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4 Inequity and Adolescence
Pages 95-146

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From page 95...
... These potent societal d ­ eterminants shape adolescents' life trajectories in multiple ways. They not only reduce access to the opportunities, services, and supports enjoyed by more privileged youth, but they also expose less privileged youth to risks, stresses, and demands that "get under the skin," adversely affecting the body and the brain during critical developmental periods.
From page 96...
... This analysis requires two tasks: We first summarize adolescent outcomes for which adequate data are available and identify disparities in these outcomes by race, ethnicity, gender, income, and, where possible, nativity, and sexual orientation.1 These disparities are neither inevitable nor irremediable. The next section therefore identifies the major sources of these disparities, because a full understanding of the sources of the disparities is necessary to formulate effective strategies for reducing them.
From page 97...
... An important question, of course, is whether our society is willing to make the necessary long-term commitment to change the conditions that underpin these stark disparities. DISPARITIES IN ADOLESCENT OUTCOMES Recently, increasing attention has been paid to understanding adolescent outcomes and, more specifically, addressing disparities in adolescent outcomes.
From page 98...
... Current Disparities in Specific Outcomes Table 4-1 presents measures of disparities in adolescent outcomes in the areas of education, justice, health, and child welfare across race and gender as well as ethnicity, income, nativity, gender identity, and sexual orientation where available. The table presents average shares (e.g., 0.11 or 11% of adolescents)
From page 99...
... c College completion (share of 0.34 0.21 0.40 0.16 0.30 0.38 - - 0.11* 25–34-year-olds with a B.A.
From page 100...
... TABLE 4-1  Continued 100 Non- Non- LGBTQ Indicator All Black White Latinx Male Female Poor Poor Native youth Health                     Mortality (ages 10–24, per 100,000) Mortality overallg 60.3 84.7 56 57.9 85.9 33.3         Mortality from unintentional injuryg 27.1 20.9 29.7 25.7 39.2 14.4         Mortality from homicideg 9 32.8 2.5 12.2 15.2 2.6         Mortality from suicideg 7.1 4.9 8.1 5.3 11.4 2.6         Obesityh 0.148 0.182 0.125 0.182 0.175 0.121 0.189 0.1604 - 0.205 Behavioral Health                     Alcohol useh 0.604 0.513 0.617 0.647 0.581 0.626 - - - 0.722 Marijuana useh 0.356 0.428 0.32 0.424 0.352 0.359 - - - 0.504 Prescription pain medicine with a 0.14 0.123 0.135 0.151 0.134 0.144 - - - 0.243 prescription useh Depressiong 0.128 0.091 0.138 0.127 0.064 0.194 - - - Tobacco useh                     Cigarette useh 0.289 0.211 0.31 0.297 0.307 0.273 - - - 0.418 Frequent cigarette useh 0.026 0.011 0.036 0.017 0.027 0.026 - - - 0.054 Vape useh 0.422 0.362 0.418 0.487 0.449 0.397 - - - 0.505 Reproductive/Sexual Health                     Adolescent pregnancyi 0.0223 0.0318 0.016 0.0349 -   - - - HIVh 0.093 0.152 0.089 0.081 0.079 0.105 - - - 0.14
From page 101...
... j 9.4 19.8 9.3 7.9 9.5 9.2 18.5 3.6 - In group homej 0.4 1 0.4 0.4 0.5 0.4 0.9 0.2 - Aging out of foster carej 0.2 0.6 0.2 0.2 0.2 0.2 0.5 0.08 - Child abuse and neglectk 0.0091 0.0139 0.0081 0.008 0.0087 0.0095 - - - NOTES: * Refers to non-native Latinx youth (related to 0.20 for native-born Latinx youth)
From page 102...
... Only in one area do disparities appear to narrow as adolescents age: females tend to improve their performance relative to males in both math and reading. The disparities in NAEP test scores correspond to disparities seen in high school graduation rates, with graduation defined as completing school within 4 years of starting ninth grade.
From page 103...
... . dInstitute of Education Sciences, National Center for Education Statistics (2015)
From page 104...
... For example, in 2013, 15 percent of Black students received an out-of-school suspension, compared with 4 percent of White students and 6 percent of Latinx students. Moreover, a disproportionate number of Native American, LGBTQ, and disabled youth are suspended or expelled from school as a result of discretionary disciplinary practices (Poteat et al., 2016; American Bar Association, 2018)
From page 105...
... Disparities in Health Outcomes and Health Behaviors Table 4-1c shows measures of equality of adolescent outcomes in the area of health. Research examining the income gradient in child health shows that there is a positive relationship between family income and ­hildren's self-reported health and that this becomes more pronounced c as children age (Case et al., 2002)
From page 106...
... fU.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention (2015)
From page 107...
... Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics (2016)
From page 108...
... Black adolescents generally have the lowest rates of alcohol consumption and cigarette smoking as compared to White and Latinx youth, though Black and Latinx youth have slightly higher rates of marijuana use than do White youth. LGBTQ youth have much higher rates of alcohol, marijuana, and tobacco use than the general population of adolescents (Dai, 2017; Fish and Baams, 2018; Centers for Disease Control and Prevention, 2016)
From page 109...
... Similarly, American Indian and Alaska Native children are disproportionately represented in the child welfare system: while they comprise only 0.9 percent of the total child population, they comprise 1.3 percent of the children identified by Child Protective Services (CPS) as victims and 2.4 percent of the children in foster care (Children's Bureau, 2016)
From page 110...
... However, important gaps in this understanding persist due to lack of available data. The inclusion of sexual attraction, behavior, and identity measures in popu lation-based studies (e.g., the National Longitudinal Study of Adolescent to Adult Health and the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System)
From page 111...
... SOURCES: j U.S. Department of Health and Human Services, Administration for Children and Families, The Adoption and Foster Care Analysis and Report ing System; and U.S.
From page 112...
... . For educational outcomes, such as test scores, high school drop-out, and college completion, the overall trend has also been one of improvement, but important differences show up in the way disparities have evolved over time across these measures.
From page 113...
... schools and increased resource allocation to schools that predominantly serve Black students. In contrast, the "90/10 income gap" shown in the figure (defined as the difference in standardized test scores between students at the 90th percentile of family income and students at the 10th percentile)
From page 114...
... Average Difference in Standardized Test Scores 0.00 1940 1950 1960 1970 1980 1990 2000 Cohort Birth Year FIGURE 4-2  Trends in disparities in reading test scores by race and income, 1943 to 2001. NOTES: Talent = Project Talent National Longitudinal Study; NLS = National Longitudinal Surveys; HS&B = High School and Beyond Longitudinal ­ Study; NLSY79 = National Longitudinal Survey of Youth 1979; NELS = National Educational Longitudinal Study; Add Health = National L ­ ongitudinal Study of Adolescent to Adult Health; NLSY97 = National Longitudinal Survey of Youth 1997; ELS = Education Longitudinal Study; SECCYD = Study of Early Child Care and Youth Development; ECLS-K = Kindergarten Class of 1998–1999; ECLS-B = Early Childhood L ­ ongitudinal Study Birth Cohort; NAEP = National Assessment of Educational Progress.
From page 115...
... . Percent 100 80 Asian 60 Pacific Islander White 40 Two or more races Black 20 Hispanic American Indian/Alaska Native 0 1990 1995 2000 2005 2010 2015 Year FIGURE 4-4  Total college enrollment rates of 18–24-year-olds in degree-granting institutions, by race and ethnicity, 1990 to 2015.
From page 116...
... Research to understand this recent rise in suicide is currently under way. Thus, the evidence clearly shows that observed levels and disparities in adolescent outcomes are not immutable, but are responsive to changes in underlying conditions.
From page 117...
... Differences in Family Income, Wealth, and Neighborhood Resources Although child poverty rates have decreased since the 1960s, more than 9 million children and youth in the United States live in households with incomes below the poverty level (NASEM, 2019) .8 Rates of child poverty are highest for Black, Latinx, and American Indian and Alaska Native youth (NASEM, 2019)
From page 118...
... Family Income From the end of World War II to the mid-1970s, the U.S. economy grew significantly, and incomes for those at the top and bottom of the income distribution grew at roughly the same rates, consistent with a growing prosperity that was broadly shared.
From page 119...
... Rising income inequality combined with the stagnation of wages for those in the bottom half of the income distribution reduces the relative resources available to lower-income families for investment in their children. Data from the American Community Survey for 2016 show that Black and Latinx adolescents live in households characterized by significantly lower average incomes than their White counterparts: Whites ($85,000)
From page 120...
... than other Americans. High levels of racial/ethnic residential segregation even affect the neighborhood characteristics of higher-income Black and Latinx families: On average, Black families with earnings of $75,000 live in higher-poverty neighborhoods than White families with earnings of just $40,000 (Logan, 2011)
From page 121...
... . Asthma, in particular, is likely to be exacerbated by poor housing conditions and is the chronic disease that causes the greatest number of school absences, which in turn are a contributing factor to diminished achievement, school drop-out, lower college completion, and greater welfare use and criminal justice involvement (Kreger et al., 2011)
From page 122...
... . Moreover, the effects of community violence exposure can follow adolescents into adulthood: using data from the National Longitudinal Study of Adolescent to Adult Health, researchers found that exposure to violence in adolescence was predictive of depressive symptoms in adulthood (Chen et al., 2017)
From page 123...
... . However, historical trauma can also be "the nexus of .
From page 124...
... . We used to laugh and make a joke about it and say there's only 12 Black students.
From page 125...
... Research has shown that this lack of job opportunities also contributes to the behavioral health disparities observed in minority adolescents, driven by feelings of hopelessness and depression (White and Borrell, 2011)
From page 126...
... Although adolescent interactions with formal institutions present opportunities to decrease disparities through either the direct provision of services, or effective screening, diagnosis, and referral to appropriate services, in practice institutions and systems often reinforce disparate outcomes through unequal funding and segregation based on income, race, and e ­ thnicity. This section discusses how various educational, health, welfare, and justice institutions and policies serve to increase disparities in adolescent outcomes, beginning with the school, an institution that almost all adolescents will interact with over a prolonged period.
From page 127...
... . The fact that parity in funding did not result in an even greater parity in test scores suggests that increasing disparities in the family resources of students attending schools has continued to exert significant influence.
From page 128...
... . The increasing income segregation of American schools, along with rising income inequality, has most likely prevented society from achieving the full benefit of the significant gains in financial parity across schools in terms of improved outcomes and decreased disparities in test scores.
From page 129...
... without special health care needs have a medical home; this includes 36 percent of Latinx adolescents, 40 percent of Black adolescents, and 60 percent of White adolescents. Income level also impacts whether any child (ages 0 to 17)
From page 130...
... Although non-criminal, these behaviors, known as "status offenses,"18 are often the primary mechanism by which youth in the child welfare system "crossover" into the juvenile justice system. Adolescents that engage in status offenses often have higher rates of mental health and substance abuse disorders, and abuse and neglect during childhood have also been found to be highly predictive of committing status offenses (Herz and Ryan, 2008a)
From page 131...
... . Chapter 8, which addresses adolescents in the child welfare system, explores how the system's processes affect adolescent outcomes in greater detail.
From page 132...
... Bias among peers and families might also affect adolescent outcomes and explain disparities; Box 4-4 discusses the impact of family or peer acceptance and support of LGBTQ adolescents. Researchers have also hypothesized that exposure to discrimination results in worse physical health, moderated by higher levels of stress as measured by elevated cortisol.22 Consistent with this, Russell and colleagues (2012)
From page 133...
... . LGBTQ youth who report higher rates of family acceptance have greater self-esteem, social support, and better general health status than those who report lower rates of ­amily ­ cceptance.
From page 134...
... found that unequal treatment based on race, ethnicity, gender, sexuality, or disability status results in disparate outcomes for children, as out-of-school suspensions are highly predictive of future involvement with the criminal justice system and reduced educational achievement.24 Recent initiatives have sought to reduce the suspensions and expulsions of youth of color from schools, but to date these initiatives have been small in scope.25 (See also Chapter 9, Box 9-2, "Relationship Between School Disciplinary Policies and the Juvenile Justice System.") Health Care Professionals Health care professionals have also been found to treat adolescents from different social and racial/ethnic groups differently (Valenzuela and Smith, 2015)
From page 135...
... Justice System Actors The area in which disparate treatment of adolescents has received the most public attention is the criminal and juvenile justice systems. As of 2013, Black adolescents were four times more likely to be committed to residential placements as White adolescents, Native Americans were three times as likely, and Latinx adolescents were 61 percent more likely (Rovner, 2016)
From page 136...
... Residential facilities include detention centers, shelters, reception/diagnostic centers, group homes, boot camps, ranch/wilderness camps, residential treatment centers, and long-term secure facilities. Rates are calculated per 100,000 juveniles ages 10 through the upper age of each state's ­uvenile court jurisdiction.
From page 137...
... and the Earned Income Tax Credit (EITC) , have been found to reduce child poverty and improve child and adult outcomes (NASEM, 2019)
From page 138...
... . To help young people thrive in the face of adversity, interventions can be developed to further capitalize on the unique characteristics of the population of interest and the protective factors associated with healthy outcomes for that particular group (Zolkoski and Bullock, 2012)
From page 139...
... found that more generous EITC payments lead to a greater number of youth in low-income families attending college. Further expanding the EITC could decrease child poverty rates by up to 2.1 percent, lifting 1.5 million children and youth out of poverty, according to the Reducing Child Poverty report (NASEM, 2019)
From page 140...
... By reducing child poverty, society can make a timely long-term investment to overcome the inequities faced by adolescents from low-income families and unleash new opportunities. Addressing Differential Exposure to Violence and Trauma Research from across disciplines has highlighted the potential impact of trauma on all aspects of an adolescent's development and functioning and recognized that in many different settings it is essential that those who encounter adolescents routinely understand how trauma may be manifested in the particular context of the encounters.
From page 141...
... In systems that work with adolescent populations that are dispropor tionately affected by trauma -- child welfare and juvenile justice -- there is an emerging literature on the implementation of trauma-informed approaches. For example, Ford and Blaustein (2013)
From page 142...
... have called for bringing a trauma-informed lens to the child welfare system. Noting that foster care youth commonly experience complex trauma as a result of family-of-origin maltreatment and separations from their families, youth involved in the study identified strategies for supporting children in foster care and reducing trauma before, during, and after foster care placement.
From page 143...
... Although to date, predictive analytic tools have primarily been used to help inform initial investigations and subsequent placement decisions during childhood, there is potential for historical data and predictive analytic tools to be incorporated as one source of data in determining optimal services and treatments for adolescents in the child welfare system as well as in other systems. For example, in tandem with caseworker and adolescent judgement, machine-learning techniques could be refined to identify clusters of risk and protective factors that would increase the likelihood that a specific service or intervention might benefit a particular adolescent.
From page 144...
... Disparities in adolescent outcomes by income, race and ethnicity, and gender will continue to translate into inequality in future adult outcomes, including, but not limited to, employment, criminal justice involvement, and health, unless significant steps are taken to reduce them. Addressing disparities in adolescent outcomes will require multipronged and multilevel interventions, as the differences in opportunity are both complex and interwoven.
From page 145...
... These trends underscore the hope that with additional effort and a comprehensive approach, further reductions in outcome disparities among adolescents are indeed attainable. Finally, while the focus of this chapter has been to provide a context for understanding various disparities in adolescent outcomes, existing research also highlights the importance of identifying and promoting resilience and strength among those traditionally considered disadvantaged or at-risk (Task Force Report on Resilience and Strength in African-American Children and Adolescents, n.d.)


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