Steps Together, Steps Ahead

NZAAHD Conference
"Youth Health '98"
Western Springs College, Auckland

Mihi.

Thank you for the opportunity to speak here today. I always enjoy my association with NZAAHD because you represent such a broad spectrum of youth providers. And, as I have met a number of you before, it's always nice to see some familiar faces in the audience.

The theme of your Conference "Steps Together, Steps Ahead", is very much one after my own heart. I am always supportive of any progress that we can make towards better integration and co-ordination of health services for young people.

I see from your programme that young men's issues have a high profile which is great because it is one of the themes that I want to touch on today. The other two are: supporting young people to acquire the knowledge and skills to make safe and informed choices to avoid unplanned pregnancy and STDs, and, encouraging and supporting young parents to return to education.

These are all areas in which I will be doing further work over the next year, so I hope to give you an insight into where that work is heading.

Young men
The issues facing young men, particularly some aspects of their risk taking behaviour, is an area of great concern for me, and it is an area that the Ministry of Youth Affairs is providing policy advice on.

Their current focus on young men is not to suggest that young women don ?t also engage in risk taking behaviour, however the evidence suggests that thrill seeking and impulsive behaviour tend to be more prevalent amongst boys and young men.

In much of New Zealand society taking risks is generally seen to be part of the developmental process during which boys become men. Engaging in risky behaviour is a normal, developmental part of 'growing up'. In fact it has been seen as a positive attribute when it is applied to areas such as sport, the business arena or going to war.

But when the risk goes too far, there are harmful consequences for young men and their families. Actions such as not wearing cycle or motorbike helmets, not wearing seatbelts, drink-driving, substance abuse, unprotected sexual intercourse, and physical violence have harmful consequences for the health and safety of young people and others. They have serious repercussions across all levels of society.

Research conducted by the Ministry suggests that New Zealand males have very distinct rites of passage that feature some fairly risky behaviours, such as:

getting blind drunk with a group of males
mutual bragging about sexual conquests, and
joy-riding in cars and speeding.
This is not news to any of you here. No doubt some of you have had some near misses yourselves!!

While I don?t imagine that we can stop young people taking risks, I am interested in exploring ways to reduce the harm both to themselves and others from this developmental need to challenge physical and social boundaries, in order to thrill seek.

Where we need to do more work is at the interface between the normal developmental stage and the problem behaviours of young men who have a fatalistic worldview, that 'nothing matters', and 'to hell with the consequences'. For many of these young men, there is a sense of hopelessness about the future and little acknowledgment of the need to take responsibility for their own actions.

In this regard there are several key points to note. Risk behaviour is more common during adolescence and young adulthood, and can be expected to occur at a certain level in a population of 'normal' young adults. It might be characterised by sensationalism, acting on impulse, rites of passage, and male socialisation but it usually passes with time.

However where risk behaviour becomes problematic, is for those young males who persist with it. When it is ongoing, it results in more negative outcomes which extend into adulthood, and then lead to an increased likelihood of conflict with societal norms.

Three possible policy responses to this are:

the need to give recognition to and positive support for the normal male transition to manhood, which includes risk behaviour and its associated nuisance impact on society;

the ability to meet the challenge to provide a positive future for every young male that will give him something to live and strive for; and

the importance of a graduated policy response to the male transition to adulthood with particular emphasis on the law enforcement, education, training, employment and health responses to transition behaviours.
The kind of policy initiatives that might flow from these include:

promoting positive images of appropriate risk behaviour by young males;

creating environments for boys and young men that support them in developing lives that have a coherence and purpose;

applying both gender analysis and developmental analysis to the issues facing boys and young men; and

developing systems to formally teach boys and young men skills they need for manhood, for example, safe driving, responsible drinking, positive aggression, communication and conflict control.
I look forward to exploring these issues and options further. Like lots of women, I have a very real interest in ensuring safe male behaviour and a healthy, happy male population.

Sexuality and relationships
The second area that I would like to touch on today is that of sexuality and relationships.

We know that young people are having sex at a younger age, and we also know that a number of them do not use contraception. The number of abortions incurred by teenage women each year shows that many pregnancies are conceived with no positive intention to parent a child.

The Liable Parent?s provisions require non-custodial parents, usually young men, to make a financial contribution to the support of their children. While this means that young men now have a greater financial incentive than before to control their fertility, there needs to be a matching policy response to support young men to do this.

Although some oral contraception is available free of charge for young women, there is room for improvement in promoting contraceptive methods that young men can access. While many health providers currently make condoms available to young people free or for a nominal charge, anecdotal evidence suggests that these avenues are much less likely to be used by young men than young women.

All of us need to examine ways of further encouraging and supporting young men to share responsibility for contraception and safe sex, by making the means readily available to them.

The Ministry of Youth Affairs is working to identify areas where government can assist young people to acquire the knowledge, skills, attitudes and resources to make safe and informed choices that avoid unplanned pregnancy and STDs.

This is important as research indicates that while awareness of issues such as HIV/AIDS is high, putting that awareness into practice is more of a challenge.

Charlotte Paul's research quite disturbingly shows that the more partners women have, the less frequently they use condoms. Scary stuff, but these are all attitudes we can challenge.

Young parents
Another challenge for us all is to heed the needs of young people who have already become parents. The 1996 census shows that there were 3,561 single parents aged 15-19 years. Just over half of these young parents had no formal qualifications and only 17% had a qualification equivalent to or above School Certificate.

Research by the Ministry of Youth Affairs shows that by the time teenagers become parents, they have long since stopped seeing school as beneficial, and have already either physically or intellectually dropped out.

Yet paradoxically, the experience of being a teenage parent can often be one of the greatest motivators in encouraging them to resume their education in order to assist their child's learning needs. And there is a major instinct to want to be a good parent. It seems to me that both of these things could be better capitalised on.

It is this that has made Te Huarahi Tamariki, Susan Baragwanath's school in Porirua, so successful. Susan is to be congratulated for her guts and determination. And I think we could express the same sentiments to her students.

The Ministry of Youth Affairs has identified the following areas that government policy must focus on in order to assist teen parents:

removing the barriers that discourage staying or returning to school for teen mothers and fathers;

creating incentives or requirements for schools and other mainstream education providers to support teenage parents to continue or return to their education;

providing support to alternative education provision either as part of a school or provided by a community/iwi organisation for those young people for whom school is no longer an appropriate option; and

supporting the other basic social, financial, and emotional needs of teen parents (for example, adequate income, secure housing, and effective relationships with their children, partners, and parents).
Of course none of this is as easy as it sounds, and it won't happen overnight. But having done this initial work enables us to head in the right direction.

Conclusion
All of the three areas I've outlined strongly impact on young people?s lives. Firstly changing the ways we look at boys' and young mens' risk taking behaviour, and getting our focus onto preventing damage to themselves and others; secondly supporting young people to acquire knowledge, skills, attitudes and resources to make and follow through health life enhancing choices that avoid unplanned pregnancy and STDs and finally encouraging and supporting young parents to return to education.

We all recognise and know these problems. I think that this NZAAHD conference provides a unique opportunity, with the breadth of skills and experience represented here, to make some real progress on positively addressing these issues.

I?ve suggested some areas that require further policy development and I look forward to receiving your input as well. I wish you all the best for the rest of the conference.