Wednesday, January 6, 2010

Gerald O'Malley, DO: Dreams from the 'hood, part 2

Our ER survey of 13- to 18-year-olds was reassuring in that most of the participants had some ambition and many of them were working toward their goals for the future.

The participants (and results) of the second part of our survey weren’t as optimistic as the first. The participants were older, between the ages of 22 and 27 years old. We chose that age range based on our own experiences; we believed that most people have some direction in their lives by the time they reach their early to mid 20s.
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One-third of the young people in our survey were unemployed or disabled, and the rest were employed in the service industry (waitress, limo driver, supermarket checkout-clerk) or were working toward their high school diplomas or technical trade certificate. When asked if there were any obstacles that had prevented or interrupted the goals that they had when they were younger, one-fourth of the respondents replied in the negative; half had children that had slowed the pace of their goal achievement, and the rest gave a variety of reasons for not being where they thought they might be when they were younger (including a war in one subjects’ native African country).

What can be derived from this summertime survey? Not much. It seems that young, primarily black individuals from the inner city have hopes and dreams for achieving success and career satisfaction, but their understanding of the process for realizing those goals is nebulous and unrealistic.

What happened to these young people in the decade from age 15 to age 25? Three-quarters of the respondents in our survey identified some obstacle that delayed or prevented them from being where they wanted to be — why were they not able to circumvent or avoid or overcome that obstacle? Many of the female respondents identified one or more unplanned pregnancies as the single greatest obstacle to their goals, despite all the financial supports that are available through social services monies and networks.

This seems like such an easy fix. Teenage pregnancy is a dream-killer — our respondents told us so. Instead of funneling lots of money on the back end, when the problem already exists, why not apply more resources to preventing unwanted pregnancies through abstinence programs and birth control education and measures? In my opinion, abortion counseling isn’t the answer because, again, the unwanted pregnancy (the problem) already exists.

Beginning at the age of 13, young men and women need to be taught not to impregnate or to allow themselves to be impregnated. Government provision of financial support to pregnant teens discourages families from doing the hard work that is necessary to work through the problems that accompany unwanted pregnancies.

Prevent the problem before it begins. Convince teenagers that getting pregnant when you are still in school is the surest way to not get what you want. Once the pregnancy occurs, the battle is lost.

Gerald O'Malley, DO, is the director of research in the largest, busiest emergency department in Philadelphia and an associate professor of emergency medicine at Thomas Jefferson University Hospital. He’s also the son of a NYC cop, die-hard Yankees fan, and a regular contributor to Practice Notes.

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