PEDIATRICS Vol. 110 No. 6 December 2002, pp. 1258-1259
Enhancing Their Likelihood for a Positive Future
--> To the Editor.—
In their recently published companion articles, Ginsburg and colleagues1,2 provide us with 2 outstanding glimpses, 1 quantitative and the other qualitative, into the world views of today’s inner-city youth. The authors identify the ongoing debate between the risk and resiliency paradigms about how to best promote adolescent and young adult well-being in their discussion and suggest that studies that explore macro social forces such as gender, race, and socioeconomic status perpetuate a focus on risk and draw attention away from "more easily acted on variables." I agree that a focus on demographic predictors of risk may not lead to interventions that easily enhance youth development and may, in fact, promote a "blame the victim" mentality. However, I reject the notion that studies of larger sociostructural factors, such as socioeconomic status, engender such a focus. How we interpret the data creates that difference. I offer an alternative interpretation of that reported in these articles.1,2
The youth studied by Ginsburg et al provide a compelling demonstration of the power and importance of socioeconomic determinants of health. Throughout their research, the top-ranking solutions suggested by the youth themselves involve socioeconomic factors. More jobs and job training, better education, less school drop-out, college scholarships—all these solutions are geared toward improving socioeconomic status, an important determinant of adolescent health and well-being.3,4 These adolescents are calling for societal change and a decrease in socioeconomic disparities. The youth are telling us that these are the areas that need attention; these are the problems that need solving. Although it is critical to support youth by increasing protective and buffering resources within the family, school, and community, it is also clear that doing so without a parallel attempt to improve socioeconomic conditions, especially for those at the lower end of the socioeconomic gradient, will be akin to putting a finger in the dike.5 To help youth negotiate their adverse environments and overcome the hurdles they face as they strive to fulfill their dreams and potential, we must address both proximal and fundamental root causes of the barriers we, as a society, have placed in their way.
Elizabeth Goodman, MD
Institute for Health Policy
Heller Graduate School for Social Policy and Management
Brandeis University
Waltham, MA, 02454-9110
E-mail: goodman{at}brandeis.edu
REFERENCES
1. Ginsburg KR, Alexander PM, Hunt J, Sullivan M, Zhao H, Cnaan A. Enhancing their likelihood for a positive future: the perspective of inner-city youth.
Pediatrics.2002; 109(6)
:1136
–1142
2. Ginsburg KR, Alexander PM, Hunt J, Sullivan M, Cnaan A. Enhancing their likelihood for a positive future: focus groups reveal the voice of inner-city youth. Pediatrics.2002; 109(6) . Available at: http://www.pediatrics.org/cgi/content/full/109/e95
3. Goodman E, Slap GB, Huang B. How much does socioeconomic status matter to adolescent health. J Adolesc Health.2001; 30 :102
4. Goodman E. The role of socioeconomic status gradients in explaining differences in US adolescents’ health.
Am J Public Health.1999; 89
:1522
–1528
5. Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav.1995; (Spec) :80 –94
In Reply.—
I would like to thank Dr Goodman for her insights into what may explain the teenagers’ clear request for better educational and employment opportunities. I highly respect Dr Goodman’s work on socioeconomic status gradients and subjective social status and agree that socioeconomic disparities are at the root cause of many of the problems that challenge youth in urban areas of concentrated poverty.
We did not mean to suggest that studies that explore macro social forces perpetuate a focus on risk. Although simple classifications by race may blame the victim, an analysis of socioeconomic disparities enhances our understanding of the context of people’s lives and of individual and community resources. Our intent was to emphasize that some protective variables may be far easier to act on than demographic variables, and may significantly enhance youth well-being. We would applaud an approach that worked on enhancing successful outcomes in youth both by building protective factors on the individual, family, and community level as well as by addressing socioeconomic disparities.
This body of research used the teen-centered method, a qualitative-quantitative technique that facilitates youth to generate, prioritize, and explain their own ideas. Ideally, the teenagers would have explained to us precisely what they meant by their items. In fact, some students discussed worn-down schools in their neighborhoods and even contrasted them to schools in more economically advantaged areas. However, these contrasts were not raised often enough to constitute a theme, and the purpose of our work was to convey the teen perspective. The teenagers did offer a consistent message that essentially stated that if we gave them decent opportunities for education and employment, as well as meaningful connections with adults, they would be better equipped to handle the adversity of their environment. These statements suggested to us that their views could best be expressed in the context of the youth development paradigm. However, the reader must remember that this was a study of perceptions; it did not attempt to elucidate root causes nor can it state definitively which interventions would produce the best outcomes. The fact that the teenagers did not often discuss socioeconomic disparities does not diminish their importance or negate them as fundamental root causes. Dr Goodman’s interpretation is important to consider. We welcome her input into the ongoing dialogue about what supports are needed to guide all of our youth to become creative, competent adults who are well-prepared to contribute to our communities.
Kenneth R. Ginsburg, MD, MS Ed
Craig-Dalsimer Division of Adolescent Medicine
Children’s Hospital of Philadelphia
Philadelphia, PA, 19104
PEDIATRICS (ISSN 1098-4275). ©2002 by the American Academy of Pediatrics
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
