11
Conclusions and Research Directions

This report describes the conditions and consequences of increasing numbers of America's youth who are growing up in circumstances that limit their development, compromise their health, impair their sense of self, and restrict their futures. The focus is on the major contexts or settings in which young people are growing up in contemporary American society and the deterioration that has occurred in them over the last two decades. Our decision to focus on settings reflects the panel's appreciation of the profound influence that context has on adolescent behavior and youth and our judgment that the power of settings on adolescent development has not been fully appreciated. The lack of attention to settings has resulted in concentration on individual adolescent behaviors and categorical programs, such as teenage pregnancy prevention, drug abuse prevention, smoking prevention, and dropout prevention. Because these problems are interrelated and have common predictors that are largely environmental, more comprehensive integrated approaches are needed to reduce the exposure of children and adolescents to high-risk settings. Reducing the risks generated by these settings is virtually a precondition for achieving widespread reductions in health-and life-compromising behavior by adolescents.

Describing the destructive effects of high-risk settings is far easier than recommending specific policies and programs to improve them. The demographic changes that are creating large numbers of poor, single-parent families are not well understood,



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Losing Generations: Adolescents in High-Risk Settings 11 Conclusions and Research Directions This report describes the conditions and consequences of increasing numbers of America's youth who are growing up in circumstances that limit their development, compromise their health, impair their sense of self, and restrict their futures. The focus is on the major contexts or settings in which young people are growing up in contemporary American society and the deterioration that has occurred in them over the last two decades. Our decision to focus on settings reflects the panel's appreciation of the profound influence that context has on adolescent behavior and youth and our judgment that the power of settings on adolescent development has not been fully appreciated. The lack of attention to settings has resulted in concentration on individual adolescent behaviors and categorical programs, such as teenage pregnancy prevention, drug abuse prevention, smoking prevention, and dropout prevention. Because these problems are interrelated and have common predictors that are largely environmental, more comprehensive integrated approaches are needed to reduce the exposure of children and adolescents to high-risk settings. Reducing the risks generated by these settings is virtually a precondition for achieving widespread reductions in health-and life-compromising behavior by adolescents. Describing the destructive effects of high-risk settings is far easier than recommending specific policies and programs to improve them. The demographic changes that are creating large numbers of poor, single-parent families are not well understood,

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Losing Generations: Adolescents in High-Risk Settings and it is not at all clear what effect specific changes in public policies might have on those trends. We therefore limit most of this concluding chapter to describing the broad changes that we believe are essential if settings are to become less pernicious for a large share of American children and adolescents. If sound empirical evidence exists for policy recommendations, we are more specific. Because understanding of adolescent development in social context is very limited, the second part of this chapter describes a framework for research on adolescent health and development that should yield better information for program and policy development over the next decade. We strongly believe, however, that some of the problems we describe are far too acute and their effects far too destructive to delay action until more research is completed and other demands on national resources reduced. In particular, the diverse ways in which poverty harms children and adolescents, inflicts lasting damage, and limits their future potential points to the reduction of poverty as a key step toward improving the condition of many of the nation's youths. Four conditions create and sustain high-risk settings. First, as noted, is the large and increasing number of families who are living in or near poverty and experiencing the emotional stress it brings. In 1991 the Census Bureau estimated that 35.7 million Americans were living in poverty (14.2 percent of the population), the largest percentage since the late 1960s. Families with young children make up the largest proportion of those living in poverty. The dramatic increases in single-parent, female-headed households both contributes to the growth in poor families and independently creates a high-risk setting for adolescent development. In fact, many of these families are headed by teenage mothers, creating a kind of double jeopardy. Parents in poor and near-poor families face significant challenges in rearing their children. Aside from their struggle to provide basic necessities, the stress of ''making do" with very little money diminishes parents' ability to form personal networks and institutional attachments and to develop the caretaking skills critical to positive adolescent development. Such parents express the difficulties they face and the need for help in providing the guidance, support, and supervision that adolescents need. Second is the concentration of poor families in some urban and rural neighborhoods and the increase in the numbers of intensely deprived neighborhoods. Such neighborhoods are characterized by racial stratification, homelessness or very degraded housing, inadequate schools, a lack of recreational and employment opportunities,

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Losing Generations: Adolescents in High-Risk Settings and, in metropolitan areas, a high level of crime and violence. Constructing a family life that can guide children and adolescents into healthy, constructive behaviors is a challenge of heroic dimensions in these settings. Third, the nation's major service institutions and systems—health, academic and vocational education, and employment and training—are not meeting the needs of many young people. Too often, they are high-risk settings, especially for those with emerging behavioral, emotional, or academic problems. Not all of these institutions have become worse over time, but they have been unable to respond to the increased needs of adolescents and the society. Similarly, the child protection and criminal and juvenile justice systems not only are unable to respond to the complex needs of adolescents who come under their care, but in many situations exacerbate the difficulties of young people. Fourth, the strong influence of racial and ethnic discrimination on employment, housing, and the criminal justice system limits the options of minorities and, hence, their ability to rear their children. Limited opportunities and the many and painful indignities that racial and ethnic minorities endure in their daily lives place children and adolescents at risk for early academic and behavioral problems. The interplay of these conditions creates very different developmental opportunities for adolescents according to the income and race of their parents, the communities in which they live, and whether they live with one or both parents. Children born into families of low socioeconomic status are likely to live in high-risk neighborhoods and attend poor schools, and they are likely to grow up in a single-parent household. They know that their opportunities are limited, and significant numbers become alienated, lose hope, and fail to acquire the competencies necessary for adulthood. Unless progress is made in ameliorating the conditions that produce high-risk settings, large numbers of young people will fail the transition into roles as healthy, productive, contributing adults. The increasing size of the problem suggests that the response must be powerful and comprehensive. Attention to policies supporting families and neighborhoods and restructuring service institutions is necessary to impart the functional academic, vocational, social and psychological competencies needed by young people.

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Losing Generations: Adolescents in High-Risk Settings DIRECTIONS FOR CHANGE IN THE 1990s This section discusses changes that could transform high-risk settings and create a more supportive environment for adolescents. We offer program models and intervention strategies that have shown success here or abroad and have strong theoretical, empirical, or evaluation support. However, it is true that little is understood about many of the causal relationships that might affect change in these settings; therefore, we describe the outcomes that we believe are necessary rather than recommend specific programs or policy directions for achieving them. Supporting Families A declining economy and changes in family structure and functioning over the past two decades have pushed large and increasing numbers of children and adolescents into poverty. At the same time, increasing numbers of young people are living in homes without a biological parent, and growing numbers are in foster care. Increases in maternal employment and the dramatic rise in numbers of single-parent families mean that adolescents are spending less time with their parents. These changes have increased the numbers of adolescents exposed to one or more high-risk settings. A return to strong economic growth in the nation will improve employment opportunities for prime-age adults. The evidence suggests, however, that growth in the overall economy will not reach a large proportion of young families. The long expansion of the mid-1980s did not arrest the increase in the number of low-income families, nor did it contribute to a reduction in high-risk settings in neighborhoods or service institutions. Instead, structural economic and social changes overwhelmed the effects of expansion. Consequently, targeted interventions will be needed to enhance job skills, provide entry employment opportunities, and improve access to critical support services, such as child care. For those whose labor market connections are very weak or do not exist at all, more directed interventions may be needed. We consider improving the economic position of large numbers of families the first priority. For many poor or low-income parents, jobs alone will not provide families with an adequate standard of living because of low wages. Income transfer programs will have to be extended and improved for families to have adequate incomes, safe housing, and access to essential services, such as health care. In addition,

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Losing Generations: Adolescents in High-Risk Settings the major institutions or settings serving children and youth—schools, health and mental health, child protection, juvenile justice, employment training—will have to be revitalized if they are to fulfill their missions. At the same time, efforts must be made to deal with youths who need help beyond traditional categorical boundaries. Existing institutions must be not only comprehensive within their domains but also flexible at their boundaries. Finally, there is a need for community-based resource centers where sustained, integrated care and support can be given to youths who face special problems of isolation and harm. Rebuilding and Strengthening Low-Income Neighborhoods The continuing deterioration of many neighborhoods condemns growing numbers of parents and their children to live in high-risk settings. Increasing numbers of adolescents—disproportionately those who are poor and minorities—live in neighborhoods characterized by high concentrations of poverty and crime. They are isolated from basic adult and recreational supports, such as those offered by youth development programs; as young adults, they are isolated from employment opportunities. Furthermore, the decline in real incomes among low-income families coupled with discrimination in housing and reduction in construction of low-income housing has compounded the problems of minorities, particularly blacks. The effect has been to trap a growing number of poor families in dangerous, bleak, and socially disorganized neighborhoods. Schools are a fundamental neighborhood institution that has historically provided the opportunity structure through which poor and disadvantaged people have gained access to the middle class. That has changed as a result of the post-World War II suburbanization of America and the abandonment of urban school systems by the middle class. Because school funding is tied to neighborhood wealth, the most adequately funded and highest quality schools are found not in the neighborhoods where the need is the greatest, but instead serve the children whose family and neighborhood environments already equip them with the knowledge and skills needed for success. Reviving depressed urban areas will require a major commitment from federal and state governments and the private sector, including support for housing, transportation, economic development, and the social services required by poor and low-income residents. Strategies for urban revival, ranging from enterprise

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Losing Generations: Adolescents in High-Risk Settings zones to community development banks, have been discussed, but few major initiatives have been started. If the nation chooses to increase the vitality of low-income neighborhoods, support will be needed to rebuild neighborhood infrastructures, including transportation networks and such basic community services as police, libraries, and parks and recreation opportunities. Affordable housing in inner cities and the fringe suburbs is urgently needed. The difficult problem of creating greater equity in school funding will also have to be addressed. Other types of programs to help families choose their neighborhood environments (e.g., vouchers) are also of great value. Finally, the issue of residential segregation will have to be addressed by all levels of government through the vigorous enforcement of fair housing laws and other civil rights laws and regulations as well as incentive programs. In the absence of federal or state support, neighborhood residents and some local governments have developed programs that highlight different models of intervention. For example, community organizing and development efforts have resulted in neighborhood beautification, increased safety, community policing, improved housing stock, and the creation of new services for disadvantaged persons. Most of these efforts have been accomplished on a shoestring and have often involved young people in service organizations. These programs suggest ways in which limited federal and state funds can have a beneficial impact on communities and the young people who live in them. Clearly, however, improvements in housing, public service, schools, and public safety will require major public-sector commitments. Health and Mental Health Services There is no integrated health or mental health system in the United States. Moreover, individual programs are often built around and financially sustained by the treatment of specific pathology and physical disorders. Health insurance, when it exists, does not provide adequate coverage of preventive services, and about one-third of all parents cannot afford health insurance for themselves and their children. Overall, the health system remains an assortment of uncoordinated services, and access for young people is difficult. Hence, the availability and quality of service directed toward the major threats to adolescent health—illicit drug use, alcohol and tobacco use, violence, teenage pregnancy, and emotional distress—is entirely inadequate. The panel is encouraged that health care reform and the need

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Losing Generations: Adolescents in High-Risk Settings to provide insurance for those now without coverage has become a high priority in the national political agenda. As these reforms move forward, it should be remembered that for adolescents, insurance coverage is not sufficient; also needed are services directed toward disease prevention and health promotion. For adolescents, insurance mechanisms should support strengthening the primary care sector to encourage the provision of consistent, comprehensive, and coordinated services and, especially, prevention services: reducing smoking, alcohol, and drug consumption and preventing other behaviors that seriously compromise future health have an enormous payoff. Strategies such as restricting or banning tobacco and alcohol advertising directed toward young people should be considered, as well as higher excise taxes. The proliferation of firearms and their increasing use by adolescents—and even children—constitutes the single most serious threat to inner-city youth. Strategies to create a safe and healthy living environment for adolescents must address the problem of firearms. At a minimum, existing laws relating to the sale or transfer of firearms to minors should be rigorously enforced; measures to disarm this population should also be explored. Education Over the last decade, the nation's schools have been the object of many broad-based reform efforts—initiatives from the federal and state governments and the business community. In response, many school districts have undertaken reforms aimed at enhancing accountability throughout the education system. The call for more emphasis in basic skills has led to common curriculums and more requirements in the areas of math, reading, and science. In addition, schools are becoming the dominant setting for preventive health services, including screening, counseling substance abuse prevention, sex education, and violence prevention. In the panel's judgment, these reform efforts are inadequate in two respects. First, only a few jurisdictions have taken on the politically charged question of inequitable funding. School-based management and parental involvement is not a substitute for inadequate resources. Breaking the link between family and neighborhood wealth and the resources available to individual schools is an urgent priority if the nation is going to improve the well-being of low-income adolescents. School "choice" proposals deserve attention as a means for allowing parents to enroll their children in better schools; however, serious questions have been

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Losing Generations: Adolescents in High-Risk Settings raised about the impact of such reforms on the poorest schools in the worst neighborhoods. In addition, different schools would not ensure that low-achieving students receive effective instruction; as discussed in the report, many negative practices are the norm throughout the American school system, and low-achieving students may become further alienated and discouraged when transferred to schools where average achievement levels are higher than those in their previous schools. Thus, our second point: there has been little attention to the widespread use of instructional practices that fail to improve the school performance of low-achieving students, and indeed, often diminish their motivation and achievement. Most schools continue to use counterproductive academic interventions—rigid ability grouping, grade retention, "pull-out" Chapter 1 programs, categorical dropout prevention programs—that have shown few benefits and many disadvantages for low-achieving students. Major changes in Chapter 1 programs appear to be on the horizon and may make that program more effective in assisting low-achieving students. However, serious research and classroom attention should be given to alternative practices that show promise for helping low-achieving students. Some school districts are implementing alternatives to traditional practices that provide possible models for wider application. These include replacing rigid ability grouping and grade retention practices with programs to provide low achievers the vitality of instruction and high expectations usually directed to higher achievers. Because of the structural changes necessary to implement such alternatives, they are usually implemented with concurrent changes in school organization and staffing patterns. For example, rather than organizing a student's entire academic program around a designated ability track, alternatives include a mix of heterogeneous and "accelerated" classes or approaches that separate only the students at the extremes of ability. Alternatives to grade retention often determine "merit" through a range of performance-based assessments. Rather than being held back because of poor performance in one or two classes, students are allowed to advance in grade level while concurrently taking "bridging classes." Transition from School to Work The United States does not have a structured school-to-work transition system, leaving transitions largely to the market. Employment-oriented

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Losing Generations: Adolescents in High-Risk Settings programs for young people are structurally isolated from the labor market and rarely give those participating in them the fundamental skills and knowledge to enter a field of employment and keep up with it as the specific demands of jobs in the field evolve. Instead, the emphasis is on improving their job search or general occupational skills. Few programs include initiatives to create new employment opportunities for young people, to encourage employers to accommodate to their needs. Furthermore, academic instruction, vocational education, and employment and training programs remain largely separate enterprises, despite the complementary nature of their missions. Growing attention is being given at the national level to creating systems or mechanisms to help young people move into the labor market. Research on systems in other industrialized countries has found the greatest success in programs that not only prepare young people for employment, but also include an explicit goal of facilitating overall youth development. Often, the systems provide education and training through the integrated efforts of different entities, including a schooling sector (to facilitate basic skills), a manpower or employment training sector (for occupational training), and a private enterprise sector (for supervised work experience). In a small number of U.S. communities, practitioners are implementing demonstration programs aimed at creating school-to-work transition systems that are consistent with the approaches used in many other industrialized countries. These models take a number of forms—cooperative education, vocational academies, apprenticeships, school-to-work transition programs, "second-chance" programs—but they all provide integrated and sequenced academic instruction, occupational training, and work experience. Lacking a structure for school-to-work transition systems, most reforms in the United States have aimed at independently strengthening vocational education and employment and training. Evaluations suggest that the most successful efforts are those that provide a coherent and logical series of courses to young people, much like the approach used to facilitate academic learning. Evaluations of innovative employment and training programs have been disappointing, yet important lessons have been learned. Results indicate that single-component programs and those of short duration—whether for occupational training, academic remediation, work experience, or job search training—have few lasting effects on young people. Successful programs provide young people with a coordinated set of services, including academic remediation, counseling,

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Losing Generations: Adolescents in High-Risk Settings peer group support, mentoring, and job placement services, over an extended period. FACING RESPONSIBILITY The nation's social institutions—including schools, foster care, health care, and the juvenile justice system—have been largely unable to respond to the needs of children and adolescents from high risk homes and neighborhoods. While the threats to positive adolescent development have increased over the past two decades, institutions have either deteriorated or failed to change. The underlying causes of the increased needs are complex, including demographic changes that have increased the proportion of adolescents living with a single parent and increases in numbers of low-income families and families living in impoverished neighborhoods. Federal and state responses to the situation have been limited in both scope and success. In the absence of effective federal and state responses, families, communities, and adolescents have had no choice but to respond, and many have. For example, in the face of high-risk settings, many parents act creatively and effectively to mobilize personal and often limited resources to provide for their children. Despite hardship and stress, many are able to fully nurture their children. Some neighborhood residents, housing projects, and community coalitions organize to "take back the streets," provide mutual support, and develop opportunities for their children. Other communities have organized comprehensive youth development programs. Similarly, adolescents call on their own resiliency and that of their families to cope with high-risk settings, and most do succeed. But the attrition is both unacceptably and unnecessarily high. Issues of Discrimination On virtually all aggregate statistical measures for adults and adolescents—income, living standards, health, education, occupation, residential opportunities—blacks, Hispanics, and other minorities remain substantially behind whites. Much of this gap is due to income differentials, but a considerable amount is due to continuing discrimination. Employment and housing discrimination limits the choices available to parents in raising their children. A single act of discrimination—be it the denial of a job promotion or the denial of housing in a desirable neighborhood—can

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Losing Generations: Adolescents in High-Risk Settings dramatically change the life course of a family. Black adolescents, disproportionately placed in less rigorous and lower quality educational, vocational, and employment and training programs and who subsequently face discrimination in the labor market, are multiply disadvantaged in their efforts to move successfully into young adulthood. Given the strong influence of family and neighborhood wealth on adolescent development, vigorous enforcement of nondiscrimination statutes in the areas of housing and employment is especially warranted. Such efforts would increase the economic security of black parents and provide improved access for their children to better neighborhoods and schools. Discrimination within the criminal and juvenile justice systems aggravate problems in an array of institutional settings. Because in some places community-level policing practices display discriminatory patterns, police and juvenile system interactions have become particularly difficult, and the juvenile and criminal justice systems are perceived with suspicion, hostility, distrust, and despair by minority citizens. Reduction in race-based inequalities throughout the justice system is critical to provide more equitable treatment for those who have contact with justice officials, as well as to improve relations between the police and minority communities. Encouraging Change Beginning a process of encouraging change will require significant commitments from governments at the federal, state, and local levels, and the panel recognizes that governments at all levels are already engaged in difficult reappraisals of current programs in the face of declining revenues. Yet this may be an appropriate time to reexamine the roles and expectations for each level of government and to think freshly about how to solve problems in a manner that is responsive to the needs of individuals and communities. The federal and state governments have a significant role in providing financial support, leadership, and incentives toward change. Yet effective change requires ground-level flexibility and discretion that cannot be directed from the top. Thus, many of the reforms that the panel believes are needed to make life better for adolescents and their families may well be more readily achieved through a realignment of authorities and responsibilities to encourage "bottom-up" decision making. Scholars of government finance and management have recently begun to write about rethinking federal, state, and local roles and funding

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Losing Generations: Adolescents in High-Risk Settings as a way of bringing the resources needed to deal with problems closer to the people who are most likely to do it sensibly. Increasing the resources available to states and localities is a necessary first step. But states and localities must also be willing to ease controls and show a greater degree of trust in providing legitimate program responsibility and accountability to community leaders, to program staff, and to young people themselves. Teachers and parents, for example, should play a greater role in school reform and have the resources to experiment with teaching methods and services that they believe will work in their neighborhoods. The legitimate need for accountability of public funds may involve more difficult auditing when programs are run at the community level rather than managed at the federal or state level. This should not blind policy makers to the costs associated with rigidly imposed standards and requirements that may be irrelevant to local needs or destructive of providers' ability to deliver effective services. Under this approach, the federal role should be focused on improving the performance of the national economy and assuring the adequacy of ''safety net" programs in income maintenance and health care for all residents. In addition, national leadership is needed to encourage and enable the design of integrated health and school-to-work transition systems, and new strategies for providing academic and vocational instruction in schools. At the same time, states and localities should have greater flexibility in the design and oversight of service delivery programs. Their priority should be to involve community-based institutions in the development and management of programs to meet the urgent need of adolescents for recreation, cultural enrichment, and legitimate opportunities to form attachments to adults and institutions and to contribute to the welfare of others and the community. Chapter 10 reviewed some of the most promising strategies developed by locally based programs to respond to the diverse needs of adolescents. Most of these have not been rigorously or systematically evaluated. However, the panel consulted extensively with practitioners, and the major elements of programs that they believe to be critical are consistent with what theory-based research suggests. Accordingly, we suggest that communities be given more resources and more flexibility to experiment and to replicate successes. At the same time, the research community should give increased attention to developing better tools for evaluation

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Losing Generations: Adolescents in High-Risk Settings and replication. Developing meaningful outcome measures should be a high priority. AN AGENDA FOR RESEARCH The findings and unresolved issues that have been identified in this report have important implications for the focus and orientation of future research on America's youths. Throughout its report, the panel has stressed that more and more young people in American society are exposed to critical settings—families, schools, neighborhoods, and systems of health care, welfare, and justice—that are under severe strain or in serious decline. Increasingly, these settings and institutions fail to provide adolescents with the support and resources needed for healthy development. Indeed, some of the settings actively jeopardize the young people who are living in them. General Framework The panel believes that a fundamental reorientation in society's approach to promoting adolescent development is needed. Consequently, there must also be reorientation in research and evaluation, accompanied by a different and more sustained pattern of funding. This new framework would have the following characteristics: It would give primary attention to achieving an understanding of the various settings in which adolescent development takes place in the course of everyday life—including families, neighborhoods, schools, and community organizations and programs. It would stress the interactive effects of multiple settings, in order to capture the full complexity of the social environment. Only by assessing adolescents in the context of their families and neighborhoods, and by assessing institutions and programs in the broader community context, can a valid understanding of adolescent development be achieved. It would require attention to both risk factors and protective factors—and to their interaction—at both the individual and social levels, in order to provide the fullest understanding of healthy adolescent development. Hence, it would encourage research protocols that capture individual differences simultaneously with assessments of social contexts and daily settings. It would dedicate support to long-term, longitudinal studies, which can illuminate processes of individual development and

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Losing Generations: Adolescents in High-Risk Settings change, as well as processes underlying change in communities and institutions. Within this framework, research would shift its focus to those young people most at risk for not making a successful transition to young adulthood and would explicitly consider the effects of gender, race, and ethnicity on adolescents: It would give special attention to those youth who have hitherto been largely ignored in research on adolescent development—those from families with low incomes, those who are members of racial and ethnic minorities, and others with backgrounds of disadvantage and limited opportunity, such as immigrants, the homeless, and persons with physical and emotional disabilities. It would assess the effects of discrimination on neighborhoods and on the lives of families and adolescents, seeking to identify independent and interactive influences of class, race, gender, and ethnicity on adolescent development. This new research orientation will require new methodologies and measures to assess the social context and the process of adolescent development. Research and evaluation studies should use multiple methods, recognizing the limitations of an exclusive reliance on single-discipline inquiries using traditional "objective" surveys and cross-sectional approaches. The research should be multidisciplinary and longitudinal; it must incorporate the unique advantages of qualitative and ethnographic methods for grasping the meaning of adolescent behavior in everyday situations. In order to simultaneously consider a process, program management, and outcome, multiple methods of research would be used: It would move beyond a sole emphasis on measuring youth problems (drug use, pregnancy, arrest) and accomplishments (graduation, employment) to include assessment of the individual and community attributes (alienation, responsibility, attachment, emotional health) that underlie the "status" outcomes. It would move beyond the isolated assessment of single settings or interventions by creating methodologies to examine the effects of a variety of influences on adolescents. It would get inside the "black box" of families, communities, schools, health care, and community-based programs to identify cross-cutting elements that support healthy adolescent development. It would encourage research on initiatives that explicitly seek to change the contexts of adolescent development, such as comprehensive

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Losing Generations: Adolescents in High-Risk Settings programs and communitywide interventions; it would include studies of policies and interventions in other countries. It would study the process of change in schools, neighborhoods, organizations, and programs to identify the mechanisms that underlie the successful replication of good practice, with explicit attention to the technical, normative, and political barriers to change. The Social Context of Adolescence The panel's findings point to a clear and urgent need for research on the social contexts of young people in contemporary U.S. society. These are, at least, the family, the school, the neighborhood, and the systems of health care, welfare, and justice. Influencing all of these is the state and shape of the economy, with its specific effects on the labor market, employment, unemployment, and family income. Research has traditionally focused on adolescents as individuals and has given far less attention to the settings in which adolescents live. From the panel's perspective, however, the highest priority for future research should shift to studies of the contexts and settings of daily life, especially for adolescents from low-income and disadvantaged backgrounds. Families The role of the family as the primary socializing agency has been compromised by increasing family poverty, by long-term changes in family structure, and by the emergence of alternative agents of socialization that are more attractive to youth, such as the media and peer groups. Research is needed to trace out the mechanisms by which poverty (low income, unemployment, and underemployment) and changes in family structure (single-parent households, two-parent households with both parents working) influence family functioning. Understanding how families manage adversity or are overwhelmed by it, and how adolescent development can or cannot be insulated from it, should be the major objectives of inquiry in this setting. Furthermore, given the pervasive trend—across all income classes, but especially among the poor—toward single parenthood, research is urgently needed to understand the causes of these changes and the types of programs that might be effective in counteracting the most damaging effects on children and adolescents.

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Losing Generations: Adolescents in High-Risk Settings Family Support Systems There is a great need for applied research on the effectiveness of family support programs, which are proliferating rapidly with little reference to the best allocation of resources. For labor-intensive case management programs, for example, research is needed to establish the optimum amount of time that a family requires from an advocate or case manager. It is also important to understand more clearly the extent to which family support programs actually have direct effects on adolescents. Research would also be useful to explore alternatives to families such as group homes or dormitories for adolescents who cannot live at home. Schools Probably nothing derails an adolescent's future more certainly than disconnecting from school, losing interest in learning, and, ultimately, dropping out of school. Adaptation to the school setting is necessary for the sequential acquisition of status and skills that provide access to future roles—whether further education, the military, or the labor market. Research on processes that sustain interest in and attachment to school—and on those that compromise that attachment—is therefore of critical importance. These processes may have to do with the availability of school resources, with such school practices as tracking, with the quality of the school climate, with school-family relations, with fear of violence in school buildings, with the adequacy of teacher training, or with other factors. Research is also needed to explore what kinds of schools work best. Evaluation of alternatives to traditional school organization and instructional practice should focus on finding ways to improve the climate of schools for all students, with special attention to low achievers and minorities. Given the weight of evidence against traditional practices—such as grade retention, suspension, expulsion, and rigid forms of tracking—research is needed to guide educators toward alternatives that can be successfully implemented. Neighborhoods This report calls repeated attention to the deteriorating and dangerous conditions that characterize the urban neighborhoods in which increasing numbers of American youth live, especially

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Losing Generations: Adolescents in High-Risk Settings those from low-income families and from disadvantaged racial and ethnic groups. We do not know how such circumstances influence adolescent growth and development. The physical condition of such settings (the anomie and dangers of high-rise housing, the decrepitude of the housing stock, the abandoned buildings and littered streets) and their social condition (the prevalence of gangs and organized drug markets, the lack of normative standards and informal social controls) have not been systematically examined for their impact on the young people in them. Research is therefore needed to determine the consequences of these conditions and to identify the elements of healthy, functioning neighborhoods that lead to healthy adolescent development. Such research needs to move beyond single settings to assess the mix of formal and informal support; descriptive research, mapping the supports available for adolescents in different communities, would be helpful in establishing a baseline. Community-level inquiries could examine the health and behavioral status of adolescents in comparable neighborhoods with and without programs or integrated service delivery systems. Health Care The lack of an integrated health care system in the United States has grave consequences for the health status of the adolescent population. The "system" is also reflected in studies of adolescent health: at present, most studies focus on isolated physical or behavioral characteristics. There is a need to broaden research to examine the effects of settings and services on individuals and communities, rather than on specific conditions. For example, do students in school with school-linked health centers enjoy better health than students who depend on other types of services? What are the most important components of primary care for adolescents and how do they differ from those for other age groups? The importance of comprehensive "one-stop" programs has been suggested. Research to document the relative efficacy of combined services versus category single-focus programs should be given high priority. The need for greater access to mental health services is often overlooked in the discussion of health delivery and finance. Research is needed to further document this need—and to determine the most effective prevention intervention and treatment. Research should examine the qualities of health care settings (such as location, staff attributes, range of service provided) that

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Losing Generations: Adolescents in High-Risk Settings are most likely to engage young people and sustain participation. Within this context, issues of confidentiality and consent need to be fully explored to identify and reduce barriers to appropriate service. As the country moves increasingly into managed care arrangements, research is needed to better document the effects of these systems on adolescents. Issues of access are particularly important. Greater use should be made of existing data to help identify research priorities and to answer research questions. Increased support for national health survey supplements that concern adolescents is of high priority, as is support of methods to improve such surveys. For example, the validity of information obtained from parents about adolescents is also a critical topic for study. However, the most important research question regarding adolescents and primary care is very simply how do we get them into the system? School-To-Work Transition The United States does not have a comprehensive school-to-work transition system, and the existing programs—vocational education and employment and training programs—provide marginal benefits to young people. On a policy level, there is a need for systematic evaluations of state, local, and foreign efforts to create school-to-work transition systems, with particular attention to the effects of such initiatives on adolescent outcomes. Specific interventions should be evaluated in the context of the overall education system, and evaluations should be consistent with this perspective. Similarly, employment and training programs need to be studied in the context of other community resources, including but not limited to the schools. Research should also examine how programs can be made more comprehensive by addressing a broader range of adolescent needs and competencies, and by providing services that offer continuity throughout the period of adolescence. Juvenile and Criminal Justice This report identifies a number of ways in which the juvenile and criminal justice systems fail to intervene before adolescent offenders become fully enmeshed in the adult criminal justice system. Like dropping out of school, contact with the juvenile justice system often acts to mortgage an adolescent's future by jeopardizing the school-to-work transition and by diminishing long-term

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Losing Generations: Adolescents in High-Risk Settings employment prospects. Yet little research has monitored this process longitudinally, and there is little research on how this process varies across community settings or labor markets. Particular attention should be paid to ways in which the justice system seems to exacerbate racial, ethnic, and socioeconomic variations in life chances. Research is needed to develop alternatives to conviction and incarceration, including school and employment programs, that can alter developmental trajectories. Child Welfare and Foster Care The child welfare system, like the justice system, is overwhelmed by rising caseloads and is caught in a continuing controversy over the relative priority of family preservation versus the needs of children. Research is needed to identify strategies for strengthening families, especially those suffering from financial hardship and emotional stress; but research is also needed to evaluate the effects of these strategies. In particular, the paucity of research on adolescents in the foster care system severely limits policy and program initiatives. Research is needed to identify the unique risks faced by adolescents—in comparison with populations—and evaluations are necessary to assess different strategies for helping them make a successful transition into young adulthood. Individual Differences in Adolescence Although it is important to investigate the effects of dangerous and disadvantaged settings on all youths, it is also important to observe the variation in behavior and development among youths who grow up in similar settings. One source of such variation is individual differences in values, attitudes, beliefs, perceptions, social and self-definitions, expectations, and the like that play an important role in adolescent behavior and development. The challenge is to map those individual differences that are logical reflections of socialization in critical settings—family, school, neighborhood—and that, at the same time, have implications for successful or unsuccessful adaptation in such contexts. Examples that seem promising on the basis of prior research include individual differences in the following characteristics: perceived self-efficacy or self-competence; values placed on achievement and health; perception of future opportunity or of life chances; attitudes about normative transgression; orientation to religion and involvement with church; self-definition, including ethnic or racial

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Losing Generations: Adolescents in High-Risk Settings self-concept; and risk-taking propensity. Research should be done on how such characteristics develop, their organization into structures of personality, their linkage to variation in social context, and their interaction with context in influencing adolescent behavior and development. Adolescent Risk Behavior Increasing numbers of America's youth, those who live in affluence as well as poverty, engage in behaviors that compromise their development and jeopardize their futures, their health, and even their lives. The prevalence of risky behaviors among adolescents—drug use, unprotected sexual behavior, delinquency, violence, dropping out of school—warrants major research attention. The growing incidence of depression and the effects of exposure to violence must be considered. There has been considerable support for descriptive epidemiological monitoring of risky behaviors, but additional research is needed in several other key areas. One such area is the organization of risky behaviors—their intraindividual covariation in the behavioral repertoires of youth. Prior research has found sufficient structures of covariation to warrant the label of "risky life-style," but this finding needs further examination, especially with the youth populations that are of concern in this report. Specifically, how do such structures or organizations of risky behaviors develop, what factors in the individual or the context promote or prevent harmful results from these behaviors, and how can one predict the link between risky behaviors and subsequent harm? Of equal research interest are the relationships among various risky behaviors and their relationship with behaviors that promote health. Such questions require longitudinal studies that can illuminate the process of behavioral development in all of its facets. Comprehensive Intervention Programs Current understanding of the needs of youth in high-risk settings suggests that no one single intervention has the power to change life-styles. Rather, it is postulated that a number of program components have to be put together to achieve a significant effect. A number of demonstration projects have been launched that measure the short-term effects of multicomponent, multiagency programs—such as community schools, school-based clinics, school-business collaboration, and communitywide youth development,

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Losing Generations: Adolescents in High-Risk Settings substance abuse, and delinquency prevention programs. High priority should be given to research that evaluates the interactive effects of these complex programs over a long enough period to confirm or deny their validity. Previous experience with comprehensive programs that focused on middle school youth has shown short-term positive effects, but they tended to "wash out" by the time of high school graduation (or dropping out). Other items of research interest are the sequencing of components (the effects of early interventions versus later ones) and whether adolescents are better served in school-based or community-based programs, questions that can only be resolved through research and evaluation. Much of the current policy research focuses on the categorical arrangement of programs—separate solutions for separate problems. The research agenda would be greatly enhanced if it included a review of how the federal government is organized to deal with the range of issues identified in this report, building on previous research, for example, that identified hundreds of federal agencies with responsibility for adolescent health services. Another major area of policy research involves the determination of how to move from demonstration projects to full-scale implementation. For example, if one comprehensive school-based family resource center appears to have a positive impact in a neighborhood, how can this model be replicated in other neighborhoods that want such an institution? Other countries are believed to have created more caring social environments for youth, and this belief is supported by documented outcomes (levels of substance use, teenage pregnancy, etc.) that are more favorable than in the United States. Research should therefore be conducted that compares the policies and practices in various nations that are relevant to school, family, and neighborhoods. State governments also have a major role to play in the integration of human services and in assisting communities to develop coordinated systems for families and youth. Policy research should explore the various models of state government reform to identify successful approaches. Monitoring the Status of the Adolescent Population If it is true that young people are the nation's most precious resource, then the nation needs better means of measuring the overall effectiveness of the socialization process. Systematic efforts are needed to assess the adolescent population over time. Such efforts will require multifaceted measures that examine a

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Losing Generations: Adolescents in High-Risk Settings range of adolescent attributes, including perceptions, behaviors, and accomplishments. Data collection must be organized to produce findings according to age, gender, race, ethnicity, and socioeconomic status. The need to adequately monitor adolescents from low-income families is especially urgent. Relatively little is known about the exposure of the adolescent population to high-risk settings on a national and regional basis. In addition, studies do not adequately sample by race or ethnicity, and hence little is known about some of the most vulnerable populations. Finally, studies must allow for disaggregation into smaller age subgroups; for example, most national health surveys group young adolescents with children, and older adolescents with adults. Reports about the problems facing children and adolescents generally conclude by reminding readers that the nation's youth constitute our future and urge steps to protect this vital resource: that is also the strongly held view of this panel. The problems are more serious than is often recognized, and if current trends continue, will become dramatically worse by the turn of the century. In this report, we have attempted to document the pervasiveness and complexity of the problems and to suggest that it is time to focus more attention on the social environments in which adolescents live and grow. Environments are socially constructed and in a constant state of evolution, which means that the destructive effects we have described need not persist. Influencing change in a positive direction is often difficult, however, because understanding is always limited and everyone—policy makers, researchers, the public—is invested in current institutional practices—in health care, housing, education, criminal justice, child welfare, and employment. But as the century closes, the nation appears to be entering a period of reexamination and reform regarding many basic social institutions. This is therefore an appropriate time to urge that the needs of children and families be brought to the forefront and given priority attention.