Building Healthy Communities with Youth 360°: A Holistic Approach to Adolescent Sexual and Reproductive Health

Date: April 3rd, 2017

Gina Desiderio

Healthy Teen Network joins the American Public Health Association in celebrating National Public Health Week 2017 this week, as well as the American Academy of Pediatrics in supporting #healthycommunities. We promote better outcomes for adolescents and young adults by advancing social change, cultivating innovation, and strengthening youth-supporting professionals and organizations. This week, and every week, we advocate for a holistic approach, or Youth 360°, to supporting and empowering young people because how and where youth live, learn, and play matters…and needs to be addressed to achieve better outcomes.

Teen pregnancy/HIV/STI prevention originates from a disease prevention public health model; it is not holistic health promotion. Rather, it is about risk reduction and counting negative outcomes. Certainly, healthy sexual behaviors are promoted, but often, the prevention model is shortsighted when compared to the greater concept of comprehensive sexuality education. Worse, this model can be stigmatizing for young people who do become pregnant and choose to parent. And yet, we should want (at least Healthy Teen Network passionately believes) to support and empower our young people to mature into adults fully prepared to lead healthy, sexual lives. Yes, we said sexual…because this is part of healthy adolescent development.

Of course, it is easier to quantify pregnancy, birth, HIV, and STI rates. It is easy to develop a logic model with SMART objectives tied to these quantifiable outcomes. Funders often tend to prefer these kinds of projects, where it is easy to tally the outcomes and focus on the same data we have always relied on. Thus, funding reinforces this disease prevention public health model, and what is funded is implemented, to the detriment of health promotion.

But why is that? Why can’t we focus on promoting healthy sexual development—for adolescents, for young adults, for adults? Why must we focus on the negative, on risk, on prevention, to be heard and to be funded? Furthermore, the solution for prevention, too often, is to focus on the individual. Certainly, an individual’s actions do matter, and a great deal can be accomplished through education, but we cannot address disparities without examining racism and other systemic inequalities and going beyond the individual. It is also much easier to prescribe more education, more services, even working to increase access, than it is to consider the more complicating factors that come into play when we are talking about health outcomes.

These factors, or social determinants of health, include access to health care, equitable education and employment opportunities, and more. Whether the issue is teen pregnancy/HIV/STI prevention or more holistic adolescent sexual and reproductive health, we cannot have a true understanding without considering the social determinants of health and how systems of inequality perpetuate health disparities. That’s reproductive justice. That’s human rights.

We see the focus on the individual in so many ways: The unjust idea that if one cannot afford the astronomical costs of quality childcare, or unpaid parental leave, then one is not fit to be a parent… The idea of buying a house in a certain zip code or school district to privilege one’s children, while it is acceptable that children in other zip codes will not have access to the same kind of equality education… The lack of insight into the systemic inequalities that create cycles of poverty because once young people who get pregnant choose to parent, society does not want to help them succeed with flexible supports for finishing school… These are all examples where we blame the individual without considering privilege, racism, and other systems of inequality that make it impossible for everyone to have equal opportunity to learn, to grow, to thrive. These are issues of human rights, of reproductive justice.

We have so much evidence about systemic inequalities and disparities, about the importance of the social determinants of health, yet this pervasive disconnect between the evidence and the idea that it only comes back to the individual is key in developing effective, positive messaging that can be a catalyst for social change in support of reproductive justice.

To change this conversation and support organizations to move beyond the individual to consider these other critically important factors, Healthy Teen Network developed Youth 360°: How and Where Youth Live, Learn, and Play Matters. We use Youth 360° to help organizations and professionals advocate for and plan interventions that integrate the social determinants of health to have a greater impact on systemic inequalities.

Support for the Youth 360° approach for health promotion is building among direct service providers, sex educators, and funders. The idea that if we want to effect change, and more importantly, address disparities, we need to move beyond the individual, is gaining traction. We continue to hear from you, our members, about how you have successfully worked to engage new kinds of partners to build healthy communities and address social determinants of health. We want to continue to hear from you (consider sharing your organization’s story here). We will be focusing on social determinants related to social norms and culture at our annual national conference in October, where we will continue the conversation (and we hope you’ll join!).

How do you work to build healthy communities? How do you do Youth 360°?

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About the Author

Gina Desiderio, Healthy Teen Network Director of Communications, has over 10 years of capacity-building and project management experience, supporting professionals to provide programs and services to empower youth to thrive.


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