It is hard to bridge scientific inquiry if the voices of those we seek to benefit are not included in the conversation. At the Disparities Research Unit (DRU), we conduct research with a focus on community-based approaches aimed at reducing racial/ethnic inequalities in health. For work dedicated specifically to address such inequalities among adolescents, incorporating their voices is critical.
With support from the Foundation, we currently work with four diverse Massachusetts communities (East Boston, Chelsea, Charlestown, and Revere), to elicit young people’s perspectives on their experiences in their neighborhoods, including experiences of inclusion and exclusion, and how these relate to adolescent behavioral health. Ultimately, we will continue working with youth and community stakeholders to translate this information into youth-driven interventions geared at increasing community action and policymaker engagement directed at adolescent well-being.
Race/ethnicity, neighborhoods, social interactions, and behavioral health
Evidence consistently suggests that racial/ethnic minorities are at elevated risk of persistent behavioral health problems. Further, environmental stressors and physical aspects of one’s neighborhood, including physical disorder, vandalism, abandoned homes, and the presence of litter and trash have been linked to symptoms of anxiety, depression, and anger. At the same time, opportunities for positive social interactions and strong social ties in their neighborhoods may contribute to youth well-being. But a neighborhood’s undesirable physical conditions often result in decreased social contact with other residents, increased concerns about community safety, and fewer positive perceptions of the neighborhood—all of which can negatively impact how one sees oneself. For example, some youth report confronting continuously negative perceptions of their communities as gang-infested, violent, and stricken with poverty, and rarely hearing about the assets that exist within their communities.
We know less about how young people living within these diverse communities experience social interactions and institutional relationships, and how their experiences subsequently impact their well-being. Our research is investigating such questions using a participatory research method known as “photovoice,” through which participants take photographs and complete interviews to document their perspectives In this project, youth serve as “co-researchers” involved throughout the research process, as the major force for data collection, sounding boards for information interpretation, and partners in dissemination. The macro-level challenges of community violence, the climate of “us” versus “them,” as well as the lack of political investment in youth health and mental health requires reflection and reformulation if we are to invest in a collective agenda to improve youth’s lives. To adequately understand youth experiences, behaviors, cognitions, and emotions—and address associated challenges—there is an imperative to directly ask how they frame the problem and what we can do to solve it.
Photovoice provides a platform for members of communities to share their narratives and articulate the assets and needs of their neighborhoods. This method can enable youth to promote critical conversations and move their neighbors toward collective identification of problems and solutions. Photovoice has been adopted to develop locally and contextually relevant theories of health disparities. It is a unique approach to bring neighborhood concerns and interests to the forefront of research. After collecting and interpreting photographic and narrative data, we will work collaboratively with youth participants and youth-serving community organizations to develop a youth-driven intervention to improve youths’ well-being.
The importance of a youth-focused, participatory approach
By empowering youth as co-researchers, we also bring forth their recommendations of how challenges in their communities should be addressed. We hope youth are empowered and more passionate about the findings, using them to develop programs tailored by their opinions and viewpoints. At the same time, we include the perspectives of other important community stakeholders (i.e., parents and staff from youth-serving organizations) whose input and engagement is essential for the success of any future youth-driven and community-supported intervention.
We have learned much from our youth participants in the first two-years of our project. To start, we have found that youth-serving organizations have a prominent role in many of their lives. For example, not only do youth benefit from the activities and youth-appropriate spaces associated with these groups, but these organizations also frequently function as advocates for youth and their families, providing them with social backing in the community. At the same time, some communities lack investment in infrastructure such as sidewalks and parks, which, when they remain broken or deteriorated, can be interpreted to suggest that young people are not a priority to community leaders. Many of our participants have expressed a belief that policymakers should want to fix sidewalks and traffic lights at busy intersections to ensure youth safety, and express disappointment when these issues are not addressed.
Problems of limited economic opportunity, homelessness, drug use, and pollution were also named as challenges that detract from the health of the community. The repercussions as well as benefits of gentrification were also described by youth. Participants described how gentrification could both generate more economic investment in the community but also change how it feels to live there, as an increase of “others,” not like them, take up space and increase the cost of rent. Some wondered why vacant spaces in communities were being used to develop amenities for newcomers, rather than to improve businesses and services for longstanding residents. Some immigrant youth reported that they had to seek spaces outside their community, like religious facilities or after school programs that taught in their native language, to feel a sense of belonging. Divisions across geographic, economic, and/or racial boundaries within communities were also seen as minimizing access to a wider selection of institutional resources for youth.
As we complete data collection with our youth co-researchers, we look ahead to our next steps, which will include developing our partnerships with allies that can help youth thrive, leading conversations with policymakers and community advocates, and building cross-sector dialogues to encourage investment in youth. We want to support youth as they galvanize their communities to develop solutions that improve their well-being. We hope to be a catalytic agent that can pinpoint the best strategies to reducing adversity and promoting well-being. We look forward to the next year, as we work together with youth and community members to further define and develop these youth-driven interventions and help young people lead the way!