Demographics Less Predictive of Teen Behavior Than Other Factors

Many adolescents engage in risk-taking behaviors that endanger their health as a result of poor academic performance, unsupervised leisure time, and who their friends are.

This was a key finding from the landmark National Longitudinal Study of Adolescent Health funded by 18 federal agencies, which was released in December at a Washington, D.C., press briefing. The ongoing study is the largest yet to examine adolescent health risk factors among an estimated 11,000 teenagers in grades 7 through 12 representing 80 schools nationally.

The adolescents included in the study were white, black, and Hispanic, and their family income levels ranged from less than $10,000 to more than $60,000 annually.

Robert Blum, M.D., M.P.H., and his colleagues at the University of Minnesota analyzed data collected from 1995 through 1996. A second wave of data collection will occur this year.

Blum, a professor of pediatrics and director of the Center for Adolescent Health at the University of Minnesota School of Medicine, told Psychiatric News that traditional demographic factors of race/ethnicity, income, and family structure (that is, one-parent versus two-parent households) were weak predictors of high-risk behaviors compared with personal and social factors.

“Demographic variables don’t tell us the underlying causes of behaviors that can lead to addictions, unwanted pregnancies, sexually transmitted diseases, and suicide. They also are not particularly amenable to change,” said Blum.

He and his colleagues found that race, income, and family structure explained only an average of 4 percent of individual differences in the amount of cigarettes teens smoke, frequency of alcohol use, level of weapons-related violence, degree of suicide risk, and whether they had sexual intercourse.

In contrast, personal and social factors predicted an average of 26 percent of individual variation in these five high-risk behaviors. These factors included academic problems, spending a lot of time with friends, lack of hobbies, working 20 or more hours per week during the school year, degree of physical maturity, bad temper, and being a victim of rape and sexual abuse.

Blum and his colleagues also examined the impact of protective factors on the high-risk behaviors including religious beliefs, positive parent/family relationships, and extended family being present in the home.

What they found was that poor academic performance was a consistent predictor of every high-risk behavior, followed by “just hanging out” with friends, especially those who engaged in a high-risk behavior, said Blum.

“We need to understand that health and education are intertwined and that school failure needs to be viewed as a health and education crisis,” he said.

No single protective factor was consistent for every risky behavior; however, positive parent/family relationships appeared to protect against suicidal thoughts and attempts and weapons-related violence. The next most influential factor was frequency of hobbies, said Blum.

The greatest risk factors for alcohol use were frequent problems in school work and the number of best friends who drank at least monthly, he noted. Drinking with best friends was also a strong predictor of weapons-related violence, according to Blum.

For cigarette smoking, the top risk factors after problems with school work were frequency of hanging out with friends each week and the number of best friends who smoked daily. The protective factors were frequent religious activities, good self-esteem, and wanting to attend college, according to the researchers.

The most significant risk factor for suicidal thoughts or attempts was having a friend who committed or attempted suicide, said Blum.

For sexual intercourse, the strongest risk factor was having been in a romantic relationship in the 18 months prior to the study. Other risk factors were no knowledge of birth control and perceived social and personal benefits to engaging in sex.

The protective factors were the perceived social costs of having sexual intercourse, including getting or making someone pregnant, and public or written virginity pledges, according to the researchers’ report.

“Friends have a powerful influence on the lives of young people. Parents need to know who their teen’s friends are, what they do, and limit the time they spend ‘hanging out,’” said Blum.

“Our results show that close parent and family relationships are a frequent protective factor against health-risk behaviors. Parents need the skills and support to develop close caring relationships with their teens,” said Blum.

At the same time, he recognizes that parents may not be available to their teens for a variety of reasons including working long hours, substance abuse, and mental illness.

“We need to capture those children in safe after-school activities or programs and build informal community networks of adult neighbors and relatives who can spend time with children,” Blum suggested.

Blum’s paper, “Protecting Teens: Beyond Race, Income, and Family Structure,” is available on the University of Minnesota Web site at www.peds.umn.edu/peds-adol/di.html.— C.L. ▪