The Socio-cultural Context of Adolescent Health: The Indian Experience

1. The Socio-cultural Context of
Adolescent Health : The Indian
Experience
Term Paper : 1
Arun Pratap Singh
Department of Psychology
University of Delhi
Delhi

2. Objectives
 To critically examine the notion of
adolescence in the changing socio-cultural
context.
 To examine the life experiences of rural,
urban and tribal Indian adolescents.
 To examine the health related issues
pertaining to adolescents .
 To identify the gaps and needs for
understanding the health related issues
and problems experienced by the
adolescents.

3. The Concept of Adolescence
 Meaning : ‘to emerge’ or ‘achieve
identity’.
 Involves physiological transformation that
gives boys and girls adult bodies and
alters how they are perceived and treated
by others, as well as how they view
themselves.
 W.H.O. (1998) : Age (spanning the ages
between 10 and 19 years) and a phase of
life marked by certain special attributes.
 Chief Attributes :Rapid physical growth
and development, physical social and
psychosocial maturity, sexual maturity,
experimentation, development of adult
like mental processes, movement toward
independence.

4. STAGES
(A) Early ( 9-13 years):
A spurt of growth and the development of
secondary sexual characteristics.
(B) Middle (14-15 years): Development of a
separate identity from parents, of new
relationships with peer groups and the opposite
sex and of experimentation.
(C) Late ( 16-19 years):
Fully developed physical characteristics (similar
to adults), and have formed a distinct identity
and have well formed opinions and ideas.

5. Adolescence : A Socio-historically
Constructed Notion
• Traditionally, Indian adolescence viewed
as a period for ascribing a set samskaras
and as the period of enjoyment .
• Experience of adolescence had a limited
scope in the Indian traditional context
(Kumar, 1993) due to delay in the puberty
(due to poor nutritional status),
prevalence of early marriage (signifying
adulthood).

6. The Changing Indian Context
Truncated and rarely experienced in the low
socioeconomic class especially girls (Saraswathi,
1999).
 A distinct phase observed in middle and upper
middle class as the scenario in this class mimics the
Western ecology of “adolescent culture”.
 Higher socio-economic class conforms to the
Western conceptualization of self development
(Reddy & Gibbons, 1999).
 Under the impact of Western education,
urbanization and industrialization adolescent lives
(Srivastava, 1955) have changed from the one of the
pleasing period to the period characterized by
dilemma in social roles, increased competition,
frustration and depression.

7. Macro Level Changes
 Demographic trends, widening economic disparities,
increased competition , life stresses, life style
changes, roles and relationships,
 Urbanization and industrialization , upbringing of
children
(Verma & Saraswathi, 2000).
 Globalization (acculturation, social comparison etc.),
liberalized economy , changed both the societal roles
of women and the importance of kinship networks ,
dearth of role models , prevalence of contradictory
messages related to moral and social values and
practices (Kanna&Pramila,2001 ; Verma &
Saraswathi, 2002).

8. Micro Level Changes
 Life in various settings : home, work,
school, peers, neighborhood.
 Changing sexual and social norms.
 Impact of media.
 Increasing competition.
 Rising frustration and conflict.
 Increasing intergenerational distance.

9. Demographic Scenario
 Between 10-19 years constitute 21.4% of population
in India (National Youth Policy, 2000) .
 Puberty : Urban 12 years. Rural menarche : between
10 to 16 years (Kumari,Singh&Dubey,1990) .
 The females to males ratio has declined from 946
females per 1000 in 1951 to 933 in 2001(Registrar
General& Census Commissioner, India, 2001) .
 Due to socio-cultural pressures adolescent marriage
and fertility rates are high. About 34 percent of girls
in between 15-19 years were married (International
Institute for Population Sciences, 2002 ).

10. Demographic Scenario
 About 29 percent of the total fertility is attributed
to women in the 15-19 years age group. In the
10-19 age groups, 86 percent of boys and 72
percent of girls are literate.
 Enrollment of rural girls lower and their drop out
rates higher as compared to their urban
counterparts (IIPS&ORC, 2000).
 Among the dropouts, majority are from lower
socioeconomic class (Kukanur, Huligavva,
Krishnaswamy & Saroja, 2001)

11. The Disadvantaged Adolescents
 Vulnerabilities are complicated by child labor, child trafficking to
commercial sexual exploitation and other forms of violence and
abuse (Chatterjee, 1990; Rath, 1991;Thapar, 1998).
 Middle and upper SES youth gaining access to new resources i.e.
more variable social experiences, longer education, access to
health care and use of ICT and other new technologies.
 A large number of children are without parental care . Orphans
constitute a major category. If it is due to the parents falling a
prey to AIDS, the stigma and consequent problems fall on the
children too.
 In most traditional and low-income families, childhood is replaced
by a precocious assumption of adult and gendered roles, with the
parents becoming more of taskmasters than caring adults.

12. Rural Adolescents
 Nuclear family and diminishing the adult
support (Bharat, 1991).
 Patriarchal set up, ideology of sun
preference.
 Vulnerability due to drug abuse, HIV/ AIDS,
other infections and sexual abuse.
 Poor nutritional status (Joshi et al, 1998.;
Kanade et al. 1999; Rao et al. 2000).Their
health is marked by deprivation and
poverty(WHO,1998).
 For girls, early marriage, premature
pregnancy and childbearing (Kumari,
Singh&Dubey, 1990) are major health
hazards.

13. Rural Adolescence
 Early gender and sex role socialization fails to equip
girls with skills and competence and undermines
self-confidence.
 Girls , due to, early marriage and various restrictions
, and gender discrimination show poor health
(Dubey, 1990).
 Sexual abuse and trafficking are rising (U.N.F.P.A.,
2003).
 A good percentage of girls never enter school and
those who do a high proportion of drop out well
before reaching the fifth standard.
 In some areas, ritualistic ceremonies are performed
to mark the stage of life (Saraswathi, 1997

14. Tribal Adolescent
 After childhood the tribal children are deprived of
proper education and are initiated into adulthood
(Kumar, 1993).
 Girls are married at an early age and assigned adult
roles.
 Boys have to earn at an early age to support family
leading to diminished possibility of adolescence
(Verma, 2000).
 Inadequate hygiene and gender inequality with
respect to food, education, parental love and
affection (Mathew, 1996).

15. Urban Adolescents
 Unique metamorphosis in its social, cultural,
ethical, and moral values. A heterogeneous
community.
 Migrant families : Face problems related to
identity formation and performing other
developmental tasks (Manhas, 2003).
 Middle class : Two social realities: Family
given (authoritarian, traditional, value
based, single income upbringing) and
Popularly represented (permissive,
authoritarian, imbalanced parenting style,
modern, individualistic and academically
oriented upbringing).
 Negotiating modern life styles and
aspirations. Confused about identities,
choices and values.

16. Adolescent Health :
A WHO Report
“Teen suicides have trebled in the past 25 years and
40% suffer from anxiety disorders. 75% adolescents
said they could not communicate comfortably with
the parents. A W.H.O backed survey of Delhi public
schools revealed that 53% of adolescents between
10 and 14 and 45% between 15 and 19 snack on
junk foods every day. The craze for junk foods and TV
is leading to obesity and related ailments like
hypertension. A third of adolescents imbibed alcohol
and addictive substances. Nearly 32% of adolescents
have alcohol and 25% smoke. The age of the first
intercourse has dropped from the early 20s to
between 16 and 18. as many as 45% of cases are in
the 15-29 age group the fact that HIV-positive takes
4-10 years to develop to full blown aids means the
victims were infected in their adolescence.”
(India Today, 4th august
2003)

17. The Emerging Reality
 The substance abuse is highly prevalent during the early twenties
(GOI, 1998). The average age at which young adolescents start
smoking could be as early as 12 years (Jha, 1994).
 Obesity is rapidly increasing among urban adolescents as life
style factors like food habits, physical activity (Ramchandran
etal,2002).
 An obsession with media and internet has taken away the
inclination for familial socialization, love for nature, exploration,
physical endurance and an attitude to engage in these activities
among the bulk of the adolescents.
 Market and media offer plethora of choices to the adolescents
regarding food, recreation, social relationships, familial
interactions and spiritual values

18. The Emerging Reality
 Parental pressure along with rising aspirations
exceed their cognitive capacity.
 Negative signs such as depression, anger,
hostility/aggression/ violence, substance abuse and
negative school related behaviors (Sharma,2006).
 Failure in examination, underachievement and the
resulting frustration .
 Threats to the health of today’s adolescents are
behavioral in nature and are significantly associated
with psychosocial risks (Verma & Singh, 1998).

19. Adolescent Health Problems
 Sexual and reproductive health are major public
health priorities in India. The HIV/AIDS epidemic
and recognition that sexual activity for many begins
in adolescence (Jejeebhoy, 1998).
 Personal appearance , body image (such as acne and
obesity) and reproductive health (e.g. dysmenorrheal
and nocturnal emissions)( Andrew& Patel,2002).
 Puberty period of adolescent girls is fraught with
internal conflicts and discontinuities (
Rangnathan,2003).
 Dietary behavior, level of physical activity,
relationships and their attitude about their own
problems are not researched adequately.

20. Major Problems
 Difficulties with their studies.
 Expressing concerns about their
appearance.
 Repetitive disagreement with parents
regarding restrictions on their activities.
 High incidence of suicide.
 School drop out.
 Violence and risk behavior (e.g. drug
addiction, smoking, unsafe sex).
 Increased stress and anxiety concomitant to
physical and psychological changes around
puberty.

21. Learnings
 Many of the threats to adolescent health are related
to social and emotional health than to their physical
health. They tend to vary across different groups.
 The changing socio-cultural and physical
environment is playing significant role in shaping the
health status.
 The issues of health in the different sections of
society (e.g. disadvantaged rural. tribal) have not yet
been adequately analyzed.
 The leading causes of morbidity and mortality
among adolescents seem to be related to the
elements of their life style.
 Being a vulnerable but important segment of society
the adolescents’ health and well being can’t be
ignored.

22. Refrences
 Singh, A.P. & Misra, G. (2015).Pattern of Leisure-Lifestyles in
Indian School Adolescents: Contextual influences and implications
for health concerns. Cogent psychology, 2(1), 1-11. doi:
10.1080/23311908.2015.1050779.
 Singh, Arun Pratap (2013). Life Style Counseling: Emerging
Challenges, Missing Opportunities and Future Directions for
Research. Asia Pacific Journal of Counseling and Psychotherapy,
4(2), 153-162.doi: 10.1080/21507686.2013.812972.
 Singh, A.P. (2013). Yoga and parapsychology: empirical research
and theoretical studies, edited by Koneru Ramakrishna Rao. Asia
Pacific Journal of Counselling and Psychotherapy, 4(1), 103-105.
doi: 10.1080/21507686.2013.77143 .
 Singh,A.P.& Misra,G.(2012).Adolescent lifestyle in India:
Prevalence of risk and health-promotive factors. Psychology &
Developing Societies, 24(2), 145-160. doi:
10.1177/097133361202400203

23. Refrences
 Singh, A. P., & Misra, G. (2012).
Adolescent Life Style Survey
[Database record]. Retrieved from
PsycTESTS.
doi:https://dx.doi.org/10.1037/t288
57-000

24. Refrences
 Singh, Arun Pratap (2015). Efficacy of a 4-week yogic
lifestyle education for promoting holistic health in Indian
school adolescents. Yog Mimamsa, 47(1), 22-29. doi:
10.4103/0044-0507.195455.
 Sawle, J.P., Lehakpure, R., Singh, A.P. & Jha, A.K. (2015).
Development of self-control in Gandhian Life. Indian Journal
of Social Science and Organizational Behaviour, 4 (1), 63-
72.
 Singh, Arun Pratap (2015). Holism in Yoga: Some
Reflections from Yoga-sutra. International Journal of Yoga
and Allied Sciences, 3(2), 61-66.
 Singh, Arun Pratap (2015). Positive Life style and Spiritual
Health: Results of a Field Experiment among School
Adolescents. Indian Journal of Social Sciences and
Organizational Behavior, 3(1 & 2), 45-54.

25. Refrences…
 Singh, Arun Pratap & Jha, Arbind Kumar (2015). Adolescent
health education in India: demographic travails, contextual
influences and implications for health concerns. Indian
Educational Review ,53(1),25-38.
 Singh, A.P. & Misra, G. (2013). Life Style Counselling in
School: Emerging Implications and Future Directions. In
Guidance and Counselling: New Directions (edited by Dr.
Sandhy Ojha, O.P. Chaudhary, and Shambhu
Upadhyaya).New Delhi: Shree Publications. ISBN: 978-81-
8329-522-2.

26.  Singh, A.P. (2012). Pattern of Health Behaviors among
Indian School Adolescents. Indian Journal of Social Science
and Organizational Behavior, 1(1), 9-16. ISSN: 2278-568X.
 Singh, A.P. & Misra, G.(2011). Lifestyle and Positive Health:
Results of 15-day Life Style Intervention Programme
among Indian School Adolescents. In S.K.Yadav and
S.B.Yadav (Ed.) Positive Psychology (p.269-282). New
Delhi: Global Vision Publishing House.