Adolescent

Health
&
Social
Development

Introduction

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

Adolescent Population
Adolescent population includes ages
10-19
o

Number of adolescents expected to keep

growing

Began to increase in 1990 and is expected

to keep increasing through 2050

Immigration
o

Higher immigration number of Hispanics and

Asians.

Birth and Fertility Rates

Distribution and Living Situations

Distribution
o

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
o

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

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

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

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

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

Health Risk Factors

Overweight
o Increases chance for:
High cholesterol
Hypertension
Diabetes
o 17% of adolescents 1219 years of age are overweight, which
has tripled since 1980.
o Why?
Technology
Convenience food
Lack of promotion of exercise
Alcohol
o 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.

Health Risk Factors

Death Rates
Suicide Ideation and Attempts
o Third leading cause of death among adolescents 1319
years of age.
o 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
o One fifth of all high school students consider suicide or
have attempted suicide
o Female students are more likely to consider suicide

Health Risk Factors

Death Rates cont.
Motor Vehicle
o 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.
o Rates increased with age for male and female
adolescents.
At ages 15 and 16 years these numbers for both
genders doubled.
o Alcohol
Almost 29% of high school students reported they rode
in a car with a driver who consumed alcohol

Health Risk Factors

Death Rates Cont.

Firearm-Related Deaths
o 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 11year-old females.
o Race and Ethnicity
Higher among black adolescents than any other
racial and ethnic groups
Lower for non-Hispanic white and Asian- or PacificIslander adolescents

Health Risk Factors

Health Care Coverage
o 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.
o Adolescents 18-19 years of age are more likely to
be uninsured than younger adolescents

The Facts
Boys vs. Girls
o

Boys use more substances than girls

Low Socioeconomic Status

o

Adolescents more likely to smoke cigarettes

Poverty
o

Higher rates of substance use

Black adolescents have the lowest use

rates

Hispanics have the highest rates

Risk Taking: Healthy vs. Unhealthy

Healthy risk-taking is an important part in an
adolescents life for:
o Discovering
o Developing
o Consolidating their identity
Unhealthy risk-taking can lead to issues in
adolescents life
o Unplanned pregnancy
o Overdose on drugs
o Alcohol related deaths
Fatal car crashes
Alcohol poisoning

Healthy Risk Taking Alternatives

Table 5.1. Risk Behaviors
and Healthy Risk
Alternatives
Unhealthy
Risk
Behavior
Dangerous
dieting,
eating
disorders

Using drugs or
alcohol

Healthy Risk
Alternatives
Physical
activities
such as
sports
teams,
horseback
riding, inline
skating,
walking, or
jogging
Under the
supervision
of a trained
expert,
engaging in
outlets for

Rosemary Parses Theory of

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

Environmental and Community

Risk Factors
Family
o 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
o Identify with their peers
o Affiliation with delinquent peers can result in risky behavior
o Not all peer influence is negative
Peers can influence positive, health promoting behaviors
o The type of peers an adolescent associates with, is a stronger
predictor of behavior than family, school, or community

Environmental and Community

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

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

Setting for Health Promotion

Activity
School programs were evaluated
o Designed to teach about violence
o Universal programs
Delivered to all children and youth regardless of
risky/violent behavior
School environment (with low socioeconomic status and
high rates of crime):
o 11.2% reduction in youth with both data points
Predominant Ethnicity:
o African American: Median reduction in violent
behavior 14.9%
o White: reduction 17.7%
o Hispanic: reduction 18.5%
Findings of study
o Universal school-based programs were found to be
effective at all school levels and across different

Healthy People 2020

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

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

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

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