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Articles: An alarming number of children in America can’t afford food

Experts say many people that are ‘food insecure’ work low-paid jobs, yet still don’t qualify as SNAP recipients
https://www.marketwatch.com/story/this-is-the-alarming-number-of-children-in-america-who-cant-afford-food-2019-05-01
By: Jeanette Settembre
Published: May 2, 2019 4:53 p.m. ET

Millions of Americans don’t have enough money to buy healthy food –– and kids are most at risk.

A staggering 97% of counties in the U.S. are home to people who can’t afford or don’t have access to healthy food, according to a study released Wednesday by Feeding America, a Chicago-based nonprofit organization that has a network of more than 200 food banks nationwide.

Out of America’s 3,142 counties, the rates of food insecurity range from 3% in Steele County, N.D., to as much as 36% in Jefferson County, Miss., the report found. And children are suffering the most: One in six kids (or 12.5 million children) are considered to be food insecure, and an estimated 750,000 live in New York City and Los Angeles.

These families are more likely to live in disadvantaged urban areas and also southern U.S. states –– areas with “food deserts” that don’t have easy access to healthy food. Experts say many families that are “food insecure” often work low-paid jobs to pay for rent and utilities, and other expenses like school supplies for their children. They may have little left over for healthy food, but may not always qualify for SNAP (Supplemental Nutrition Assistance Program), formerly known as food stamps.

Approximately 12.5 million children in the U.S. are considered ‘food insecure,’ and an estimated 750,000 of them live in New York City and Los Angeles.

Mississippi is the state with the highest rate of food insecurity (19.2%) or the state with the least access to food; followed by Arkansas with 17.3%; Louisiana with 16.5%; Alabama with 16.3%; Oklahoma with 15.8%; New Mexico with 15.5%; Texas with 14.9%; and Georgia with 14.4%.

The national cost on average of a meal was $3.02 in 2017, down from $3.06 in 2016, according to the study. That said, 43% of counties in the U.S. have meal costs that are higher than the national average, with some costing nearly double. The average cost of a meal on the West Coast is $3.27 and $3.32 in the Northeast.

The South is where 87% of people live in food deserts. These are areas that typically have low-income residents and where many of those who are food insecure live, according to the most recent study. Without access to healthy food, people tend to eat cheaper, less nutritious meals that can negatively impact health leading to illnesses like diabetes, the authors explained.

Of those people living in counties where healthy food is scarce, 29% are not eligible for most federal nutrition assistance programs. To be eligible for SNAP benefits, a household’s gross monthly income must be at or below 130% of the federal poverty level. So for a three person family, that would be $2,213 a month, or around $26,600 a year.

Without access to healthy food, people tend to eat cheaper, less nutritious meals that can negatively impact health leading to illnesses like diabetes.

SNAP benefits can buy any food product aside from beer, wine, liquor, cigarettes, tobacco or any nonfood items like vitamins and medicines, which are exempt. The benefits are strictly for food meant to be eaten or prepared at home –– so items that are prepared in store and hot foods aren’t included, though items like fresh fruit, and snacks like pretzels and ice cream are covered at some convenient stores.

The number of authorized SNAP retailers increased by 4% between 2013 and 2017, and more than 80% of SNAP benefits are spent at big-box stores and supermarkets, according to the Center on Budget and Policy Priorities.

For the first time, the U.S. Department of Agriculture gave retailers the green-light to allow people to use SNAP benefits to shop for food online. SNAP participants can spend their benefits at any retailer that accepts electronic benefit transfer (EBT) cards.

Last month, the USDA announced a two-year pilot program, now live in New York state, at grocery retailers Walmart, Amazon and ShopRite. The pilot program will eventually expand into other parts of New York along with Iowa, Alabama, Maryland, Nebraska, New Jersey, Oregon and Washington.

People who receive SNAP will be able to order groceries from Walmart WMT, -0.68% online to get in-store pick up or delivery. And AmazonFresh AMZN, -1.62% and Prime Pantry is not charging a membership fee for SNAP recipients, the company said in a blog post. To access the portal, users can create an Amazon account or sign in and type in their SNAP EBT card number. Only New York cards are accepted at this time.

In counties where healthy food is scarce, 29% are not eligible for most federal nutrition assistance programs like SNAP, formerly known as food stamps.

However, some worker advocates have criticized Walmart and Amazon’s move to cater to more SNAP recipients. The new access to online shopping will allow these companies to tap into the SNAP market profiting off of lower-income families, many of whom work at their stores.

For SNAP parents who are stuck in low-paid jobs and their children, that’s something of a Catch 22.

Walmart is the No. 1 employer of SNAP recipients in Arizona, Kansas, Ohio, Washington and Pennsylvania, and thousands of low-wage Amazon employees are on food stamps, according to an April 2018 report from Newfoodeconomy.org. Amazon raised its minimum wage to $15 an hour for all U.S. employees in November 2018 after criticism over low pay and poor working conditions.

Amazon disputes those findings. “We encourage anyone to compare our median pay and benefits to other retailers,” Lori Torgerson, a spokeswoman for Amazon told MarketWatch in an email. “Amazon increased our starting minimum wage for all full-time associates to $15 per hour.”

“This compensation is in addition to our benefits package that includes comprehensive health, vision and dental insurance, retirement, generous parental leave and training for in-demand jobs through our Career Choice program,” she added.

Amazon could not confirm whether there are fewer Amazon employees receiving SNAP benefits since it upped its minimum wage last year.

The new access to online shopping will allow Amazon and Walmart to tap into more low-income families that use SNAP, many of whom work at their stores.

Walmart, the world’s largest retailer, pays entry-level workers $11 an hour. When asked for comment regarding criticism about providing a new online service for SNAP recipients instead of paying low wage workers more, a spokeswoman for Walmart said: “We think services like grocery pick-up should be available to everyone, regardless of income or individual circumstances. It’s pretty shocking to hear that someone would disagree with that.”

Catering to SNAP participants is not a new strategy: Major retailers like Walmart, Sam’s Club, Costco COST, -0.96% and brands like Kroger KR, -0.82% Kmart and Albertson’s have allowed SNAP recipients to buy goods with their EBT cards for years.

“This move was an inevitable extension of the SNAP market,” Michele Simon, a public health attorney and author of “Food Stamps: Follow the Money,” told MarketWatch. “There’s a lot of money here. If retailers can encourage more SNAP spending they’re going to look for ways to do that.”

But since Congress does not require data collection on SNAP product purchases, it’s unclear what kinds of foods are being bought and exactly how much retailers are making off the $63 million SNAP market.

Trying to get government data on the nation’s food assistance program has been an eight year quest for South Dakota’s Argus Leader, leading to an ongoing Supreme Court case hearing with supermarket trade association arguing against the release of information.

“We don’t even know how these taxpayer dollars are being spent,” Simon said. “Is this really the best thing for public health? Or is it making it easier for people to buy soda, chips and junk and food?”

Article: School Grades Trigger Family Violence

By Melissa Bright
April 30, 2019


In elementary school, I was typically excited for report cards to come out. I knew my grades were good–which would earn me a reward from my parents–and any notes about my behavior would be neutral at worst. I didn’t realize that for some of my peers, bringing this piece of paper home would be a completely different experience.

Fast-forward a few decades, and I’ve started to learn how my peers’ experiences may have differed. A colleague of mine, a pediatrician, explained to me that he and many of his peers, as well as many K-12 teachers, believe that for some children, report cards result in punishment so severe that it turns into physical abuse. It turns out that this idea has been around for some time. I doubted my colleague. But he was right.

To test his theory, my colleague and I, along with the rest of our research team, conducted a study of all calls to a statewide child abuse hotline for a single academic year. We then narrowed the data to just calls for children aged 5-11 years and calls that were later investigated and verified physical abuse. Next, our team integrated the dates of report card release (typically 4 per year) for each school district. We found that there was more than a two-fold increase in the risk of a child physical abuse report on a Saturday when report cards were released on a Friday.

Our study has inspired several new questions around the timing of report cards and physical abuse.

That is all we can say definitely from the study. We cannot say why this link appears on a Friday but not on other days and we cannot say why there is a link. But we do have some thoughts based on the current scientific literature and anecdotal cases from expert clinicians. We believe that we observed a link between school report cards and physical abuse because these report cards were poor. Parents responded to these report cards with corporal punishment, and this corporal punishment crossed the line to physical abuse.

Corporal punishment is broadly defined as using physical force to correct or control a child’s behavior. Corporal punishment is legal in the US, common practice among parents of young children, and effective at stopping unwanted behavior in the short-term (e.g., eliminating a behavior for 10 minutes or less). The practical line between corporal punishment and physical abuse is gray and the legal line differs between states. As a result, corporal punishment can quickly turn to physical abuse.

Corporal punishment is associated with poor academic achievement, emotional and behavioral problems, and conduct disorders. It is not effective at changing behavior long-term, including improving academic performance or reducing poor behavior in school. Numerous expert psychologists and pediatricians have written extensively on the evidence against using corporal punishment.

Our study has inspired several new questions around the timing of report cards and physical abuse. In a series of studies, our next steps will be to measure these assumed middle steps–bad report cards beget corporal punishment which leads to abuse – and to gain systematic feedback from experts in the field. We are anxious to hear from teachers, pediatricians, administrators, parents, and children about their experiences about report cards. Understanding the details of the problem, and then generating ideas for tackling it are key to developing prevention strategies.

Leadership Program: Summer Leadership Institute for School and Public Health Nurses

By Andree EntezariApril 11th, 2019in SHIELD Updates

 

 

 

Boston University School of Public Health’s Population Health Exchange (PHX) and the School Health Institute for Education and Leadership Development (SHIELD) are collaborating to offer our second annual Leadership Program for School and Public Health Nurses beginning in June, continuing through the year*, and culminating with an advanced leadership  program the following summer.
Course topics are tailored to learners and may include:

  • Developing Your Leadership Strengths
  • Communicating for Impact
  • Using the Power of Data to Tell a Story (Story Mapping)
  • Community Assessments w/ an Emphasis on Equity

*The team will meet for four additional workshops and a culminating event over the course of the year
In addition to providing deep learning opportunities in leadership, this program provides the skills needed to assess for, and effectively communicate about, a community health disparity to initiate change.

Audience: School and Public Health Nurses

Fee: $1,000 for summer workshop;$2500 for full year **NEW! Due to a generous private scholarship donation, we are able to offer a 40% discount to the first 20 registrants. $600 for summer workshop;

$1500 for full year

Location: Boston University, Charles River Campus

Housing (optional): Shared apartment style suites (private bedrooms, kitchen living rooms) are available on campus for $72/day (see attached brochure).
Registration: https://populationhealthexchange.org/learning-opportunities/summer-institute/leadership-institute-s19/ 

Course limited to 30 participants.

Continuing Nursing Education Provider Unit, Boston University School of Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation

SHIELD is a DESE approved provider of Professional Development

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Event: Exploring Our Role in Creating a More Just World for Youth

By Andree EntezariApril 1st, 2019in SHIELD Updates

Professionals, volunteers, activists, and community members that work or interact with youth are invited to come together to explore and grow their role in creating a just world for youth. This conference will offer various workshops that use positive youth development approaches to improve health. This conference is intentionally being held for an adult audience.

Event: ‘Nurses Are with You at Every Step of Life’

By Andree EntezariApril 1st, 2019in SHIELD Updates

Posted: March 28th, 2019
Link: https://www.bu.edu/sph/2019/03/28/nurses-are-with-you-at-every-step-of-life/

As the largest group within the healthcare profession, nurses operate as the primary link between the healthcare system and the patients and communities they serve. From traditional RNs to advanced practice registered nurses, the role of nurses has expanded due to an aging population and an evolving healthcare system, both in the United States and abroad. They are involved in every aspect of patient care as they work to preserve and promote health across all patient populations.

On Tuesday, April 2, the School of Public Health will hold the Dean’s Symposium, “Nursing and the Health of Populations,” to examine the current state of nursing science and practice, and explore how nurses can continue to impact global population health. The event will feature a keynote speech by Barbara Stillwell, executive director of Nursing Now and a veteran leader in international health workforce issues and health worker migration. Stillwell is heralded for introducing the nurse practitioner role in general practice in the UK.

The symposium will also feature a panel of nursing experts in clinical, administrative, academic, and policy roles, including Jacqueline Fawcett (SON’64), professor of nursing at the College of Nursing and Health Science at University of Massachusetts Boston; Karen Daley (SPH’88), former president of the American Nurses Association; Kelley Brittain, associate professor at Michigan State University College of Nursing; Kate Lorig (SON’64), professor emerita of immunology and rheumatology at Stanford University; and Deborah Washington, director of diversity for patient care services at Massachusetts General Hospital. The panel discussion will be moderated by Maureen Bisognano, president emerita and senior fellow of the Institute for Healthcare Improvement.

Ahead of the event, Stilwell and Bisognano spoke about the expanding role of nurses and the impact of their work on global population health.

In which way has the role of nurses in the healthcare system changed most significantly in the past 10 years, and what are the best skills to have as a nurse?

BISOGNANO: I’ve met a nurse in Sweden who partnered with a young man to teach him self-care in doing hemodialysis and together, they developed a new way of co-producing care that results in better health for chronic dialysis patients across the county of Jonkoping. This nurse has joined with the patient to spread this model across Sweden, and now around the world. Seeing them teaching a nephrologist in Texas this new way really demonstrates the shift in hierarchy and bureaucracy when nurses take the lead in design.

The skills of nurses are so well recognized. Nurses demonstrate the three skills I consider most critical to our mission today. I value IQ and nursing research is adding to our clinical knowledge every day. Nursing education is adapting to include all new methods of building clinical and scientific skills for students and continuing learners. And nurses show EQemotional quotientand empathy. Every day, I meet patients and family members who tell me that nurses’ empathy meant so much at a critical time in their lives. And nurses are always champions of CQcuriosity quotient. Nurses have taken a challenge I gave several years ago, and have spread a campaign to ask patients not only “what’s the matter?” but also, “what matters to you?” The campaign has spread to over 35 countries and impacts thousands of organizations, patients, and families, and interestingly, has a positive impact on joy within the nursing workforce.

STILWELL: Many ofour Nursing Now groups, now in over 80 countries, are keen to try developing Advanced Nursing Practice in a number of care settings. I think this reflects the way that healthcare is changing overall, with a much greater use of technology and sophisticated medicines shifting the pattern of caregiving so that nurses take on more responsibility for leading and coordinating the overall care of a patient.

While we all appreciate the great strides in medicine that keep us alive longer and cure our ills, we still need to understand what is happening to us, and nurses can provide that bridgenot separately from other providers, but as the advocate and interpreter for the patient. Nurses and midwives are with you at every step of life: midwives see you into the world and nurses care for you as you leave it.

Nursing care is cost-effectiveso investing in nursing is smart. A nursing workforce has great clinical skills, as well as the ability to practice the art of nursingbringing it all together with the patient at the center. This is where the IQ, EQ and CQs all come in so powerfully. They create the influential leaders who listen to the team, digest the information, feedback what they hear and plan a pathway of care with the patient.

How has information and communication technology transformed nursing practices and improved patient outcomes?

BISOGNANO: Nurses in Sao Paulo, Brazil have worked with technical experts to design new artificial intelligence and machine learning systems to improve patient flow and to reduce complications. The impact of new technologies, designed with nurses, is making a huge difference in care and caring.

STILWELL: The potential to use technology to get just-in-time advice is huge. It is possible to take X-rays and get them read, take pictures of injuries and skin conditions and send them for specialist opinion, or ask for help. This can transform care with nurses taking the lead backed up by a team at a distance.

And we now have the possibility of collecting and using big data to show the patterns of nursing care. Nursing Now is working with the University of Edinburgh on innovative ways that we can support nurses to collect data and use it in dialogue with policy makers to improve decision-making.

There is currently a global shortage of nurses. How can the industry retain and attract more people to this profession?

BISOGNANO: This is the first time in history we have had five distinct generations in the nursing workforce. We need more nurses entering the workforce and need new ways to engage nurses to stay. I believe we need new ways to lead that recognize the assets and drivers of each generation, including ways to demonstrate regularly the meaning and impact of this work to the nurses providing the care. Young nurses need a mentor who will work with them to build a plan to develop new skills, every year. They have a strong expectation that each year will bring opportunities for new ways to work. I think each nurse needs several “stay interviews” each year rather than an “exit interview” as they seek new opportunities.

STILWELL: Nursing remains a gendered professionpredominantly women, with men often not viewing it as a profession for them. In many countries, this gender effect lowers the status of nurses and nursing. Nursing Now carried out a global survey recently with questions about women nurses and leadership. Survey respondents were asked to rank the top five out of twelve items they felt would interest them in staying in the profession in a higher-level nursing job. The following items were ranked most often in the top five requests: having equipment and resources to perform the job (47%), leadership training (45.3%), good and fair salary (45%), having clear decision-making guidelines (38%), and decision-making support from senior management (35%). These are great signposts for us as we try to recruit and retain nursesthey are not rocket science, but surprisingly often overlooked.

What can be done to increase diversity and inclusion in nursing?

BISOGNANO: Recruiting a more diverse nursing workforce will require us to expand the public image of who is a nurse. We can use many ways to send this message, including sharing stories  on social media and including examples in films and books. We’ll need to focus recruitment in the field, where these people live today. I visited recently the Frontier Nursing University in Kentucky, and was amazed at how effective this university is in recruiting nursing and midwifery students from very rural parts of the country, and in using electronic education to keep these students connected to their home sites. We can have a diverse group of young nurses visiting schools, as they are doing in England, to change the face of nursing for the young. It’s a vital need for us to expand the diversity of our teams.

STILWELL: In some places, we need to be careful to recruit nurses from the populations that are under-represented, by going into schools and colleges and having nursing schools in places that are easy for students to access. As we get better with distance education, it will be possible to create more innovative ways of education delivery that will open opportunities for those who might not be able to otherwise access education.

Jillian McKoy

Link to BUSPH Post: https://www.bu.edu/sph/2019/03/28/nurses-are-with-you-at-every-step-of-life/

 

Webinar: Trauma Informed Care

By Andree EntezariMarch 8th, 2019in SHIELD Updates

We are very excited to invite you to our two part series on Trauma-Informed Care to Support Health and Well-Being for Community Health Workers.

Part 1 of the webinar series will be held on Tuesday, April 16, from 12:00-1:00pm ET.  It answers the question: How common are trauma experiences and how do they effect the lives of those they touch?  At the end of the webinar, participants will be able to:

 

  • Describe the “dose effect” findings of the ACES study. 
  • Identify 3 neurobiological effects of toxic stress and trauma can affect the lives of children and adults. 
  • Identify 3 of the long-term consequences of unaddressed trauma.

Part 2 of the webinar series will be held on Tuesday, April 23, from 12:00-1:00pm ET. It answers the question: What can you do to help adult survivors avoid the long term consequences of trauma? At the end of the webinar, participants will be able to:

 

  • Describe the ways in which trauma manifests in adult as adaptations for survival.
  • describe the 3 brief interventions that they can use to support individuals to support healing from trauma and build resilience. 
  • Participants will be able to identify 3 signs of burnout/vicarious trauma in themselves and others.

The webinar subject matter expert is Kristal Cleaver, LICSW, Director of Community Education, Clinical & Support Options, Inc. Kristal Cleaver is a Licensed Independent Clinical Social Worker who has had the privilege of watching resilience in action in lives of the children and adults she has worked with over the last 15 years. Throughout her career Kristal has strived to integrate a trauma informed philosophy into her work. In her current role as CSO’s Director of Community Education she trains and consults with schools, government agencies, and non-profits to help them establish trauma awareness and responsiveness within their organizations.

NEPHTC looks forward to welcoming you online.

Register for both webinars here

Event: Empower~Innovate~Cultivate~Change

By Andree EntezariFebruary 26th, 2019in SHIELD Updates

Join us for nurses week!

Indulge yourself mind, body and spirit.  Let us pamper you with breakfast and lunch, motivational speakers, experiential Yoga sets to reset your nervous system. Raffles and shopping too.  Top it off with contact hours to complete the day.  Let us fill your cup.

Only $99 for the general public.

New This Year!
T-shirts - order your BMC Integrative Nursing t-shirt. They are blue, shortsleeve and cost $20.  You can pre-order on the website and pick it up at the conference.

Poster Session Submit a poster on your institution's latest integrative nursing techniques.  For more information, click here

Presented by:
Boston Medical Center Integrative Nursing Council

Sponsored by:
Sponsored by the Anna Ross Committee of the Massachusetts Memorial Hospital Nurses’ Alumnae, Inc. and the Boston Medical Center Nursing Department.

Julianne Benvie, RN, BSN
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Erin Taylor, DNP, MSN, RN, CNOR
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Vicky Dennis,
MBA, MSN, RN, CPNP(c)
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Rebecca Love, RN, BS, MSN
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Jeff Jones
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Margaret “Peg” Baim, MS,
ANP-BC
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Leslie Salmon Jones
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Accreditation
The application to award contact hours has been submitted to Boston Medical Center. Boston Medical Center is an approved provider of continuing nursing education by American Nurses Association, Massachusetts, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
This program is supported by the Anna Ross Committee of the Massachusetts Memorial Hospital Nurses’ Alumnae, Inc. Faculty and planners have no vested interests, and there are no conflicts of interest. There will be no discussion of off label uses of drugs.

Research: US Teens Anxiety and Depression

By Andree EntezariFebruary 26th, 2019in SHIELD Updates

For boys and girls, day-to-day experiences and future aspirations vary in key ways

Link: https://www.pewsocialtrends.org/2019/02/20/methodology-19/
Date: February 20th, 2019

(Getty Images)

Anxiety and depression top list of problems teens see among their peersAnxiety and depression are on the riseamong America’s youth and, whether they personally suffer from these conditions or not, seven-in-ten teens today see them as major problems among their peers. Concern about mental health cuts across gender, racial and socio-economic lines, with roughly equal shares of teens across demographic groups saying it is a significant issue in their community.

Fewer teens, though still substantial shares, voice concern over bullying, drug addiction and alcohol consumption. More than four-in-ten say these are major problems affecting people their age in the area where they live, according to a Pew Research Center survey of U.S. teens ages 13 to 17.

When it comes to the pressures teens face, academics tops the list: 61% of teens say they feel a lot of pressure to get good grades. By comparison, about three-in-ten say they feel a lot of pressure to look good (29%) and to fit in socially (28%), while roughly one-in-five feel similarly pressured to be involved in extracurricular activities and to be good at sports (21% each). And while about half of teens see drug addiction and alcohol consumption as major problems among people their age, fewer than one-in-ten say they personally feel a lot of pressure to use drugs (4%) or to drink alcohol (6%).

The pressure teens feel to do well in school is tied at least in part to their post-graduation goals. About six-in-ten teens (59%) say they plan to attend a four-year college after they finish high school, and these teens are more likely than those who have other plans to say they face a lot of pressure to get good grades.

Boys’ and girls’ goals and experiences differ in some key waysGirls are more likely than boys to say they plan to attend a four-year college (68% vs. 51%, respectively), and they’re also more likely to say they worry a lot about getting into the school of their choice (37% vs. 26%). Current patterns in college enrollment among 18- to 20-year-olds who are no longer in high school reflect these gender dynamics. In 2017, 64% of women in this age group who were no longer in high school were enrolled in college (including two- and four-year colleges), compared with 55% of their male counterparts.

Boys are more likely than girls to prioritize having a lot of money as adultsIn many ways, however, the long-term goals of boys and girls don’t differ significantly. About nine-in-ten or more in each group say having a job or career they enjoy would be extremely or very important to them as an adult (97% of girls and 93% of boys say this). And similar shares of girls and boys see getting married (45% and 50%, respectively) and having children (41% and 39%) as priorities for them, personally, when they grow up. Still, boys are considerably more likely than girls to say having a lot of money would be extremely or very important to them (61% vs. 41%).

While boys and girls face many of the same pressures – for example, they’re about equally likely to say they feel pressure to get good grades – their daily experiences differ in other ways. Girls are more likely than boys to say they face a lot of pressure to look good: About a third of girls (35%) say this is the case, compared with 23% of boys. And a larger share of girls than boys say they often feel tense or nervous about their day (36% vs. 23%, respectively, say they feel this way every day or almost every day). At the same time, girls are more likely to say they regularly get excited about something they study at school: 33% of girls say this happens every day or almost every day, versus 21% of boys. And while small shares of girls (7%) and boys (5%) say they get in trouble at school daily or almost daily, girls are more likely than boys to say this never happens to them (48% vs. 33%).

Teens in higher-income households are more likely to say they plan to go to college, less worried about family financesIn addition to these gender differences, the survey also finds some differences in the experiences and aspirations of teens across income groups. About seven-in-ten teens in households with annual incomes of $75,000 or more (72%) say they plan to attend a four-year college after they finish high school; 52% of those in households with incomes between $30,000 and $74,999 and 42% in households with incomes below $30,000 say the same. Among teens who plan to attend a four-year college, those in households with incomes below $75,000 express far more concern than those with higher incomes about being able to afford college.

Mental health concerns cross income boundaries, but teen pregnancy is seen as a much bigger problem by teens from lower-income householdsAnd while a relatively small share of teens overall say they face a lot of pressure to help their family financially, teens in lower-income households are more likely to say they face at least somepressure in this regard.

There are also differences by household income in the problems teens say exist in their communities. Teens in lower-income households are more likely to say teen pregnancy is a major problem among people their age in the area where they live: 55% of teens in households with incomes below $30,000 say this, versus 38% of those in the middle-income group and an even smaller share (22%) of those in households with incomes of $75,000 or more. Compared with teens in the higher-income group, those in households with incomes below $30,000 are also more likely to cite bullying, drug addiction, poverty and gangs as major problems.

A note on racial and ethnic differences among teens

The survey suggests that, in some ways, the attitudes and experiences of teens may vary along racial and ethnic lines. However, because of small sample sizes and a reduction in precision due to weighting, estimates are not presented by racial or ethnic groups.

Teens in lower-income households also have different assessments of the amount of time they spend with their parents. Four-in-ten teens in households with incomes below $30,000 say they spend too little time with their parents, compared with about one-in-five teens in households with higher incomes.

These are among the key findings of a survey of 920 U.S. teens ages 13 to 17 conducted online Sept. 17-Nov. 25, 2018.1 Throughout the report, “teens” refers to those ages 13 to 17.

A majority of teens say they plan to attend a four-year college after high school

Girls are more likely than boys to say they plan to go to collegeAbout six-in-ten teens (59%) say they plan to attend a four-year college after they finish high school; 12% plan to attend a two-year college, 5% plan to work full time, 4% plan to enroll in a technical or vocational school and 3% plan to join the military. Another 13% of teens say they are not sure what they’ll do after high school.

Girls are more likely than boys to say they plan to attend a four-year college after finishing high school: 68% of girls say this, compared with about half of boys (51%). Differences in the shares of boys and girls who say they plan to attend a two-year college, enroll in a technical or vocational school, work full time or join the military after high school are small or not significant.

Among teens with at least one parent with a bachelor’s degree or higher, as well as those in households with annual incomes of $75,000 or more, about seven-in-ten say they plan to attend a four-year college after high school. By comparison, about half of teens whose parents don’t have a bachelor’s degree or with household incomes below $75,000 say the same.

Some 65% of teens who say they plan to attend a four-year college after high school say they worry at least some about being able to afford college. Similarly, 70% express at least some concern about getting into the college of their choice.

Perhaps not surprisingly, concerns about affording college are more prevalent among teens in lower-income households. Among teens who say they plan to attend a four-year college, about three-quarters (76%) in households with incomes below $75,00o say they worry at least some about being able to afford it, compared with 55% of those in households with incomes or $75,000 or more.

Having a job or career they enjoy is at the top of teens’ long-term goals

Most teens say having a job or career they enjoy would be extremely important to them as adultsLooking ahead, virtually all teens say they aspire to having a job or career they enjoy: 63% say this would be extremely important to them, personally, as adults, and another 32% say it would be very important. Most teens also say helping other people who are in need would be extremely (42%) or very (39%) important to them when they grow up.

Teens give lower priority to marriage and kids. About half (47%) say getting married would be extremely or very important to them as adults, and 39% say the same about having children.

When it comes to fortune and fame, 51% of teens say having a lot of money would be extremely or very important to them, while relatively few (11%) say the same about becoming famous.

For the most part, boys and girls have similar aspirations. Roughly equal shares of boys and girls say getting married, having kids, and having a job or career they enjoy would be extremely or very important to them as adults. But boys (61%) are far more likely than girls (41%) to say having a lot of money when they grow up would be extremely or very important to them.

Teens in lower-income households are less likely than higher-income teens to prioritize marriage or childrenTeens’ aspirations are also fairly consistent across income levels, with similar shares in each income group saying having a job or career they enjoy, helping others in need, having a lot of money and becoming famous would be extremely or very important to them as adults.

However, teens in households with incomes below $30,000 are less likely than those in households with higher incomes to prioritize marriage and children. Some 56% of teens in households with incomes of $75,000 or more and 46% in households with incomes between $30,000 and $74,999 say getting married would be extremely or very important to them when they grow up, compared with 31% of those in the lower-income group. And while about four-in-ten in the higher- and middle-income groups (43% each) say having children would be extremely or very important to them, 27% of those in the lower-income group say the same.

Academics are at forefront of the pressures teen face

About six-in-ten teens say they feel a lot of pressure to get good gradesMost teens (61%) say they personally feel a lot of pressure to get good grades, and another 27% say they feel some pressure to do so.

Compared with getting good grades, about half as many say they feel a lot of pressure to look good (29%) and to fit in socially (28%). Roughly one-in-five say they face a lot of pressure to be involved in extracurricular activities and to be good at sports (21% each), while smaller shares say they feel a lot of pressure to help their family financially (13%), to participate in religious activities (8%), to be sexually active (8%), to drink alcohol (6%) or to use drugs (4%).

Boys and girls, as well as teens across income groups, generally feel similar levels of pressure in each of these realms, but there are some exceptions. Girls are more likely than boys to say they feel a lot of pressure to look good (35% vs. 23%). And teens in the lower- and middle-income groups are more likely than those in higher-income households to say they feel at least some pressure to help their family financially (42% and 38%, respectively, vs. 28%).

In some ways, teens’ day-to-day experiences vary by gender and income

About three-in-ten teens feel tense or nervous, wish they had more good friends almost dailyWhen asked how often they have certain experiences or feelings, four-in-ten teens say they feel bored every day or almost every day, while about three-in-ten say they feel tense or nervous about their day (29%) or wish they had more good friends (29%) with the same frequency. Roughly a quarter of teens say they get excited by something they study in school (26%), come across people who try to put them down (24%) or worry about their family having enough money for basic expenses (23%) every or almost every day.

Smaller shares say they regularly feel targeted by law enforcement (7%) or get in trouble at school (6%). In fact, 54% of teens say they never feel targeted by law enforcement, and 40% say they never get in trouble at school.

Concerns about their family having enough money for basic expenses differ greatly by income: 36% of teens in the lower-income group and 29% of those in the middle-income group say they worry about this daily or almost daily, whereas 13% of teens in higher-income households say the same.

Gender differences are also apparent, particularly when it comes to experiences in school. Girls are more likely than boys to say they get excited every or almost every day by something they study in school (33% vs. 21%), and they’re less likely to get in trouble at school. About half of girls (48%) say they never get in trouble at school, compared with 33% of boys. In addition, higher shares of girls than boys say they feel tense or nervous about their day on a daily or almost daily basis (36% vs. 23%).

Parents are more likely to say they don’t spend enough time with their teens than teens are to say the same about their parents

Four-in-ten teens in lower-income households say they spend too little time with their parentsWhen it comes to the amount of time they spend with each other, parents and teens diverge in their assessments, with parents far more likely to say it’s not enough. Among parents who live with their teens, 45% say they spend too little time with their teenage children; a quarter of teens say the same about the time they spend with their parents.2 Most teens (65%) say they spend the right amount of time with their parents, while 9% say they spend too much time.

Teens from lower-income households are the most likely to say they spend too little time with their parents: Four-in-ten teens in households with annual incomes below $30,000 say this, compared with roughly one-in-five in households with higher incomes. These same income differences are not evident among parents, however. Similar shares of parents across income levels say they spend too little time with their teenage children.

Among parents who live with their teens, fathers are more likely than mothers to say they spend too little time with their teenage children (53% vs. 39%).

Majority of teens say they get a hug or kiss from their parents almost daily

About three-in-ten teens say they get help from parents with schoolwork almost every dayWhen asked about interactions with their parents, about six-in-ten teens (59%) say they get a hug or kiss from their parents every day or almost every day. Roughly three-in-ten (31%) say they get help or advice from their parents with homework or school projects on a daily or almost daily basis, and 19% say they regularly get into arguments with their parents.

Girls and boys are about equally likely to say they get a hug or kiss from their parents every day or almost every day, as are teens from different socio-economic backgrounds.

The share of teens who say their parents help them with homework or school projects every day or almost every day is considerably lower than it was two decades ago. A Public Agenda survey conducted in 1996 found that, at that time, about half of teens (48%) reported daily or almost daily involvement from parents in their schoolwork.3

Acknowledgments

This report is a collaborative effort based on the input and analysis of the following individuals. Find related reports online at pewresearch.org/socialtrends

Kim Parker, Director, Social Trends Research
Juliana Horowitz, Associate Director, Research
Nikki Graf, Research Associate
Ruth Igielnik, Senior Researcher
Anna Brown, Research Analyst
Anthony Cilluffo, Research Assistant
Deja Thomas, Research Assistant
Claudia Deane, Vice President, Research
Jessica Pumphrey, Communications Associate
Michael Keegan, Information Graphics Designer
David Kent, Copy Editor
Travis Mitchell, Digital Producer

In addition, the project benefited greatly from the guidance of the Pew Research Center methodology team: Courtney Kennedy, Andrew Mercer, Nick Bertoni, Nick Hatley and Arnold Lau, and from feedback provided by the following Pew Research Center researchers: Philip Schwadel, Aaron Smith and Monica Anderson; and Amanda Lenhart, Deputy Director, Better Life Lab, New America.

Methodology

Teens survey methodology

The teens survey was conducted using the NORC AmeriSpeak panel. AmeriSpeak is a nationally representative, probability-based panel of the U.S. household population. Randomly selected U.S. households are sampled with a known, nonzero probability of selection from the NORC National Frame, and then contacted by U.S. mail and telephone. A subsample of nonresponding households is selected to receive additional, in-person follow-up from field interviewers. More details about the NORC AmeriSpeak panel methodology are available here.

This particular survey featured interviews with 920 teens ages 13 to 17. Interviews were conducted online and by telephone from Sept. 17 to Nov. 25, 2018. Of the 920 teens, 389 were sampled directly from NORC’s AmeriSpeak Teen Panel. These are teens living in empaneled households who have already agreed to participate in surveys and for whom parental consent has already been obtained. The remaining 531 teens came from a sample of AmeriSpeak households known to have at least one child ages 12 to 17. In these households, sampled adults were screened to confirm that they were the parent or guardian of a teen ages 13 to 17 and were asked to solicit the participation of their teen. Interviews are conducted in both English and Spanish.

The teens survey had a survey completion rate of 55% (920 completed interviews out of 1,683 screened eligible panelists for whom parental consent was granted). After accounting for nonresponse to the panel recruitment surveys, attrition, and nonresponse to the parental screener, the weighted cumulative response rate for the teens survey is 5%.

The AmeriSpeak teen sample was weighted in a multistep process that began with the panel base sampling weights that reflect each household’s probability of selection and the fact that some households are subsampled for in-person nonresponse follow-up. These household-level weights were then further adjusted for nonresponse and unknown eligibility. These household-level weights were passed on to all eligible adults in each participating household and further adjusted to correct for within-household nonresponse, and calibrated to match the U.S. Census Bureau’s Current Population Survey (CPS) on age, sex, education, race/Hispanic ethnicity, housing tenure, telephone status and census division to create the final panel weights.

Empaneled teens already belonging to the AmeriSpeak Teen Panel received the same weight as their parent. For the 389 who completed the survey, a nonresponse ratio adjustment was performed using the teen’s age, gender, race/ethnicity, and their parents’ highest level of education.

For parents who completed the screener and consented to their child’s participation, a ratio adjustment was performed using the parents’ age, gender, race/ethnicity, and education to correct for nonresponse and non-consent. This weight was then passed on to the eligible teen. For the 531 non-empaneled teens recruited through their parents, a final ratio adjustment based on their parents’ age, gender, race/ethnicity and education was performed.

Finally, the empaneled and non-empaneled teens were combined, and the data were raked to match the 2018 CPS March supplement with respect to age, gender, race/Hispanic ethnicity, census division, parents’ highest level of education and household size.

Sampling errors and statistical-significance tests take into account the effect of weighting. The following table shows the unweighted sample sizes and the error attributable to sampling that would be expected at the 95% level of confidence for different groups in the survey:

In addition to sampling error, one should bear in mind that question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of opinion polls.

Sample sizes and sampling errors for other subgroups are available upon request.

© Pew Research Center, 2019

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Article: Tool to Identify Adolescent Cigarette Smoking Risk

By Andree EntezariFebruary 22nd, 2019in SHIELD Updates

February 22, 2019
Link: https://www.publichealthpost.org/research/a-screening-tool-to-identify-adolescents-at-risk-of-cigarette-smoking-initiation/ 

Cigarette smoking typically begins in adolescence. The younger the age of initiation, the greater the risk of daily smoking, heavy cigarette consumption, nicotine dependence and difficulty quitting. Pediatricians and family practitioners are important sources of preventive counseling, but the lack of a screening tool to rapidly identify which adolescents need tobacco counseling is a major barrier in busy clinical practices.

My colleagues and I, at the Research Centre of the University of Montreal Hospital Centre in Montreal designed a new tool that quickly and accurately identifies adolescents at risk of starting to smoke in the next year. Our goal is to streamline counseling referrals for those who most need it.

We used data from the Nicotine Dependence in Teens (NDIT) study, which investigates the natural course of cigarette smoking in youth. The NDIT cohort includes 1,294 students initially recruited in 1999 at age 12-13 (grade 7) in ten Montreal-area high schools. Students completed in-class questionnaires every three months during the 10-month school year, from grade 7 to 11 (1999-2005), for a total of 20 cycles. In addition to information on cigarette smoking, they provided data on demographic characteristics, academic performance, smoking habits of family and peers, physical and mental health, weight, nicotine dependence, substance use, other lifestyle-related variables, and school and neighborhood smoking context.

Using state-of-the art artificial intelligence methods to select from among 58 known predictors of smoking initiation, we identified variables for inclusion in the screening tool.

A total of 370 adolescents began smoking during high school. Using state-of-the art artificial intelligence methods to select from among 58 known predictors of smoking initiation, we identified variables for inclusion in the screening tool. Adolescents need to respond to 12 questions including their age and alcohol consumption in order for us to be able to predict their risk of initiating smoking in the next year. The questionnaire includes questions on tobacco, such as whether the teen feels the need for a cigarette, whether they find it difficult not to smoke when others are smoking, and whether they have friends who smoke. The questionnaire contains two questions on self-esteem, one question on feeling hopeless about the future, and four stress questions focused on loneliness, weight, health problems, and relationships with siblings.

Each answer corresponds to a certain number of points which are summed to create a risk prediction for smoking initiation. Items associated with a reduced risk of smoking initiation were assigned negative points. Items associated with an increased risk of initiation were assigned positive points.

For example, the risk of initiation decreases with older age, worry about loneliness or health, and having high self-esteem. Consuming alcohol, worry about weight, and having friends who smoke increases the risk. We recommend that any young person with a positive score needs tobacco counseling. Since most variables included in this tool represent issues that can be addressed in preventive care, results can also guide physicians in how to counsel the youth identified as at-risk of becoming smokers.

A version of the tool is available online. This new screening tool shows good predictive properties, and takes only a minute to complete. Teens can easily do so while waiting to see their physician.

Feature image: imantsu/iStock

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