- Adolescents who should be the 34 million
healthiest people in America are dying at an alarming rate.
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- Most are not dying of incurable diseases
or unavoidable mishaps. They are dying from the consequences of their own
risky behavior. And even the most involved and caring parents cannot always
save their children from themselves or their schoolmates.
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- Leading Causes Of Death In The US In
1995
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- Ages 5-24 Motor vehicle crashes
30% Other causes *
27% Homicide
18% Suicide
12% Other injuries
11% HIV infection 2%
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- Ages 25 and older Cardiovascular disease
43% Other causes **
33% Cancer
24%
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- * includes heart disease, cancer, birth
defects, stroke, pulmonary disease, flu and influenza
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- ** includes homicide, suicide, stroke,
pulmonary ailments, infectious disease, renal failure and liver disease
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- Source: National Center for Health Statistics,
Centers for Disease Control and Prevention, 1995
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- Of the 37,000 young people who die each
year, 30% are killed in car crashes, almost half of them linked to alcohol.
Roughly 10,000 are murdered, commit suicide or die of complications of
AIDS.
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- "I think this is one of the most
important challenges we, as a nation, face," says Lloyd Kolbe, director
of adolescent health at the Centers for Disease Control and Prevention
(CDC), Atlanta. If the situation isn't remedied soon, he adds, "We're
risking our future and the future of our children."
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- What are parents to do? On Tuesday, parents
will have a chance to ask two groups of experts in USA TODAY's Adolescent
Hot Line. Members of the Society for Adolescent Medicine will answer questions
on adolescent health and behavior. Volunteers from the National Middle
School Association will field questions on middle-school education.
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- In the minds of many experts, adolescence
itself now spans the teen-age years, but they also know that dangerous
behaviors of the older adolescent need to be addressed in the preteen years.
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- "We can make a clear case showing
that three types of behavior usually established during youth smoking,
an unhealthy diet, and a lack of exercise extend into adulthood,"
Kolbe says.
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- Two-thirds of adolescent deaths could
be averted if parents and their children did a better job of recognizing
risks and guarding against them. Virtually all deaths due to injuries and
HIV, the AIDS virus, are preventable, experts say.
-
- Yet HIV in America is increasingly an
epidemic of the young. Half of the 40,000 new HIV infections that occur
each year crop up in people younger than 25, CDC statistics indicate.
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- The most recent CDC Youth Risk Behavior
Surveillance Survey, out in September, found that while many high school
students were courting trouble, different groups chose different ways to
put themselves at risk.
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- For instance, boys were more likely than
girls to acknowledge that they have never worn a seat belt; that they fight,
carry weapons, and use illicit drugs or smokeless tobacco; that they drink
in binges and have sex with four or more partners. Girls are more likely
to flirt with suicide, suffer from distortions of body image and experiment
with weight-loss programs, the survey shows.
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- Together, teens account for more than
1 million unintended pregnancies and 3 million cases of sexually transmitted
diseases each year.
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- Adolescent mortality is worse in the
USA than in many developed nations. The death rate for young girls in the
USA is twice that of girls in the United Kingdom, Italy, Japan and Germany.
The rate for boys in the USA is 160% that of those in Sweden, which has
the lowest rate.
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- But death rates tell only a small part
of the story. Just as worrisome, he says, are studies showing that unhealthy
habits formed in childhood and early adolescence prime people for eventual
heart disease or cancer, the nation's leading killers.
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- Getting an adult to adopt healthier behaviors
is tough. Getting teen-agers who sometimes seem to regard themselves as
immortal to take care of themselves is tougher, especially when it means
exercising, eating right, and clamping down on drinking, smoking and having
sex.
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- Why do so many young people put themselves
at risk?
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- An explanation commonly echoed by parents
is that adolescence is a time of risk-taking and pleasure-seeking, of symbolic
declarations of independence by youthful rebels who reject their parents'
guidance.
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- But a consensus has emerged among public
health officials, educators and others that adolescents owe much of the
turmoil they experience to profound cultural changes. For instance, with
the growth of the two-income household and one-parent families, many early
adolescents lack the more structured environment that existed when mom
stayed at home. Also, teens are engulfed by a media culture that extols
sex and excitement.
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- Further, says Steve Small, a professor
of child and family studies at the University of Michigan, adolescence
now lasts far longer than it did 25 years ago. Unlike their forebears,
many parents today support children through the lengthy schooling needed
to prepare them for success in a competitive, high-tech world.
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- That combined with the ready availability
of birth control, shifts in global morality and advances in obstetric care
all have made it possible for millions to postpone the responsibilities
of adulthood.
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- "They have the physical characteristics
of adults, but they don't have adult roles and responsibility," Small
says. "They probably try, at least in part, to adopt some of the superficial
markers of adult life.
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- "They do things like drink and smoke
and become sexually active," he says. "A lot of what we see in
adolescents reflects some of the worst (excesses) of adult society."
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- Given this extended adolescence, researchers
now divide young people into three age groups, each facing distinct challenges:
"preadolescents" of 10 to 14, adolescents of 15 to 19, and young
adults of 20 to 24. While preadolescents are forming the habits that will
govern their health later in life, adolescents are taking risks and testing
the bounds of their independence. Young adults have more freedom to engage
in promiscuous sex and other risky behaviors.
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- Today, confronted by AIDS and sexually
transmitted bacteria that no longer surrender to antibiotics, even many
adolescents recognize that what once might have seemed to be an acceptable
risk might now have fatal consequences.
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- A CDC study released last month showed
that sexual activity has declined among high school students for the first
time in two decades.
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- The study, which compared surveys of
more than 10,000 students each between 1991 and 1997, also found that fewer
high school students report having sex with a series of partners and that
more are using condoms.
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- "It's no longer the dawning of the
Age of Aquarius," says Nathan Hart, 16, a student at Greenfield (Ind.)
Central High School. Hart traveled to Atlanta in August with more than
a dozen other students to present a play on the impact of HIV on adolescents.
The occasion was a CDC-sponsored meeting on HIV prevention and comprehensive
school health.
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- The title of the play: Endangered Species.
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- Nevertheless, 10% of all adolescents
and 25% of blacks begin having sex before their 13th birthday before many
are even aware that sex has risks, reports Janet Collins of CDC. To motivate
kids to delay, she reported at the meeting, parents must raise the issue
early.
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- If parents do not broach the subject
and show that they're open to discussion, kids become tongue-tied themselves,
says Greenfield student Willis Weyrich, 17. "How do you go to your
parents, who've been telling you all your life not to do things, and tell
them you are?"
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- "I don't have a friend who really
talks with their parents," says Annet Isa, 17, a student at Laurel
(Md.) High School. "We rely on each other."
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- Isa spoke one day last week at an after-school
drop-in center, called The House, in Hyattsville, Md., where she and other
teens from low-income families gather for companionship, counseling, snacks
and activities. If required, they may obtain condoms and HIV tests.
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- Carrie Stone, who administers The House,
which is sponsored by Metro TeenAIDS, says kids have different reasons
for ignoring risks. "On one side, you have kids from better homes
who say this will never happen to me. They live in a bubble. On the other
side, you have kids who have no hope, and say 'What difference does it
make? I'm going to die in two years anyway.'"
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- Much of the talk at the Atlanta meeting
centered on ways to change youthful behavior. Many key factors emerged:
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- Parents must act as positive role models
from childhood, making sure children develop healthful habits as early
as possible. They also must learn to discuss sexuality, including teen
pregnancy, HIV prevention and contraception.
-
- School is an opportune place to get these
messages across, but the effort is complicated by the politics of public
education. In addition, many teachers feel sandwiched between administrators
and parents.
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- Studies show that prevention efforts
involving peer education, mass media, and condom marketing can help. Many
parents, however, prefer morally rigorous abstinence-only education, which
encourages kids to delay having sex until after they are married.
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- But studies show that focusing on abstinence-only
messages doesn't work, says Thomas Coates of the University of California,
San Francisco. Many teens, he says, become sexually active before they
reach health education classes in the eighth grade. Abstinence-only discussions
come too late. The approach fails to give them the tools needed, he says,
to guard against risks.
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