Good Practices
'Socio-economic Situation as Risk/Protective Factor'
A body of international research shows that the general health status of a society is heavily influenced by the social, educational and economic circumstances of its people. General educational levels and income levels are major factors influencing the health of a population. Gaps in income between the rich and poor also play a role - that is, societies where the gap is small tend to be healthier than societies where it is larger. Although the relationship between these "determinants of health" and substance use problems needs more investigation, it may well be that these factors do have an affect on the use of substances by young people.
Another way of looking at income and education is to see them as major protective factors. There is some debate about whether to focus on protective or risk factors when trying to prevent substance abuse among youth. For most youth in difficult situations, there doesn't seem to be much debate. Street youth indicate that basic needs such as food and stable housing are their priorities, while job training, educational upgrading and personal counselling are also important. Youth groups in developing countries often include Income Generating Programmes (IGPs) in their prevention work.
A 2002 study of about 5,000 inner city youth in the US adds to this evidence. These youth were asked which factors would increase their ability to have a positive future. The study was interesting not only because of the results, but because of the way it was designed. The study used a highly participatory method of involving the young people and benefiting from their perspective:
Stage 1: Students in focus groups discussed and came up with the overall research question: What is it that would most influence their ability to succeed?;
Stage 2: Students brainstormed a list of possible responses;
Stage 3: Students were surveyed and asked to rank the factors;
Stage 4: Students in focus groups explained and interpreted the results.
The results of the study were clear. These young people, when asked what could be done to make their future more positive, indicated that more jobs, more education and more scholarships for teenagers were most important - much more so than prevention programmes focusing on risky behaviours (like drug abuse).
Does this make sense to you? What do you think this means for prevention programmes. Should programmes be spending more time on these kinds of protective factors and maybe less time educating people on the risks of drug use?
Main Reference:
Kenneth G., et al. "Enhancing Their Likelihood for a Positive Future: The Perspective of Inner City Youth", Pediatrics, Vol. 109: 1136-1143, 2002. http://www.pediatrics.org/cgi/reprint/109/6/e95.pdf
Other References:
Deaton, A. "Policy Implications of the Gradient of Health and Wealth", Health Affairs, Vol. 21(2), 2002.
Evans, R. et al. (eds.). "Why Are Some People Healthy and Others Not? The Determinants of Health of Populations", New York, NY: Aldine De Gruyter, 1994.
Anderson, J. "A Study of Out-of-the-Mainstream Youth in Halifax, Nova Scotia", Ottawa: Minister of Supply and Services, 1993.
Smart, R.G., Adlaf, E.M., Walsh, G.W. et al. "Drifting and Doing: Changes in Drug Use Among Toronto Street Youth, 1990-1992", Toronto: Addiction Research Foundation, 1992.
Gary Roberts, Senior Associate
Canadian Centre on Substance Abuse
Phone: 613-235-4048-225/613-829-3152(home)
Fax: 613-235-8101/613-829-3307(home)
Email:groberts@ccsa.ca
Web: http://www.ccsa.ca