If “youth are our future,” we’re in trouble as a species.

According to the International Labor Organization, child-workers ages 5-17 number 218 million worldwide. UNICEF reports that 133 million children were orphans, 15 million due to AIDS alone (2005), 25 percent of all children suffer from being moderately or severely underweight (1999-2005), and 76 of every thousand children die before they reach age 5.

In the United States, nearly one in five children lives in poverty, according to the Annie E Casey Foundation (2005), one of the highest rates among rich countries. The foundation also estimates that more than one million US youth between 16 and 19 years old in 2005 were not in school and did not have a high school diploma and that 38 teenagers lose their lives every day to accidents, homicides, and suicides (2002).

Even closer to home, Washington State just released its 2006 Healthy Youth Survey (www.doh.wa.gov/EHSPHL/hys), and the picture is anything but pretty. Yes, cigarette smoking, binge drinking, and marijuana use have dropped among youth since the late 1990s, but according to the survey:

• Nearly one in four 10th graders reported being drunk in the past 30 days.
• One in five 12th graders and almost as many 10th graders said they were drunk or high at school in the past year—21 percent more 10th graders than two years ago.
• More youth surveyed reported carrying a gun, knife, or club to school, and fewer students said they felt safe at school.
• The percentage of 8th, 10th, and 12th graders who said they belong to a gang increased significantly.

According to our Viewpoint by Michael Males, we’ve reacted to this picture of “unruly” youth by scapegoating them rather than using what we know to address the underlying causes these data manifest. And, as this issue of Northwest Public Health should reveal to you, we know quite a bit and can point to programs that work.

Ramowski and Nystrom, Hample and Didrickson, and Powell, Keifer, and Byrd make the important point that efforts to improve the health and well-being of youth must involve them as participants and resources, not just subjects. The ways we involve them, however, must take into account that the brain continues to change through adolescence and youth (Ramowski and Nystrom).

Some health problems are unique to or at least important in youth and require special attention by those responsible for the well-being of young people. Visiting Pakistani scholar Mehmood and soon-to-be MPH graduate Jones describe homelessness among youth and suggest some avenues to address this complex situation. Stern notes the importance of close coordination between school activities and public health agencies for everything from immunizations to treatment services. Of very practical use, DeCastro and Eastgard give us guidelines for preventing and responding to cases of self-harm and suicide, respectively. Finally, Koutsky and Golden discuss the HPV vaccine to prevent cervical cancer, an issue hotly debated nowadays in both professional and public circles.

If youth are our future, we’ve got some work to do to secure that future, and I hope this issue of Northwest Public Health contributes a little to the effort.

Aaron Katz, Editor-in-Chief
Director, Packard-Gates Population Leadership Program