Reducing Risky Health Behaviors In Teens: A Tall Order

“To really improve adolescent health, programs should seek to reduce risk taking, improve social capital and improve levels of affluence,” said study co-author Owen Gallupe, although he acknowledges that this is a tall order.

Gallupe is a researcher with the Social Program Evaluation Group at Queen’s University in Ontario. The study appears in the September issue of the Journal of Adolescent Health.

The authors sought to determine how risk taking, affluence and neighborhood social capital — whether an individual believes he lives in a safe, trusting and helpful place — influence health.

They analyzed Canadian data from a World Health survey involving 2,384 teens in 9th and 10th grade during 2001-2002. Teens rated their own health on a four-point scale, ranging from “excellent” to “poor.” Overall, 13.8 percent of boys and 20.1 percent of girls reported themselves in poor health.

Richard Crosby, chairman of the Department of Health Behavior, in the College of Public Health at the University of Kentucky, noted that the study’s primary outcome variable — self-rated health — relied on a single item. “This may be a very weak measure,” he wrote in an e-mail.

Gallupe agreed that different questions involving health could produce more nuanced results. However, he added, “overall assessments of health may be an important measure for different reasons than more specific and detailed measurements. It is a holistic approach as opposed to a specific approach.”

The study also looked at how often children engaged in risky behavior. Researchers measured risk taking using a combination of smoking, drunkenness, seatbelt use, marijuana use, use of other illicit drugs and non-use of condoms.

Nearly 32 percent of low-income children said they frequently engaged in risky behaviors, compared with 16.7 percent of moderate-income students and 11 percent of high-income students.

The study also found that a larger percentage of students with low social capital reported that they frequently engaged in risky behaviors. However, Gallupe said, “Our analysis actually states that social capital, affluence and risk taking all influence health, but these things do not work together.”

As a result, if a program aims to reduce risk taking, low-income children and those in neighborhoods with low social capital are still more likely to report poor health.

Some programs, for example the New York-based Harlem Children’s Zone, already target education, as well as health care and economic issues faced by families.