Families | Overview

CA Strategic Plan

Recommendations

Public Support

Youth Involvement
& Development

Access to Care

Service Coordination

Families

Communities

Schools

Data

Outcome Areas

Injury Prevention

Mental Health and Suicide

Nutrition & Physical Activity

Alcohol, Tobacco
& Other Drugs

Teen Pregnancy & STI’s

Oral Health

Environmental
& Occupational Health

Out of Home Youth –
Resources on Mental Health

Families | Overview

Build stable families that can support teens

This is Chapter 2, Recommendation 5 of California's adolescent health strategic plan. To view the full plan, click here.

Barriers to coordination among service providersThe human service system lacks resources at all levels, resulting in limited time to devote to each client. For medical providers, pressure to see a large volume of patients makes it difficult to conduct the type of comprehensive assessments that are needed. Similarly, social workers have notoriously high case loads; teachers have large classes; and school nurses cover multiple schools. The system is stretched in all directions and cannot function to its full potential.

The role of families in assuring a successful transition through adolescence into adulthood and in enhancing youth resiliency is well established. The family often serves as one of the most important elements in an adolescent’s life, creating the initial environment in which they receive emotional, social, and economic support. Supportive family relationships protect youth against many different kinds of health risks, including emotional distress and suicidal thoughts and attempts; cigarette, alcohol, and marijuana use; violent behavior; and early sexual activity. Data from the California Healthy Kids Survey suggest that most teens feel supported by their families, but that the perception of family support diminishes as teens age.

Financial Stability

Figure 2.2

California is entering the new millennium with one of the strongest economies in many decades. Yet many low-income families are experiencing increasing hardships. Despite the state’s tremendous prosperity, the percentage of children living in poverty in California (20.3%) is above the national average of 16.9% (Figure 2.2), and is the fifth highest in the nation. Many children and youth in California live with parents who do not have full-time, year-round employment —31% in California compared to 27% nationally. In 1997-1998, 1.4 million California youth were receiving public assistance or living in families supported by public assistance.⁷

The cost of housing in some areas is emerging as a critical obstacle to successfully moving families from welfare to work. In many communities, it is not uncommon for families on welfare to spend more than 50% of their grant on housing. In 1996-1997, a national survey found that approximately 25% of low-income California parents experienced problems paying their mortgage, rent, or utility bills.⁵⁰

These figures are cause for concern. Almost all health indicators become considerably worse as either income or education decreases. Low income youth, for example, are at least 50% more likely than higher income youth to die during childhood. They are five times more likely to die from infectious diseases before the age of 18, and are more than twice as likely to lack a recent physician visit.^51,52 They are also more likely to have risk factors such as cigarette smoking, a sedentary lifestyle, and obesity, which put them at higher risk for cardiovascular disease and cancer.^53,54 Given the impact of poverty on health status, health service utilization and health behaviors, the high percentage of youth living in poverty or in economically unstable households must be addressed in order to improve health outcomes.

Supportive Family Relationships

View Indicator

Supportive family relationships are an important foundation for healthy adolescent development. A recent national study on adolescent health found that, controlling for demographic factors, youth who reported feeling connected to a parent were protected against many different kinds of health risks including emotional distress and suicidal behavior; cigarette, alcohol, and marijuana use; violent behavior; and early sexual activity.⁵⁵ Yet the changing needs of children as they enter adolescence, parents’ lack of understanding of these developmental processes, and generational differences make it challenging for parents to support, discipline, and communicate with their teens.

Nonetheless, statewide data from the California Healthy Kids Survey indicate that 60% to 76% of teens experience a high level of family support (Indicator box). Similarly, among over 1,556 ethnically diverse youth surveyed throughout the state, 89% rated their family as “one of the best things they had going for them.”⁵⁶ Data from a national sample of predominantly white, rural and suburban youth found that 64% reported supportive family situations.⁵⁷

Changes in the family environment have increased the challenge of providing teens with the supports they need. The percentage of single-parent families in California increased from 23% in 1985 to 26% in 1997.⁵⁸ Slightly more than half of all California youth today will spend at least part of their childhood living with only one parent.⁵⁹ In addition, there are now fewer extended families living together and many more families with two working parents. These changes have contributed to a decrease in the amount of time that teens spend with their parents or other adults.

Services have not kept pace with changing family needs. Many families have great difficulty finding community resources such as after-school activities for teens, recreation areas, or accessible public transportation. Family-friendly employment arrangements are still difficult for many families to find. And while there has been significant investment in parent education for childbirth and infant care, far less societal attention has been placed on equipping parents with the knowledge and skills they need to successfully raise their adolescents. The programs that do exist tend to be crisis-oriented—reaching families after problems have already emerged—rather than prevention-oriented.

Strategies

1. Help families achieve social and economic stability.

Enact a state earned-income credit (EIC) (a refundable tax credit for low-income working families) to supplement the federal EIC. Eleven other states (as of January 2000) have enacted EICs.
Establish a permanent source of funding to help the private market, public-housing agencies and non-profit housing organizations build affordable housing units for low-income Californians.
Ensure the availability of adequate funding for community-based support and treatment services that assist families in coping with severe stressors such as domestic or community violence, substance abuse, gang participation, and caring for children with severe disabilities or special health care needs.
Increase family economic security by taking full advantage of existing state, federal, and private funds, and by strengthening services such as adult education, family literacy, job training/search, housing assistance, affordable childcare, etc.

2. Support families in raising teens.

Increase funding for family and teen resource centers through new funding or mandated blending of existing categorical programs. Ensure that new and existing family resource centers meet the needs of teens and their families.
Provide incentives for employers to adopt family-friendly policies such as flexible hours or job sharing.
Increase the availability and accessibility of parent education and support for parents of adolescents. Place special emphasis on assisting parents in supporting all types of adolescents (e.g., those with special health care needs, gay/lesbian youth, foster children). Promote strategies that bring parents together in mutual-support settings (discussion groups, parent-to-parent programs) as opposed to one-way informational presentations.

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