Eli Ginzberg - Young People At Risk: Is Prevention Possible? (Conservation of Human Resources Studies in Health Policy)

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Young People at Risk

Conservation of Human Resources Studies in Health Policy

Strategie Factors in U.S. Health Care: Human Resources, Capital, and Technology, Howard S. Berliner

Medicine and Society: Clinical Decisions and Societal Values, edited by Eli Ginzberg

From Physician Shortage to Patient Shortage: The Uncertain Future of Medical Practice, edited by Eli Ginzberg

Young People at Risk

Is Prevention Possible?

Eli Ginzberg, Howard S. Berliner, and Miriam Ostow

First published 1988 by Westview Press, Inc.

Published 2021 by Routledge 605 Third Avenue, New York, NY 10017 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright 1988 by Conservation of Human Resources, Columbia University

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data Ginzberg, Eli, 1911- Young people at risk. (Conservation of human resources studies in health policy) Includes bibliographies and index. 1. Juvenile delinquencyUnited States. 2. Juvenile delinquencyUnited StatesPrevention. 3. Drug abuseUnited StatesPrevention. 4. Pregnancy, AdolescentUnited StatesPrevention. 5. DropoutsUnited States. I. Berliner, Howard S., 1949- II. Ostow, Miriam. III. Title. IV. Series. HV9104.G547 1988 364.3'6'0973 87-21557 ISBN 0-8133-0525-X

ISBN 13: 978-0-3672-1388-6 (hbk) ISBN 13: 978-0-3672-1669-6 (pbk)

DOI: 10.4324/9780429267963

Contents

1. 2 The Prevention Paradigm
   1. Basic Institutions and the Developmental Process
   2. Changing Strategies of Intervention
   3. Prevention and Other Intervention Strategies
   4. A Few Concluding Observations
   5. Notes
2. 3 Drunk Drivers
   1. Background Concepts and Statistics
   2. Programs Aimed at Reducing Teenage Drunk Driving
   3. Preventive Intervention and Strategies
   4. Deterrent Interventions and Strategies
   5. Technological Interventions
   6. Community Efforts
   7. Secular Improvements
   8. Evaluating Adolescent Drunk Driving Reduction Interventions
   9. Concluding Observations
   10. Notes
3. 4 Teenage Pregnancy
   1. Why Are Teenage Pregnancy and Parenthood a Problem?
   2. Programmatic Approaches
   3. Services to Pregnant and Parenting Teenagers
   4. Societal Attitudes and Parental Practice
   5. Conclusions
   6. Notes
4. 5 Drug Users
   1. Types of Drugs and Their Use
   2. Methods of Prevention
   3. Programs to Interdict Drug Use
   4. Conclusions
   5. Notes
5. 6 School Dropouts
   1. Framework and Parameters
   2. A Catena of Intervention Efforts
   3. New and Strengthened Interventions
   4. Concluding Observations
   5. Notes
6. 7 Directions for Policy

1. 2 The Prevention Paradigm
   1. Basic Institutions and the Developmental Process
   2. Changing Strategies of Intervention
   3. Prevention and Other Intervention Strategies
   4. A Few Concluding Observations
   5. Notes
2. 3 Drunk Drivers
   1. Background Concepts and Statistics
   2. Programs Aimed at Reducing Teenage Drunk Driving
   3. Preventive Intervention and Strategies
   4. Deterrent Interventions and Strategies
   5. Technological Interventions
   6. Community Efforts
   7. Secular Improvements
   8. Evaluating Adolescent Drunk Driving Reduction Interventions
   9. Concluding Observations
   10. Notes
3. 4 Teenage Pregnancy
   1. Why Are Teenage Pregnancy and Parenthood a Problem?
   2. Programmatic Approaches
   3. Services to Pregnant and Parenting Teenagers
   4. Societal Attitudes and Parental Practice
   5. Conclusions
   6. Notes
4. 5 Drug Users
   1. Types of Drugs and Their Use
   2. Methods of Prevention
   3. Programs to Interdict Drug Use
   4. Conclusions
   5. Notes
5. 6 School Dropouts
   1. Framework and Parameters
   2. A Catena of Intervention Efforts
   3. New and Strengthened Interventions
   4. Concluding Observations
   5. Notes
6. 7 Directions for Policy

Guide

Tables and Figures

Tables

1. 3.1 Automobile fatalities by age, sex, and role, 1984
2. 3.2 Alcohol-related automobile fatalities by age, 1984
3. 3.3 Proportion of alcohol involvement in injury accidents by age, National Accident Sampling System data, 1979-1980
4. 3.4 Proportion of alcohol involvement in fatal accidents by age, 1980
5. 3.5 Alcohol-involved fatal accident rates by driver age, 1980
6. 3.6 Automobile fatalities by road type and land use, 1984
7. 3.7 Automobile fatalities by day of week and hour of day, 1984
8. 3.8 Driver age and alcohol involvement in accidents, NASS data, 1979-1980
9. 3.9 Comparison of intervention strategies
10. 4.1 Pregnancy and fertility, women under age twenty
11. 5.1 Drug use in the United States, 1982
12. 5.2 Drug-related deaths reported to DAWN system, 1981
13. 5.3 Drug-related emergencies reported to DAWN system, 1981

Figures

1. 2.1 Behavior-intervention matrix
2. 3.1 Teenage drinkers and drivers as a subset of drinkers and drivers
3. 3.2 Conditional probabilities of accident and arrest while driving
4. 5.1 Continuum of drug use
5. 5.2 Points of intervention
6. 6.1 Behavior-intervention matrix

Preface

This book is a collaborative undertaking among the three authors. Howard S. Berliner had primary responsibility for .

We are indebted to the Commonwealth Fund for the grant that underwrote this effort and to Thomas Moloney, the senior vice president, for encouraging us to direct our attention to the challenging question of whether the "prevention paradigm" can be transferred from the health arena to problems of social pathology.

In preparing this book for press we were assisted by Ruth Ginzberg, who gave editorial support; by Penny Peace, who served as the linkage between the Conservation Project and our publisher; and to Sylvia Leef and Shoshana Vasheetz, who transcribed and prepared the multiple versions of the manuscript.

Eli Ginzberg, Director, Conservation of Human Resources

The Setting

DOI: 10.4324/9780429267963-1

This introductory chapter has a limited number of goals including providing the reader with the background of this undertaking, its place in the ongoing research in human resources and health policy that are the center of the Conservation of Human Resources research program at Columbia University, and the relationships between its findings and public policy aimed at assisting young people at risk.

The origin and purpose of this research effort can be briefly outlined. The Commonwealth Fund, under the leadership of its senior vice president, Thomas Moloney, explored our potential interest in assessing the current efforts of various foundations to reduce ineffective behavior among adolescents such as drunk driving, teenage pregnancy, and dropping out of school. The Foundation specifically considered whether prevention programs held promise of reducing the individual and social costs of disability and death resulting from such destructive behavior.

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