Why We’re Addressing Risks to Adolescent Health

An estimated 12 percent of U.S. 16- to 24-year-olds, or nearly five million young people, fall into the category of “opportunity youth.”

These young people are disconnected from school and employment, and they suffer from a disproportionate share of problems as they approach adulthood, including chronic unemployment, poverty, mental health issues, criminal behaviors, incarceration, poor health and early mortality. 

At the Bloomberg American Health Initiative, we believe it’s of vital national importance not to let young people continue to fall through the cracks. Researchers have covered a lot about what leads to disconnection and have taken steps toward addressing the root causes. But a lot more could be learned about what young people need and how to provide it.

Addressing Trauma, Poverty and Failed Systems

Opportunity youth are often the victims of family trauma, failed schools, broken child welfare systems and poverty-stricken neighborhoods. And looking beyond the individual costs of disconnection, the societal and economic costs of failing to address the needs of disconnected young people are high: loss of human resources to compete in a global economy, increased demands for public assistance, rising crime and mass incarceration, drug abuse, and massive health service delivery costs. 

To date, the primary strategies for efforts to address youth disconnection have focused on re-engaging youth by reconnecting them with education or providing apprenticeships, other job training or employment. For example, national re-engagement programs such as YouthBuild, Job Corps and Year Up have demonstrated measurable (though small) improvements in graduation rates and increases in wages. Large-scale initiatives are emerging to broaden the scope and impact of this work. 

The Importance of Prevention

But prevention is as critical as reconnection. Preventive approaches focus on strengthening connections with school, family and community, promoting youth academic or career engagement, and enhancing meaningful relationships and supports to avert youth disconnection. For instance, the Good Behavior Game, a classroom-centered universal prevention program delivered in early elementary grades, was found to produce significant gains in a host of short- and long-term youth outcomes relevant to positive engagement. Johns Hopkins Bloomberg School of Public Health researchers and colleagues from other institutions, for example, studied the game’s effects on Baltimore public-school students years after they participated in the program. Young adults who had played the game in first and second grade were less likely than their peers to have drinking or drug problems, smoke regularly, be incarcerated for violent crimes or experience suicidal ideation.  

To be most effective, prevention strategies like the Good Behavior Game must be delivered in various settings, from infancy through adolescence, and ideally be reinforced across sectors — in schools and health care settings and out-of-school programs. Addressing a problem as complex as youth disconnection requires multi-sector approaches that use coordinated data systems, youth engagement, consolidated service delivery and systematic intervention strategies that span prevention and re-engagement. Public health strategies are well suited to this effort.