Adolescent Health & Social Development

1. Adolescent Health & Social Development Nurs 250 Health Promotion Kate Abbgy Lindsay Bolhuis Shannon Gregson Kim Peterson

2. Introduction Photo source: http://media.sspediatrics.com/images/stock1.jpg

3. Adolescent Population • Adolescent population includes ages 10-19 • Number of adolescents expected to keep growing • Began to increase in 1990 and is expected to keep increasing through 2050 • Immigration • Higher immigration number of Hispanics and Asians. • Birth and Fertility Rates • Decrease in birth and fertility rates among Whites and Blacks, increase among Hispanics.

4. Distribution and Living Situations • Distribution • Ethnicity • Northeast and Midwest • South • West • Largest Percentage of adolescents live in the South • Suburbs, City, and Rural Areas • 53.8%-Suburban • 19.0%-Rural • 27.2% Central City • Living Situations • Two thirds of adolescents age 12-17 live with both parents • Decrease from 73% in 1995 • 46% of Black Adolescents live with their Mother only • 77.8% of Asian Adolescents live with both parents • Poverty • Black and Hispanic youth experience poverty at a higher rate than their peers. • In 2002, 1 out of 6 youths under the age of 18 lived below the federal poverty lines.

5. Cultural Considerations • Religion • Integral to culture, extends into all aspects of life • Guides attitudes • Important to know what religious factors are valued • Not all have same spiritual beliefs • Younger adolescents • Ethnicity • Do not confuse race with ethnicity • Ethnicity refer to a large group of people who feel a sense of shared identity. • Adolescents may be multiethnic

6. Cultural Considerations • Birthplace • Culture varies with geography • Insight into how adolescents were raised • Knowing the length of time spent in the birthplace • Generational Status • Reason for immigration • Generational status effects cultural identity, affiliation, beliefs, attitudes and practices • Length of time in the United States • Recent Immigrant tend to cling to the culture of their homeland

7. Cultural Considerations • Language • Transmits culture • A shared language provides familiarity among strangers. • Can be considered positive or negative • Multilingual is seen as a gift • Education • Education importance to the culture • Quality and length of education • Never confuse a lack of formal education with ignorance or diminished mental ability.

8. Adolescent Stage • Begin experiencing: • Hormonal changes • Emotional and social changes • Physical maturation • Opportunities to engage in risky behaviors • Risky Behaviors • May cause issues later on in life

9. Health Risk Factors • Overweight • Increases chance for: • High cholesterol • Hypertension • Diabetes • 17% of adolescents 12–19 years of age are overweight, which has tripled since 1980. • Why? • Technology • Convenience food • Lack of promotion of exercise • Alcohol • Most widely used drug among adolescents. • Uniform Drinking Age Act • 230,000 alcohol-related ED visits among adolescents • ED visits differ with gender and age.

10. Health Risk Factors Death Rates • Suicide Ideation and Attempts • Third leading cause of death among adolescents 13–19 years of age. • Factors that may contribute to attempting suicide include • History of previous suicide attempts • A family history of suicide • Alcohol or drug abuse • Stressful life event or loss • Substance abuse • One fifth of all high school students consider suicide or have attempted suicide • Female students are more likely to consider suicide than male

11. Health Risk Factors Death Rates cont. • Motor Vehicle • Leading causes of injury death among adolescents 10-19 years of age. • Combined with firearm related deaths, it accounted for 51% of all deaths and 72% of all injury deaths for adolescents. • Rates increased with age for male and female adolescents. • At ages 15 and 16 years these numbers for both genders doubled. • Alcohol • Almost 29% of high school students reported they rode in a car with a driver who consumed alcohol • 15% reported that they drove after drinking alcohol. • Safety • 39% were speeding at the time of the crash • 10% percent of students surveyed rarely or never wear seatbelts

12. Health Risk Factors Death Rates Cont. • Firearm-Related Deaths • Increase substantially with age • Males 19 years of age were 59 times the rate for those 10 and 11 years of age. • 9-year-old females were 9 times the rate for 11-year-old females. • Race and Ethnicity • Higher among black adolescents than any other racial and ethnic groups • Lower for non-Hispanic white and Asian- or Pacific-Islander adolescents

13. Health Risk Factors • Health Care Coverage • Family income is a key factor • One fifth of adolescents in families below the poverty level have no health insurance • 8% of adolescents in families with income at twice the poverty threshold or greater have no health insurance. • Adolescents 18-19 years of age are more likely to be uninsured than younger adolescents

14. The Facts • Boys vs. Girls • Boys use more substances than girls • Low Socioeconomic Status • Adolescents more likely to smoke cigarettes • Poverty • Higher rates of substance use • Black adolescents have the lowest use rates • Hispanics have the highest rates

15. Risk Taking: Healthy vs. Unhealthy • Healthy risk-taking is an important part in an adolescent’s life for: • Discovering • Developing • Consolidating their identity • Unhealthy risk-taking can lead to issues in adolescent’s life • Unplanned pregnancy • Overdose on drugs • Alcohol related deaths • Fatal car crashes • Alcohol poisoning

16. Healthy Risk Taking Alternatives

17. Rosemary Parse’s Theory of Human Becoming • Theory focuses on the person • How they interact with their environment • Each person • Chooses values • Has their own way of living • Will grow more diverse with time • Social development and the adolescent • Highly influenced • Impacted by their environment • Influenced by who they associate with

18. Environmental and Community Risk Factors • Family • Major role • Provide support • If the adolescent does not have emotional support or encouragement from their families, they may develop bad behaviors. • Set the groundwork for the moral and ethical development of the adolescent (Maville & Huerta, p. 233). • Peers • Identify with their peers • Affiliation with delinquent peers can result in risky behavior • Not all peer influence is negative • Peers can influence positive, health promoting behaviors • The type of peers an adolescent associates with, is a stronger predictor of behavior than family, school, or community characteristics.

19. Environmental and Community Risk Factors • Neighborhoods • Distressed neighborhoods (concentrated poverty) • Poor physical and mental health • Delinquency • Risky sexual behavior • Media and Technology • Abuse of Technology • Kaiser Family study • National Campaign to Prevent Teen and Unplanned Pregnancy study • Media Influence • At risk for adopting bad behaviors

20. Plan of Action • Programs are found to be effective in • Preventing teen pregnancies or births • Reducing sexually transmitted infections • Reducing violent behaviors • Programs include • After school programs • Community-based organizations • Programs for elementary, middle and high school settings • Example programs • Be Proud! Be Responsible!- after school program • Teen Outreach Program- high school program

21. Setting for Health Promotion Activity • School programs were evaluated • Designed to teach about violence • Universal programs • Delivered to all children and youth regardless of risky/violent behavior • School environment (with low socioeconomic status and high rates of crime): • 11.2% reduction in youth with both data points • Predominant Ethnicity: • African American: Median reduction in violent behavior 14.9% • White: reduction 17.7% • Hispanic: reduction 18.5% • Findings of study • Universal school-based programs were found to be effective at all school levels and across different populations. • Programs may benefit taxpayers and potential victims from reduced crime

22. Healthy People 2020 • Focus on adolescent health • Family • Positive influences for adolescents • Adolescents in foster care easy transition • School • Get adolescents more enthusiastic about school through programs • Get more involvement in after school activities to prevent risky behavior

23. Conclusion • Adolescents are at a vulnerable stage in their lives, and their social development is influenced by many factors • Health risk factors • Environmental factors • Community • It is important that adolescents receive support from their family and peers and are around positive influences • Keeps them out of trouble • Reduces risks for disease, injury, and teen pregnancy

24. References Children, adolescents, and the media. Pediatrics. 132 (5). (2013). Retrieved July 25, 2014, from http://pediatrics.aappublications.org/content/132/5/958.full Hahn R, Fuqua-Whitley D, Wethington H, Lowy J, Crosby A, Fullilove M, Johnson R, Liberman A, Moscicki E, Price L, Snyder S, Farris T, Cory S, Stone G, Mukhopadhaya K, Chattopadhyay S, Dahlberg L; Task Force on Community Preventive Services. Effectiveness of universal school-based programs to prevent violent and aggressive behavior: a systematic review. Atlanta (GA): Task Force on Community Preventive Services; 2007 Aug. Retrieved July 25, 2014 from http://www.thecommunityguide.org/violence/School_Evidence_review.pdf Maville, J. A., & Huerta, C. G. (2013). Health promotion in nursing (3rd ed.). Clifton Park, NY: Delmar, Cengage Learning. National Adolescent Health Information Center. (2008). Fact Sheet on Demographics: Adolescents. San Francisco, CA: Author, University of California, San Francisco. National Campaign to Prevent Teen and Unplanned Pregnancy.Sex and Tech. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy. 2008. Retrieved July 25 from http://thenationalcampaign.org/resource/sex-and-tech Sutton, A. "Statistics on Adolescent Health in the United States." Adolescent Health Sourcebook. 3rd ed. Detroit: Omnigraphics, 2011. 3-8. Health Reference Series. Gale Virtual Reference Library. Retrieved July 13, 2014, from http://go.galegroup.com/ps/i.do?id=GALE%7CCX1727600008&v=2.1&u=lom_ferrissu&it =r&p=GVRL&sw=w&asid=aed5044bf02ee5fe9955614fbc6d7888

25. References cont. The science of adolescent risk-taking: Workshop report institute of medicine (US) and national research council (US) committee on the science of adolescence. Washington (DC). National Academies Press. 2011. Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK53412/ United States Department of Health and Human Services (2010). Healthy People 2020. Adolescent health. Retrieved July 19, 2014, from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=2 U.S. department of health and human services: Office of adolescent health (2014, June 25). Office of Adolescent Health. Retrieved July 24, 2014, from http://www.hhs.gov/ash/oah/oah-initiatives/programs.html