Teenagers health

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Teenagers health

• D.Marks_at_city.ac.uk

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Lecture outline

• The biopsychosocial and environmental context
• Health not important
• Being, looking and feeling cool
• Eating and smoking

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Recommended reading

• Shucksmith, J. Hendry, L.B. (1998).
• Health issues and adolescents. Routledge.
• Lloyd, B. Lucas, S. (1998).
• Smoking in adolescence Images and identities.
  Rouledge.

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The worlds young population

• 29 of the worlds population between
• 10 and 25.
• 83 lived in developing countries.
• (WHO, 1990).

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Adolescence

• Onset of puberty (10 years) to age of
  independent adulthood (15-19) which depends upon
  culture, social class, etc.
• Puberty rapid height and weight increases
• secondary sexual characteristics
• reproductive maturity

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Research on youth culture

• Late 1960s - youth revolution against the Vietnam
  war - Woodstock or flower power generation -
  make love not war
• Challenged established norms and institutions.
• Social scientists/psychologists could not explain
  why this had happened.
• Jessor Jessor (1977) carried out a longitudinal
  study of US school and high school students -
  problem behaviour theory

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Children and young people are seen as an alien
group

• Children are a people, and they live in a
  distant land
• From The Mysterious People by Olle Adolfson
  (Swedish folk singer)
• SourceShuksmith Henry, 1998

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Young peoples health

• Researched from a medically-oriented,
  middle-class, middle-aged adulthood perspective
• E.g the terms risk behaviour and problem
  behaviour are applied to most aspects of
  teenagers recreational activities, incl.
  smoking, drinking, drugs and sexuality.
• These behaviours are rarely viewed as necessary
  and normal stages of normal psychosocial
  development and experience.

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Methodology

• Anecdotal evidence
• Observational methods
• Surveys, interviews questionnaires
• Qualitative methods focus groups, discourse,
  diaries, narratives

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Theories

• Developmental theory
• Social representation/identity theory
• Deviance/alienation theory
• Problem behaviour theory
• Sensation seeking and risk taking theory

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Developmental perspective

• Bronfenbrenners ecological model
• microsystems primary groups and settings, incl.
  school, park, street corner, MacDonalds, youth
  club, football team, home
• mesosystems interrelations and linkages among
  two or more settings (e.g. friends may share some
  of these settings a parent may be a football
  coach, a member of the PTA, and/or a youth club
  leader parents may be friends and share info.)

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Adolescent health behaviours

• Increased interest in experimentation
• plus
• a self-centred view of the world
• plus
• feelings of indestructibility

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Social context

• Shifts in varying degrees from a family-centred
• context to a peer-centred context.
• Peer groups and media figures (teenage heros)
  provide models and values
• fashion, music, sex, drinking, smoking, drug
  use, sports
• A third influence is parents.

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C o o l (L A B E L)

• L ooks
• A ttitude
• B ehaviour
• E njoyment
• L anguage

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Adolescent concerns

• Issues may peak in importance at different ages
• 13 years concern about gender role
• 15 years acceptance or rejection from peers
• 16 years gaining independence from parents
• SourceShuksmith Henry, 1998.

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Adolescent egocentrism (Elkind, 1967)

• 2 types of thinking
• the imaginary audience
• the belief that others are as preoccupied with
  their behaviour as they are
• the personal fable
• a sense of personal uniqueness (no one
  understands me), omnipotence and
  indestructibility

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Problem behaviours

• cigarette smoking
• drinking alcohol
• taking illicit drugs
• early unprotected sexual intercourse
• delinquency

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Adolescent risk taking

• Experimentation - a necessary way of learning
  by trial and error
• 2 types of factor
• Biopsychosocial endogenous to the individual -
  affective states, sensation-seeking, attitudes,
  beliefs, knowledge, intentions, values placed on
  independence,
• and expectation for academic performance.
• Environmental exogenous to the individual -
  school, health promotion, parental and peer
  pressure, media, substance availability

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Just say no

• Telling adolescents to Just say no is like
  telling Christopher Colombus to stay home.
• Frank Farley (1985 In Blackman, R. et al.
  (eds.) Proceedings of a conference on adolescent
  risk-taking behaviour.

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Health is an insignificant factor

• Teenagers find it difficult or impossible at the
  age of 15 to think about the health of a
  50-year-old stranger, that is, themselves 35
  years into the future (Coffield, 1992)
• Young people ignore messages on diet, exercise,
  smoking, drinking etc if the messages conflict
  with their immediate goals in the here and now -
  losing weight fast having a good time,
  immediate gratification.
• SourceShuksmith Henry, 1998

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Eating, appearance and diet

• Issues about eating rarely seen in health terms.
  Eating is all about weight, body shape and
  attractiveness.
• E.g. 40 of Scottish 15-year-olds said they
  thought they should lose weight, and half were
  already dieting.
• Similar findings from across the western world.
• Source Shuksmith Henry, 1998

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Identity and body image

• Adolescent and adult females often express
  dissatisfaction with their body shape and weight.
• Many judge themselves as too fat even when of
  average build or thin, esp. the middle-or
  upper-class.
• Young men are less affected although it is on the
  increase and many teenage males would like to be
  more muscular.
• SourceShuksmith Henry, 1998.

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Identity and body image

• Research with Scottish adolescents suggests
  worries about being fat are a major issue, esp.
  in girls.
• Girls are concerned about their friends
  opinions boys are more concerned about being
  attractive to the opposite sex.
• Unrealistic stereotypes, attempting to
  approximate cultural ideals reinforced by the
  media, lead to problems in adjustment, incl.
  eating disorders.
• SourceShuksmith Henry, 1998.

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Teenage smoking

• Prevalence increased in the UK in the 1990s.
• Health education appears to be failing.
• Higher prevalence is associated with parental
  smoking, nonstandard families, and peer smoking.

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Smoking as a meaningful activity

• Lloyd Lucas (1998) argue that smoking smoking
  actually fulfils a variety of functions in the
  everyday lives of many adolescents
• Lloyd Lucas explored young peoples meanings of
  smoking in a non-judgmental manner.
• Source Lloyd Lucas, 1998

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Smoking and mood

• 1/ Pleasure
• 2/Control stress/alter moods
• 3/ Rebellious identity
• 4/ Peer group bonding
• 5/ Time filler

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Social identity

• Self perception scales
• 1/ Positive vs negative self-evaluation
  -exciting, happy, popular, healthy, clever, makes
  up own mind vs. dull, unhappy, unpopular,
  unhealthy, thick, follows others
• 2/ Fun loving - likes partying, liked the
  opposite sex, attractive, cool
• 3/ Conforming vs nonconforming - cared about
  environment, likes school work vs rule breaking,
  doesnt like school work
• Source Lloyd Lucas, 1998

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Interventions

• Lloyd Lucas (1998) conclude their research by
  arguing for a change in thinking about the role
  of education
• not only as a vehicle leading to academic
  qualificiations but as an opportunity to promote
  self-esteem, to instil a sense of purpose, to
  develop positive relationships with adults and to
  foster an appreciation in both adolsecents and
  adults of pupils developmental potential and
  limitations.
• (p. 189)

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Promoting healthy development

• WHO 7 point plan
• A supportive environment over a long period
• with graded steps towards autonomy, enhancing
  self-esteem and a healthy lifestyle
• Good communication between young people and key
  adults and peers
• Approaches based on a sound understanding of
  cultural beliefs and behaviour
• Use of people who respect the young, have a
  sound knowledge of their needs, and are trained
  in commn. Skills

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Promoting healthy development(continued)

• Focusing on total lifestyle rather than
  individual aspects of behaviour
• An intersectoral approach with the full
  involvement of key groups who deal with young
  people, incl. The school, the family, the health
  system, religious and community leaders
• and community organisations
• The greatest possible involvement of young
  people themselves in planning and implementation
  of programmes

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Health promotion or social control?

• Adults perceive adolescents as at risk,
  rebellious or out of control.
• Health education is seen as one means for
  educating young people to think about their
  actions and make responsible choices, say no,
  etc.
• Is health education anything more than social
  control?

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Summary

• 1/ Family, school and community expectations
  about problem behaviours are out of step with
  the psychosocial realities of adolescent
  development.
• 2/ Adolescent health is a topic low on facts,
  high on moralising, and with poor understanding.
• 3/ Adolescents themselves are hardly ever
  included in the research design process - they
  need and deserve a voice, a platform, and more
  respect as citizens.
• 4/ Coolness is more important than healthiness.
• 5/ It is not surprising that health education is
  failing. Until it is cool to be healthy,
  education is unlikely to bring about the changes
  to which it aspires.