Risks and Opportunities

SYNTHESIS OF STUDIES ON ADOLESCENCE

Forum on Adolescence

Michele D. Kipke, Editor

Board on Children, Youth, and Families

Commission on Behavioral and Social Sciences and Education

National Research Council and

Institute of Medicine

NATIONAL ACADEMY PRESS
Washington, D.C.



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Risks and Opportunities: Synthesis of Studies on Adolescence Risks and Opportunities SYNTHESIS OF STUDIES ON ADOLESCENCE Forum on Adolescence Michele D. Kipke, Editor Board on Children, Youth, and Families Commission on Behavioral and Social Sciences and Education National Research Council and Institute of Medicine NATIONAL ACADEMY PRESS Washington, D.C.

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Risks and Opportunities: Synthesis of Studies on Adolescence NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. The study was supported by Contract/Grant No. B6509 between the National Academy of Sciences and Carnegie Corporation of New York. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number 0-309-06791-X Additional copies of this report are available from National Academy Press, 2101 Constitution Avenue, N.W., Lockbox 285, Washington, D.C. 20055 Call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area) This report is also available on line at http://www.nap.edu Printed in the United States of America Copyright 1999 by the National Academy of Sciences. All rights reserved. Suggested citation: National Research Council and Institute of Medicine (1999). “Risks and Opportunities: Synthesis of Studies on Adolescence.” Forum on Adolescence. Michele D. Kipke, Editor. Board on Children, Youth, and Families. Washington, DC: National Academy Press.

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Risks and Opportunities: Synthesis of Studies on Adolescence THE NATIONAL ACADEMIES National Academy of Sciences National Academy of Engineering Institute of Medicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A. Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.

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Risks and Opportunities: Synthesis of Studies on Adolescence FORUM ON ADOLESCENCE DAVID HAMBURG (Chair), Carnegie Corporation of New York (President Emeritus) HUDA AKIL, Mental Health Research Institute, University of Michigan CHERYL ALEXANDER, Center for Adolescent Health, Johns Hopkins University CLAIRE BRINDIS, Institute for Health Policy Studies, University of California, San Francisco GREG DUNCAN, Institute for Policy Research, Northwestern University JACQUELYNNE ECCLES, School of Education, University of Michigan ABIGAIL ENGLISH, Adolescent Health Care Project, National Center for Youth Law, Chapel Hill, North Carolina EUGENE GARCIA, School of Education, University of California, Berkeley HELENE KAPLAN, Skadden, Arps, Slate, Meagher, and Flom, New York City IRIS F. LITT, Division of Adolescent Medicine, Stanford University JOHN MERROW, The Merrow Report, New York City ANNE C. PETERSEN, W.K. Kellogg Foundation, Battle Creek, Michigan KAREN PITTMAN, International Youth Foundation, Baltimore ANNE PUSEY, Jane Goodall Institute's Center, University of Minnesota MICHAEL RUTTER, Institute of Psychiatry, University of London STEPHEN A. SMALL, Department of Child and Family Studies, University of Wisconsin, Madison BEVERLY DANIEL TATUM, Office of the Dean, Mt. Holyoke College CAMILLE ZUBRINSKY CHARLES, Department of Sociology, University of Pennsylvania BARUCH FISCHHOFF (liaison from Institute of Medicine Council), Social and Decision Sciences, Carnegie Mellon University ELEANOR E. MACCOBY (liaison from Commission on Behavioral and Social Sciences and Education), Department of Psychology (emeritus), Stanford University

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Risks and Opportunities: Synthesis of Studies on Adolescence Michele D. Kipke, Director Elena Nightingale, Scholar-in-Residence Amy Gawad, Project Assistant

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Risks and Opportunities: Synthesis of Studies on Adolescence BOARD ON CHILDREN, YOUTH, AND FAMILIES JACK P. SHONKOFF (Chair), Heller Graduate School, Brandeis University DAVID V.B. BRITT, Children's Television Workshop, New York City LARRY BUMPASS, Center for Demography and Ecology, University of Wisconsin SHEILA BURKE, John F. Kennedy School of Government, Harvard University DAVID CARD, Department of Economics, University of California, Berkeley KEVIN GRUMBACH, Department of Family and Community Medicine, Primary Care Research Center, University of California, San Francisco MAXINE HAYES, Department of Community and Family Health, Washington State Department of Health MARGARET HEAGARTY, Department of Pediatrics, Harlem Hospital Center, Columbia University ALETHA C. HUSTON, Department of Human Ecology, University of Texas, Austin RENEE JENKINS, Department of Pediatrics and Child Health, Howard University SHEILA KAMERMAN, School of Social Work, Columbia University SANDERS KORENMAN, School of Public Affairs, Baruch College CINDY LEDERMAN, Circuit Court, Juvenile Justice Center, Dade County, Florida SARA McLANAHAN, Office of Population Research, Princeton University VONNIE McLOYD, Center for Human Growth and Development, University of Michigan PAUL NEWACHECK, Institute of Health Policy Studies and Department of Pediatrics, University of California, San Francisco DEBORAH STIPEK, Graduate School of Education, University of California, Los Angeles PAUL WISE, Department of Pediatrics, Boston Medical Center

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Risks and Opportunities: Synthesis of Studies on Adolescence EVAN CHARNEY (liaison from IOM Council), Department of Pediatrics, University of Massachusetts Medical School RUTH T. GROSS (liaison from IOM Board on Health Promotion and Disease Prevention), Professor of Pediatrics Emerita, Stanford University ELEANOR E. MACCOBY (liaison from Commission on Behavioral and Social Sciences and Education), Department of Psychology, Stanford University Michele Kipke, Director Deborah Phillips, Director (through June 1998) Mary Graham, Associate Director of Dissemination and Communications Elena Nightingale, Scholar-in-Residence Mary Strigari, Administrative Associate

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Risks and Opportunities: Synthesis of Studies on Adolescence Contents 1   INTRODUCTION   1     Wealth of Research   2     Scope of Report   2 2   ADOLESCENCE: A TIME OF OPPORTUNITY AND RISK   6     The Developing Adolescent   7     Social Context in Which Adolescents Develop   11     Changes in U.S. Families   13     Peer Relationships   16     Reports Referenced   17 3   SUPPORTING ADOLESCENTS WITH SOCIAL INSTITUTIONS   18     Neighborhoods and Community Settings   18     Schools   20     Health Care Delivery System   23     Child Welfare and Juvenile Justice   26     Reports Referenced   29 4   ADDRESSING CHALLENGES AND PROMOTING THE HEALTHY DEVELOPMENT OF ADOLESCENTS   30     Sexual Risk, Unintended Pregnancy, and Sexually Transmitted Diseases   31     Tobacco, Alcohol, and Illicit Drugs   38     Reports Referenced   42

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Risks and Opportunities: Synthesis of Studies on Adolescence 5   ADOLESCENTS TAKING THEIR PLACE IN THE WORLD   43     Adolescents in the Workforce   43     School-to-Work Programs   46     Adolescents in the 21st Century: Changing Sociodemographic Patterns   47     Reports Referenced   50 6   IMPLICATIONS FOR RESEARCH AND LINKING RESEARCH TO POLICY AND PRACTICE   51     Increasing Numbers and Growing Diversity   52     Healthy Adolescent Development   53     Relationships Between Teenagers and Parents   55     New Trends in Adolescent Behavior   56     Adolescent Well-Being   60     Programs for Intervention and Youth Development   62     Developmentally Appropriate Health Care Services   65     The Media and Advances in Technology   67     Role of the Forum   68     REFERENCES   69 APPENDIX:   INSTITUTE OF MEDICINE/NATIONAL RESEARCH COUNCIL REPORTS RELEVANT TO ADOLESCENCE   71     OTHER REPORTS FROM THE BOARD ON CHILDREN, YOUTH, AND FAMILIES   82

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Risks and Opportunities: Synthesis of Studies on Adolescence RISK AND OPPORTUNITIES

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