It has long been assumed that the cavalier behavior of teenagers driving too fast, engaging in unprotected sex, dabbling in illicit drugs is due in part to their characteristic disregard for mortality. Teens, as any beleaguered parent of one can attest, usually operate under the presumption that they know it all and will live forever.
Or, do they? A new study published in the July issue of the journal Pediatrics would suggest precisely the opposite. For some teens, at least, their reckless, sometimes life-endangering choices are fueled not by feelings of being bulletproof, but by the belief that they're doomed to die young anyway.
In a long-term analysis of 20,594 American teens in grades 7 through 12, researchers interviewed the youngsters on three different occasions: first in 1995, again in 1996, then a final follow-up from 2000 to 2001. At the first interview, 1.4% of participants thought there was "almost no chance" that they'd reach their mid-30s; 2.4% thought it was possible, but hugely unlikely; and 10.9% believed they had only about a 50-50 shot of celebrating their 35th birthday. Researchers discovered that those who believed they were likely to die young were more likely to make potentially life-threatening choices such as getting into violent fights or having unprotected sex with multiple partners than teens who weren't expecting an early death.
"Thankfully most youths don't hold this belief," says lead author Dr. Iris Wagman Borowsky, an associate professor of pediatrics at the University of Minnesota, "but 15% did. That's one in seven youths in this country."
Whether it was the risky behavior or the fatalistic worldview that presented itself first during the course of the study, Borowsky found they remained correlated over the years. Youths who reported that they had contemplated suicide, consistently gotten into fights, had unprotected sex or abused drugs by the time of the first interview in 1995 were more likely to develop a pessimistic attitude about their mortality during the subsequent interviews. Likewise, says Borowksy, "We found that those who felt they had a higher likelihood of dying early were more likely in later years to begin engaging in risky behaviors."
What's more, having a negative view of the future varied widely among respondents, depending on their ethnicity, gender and socioeconomic status. Older male Hispanic adolescents were the most likely to believe their lives would be cut short. Among teens whose families received any form of financial assistance from the government, nearly one-quarter believed they were likely to die young.
The fact is that minorities and the underprivileged are among the populations in the U.S. who are statistically at higher risk of early death than, say, wealthy white Americans, according to government data. The irony, Borowsky says, is that these fatalistic belief systems may help perpetuate the tendency toward poor health and early demise in certain social or ethnic groups. "What's disturbing to me is how this could contribute to health disparities among minorities as well as youths from different socioeconomic backgrounds," she says. "If youths are in an environment where they look around and see more adults dying early, then they may develop this perception that they will die early as well." And that may drive teens toward careless behaviors.
Borowsky's findings, while grim, present an opportunity to interrupt that self-fulfilling cycle (and she also found that as teens grow up, their negative views don't always persist). In the long term, she says, more research is needed for a deeper understanding of teens' emotional lives. But in the short term, prevention may be as simple as encouraging teenagers to think about their futures and set goals going forward; families and communities should then support children in achieving them.
"I think this is something that can take place in primary medical settings as well as school settings," Borowsky says. She believes we can make a difference even save lives just by asking teens one simple question: "What do you want to do when you get older?"