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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 Grant No. B7128 and B6815 between the National Academy of Sciences and the 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 views of the organizations or agencies that provided support for this project.
Library of Congress Cataloging-in-Publication Data
Adolescent risk and vulnerability : approaches to setting priorities to reduce their burden / Baruch Fischhoff, Elena O. Nightingale, Joah G. Iannotta, Editors.
Includes bibliographical references.
ISBN 0-309-07620-X (perfectbound)
1. Risk-taking in adolescence (Psychology)—United States—Congresses. 2. Teenagers—United States—Social conditions—Congresses. 3. Teenagers—Health risk assessment—United States—Congresses. 4. Youth—Government policy—United States—Congresses. I. Fischhoff, Baruch, 1946- II. Nightingale, Elena O. III. Iannotta, Joah G.
HV1431 .A633 2001
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Suggested citation: National Research Council and Institute of Medicine. (2001). Adolescent risk and vulnerability: Concepts amd measurement. Board on Children, Youth, and Families. Division of Behavioral and Social Sciences and Education. Baruch Fischhoff, Elena O. Nightingale, and Joah G. Iannotta, Eds. Washington, DC: National Academy Press.
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BOARD ON CHILDREN, YOUTH, AND FAMILIES
EVAN CHARNEY (Chair),
Department of Pediatrics, University of Massachusetts
JAMES A. BANKS,
Center for Multicultural Education, University of Washington
Child Study Center, Yale University
Children’s Hospital Medical Center of Cincinnati
MARY JANE ENGLAND,
Washington Business Group on Health, Washington, DC
Center for Children’s Environmental Health, Columbia University
Department of Psychology, University of California, Los Angeles
RUTH T. GROSS,
Department of Pediatrics, Stanford University
Department of Family and Community Medicine, University of California, San Francisco/San Francisco General Hospital
School of Public Health, University of California, Los Angeles
Washington State Department of Health, Olympia, Washington
Department of Pediatrics, Harlem Hospital Center, Columbia University
Department of Pediatrics and Child Health, Howard University
School of Nursing, University of Rochester
School of Public Affairs, Baruch College
HON. CINDY LEDERMAN,
Juvenile Justice Center, Dade County, Florida
Center for Human Growth and Development, University of Michigan
Department of Sociology, University of Wisconsin-Madison
Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
Department of Pediatrics, Montefiore Medical Center, Bronx, New York
ELEANOR E. MACCOBY (Liaison, Division of Behavioral and Social Sciences and Education),
Department of Psychology (Emerita, Stanford University
WILLIAM ROPER (Liaison, Institute of Medicine),
School of Public Health, University of North Carolina, Chapel Hill
Elena O. Nightingale, Scholar-in-Residence
Michele D. Kipke, Director
Mary Graham, Associate Director, Dissemination and Communications
Sonja Wolfe, Administrative Associate
Joah G. Iannotta, Research Assistant
ADOLESCENT RISK AND VULNERABILITY: OVERVIEW
PERCEPTIONS OF RISK AND VULNERABILITY
VULNERABILITY, RISK, AND PROTECTION
MODELING THE PAYOFFS OF INTERVENTIONS TO REDUCE ADOLESCENT VULNERABILITY
ADOLESCENT VULNERABILITY: MEASUREMENT AND PRIORITY SETTING
In September 1997 the Board on Children, Youth, and Families organized a planning meeting on indicators for the safety and security of adolescents. A number of important ideas developed in this workshop, including the need to reassess and redefine adolescent vulnerability in order to develop more effective policies and programmatic interventions to safeguard young people.
Early in 2000, and under the auspices of the Board, the two moderators in the planning meeting, Elena Nightingale, Scholar-in-Residence with the Board on Children, Youth, and Families, and Baruch Fischhoff, Professor of Social and Decision Sciences at Carnegie Mellon University, initiated the development of a workshop to stimulate thinking about the meaning of adolescent vulnerability, the methodologies that can be employed to measure vulnerability and its disparate predisposing risk factors, and the steps that would advance the work necessary for setting priorities for policies and practices to reduce the total burden of vulnerability for young people.
A small planning group was formed to develop a workshop on reconceptualizing adolescent risk and vulnerability. This committee included Robert William Blum, Professor of Pediatrics at the University of Minnesota; Martha R. Burt, Program Director and Principal Research Associate at the Urban Institute; Susan G. Millstein, Professor of Pediatrics at the University of California at San Francisco; as well as Baruch Fischhoff and Elena O. Nightingale, who served as co-chairs of the group. The task
was to plan a workshop that would bring together the work and experience of several disciplines, from health science to psychology, decision science, and economics, that could further current research and thinking about adolescent vulnerability. As a part of this task, Drs. Blum, Burt, Millstein, and Fischhoff and their colleagues wrote papers that focused on the particular aspect of reconceptualizing adolescent vulnerability within their respective field of expertise. These papers were deliberately interconnected with the intention of generating not only a new way of defining adolescent vulnerability, but also of creating new methodological approaches to conducting research on both vulnerability and positive attributes of young people that could offer a more effective knowledge base for policy and intervention than available currently.
With funding from Carnegie Corporation of New York, the Workshop on Adolescent Risk and Vulnerability: Setting Priorities took place on March 13, 2001, in Washington, DC. The workshop’s goal was to put into perspective the total burden of vulnerability that adolescents face, taking advantage of the growing societal concern for adolescents, the need to set priorities for meeting adolescents’ needs, and the opportunity to apply decision-making perspectives to this critical area. The workshop included five sessions, the first four of which were based on the papers prepared for the workshop.
The first session examined a new conceptual framework for understanding and moderating adolescent vulnerability. The second session focused on the social costs of adolescent risk taking and vulnerability. The discussion included ways to model the lifelong costs and benefits of risky behavior in adolescence and the payoffs of interventions to reduce them. The third session proposed ways to assess the total burden of adolescents’ vulnerability and its components, as well as what indices are useful to monitor progress in reducing vulnerability and what social mechanisms can be used to set priorities for reducing them. The fourth session centered on perceptions of vulnerability by adolescents and by adults and how their accuracy can be measured and analyzed. How beliefs about risks influence risk taking and adolescents’ ability to manage the risks and vulnerabilities they face also were discussed. The final session considered the implications of these approaches to adolescent vulnerability as well as opportunities they might provide to bridge research, policy, and practice.
This report includes an introduction by co-chairs Fischhoff and Nightingale that summarizes issues raised at the workshop and the four papers prepared and presented by the planning group members. The summary
reflects the presentations and perspectives of the presenters and participants at the workshop. It is not intended to be a comprehensive review of all the issues that emerged at the workshop or of all those relevant to adolescent risk and vulnerability. Rather, it attempts to highlight key issues and viewpoints that emerged from the rich discussions that took place. The information distilled in this summary is drawn from the presentations of the speakers and the dialogue that ensued, and every effort has been made to accurately reflect the speakers’ content and viewpoints.
The papers in this volume were reviewed in draft form by the workshop discussants, chosen for their diverse perspectives and technical expertise. For their insightful and constructive comments, we thank Mark Cohen, Susan Curnan, Peter Edelman, Beatrix A. Hamburg, Lloyd J. Kolbe, Richard M. Lerner, Ann S. Masten, Gary B. Melton, Shepherd Smith, Matthew Stagner, and Heather Weiss. We also especially thank Anne Petersen, who generously gave of her time to oversee the review and further strengthen the contents of this volume. Although the individuals listed provided constructive comments and suggestions, it must be emphasized that responsibility for the final content of the volume rests entirely with the authors.
The Board is particularly grateful to the planning group that developed the workshop framework and prepared the papers included in this volume. We especially thank Elena O. Nightingale and Baruch Fischhoff, who co-chaired the workshop and who, with Joah Iannotta, edited this volume, and Mary Graham, who provided assistance in coordinating this publication.
Michele D. Kipke, Director
Board on Children, Youth, and Families