Barriers to Wellness
Voices and Views from Young People in Five Cities
Youth of color represent the fastest growing segment of the U.S. child population and make up the majority of the youth population in about half of the 100 largest U.S. cities. Fear, along with inequitable access to social supports, opportunities and experiences essential for healthy development, place this group at increased risk for poor health outcomes.
To better understand the obstacles to well-being experienced by young people of color, the Center for Promise (CfP) implemented a youth-led health and wellness assessment in five cities -- Boston, Chicago, Denver, Philadelphia, and St. Paul.
To our knowledge, this is the first youth-led assessment conducted simultaneously in multiple U.S. cities.
This report provides new insights into the obstacles to wellness young people of color face in five cities and brings young people’s voices and views into the discussion about what affects their health and wellness.
This youth-led health assessment was designed to tap into young people’s perspectives by engaging them not only as partners, but as leaders in community health research and assessment. To our knowledge, this is the first youth-led assessment conducted simultaneously in multiple U.S. cities.
To conduct the pilot program, the university-based research team partnered with youth development organizations and grassroots organizers to engage young people in the design and implementation of youth-led health and wellness assessments in five U.S. cities between May and September 2016.
Young people identified and prioritized health areas and threats in their communities and led the assessment design and implementation. Adult program staff at each site supported the young people with protocol development and implementation as well as data analysis.
While the assessment methods varied from surveys and interviews to photovoice (using photography to observe, document, and discuss the features of a community), common themes emerged across the five cities.
“Many young people of color in the study cite feeling overpoliced, undervalued, and unsafe in their own communities as barriers to wellness.”
--Jonathan Zaff, executive director, Center for Promise
FINDING 1: Young people are under stress.
In all five cities, respondents described employment concerns, race relations, violence, lack of community resources, and other environmental challenges as meaningful barriers to their well-being.
In Boston, 78 percent of respondents said they are living under stress.
FINDING 2: Young people feel unsafe.
Feeling unsafe was perceived by young people as a stressor. In Chicago, over 70 percent of respondents said they felt unsafe in their neighborhoods either “always” or “sometimes.”
“Kids can’t freely walk or play in the community without being worried about getting beat up or shot and killed.”
Survey respondent, Chicago
FINDING 3: Young people mistrust and fear police, leading to anxiety and avoidance of public places.
In all five cities, the police served as an additional stressor for young people of color – despite respondents’ concerns about community violence.
Sixty percent of respondents in Chicago said they believed that police antagonize youth. Respondents in Philadelphia shared similar anecdotes about experiences that damaged their trust in law enforcement.
Only 20 percent of respondents in Boston agreed with the statement that, “Young people in my community go to the police if they need help.” The vast majority did not. This finding was not unique to Boston.
“With an increase in police brutality reports, I think it causes youth to distrust police and look at police as enemies. It promotes an ‘us and them’ mentality.”
Survey respondent, Chicago
FINDING 4: Young people observe and suffer from a lack of access to community resources.
Gentrification, limited local food options, and unemployment concerned respondents across the five cities.
The vast majority of respondents in Chicago said they purchased food at gas stations and corner stores. In Denver, respondents said gentrification pushed them out of once-familiar public spaces, forcing them indoors during after-school hours.
To avoid interactions with the police and surveillance, young people said they are more likely to stay inside and spend time in people’s homes as opposed to walking around and spending time downtown.
FINDING 5: Young people cite stereotyping and racial bias as reasons they feel unsafe and unwelcome.
Stereotypes and racial profiling, along with racism, were described as stressors and seen as threats to the health and well-being of young people.
The Philadelphia team explored factors that influence stereotypes and found that race was the most cited factor, followed by social class and appearance. Blacks were identified by respondents as the group most commonly stereotyped.
The youth researchers in Philadelphia also used photovoice to explore stereotypes. Reflecting on the images they had captured, youth researchers discussed stereotypes associated with race, gender, style of dress, and hair. They then discussed how young people internalize negative stereotypes and the impact of that internalization on their confidence, esteem, and mental well-being.
“The study’s findings send a clear message that including young people’s voices in decisions related to health and wellness changes the conversation.”
FINDING 6: Young people engage in risky behaviors to cope with stress.
Youth identified drug use, sexual health practices, and social media as threats to health. The most common reasons cited to explain why youth use drugs were stress relief, peer pressure, or to fit in.
Both the Chicago and Philadelphia teams asked respondents, “Are you having safe sex?” The vast majority of respondents in both cities (72.5 percent) said no. In Chicago the most common reason cited for not having safe sex was not being taught about safe sex.
“When we listen to what young people say about striving for wellness against the odds that adversity creates, we hear that feeling safe and welcome in their own communities is an essential precursor to improving health.”
- Funders of health-related efforts, including public health practitioners, should consider a holistic wellness approach to investing in urban communities and communities of color and seek youth input to inform it.
- Urban planners, developers, and housing advocates should engage community residents including youth to conduct a neighborhood health assessment, identifying assets and challenges in the community to avoid the unintentional loss of social, cultural, and recreational spaces.
- Youth-serving organizations, educators, and local political officials should be equipped with the appropriate training to create safe spaces for racial healing, particularly for youth of color who have experienced traumatic events with community violence and police brutality.
- Public safety officials and mayors should invest resources to engage key stakeholders in the public safety and juvenile justice system and engage youth of color in safe and structured dialogues to rebuild trust and improve police-community relations.
- All adults involved with the justice system—police officers, juvenile court judges, parole officers, and caseworkers—should look for opportunities for positive interactions with young people, seek to examine their own biases about individual youth and groups of youth, and watch out for negative behavior among their peers.
- Cities, counties, and states should create pipeline programs to increase racial, cultural, gender, and age diversity in municipal and state leadership.
- State and local decision-making bodies—citizen advisory boards, school boards, state boards of education, local boards of health, city and county councils—should include one or more positions for young people to serve as full voting members.
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The 5 Promises
The 5 Promises represent conditions children need to achieve adult success. The collective work of the Alliance involves keeping these promises to America’s youth. This article relates to the promises highlighted below: