviors--factors such as the absence of dependable, close relationships, low self-esteem, underdeveloped interpersonal and decision-making skills, alienation from school, inadequate education, low perception of opportunities, and meager incentives to delay gratification.
• Adult Mentoring. A fundamental need of young people, particularly in high-risk areas, is for a stable, supportive bond with a caring adult who can help them prepare for social roles that earn respect, route them to needed resources, and encourage them to persist in education. Among poor children from urban areas, research has shown that those who cope well usually have at least one significant, positive adult role model, not necessarily the parent. Elder citizens can contribute substantially as mentors to adolescents, bringing new meaning to their own lives while helping the younger generation grow up. The task is not a simple one. A mentor is expected to provide sustained support, guidance, and concrete help when an adolescent goes through a difficult time, enters a new situation, or takes on new tasks. It is also important that a mentoring program be integrated with other resources in the community. Particularly for high-risk youth, who often experience multiple problems, connecting them to education, health, and social services is crucial.
• Peer-Mediated Counseling and Peer Tutoring. Education- and health-oriented programs led by trained and supervised peers can be a credible source of sympathetic attention, knowledge, and advice to troubled youth who are otherwise hard to reach. Well-developed peer-led programs have shown they can substantially reduce the onset of smoking in early adolescence, teach younger adolescents social skills to resist pressures to use drugs or engage in premature sex, and help them identify and practice health-enhancing behaviors. Similarly, one-to-one tutoring by an older, appropriately prepared student is an effective teaching method, especially with difficult subjects such as mathematics. A well-functioning program in which students serve as auxiliary teachers allows regular teachers to use their professional skills more fully and promotes cooperation and mutual respect among the students, leading to an improved climate in the classroom.
• Life-Skills Development. If adolescents are to solve problems of human relations, develop healthy lifestyles, cultivate intellectual curiosity, access the social systems they need, and meet the demands of the workplace, they must learn certain basic skills for everyday life. Training in interpersonal, decision-making, and coping skills can help students resist pressures from peers, from irresponsible adults, or from the media to engage in high-risk behaviors. It can increase their self-control, help reduce stress and anxiety, and teach them ways to make friends if they are isolated and to assert themselves without resorting to violence. Students can acquire these skills through systematic instruction and practice and through role playing and group problem solving. When combined with a life sciences curriculum in the middle schools, life-skills training can be a potent force in motivating young adolescents to build healthy lifestyles of enduring significance.

The generic approaches described above have the potential to prevent major problems in adolescent health and education and to promote those practices that lead to healthy, fulfilling lives. These strategies can be implemented by a wide array of institutions concerned with offering young adolescents a decent chance in life.

Economic Consequences of Preventable Problems

Adolescent pregnancy and substance abuse are not simply problems when they happen. The consequences of these acts reach far into the future, and their antecedents emerge even before adolescence. The following costs illustrate the importance of preventing such problems.

DROPPING OUT

• Remaining in school is the single most important action adolescents can take to improve their future economic prospects. In 1992, a high school graduate earned almost $6,000 per year more than a high school dropout.[1]
• Going to college boosts income even more. In 1992, college graduates had a mean annual income of $32,629, while high school graduates had a mean annual income of $18,737. Earning a professional degree added $40,000 a year to the mean annual income of college graduates.[1]
• Gender also affects income. A male high school graduate's mean monthly income is likely to be twice as much as a female high school graduate's, a statistic that highlights the significance of education for women.[2]

BEARING CHILDREN

• Women who become mothers as teenagers are more likely to find themselves living in poverty later in their lives than women who delay childbearing. Although 28 percent of women who gave birth as teenagers were poor in their twenties and thirties, only 7 percent of women who gave birth after adolescence were living in poverty in their twenties and thirties.[3]
• In 1992, the federal government spent nearly $34 billion on Aid to Families with Dependent Children, Medicaid, and food stamps for families begun by adolescents.[4]
• Providing family planning services is one way to lower taxpayers'costs. Each public dollar spent on family planning services saves an average of $4.40 by reducing expenditures on medical, welfare, and nutritional programs.[5]

SUBSTANCE USE AND ABUSE

• Substance abuse costs the United States more than $238 billion a year, including the expense for treatment of abuse, the productivity losses caused by premature death and inability to perform usual activities, and costs related to crime, destruction of property, and other losses.[6]
• Each year more than a million young people start smoking regularly, a decision that will cost the health care system $8.2 billion in preventable medical expenditures during their lifetimes.[7]
• During the last two decades, the tobacco industry has dramatically increased the money it spends on advertising. In 1992, the industry spent more than $5.2 billion on advertising, making cigarettes second only to automobiles in advertising dollars spent.[8]

INJURIES

• An estimated 10 to 20 percent of all injuries to children and young people occur in and around schools. Falls were the most common cause of injuries. Representing 46 percent of all incidents, falls were followed by sports activities at 30 percent and assaults at 10 percent. The resulting costs of these injuries vary substantially. The bill for treating something as simple as a forearm fracture, for example, can exceed $3,900. A serious injury such as spinal cord damage can incur medical costs higher than $188,000.[9]
• Injuries to young adolescents, ages ten to fifteen, in motor vehicles cost more than $13 million in 1991, or about $56,000 per injured child.[10]
• The U.S. Centers for Disease Control and Prevention estimates that simply switching to break-away bases for softball games could prevent 1.7 million injuries a year and save $2 billion in acute medical costs.[11]
• A recent U.S. Government Accounting Office report estimated that the nation's schools need $112 billion to complete all of the repairs, renovations, and modernizations required to restore facilities to good overall condition and comply with federal mandates that ensure the safety of students.[12]

VIOLENCE

• Violence is a social problem with tremendous economic costs. In 1993, the cost of providing emergency transportation, medical care, hospital stays, rehabilitation, and related treatment for American firearm victims ages ten through nineteen was $407 million.[13]

SOURCES

1. U.S. Department of Commerce, Bureau of the Census. (1994). More education means higher career earnings. Statistical Brief SB/94-17. Washington, DC: Author.

2. U.S. Bureau of the Census. (1994). Statistical abstract of the United States: 1994. (114th edition). Washington, DC: U.S. Government Printing Office.

3. Alan Guttmacher Institute. (1994). Sex and America's teenagers. New York: Author.

4. U.S. Government Accounting Office. (May 1995). Welfare dependency: Coordinated community efforts can better serve young at-risk teen girls. RCED-95-108. Washington, DC: Author.

5. Morbidity and Mortality Weekly Report. Teenage pregnancy and birth rates--United States, 1990. October 1, 1993, 42 (38): 733-737.

6. Institute for Health Policy. (1993). Substance abuse: The nation's number one health problem: Key indicators for health policy. Waltham, MA: Author.

7. Lynch, B. S., & Bonnie, R. J. (1994). Growing up tobacco free: Preventing nicotine addiction in children and youths. Washington, DC: National Academy Press.

8. Federal Trade Commission. (1992). Report to Congress pursuant to the federal Cigarette Labeling and Advertising Act. In remarks by David A. Kessler. The Samuel Rubin Program at the Columbia University School of Law, March 8, 1995.

9. Children's Safety Network. (1994). Injuries in the environment: A resource packet. Newton, MA: Author.

10. Children's Safety Network Economics and Insurance Resource Center, National Public Services Research Institute. (1992). Child Occupant Injury Facts. Landover, MD

11. National Institutes of Health. (1992). Sport injuries in youth: Surveillance strategies. NIH Publication No. 93-3444. Washington, DC: U.S. Government Printing Office.

12. U.S. General Accounting Office. (1995). School facilities: Condition of America's schools. HEHS-95-61. Washington, DC: Author.

13. Miller, T. (1995). Children's Safety Network Economics and Insurance Resource Center, and National Public Services Research Institute. Unpublished data.

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