GENDER DIFFERENCES AND ADOLESCENT RISKS.

• Author: Davey, Judith

INTRODUCTION

This paper examines characteristics and behaviour that are construed as posing risks to the well-being of adolescents in New Zealand, concentrating on the differential incidence and impacts of these risks on males and females.

The term "at risk", applied to individuals, families and households or to larger sections of society, such as age or ethnic groups, has gained increasing currency in policy literature in New Zealand and elsewhere.(1) "Risk factors" are assumed to predispose an individual or group to some negative outcome and therefore to pose a threat to well-being. These factors may be personal characteristics (gender, race, intelligence or temperament) or external factors, inherent in the family, community, educational or peer group environment. They may also be choices relating to behaviour or lifestyle. Risk may be perceived in relation to a specific threat to well-being, such as susceptibility to an illness, or to a combined or cumulative set of risk factors, such as those which might lead to a "cycle of disadvantage". The concepts of "risk factors" and "at risk" status are complex and fluid. It is easy to over-simplify them and to assume linkages and causality, resulting in deterministic or prescriptive conclusions. Use of the concepts must also avoid the dangers of generalisation and stereotyping. Like the concept of poverty, risk may be assessed on a relative or on an absolute basis. Risk is potential -- it may or may not result in a negative outcome, so that an attempt can be made to assess and measure the level of risk inherent in any situation.

Bearing in mind the caveats expressed in the previous paragraph, this paper examines factors that may constitute risks to the well-being of adolescents in New Zealand. This group is defined as young people of secondary school age (13-17), although information from beyond this range is drawn in as relevant. Gender is highlighted in the analysis because it is clearly a major factor in social differentiation. This is not to imply that other characteristics, especially socioeconomic status and ethnicity, are irrelevant to patterns of risk. They also must be considered in analysis and in the development of policy.

The paper begins by presenting a typology of risk, listing factors commonly assumed to be associated with negative outcomes. It then reviews recent New Zealand research findings on a range of risk factors. It does not attempt to assess the proportions of young people at risk or to measure the degree or intensity of risk.

A TYPOLOGY OF RISK

Risks have been defined as threats to well-being, here considered on an individual basis. Well-being has many dimensions. It encompasses security: physical, psychological, social, and economic security. It also includes health in the widest meaning of the term -- mental, physical, social and spiritual health. Many threats to health and security arise from pathologies within the family, such as violence and abuse of various kinds, and in society - for example, crime victimisation. Others emanate from lifestyle choices -- smoking, alcohol and drug use, and dangerous behaviour. The high degree of injury and illness that is related to lifestyle highlights the interactions between health, well-being and social factors such as living arrangements, work status and income. Well-being is the result of real-world influences which are complex and interactive.

Table 1 classifies and lists significant threats to the well-being of young people and indicates whether (according to evidence from recent New Zealand research) males or females are more likely to be susceptible, or whether the risk affects both groups more or less equally. The table omits risks that apply only to one sex, such as pregnancy.

Table 1 Adolescent Risks - Gender Differences

Both Mainly Risk Type Specific Risk Genders Male Mental Health Behavioural and conduct problems X and Behaviour Truancy X Suspension/expulsion X Mental health problems X Substance dependence X Serious offending/arrest X Delinquency (adolescence limited) X Health Alcohol misuse X Smoking Cannabis use X Other drug use X Physical Accidental injury and death X Intentional injury and homicide X Suicide X Suicide attempt Family violence Sexual Abuse (sexual) Early sexual experience Unsafe sexual behaviour X STD Economic Financial hardship (family) X Unemployment Low income Lack of educational X qualifications Mainly Risk Type Specific Risk Female Mental Health Behavioural and conduct problems and Behaviour Truancy Suspension/expulsion Mental health problems Substance dependence Serious offending/arrest Delinquency (adolescence limited) Health Alcohol misuse Smoking X Cannabis use Other drug use Physical Accidental injury and death Intentional injury and homicide Suicide Suicide attempt X Family violence X Sexual Abuse (sexual) X Early sexual experience X Unsafe sexual behaviour STD X Economic Financial hardship (family) Unemployment X Low income X Lack of educational qualifications MENTAL HEALTH AND BEHAVIOUR RISKS

This category ranges from behavioural and conduct problems to serious mental health disorders, which can be diagnosed clinically. It also includes offending against the law, from minor delinquency to serious criminal behaviour.

Behaviour and Conduct Problems

Both the Christchurch Health and Development Study (CHDS) and the Dunedin Multidisciplinary Health and Development Study (DMHDS) found that boys were more prone to behaviour and conduct problems in childhood than girls. The patterns are established before the age of 10 (Fergusson and Horwood 1995, Fergusson and Horwood 1997, Feehan et al. 1994). These problems are strongly associated with family disadvantage and instability and have their sequel in adolescent offending and mental health problems.

Truancy is an indicator of school problems and has been linked to educational failure and under-achievement. The CHDS showed that 39% of males and 40% of females in the sample had played truant by the age of 16, so gender differences are not significant (Fergusson, Lynskey and Horwood 1995:30). Mild and occasional truancy is probably not pathological, but severe truancy is related to adjustment problems. Suspensions and expulsions from school are further measures of unacceptable behaviour. On a national basis the number of suspensions has doubled since 1990, and totalled more than 10,000 in 1998. Over 70% of the latter were of male students. The leading reasons for suspension, of all students, in 1998 were continual disobedience, physical assaults on other students and verbal assaults on staff (Ministry of Education data) (no breakdown given by gender).

Mental Health Problems

Estimates of the incidence of mental ill health among young people vary depending on how it is defined. McGeorge suggested that 5% of those aged 0-19 have mental health disorders requiring specialist assessment or treatment (O'Reilly 1996). DMHDS figures are higher (16% overall at age 13), but all agree that boys significantly outnumber girls in these statistics (Silva and Stanton 1996:155). There was again an association with family problems, such as poor maternal mental health and history of parental separation, and also with poorer language and literacy skills. These problems frequently originate in the pre- or early school periods, but tend to persist into adolescence.

The Christchurch study showed at age 15 a 26% prevalence of identifiable mental health disorders (Fergusson, Horwood and Lynskey 1993). In the Dunedin cohort, also at 15, the rate was 22% (McGee et al. 1990). This grew to 37% by age 18 (Feehan et al. 1994)(2). Alongside higher male incidence were gender differences in the conditions diagnosed. Females had higher rates for social phobia and major depression (the most common categories), but there was a male predominance in alcohol dependence, conduct disorder and marijuana dependence.

Much mental ill health goes untreated, with serious implications for well-being (see the later section on suicide). Increased rates of admission to psychiatric hospitals suggest a higher incidence of serious mental health problems among young adults. The rate of first admission is high for the 15-19 age group -- 22.5 per 1000 for males, and 18.9 per 1000 for females (Ministry of Youth Affairs 1994). The most common reason recorded for admission at this age is alcohol dependency, heavily weighted to males.

Offending/Delinquency

Adolescents, especially boys, report high levels of minor offending, such as occasional truancy and experimentation with alcohol, tobacco and cannabis. Much of this could be considered "normal" adolescent behaviour. Moffit and Harrington (1996) described it as "Adolescent Limited Delinquency". It accounts for the high proportion of males who have police contact for minor offences -- 25% of New Zealand boys aged 10 in 1967 had appeared in court before their 25th birthday (Lovell and Norris 1990). Maxwell and Morris (1993) studied juvenile offenders during the first year of the Children and Young Persons and their Families Act, 1989. Boys committed most of the more serious offences and accounted for 83% of those arrested.

Exposure to delinquent peers plus the onset of puberty, about the time of entry to secondary school, combine as important links to delinquency (Moffit and Harrington 1996:179). Girls may be involved in adolescent-limited delinquency (though not to the same extent as boys) if they experience early puberty and attend co-educational schools. Access...