Adolescence

July 28, 2011

Adolescence, by many accounts, is a period rooted in culture and society. Prior to the industrial revolution, children were treated like adults and worked side by side with their parents in the factories. Industrialization during the 19th century led to new patterns of work that excluded children, lengthened the amount of formal schooling, and brought increased economic dependence of youth on their families. These events ushered in the period of the life cycle we now call adolescence, defined as a transitional stage whose chief purpose is to prepare children for adulthood. Broadly speaking, this developmental period spans the second decade of life and ends with the assumption of adult work and family roles.

Adolescence is characterized by a series of dynamic and interactive changes across several spheres, including biology, psychology, cognitive functioning, social interactions, and emotions. While these changes proceed in relatively the same sequence for most teens, they occur at varying rates and times for youth and are shaped by the environments in which they take place. Thus, it is typical for teens to mature in some respects before others. A more complete understanding of these changes is achieved by using a multidisciplinary contextual perspective that incorporates the impact of culture, families, peers, schools, communities, neighborhoods, and society. Indeed, youth face unprecedented challenges in society today compared to 20 years ago, and these challenges shape their long-term functioning in fundamental ways. Today, more than ever, teens are confronted with an array of confusing messages about their responsibilities, sexual behavior, health risks, life choices, job opportunities, interpersonal relationships, and future potential. Yet, despite these added challenges, most young people traverse the teen years with relative ease and success. Research indicates that youth have the capacity to cope with these challenges, and in fact, it is through the successful resolution of these experiences that most youth achieve significant personal growth.

Status of adolescents

In 1999, there were approximately 39.5 million youth between 10 and 19 years of age in America. Recent census data show that the majority of these youth lived in Western states and metropolitan areas. Based on current projections, the racial and ethnic makeup of the adolescent population in the United States will become increasingly heterogeneous, including a decrease in whites, an increase in other racial/ethnic groups, and growing numbers of Hispanics. One in six youth less than 18 years of age live at or below the poverty line, and ethnic minorities constitute a large percentage of poor youth; nearly one third of black and Hispanic youth live in poverty. Poverty is related to a host of conditions that negatively affect youth’s development, including increased exposure to crime and unemployment, poor health status, low-quality schools, and limited access to health care and adequate housing. Moreover, economic hardship on the family influences adolescents’ functioning and well-being through increased parental distress and less effective parenting behavior. The percentage of adolescents living in two-parent households has fallen sharply over the past 20 years particularly for minority youth, and nearly 42% of teens living in single-parent female-headed households are poor.

Trends in adolescent physical and mental health

The majority of adolescents appear to be in good-toexcellent physical health. They show low rates of cancer, hypertension, and other physical disorders, and mortality rates have dropped dramatically for all adolescents over the past two decades. Nonetheless, trends in mortality rates underscore the health disparities for males and females and different ethnic groups. Mortality increases with age, and males are three times more likely to die than females. The rate of death among black males continues to be much higher than for any other group. The leading causes of death for teens are no longer a natural phenomenon but instead constitute injury and violence resulting from motor vehicle accidents, homicide, suicide, and other unintentional injuries. Thus, a large majority of the deaths are preventable, and understanding these behaviors is critical to public health prevention efforts.

The Surgeon General recently released a report on mental health indicating that nearly 21% of youth aged 9-17 meet criteria for a diagnosable mental or addictive disorder, and 11% report significant impairment as a result of their mental health problems. There is additional evidence that mental health disorders are underdiagnosed among youth, and that more than 30% may have some mental health symptoms. Obesity has emerged as a major health and mental health concern because evidence points to serious risks associated with poor nutrition and excess weight. Indeed, the percentage of overweight youth rose from 5% in 1980 to 20% in 2002 with black adolescents at greatest risk.

Trends in adolescent risk behavior

Experimentation and risk taking are hallmarks of adolescence, yet the negative health consequences today are more serious than ever before. Unprotected sex will not only result in unwanted pregnancy, but it may also lead to HIV transmission. Illegal substances are more potent and more addictive, and cars and guns are easily accessible. Specific risk behaviors show divergent patterns among adolescents. Tobacco use peaked in 1997 but appears to have stabilized, while alcohol use remains high. Almost half of all high school seniors report using marijuana at some point in their lifetime, although recent use (in the past 30 days) has fallen in the past 5 years. The trends for sexual behavior are more mixed. For the first time in two decades, fewer adolescents are having sexual intercourse and more teens are using condoms. However, only 30% report using condoms consistently, and almost 75% of high school seniors have had sexual intercourse. Furthermore, teens account for approximately 25% of new sexually transmitted diseases reported annually, and adolescents are one of the only groups for which rates of HIV infection are increasing. The primary mode of HIV transmission for adolescents is through unprotected sexual activity, and adolescent females are now almost as likely to become infected with HIV as males, comprising 59.7% of new HIV cases in 2001. These trends underscore the new predominance of heterosexual HIV transmission among youth.

SEE ALSO: Child abuse, Environment, Menarche, Puberty, Sexual abuse, Socioeconomic status, Substance use

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Category: A, Adolescence