How to Improve the Health of American Adolescents

Abstract

The major threats to the health of American teenagers are behavioral—risky and reckless things adolescents do that threaten their well-being and that of others. The primary approach to preventing adolescent risk taking has been classroom-based health education. Yet, most systematic research indicates that even the best programs are successful mainly at changing adolescents’ knowledge but not in altering their behavior. Research on adolescent brain development has revolutionized our understanding of this stage of life, but our approach to deterring adolescent risk taking remains grounded in old, antiquated, and erroneous views of the period. Classroom-based health education is an uphill battle against evolution and endocrinology, and it is not a fight we are likely to win. Instead of trying to change teenagers into something they are not, we should try to reduce the risks they are exposed to. We should spend less money and effort trying to influence how adolescents think, and focus more on limiting opportunities for their inherently immature judgment to hurt themselves or others. Although there is evidence that some programs aimed at strengthening adolescents’ self-regulation may also deter risky behavior, our public health policies should emphasize changing the context in which adolescents live, rather than solely attempting to change adolescents themselves.