We were pleased to hear about the "My Brother's Keeper" initiative. As President Obama indicated, young men of color are at greater risk for a wide variety of problems, largely due to poorer living conditions in which they are raised. The consequences for the nation are substantial. Economist Ted Miller estimated the cost of the most common youth problems, including antisocial behavior, binge drinking, cocaine/heroin abuse, high-risk sexual behavior, tobacco use, high school dropouts, and suicide attempts. For all youth in the nation, the total is about $462 billion annually. Minority youth contribute to a larger proportion of this figure than their numbers given multiple disadvantages on an individual and societal level.
It is important to understand that these diverse problems are inter-related and stem from the same set of adverse conditions which are more prevalent in high poverty neighborhoods where African Americans are in the majority. Children in these communities experience a lack of resources ranging from families suffering from low wages and unemployment, to poorly equipped schools and inaccessible health care services. These children are also more likely to encounter high levels of conflict, threat, dysfunction and deprivation in their lives and, thus, do not develop adequate self-regulation skills. The aggressive behavior that often emergencies in these children is, in turn, associated with academic failure, peer rejection, affiliation with other troubled kids and family problems. By early adolescence, groups of troubled youth frequently experiment with substance use, delinquency, and risky sexual behavior.
In the interest of minority youth and, in fact, all children and adolescents, we need to build a world class national prevention system. The Institute of Medicine's report on prevention in 2009 identifies science-based interventions and policies that are capable of preventing the development of virtually the entire range of psychological problems that hamper the development of children and adolescents who are at risk due to poverty and related social and environmental conditions. In summarizing the extensive evidence for the efficacy of prevention, the IOM report concluded that "The scientific foundation has been created for the nation to begin to create a society in which young people arrive at adulthood with the skills, interests, assets, and health habits needed to live healthy, happy, and productive lives in caring relationships with others." Many of these programs have been implemented already across the country, but only on a piecemeal basis; they need to be institutionalized.
The U.S. can significantly improve the success of its young people by ensuring that the nation puts in place programs, policies, and practices that are supported by rigorous scientific evidence for their effectiveness. Many initiatives in the past have not produced favorable results largely due to the lack of concern for the quality of programs and the rigor with which they were implemented and evaluated. It is a significant undertaking that requires several years of concerted effort, but if we can unite everyone around a common understanding of what is needed, we can build a system to support child and adolescent development and prevent problems to a degree never before seen in human history" accompanied by a substantial cost savings.
A comprehensive and effective prevention system would have five facets: (a) An effective and nurturing system of family supports; (b) Effective positive behavioral supports in all schools; (c) A set of well-tested and proven prevention programs and policies; (d) Ongoing public education about prevention and accurate information about mental and behavioral health, including violence and drug abuse; and (e) A system for monitoring the wellbeing of children and adolescents. Such a system should be built in stages with careful attention to the effective implementation of evidence-based interventions. It might begin by concentrating resources in a small number of high poverty communities, such as the Harlem Children's Zone and also other "Promise Neighborhoods" which are currently being supported by another Presidential initiative. The impact of the effort should be carefully evaluated--not because "more research is needed" (though it is) --but because experimental evaluation should routinely be built into every social program for continuous improvement, to amass evidence of the effects programs, and for citizens to judge the benefits of these efforts.
The newly formed Coalition for Science-Based Solutions to Promote Child and Adolescent Well-being strives to improve the health and wellbeing of children, adolescents, families and communities by (1) promoting a science-driven approach to preventing risks and disadvantages; (2) building bridges between researchers and child/adolescent-serving organizations, advocacy groups and influencers of public policy and media; and (3) working with government to adopt a "prevention model" that would reduce costs while benefitting society. We stand with and are ready to work with My Brother's Keeper Task Force and partnering philanthropic and business sectors to equalize the playing field for all children and youth to have the opportunity to lead happy, healthy and successful lives.
Address correspondence to Neil Wollman; Senior Fellow, Bentley Alliance for Ethics and Social Responsibility; Bentley University; Waltham, MA, 02452; Email address removed ; 260-568-0116
Anthony Biglan, Ph.D., Oregon Research Institute, Coauthor of the IOM Report on Prevention and Former President of the Society for Prevention Science
Diana Fishbein, Ph.D., Director of the Center for Translational Research on Adversity, Neurodevelopment and Substance abuse, University of Maryland School of Medicine
Neil Wollman, Ph.D., Chair of the "Prevention Project" and Organized Two Congressional Briefings on this topic, from Bentley University