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September 10, 1997JAMA2,806 citations

Protecting Adolescents From Harm

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MRMichael D. Resnick

Key Points

  • To identify family, school, and individual risk and protective factors associated with adolescent emotional health, violence, substance use, and sexuality.
  • Cross-sectional analysis of in-home interview data from the National Longitudinal Study of Adolescent Health involving 12,118 adolescents in grades 7 through 12, subsampled from an initial school survey of 90,118 students across 80 high schools and feeder middle schools.
  • Assessed independent measures of family context, school context, and individual characteristics against eight health-risk domains: emotional distress, suicidal thoughts/behaviors, violence, substance use (tobacco, alcohol, marijuana), age of sexual debut, and pregnancy history.
  • Parent-family connectedness and perceived school connectedness were protective against all health risk behaviors examined, with the exception of pregnancy history.
  • Ease of access to firearms at home was associated with suicidality (grades 9–12: P<0.001) and violence (grades 7–8: P<0.001; grades 9–12: P<0.001), while home access to substances was associated with use of cigarettes (P<0.001), alcohol (P<0.001), and marijuana (P<0.001).
  • Working ≥20 hours weekly was linked to emotional distress (P<0.01) and substance use (P<0.001); repeating a grade was linked to emotional distress (junior high: P<0.001; high school: P<0.01) and tobacco use (P<0.001), whereas parental disapproval delayed intercourse onset (P<0.001).

Abstract

Context. —The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. Objective. —To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. Design. —Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. Participants. —A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. Setting. —The interview was completed in the subject's home. Main Outcome Measures. —Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. Results. —Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12:PPPPPPPPPPPPPPPConclusions. —Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

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Cite This Study

Michael D. Resnick (1997) studied this question.

synapsesocial.com/papers/69d72f89d2e0540b79f5085ehttps://doi.org/10.1001/jama.1997.03550100049038
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