ORIGINAL RESEARCH

 

Youth participation and health promotion: strategy for human development

 

 

Jamile Silva Guimarães^I; Isabel Maria Sampaio Oliveira Lima^II

^IInstituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA). Rua Basílio da Gama, s/n - Campus Universitário Canela, Salvador, Bahia. CEP: 40110-040
^IIFaculdade de Direito, Programa de Pós-Graduação em Família na sociedade contemporânea, Universidade Católica do Salvador (UCSAL). Av. Cardeal da Silva, 205 - Campus Universitário Federação, Salvador, Bahia. CEP: 40.231-902

Correspondence to

 

 

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ABSTRACT

Youth participation has been investigated in many fields of knowledge. Even though literature approaches aspects regarding psychological, educational and civic dimensions, there has not been a tendency to link them to a health perspective. The purpose of this article is to analyze how participative practices promote healthy developmental processes. The Sage, Scielo, Lilacs and Dialnet databases have been consulted, and articles published between 1999 and 2011 have been collected. The review of literary works combines participation and health promotion through the learning of skill sets that engender empowerment - which prepares youths to lead their own lives. Participation may be understood as a conscious and propositive socialization through which values are learned and democratic practices are assimilated, giving them the choice to be active in the public sphere. While a domain of self-promotion, participation enables youths to lead their own lives through the making of an existential project: the opportunity to define their personality as a strategy of self-care. It is understood then that participation adjusts formative mechanisms that propel a cognoscitive reflection, which is a mediator of the youth's autonomy and authorship.

Key words: participation; health promotion; citizenship; care; youth.

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INTRODUCTION

The contradictions stemming from the contemporary value, social and economic crisis's multiple forms, which have arisen mainly from changes caused by globalization, have stimulated the escalation of social inequality. These social issues reverberate with greater intensity among vulnerable groups, especially amid younger population segments. This article is part of the contemporary debate fostered by Social Sciences on the empowerment and recognition of these groups. To this end, it reviews and discusses national and international output on youth participation, linking it to health promotion.

Contemporary researches evince continuing negative indexes in youth education and health¹. Youths experience vulnerabilities in several dimensions and aspects related to the tension between values, socials representations and cultural contexts. Out of their social representation as tied to a condition of transactional being, characterized by attributes such as irresponsibility, adventure and hedonism, there arises the inherent vulnerability to an immaturity typical of their age and lack of life experience. Structural vulnerability, in turn, is a socio-historical construct related to social status, and is expressed by the limitation of political and economic power, coupled with the youths' limited civil rights^{2, 3}. Apart from social inequality-related vulnerability, which reaches youths living in poverty via urban violence, drug trafficking and unemployment, such circumstances constitute individual or environmental barriers, negatively affecting youth development.

With the arrival of the socio-ecological perspective in the 1980s, health promotion started aiming for change in the vulnerable social groups' living conditions, along with their participation in everyday-life contexts⁴. This perspective, innovative back then, is based on an expanded concept of health, defined as a dynamic and positive state of well-being, which integrates physical, mental, environmental, emotional and social aspects.

Youth participation is linked to empowerment, care and citizenship concepts by addressing skill learning and life project as driving concepts of human development. To participate means to fashion a complex process of building both the agency and point of reference of which these individuals make use. The experiences and knowledge acquired constitute resources toward the development of one's own autonomy and of the social actor himself.

This article sets out to analyze how participatory practices foster healthy developmental processes.

 

METHODS

This article adopts a qualitative strategy by using literature review on youth participation as a promoter of health. The Sage, Scielo, Lilacs and Dialnet databases have been consulted, whereby articles published between 1999 and 2011 and written in Portuguese, English and Spanish have been collected. Articles were selected through the following keyword combinations: youth participation; empowerment; agency; citizenship; resilience; wellness and health promotion (in the languages mentioned above).

Once their abstracts were read, 64 articles were collected. However, it was noted that 29 of them had focused on this study's very core theme and met the established inclusion criteria. The works selected have been structured around the concept of empowerment adopted by the World Health Organization, and analyze the experiences of youth participation in educational, cultural and socio-political projects and activities. While a fundamental practice for health promotion, empowerment is an element of participation, and is defined as the process of developing personal and social skills, as well as the ability to control decisions that affect one's life, so as to generate changes individually and collectively⁴.

Throughout the review a summary of the concept of health promotion was prepared. During the shaping of the subject, key elements for both theoretical understanding and practical implementation of health promotion were identi-fied: empowerment and participation.

This theoretical approach to the relationship of young individuals' participatory practices and healthy developmental processes gave rise to reflection on youth participation in social institutions, whose significance and effects on the formation of autonomous and socially integrated individuals were sought to be understood.

Regarding data analysis, a categorization was carried out based on three main themes identified on researches: social participation and citizenship; skill and ability development in participatory processes; and youth participation as a mediator for the change of attitude toward self-care. For each issue a table was made, comprised of the adopted theory, concepts used, methodology approach and main results found.

 

RESULTS AND DISCUSSION

Health promotion and participation

When the year of 1986 occurred the First International Conference on Health Promotion, in Canada, the Ottawa Charter became an elementary reference to "new health promotion"⁴ ideas. This document acknowledges health both as a central component in human development and a result of social conditions.

Since then, health promotion has been defined as the process that enables people to act to achieve a good living conditions⁵. This concept is associated with a set of values, among which are: solidarity, equity, democracy, citizenship, development, participation and collective action.

The emphasis on individual and group participation in health practices establishes the need to structure empowerment strategies that provide the means and resources to an increased control over the social determinants that affect their health^{4, 5}. This empowering process corresponds to the self-promotion of individuals as co-managers in meeting their needs. This study proposes that the participatory process act as a formative context, boosting personal and social development in order to provide a better quality of life.

Carvalho⁴ argues that there are two approaches to empowerment: the psychological and the community-based. The psychological takes into account the idea of restrained, independent and self-reliant, individuals as well as educational strategies that strengthen their self-esteem and ability to adapt to the environment. The emphasis on a purely individual perspective is risky in that the actions undertaken may be restricted to changing unwanted behavior.

Community empowerment, on the other hand, is a strategy for the development of individual and collective resources toward social and political actions. It involves participation in the definition of actions targeting structural changes, in order to promote status quo transformations. As a process, it combines factors of different social life spheres through the acquisition of personal skills, sharing of knowledge and increased critical awareness in groups. As for social and macro-economic structures, this process focuses on social equity.

By having a social development model based on development of people, participation is directly linked to the concept of a problematizing education. This education, reflective, implies a constant act of unveiling reality for transformative intervention and inclusion^{4, 6}; a learning model whose knowledge and experience exchange results in skills that generate and organize autonomous and responsible subjects' structuring practices.

Youth participation as an exercise of citizenship: developing social agents

Participation allows for learning to take place through practice. Young people who have experienced discrimination and social exclusion often have low self-esteem, trust and skill development issues³. They are dragged into a downward spiral by internalizing negative attitudes that define their own limits and abilities.

There are currently 51 million youths^* in Brazil between 15 and 29 years of age, which correspond to 27.4% of the population. Among the many problems faced are the high index of homicides - 38% of the total; unemployment reaching 46% of said age range; and poverty, whereby 31% of young Brazilians live with a per capita household income of less than half the minimum wage¹. Such inequality raises discontentment towards the future, an increased sense of insecurity and uncertainty as to how society progresses and how to lead life.

The lack of opportunity in youth training and education reveals how they live an incomplete citizenship⁷. Lans-down³ relates low youth abilities to a life of poor personal experiences, rather than to a weak educational potential. Experiencing control over events and having a voice in decision-making processes provide a strong sense of self-confidence and self-efficacy to deal with everyday challenges^{8, 9}. Such skills nurture the pursuit of expanded roles within the community. This changes in the social position, replicated by the surrounding community, subsidizes the redefinition of the self. Youths develop a sense of value and purpose^{10, 11}, building up their agency and spreading their actions on to other areas and social institutions.

Group experience tends to arouse republican-natured communitarian views^{12, 13} in youths. This condition takes them from a subjectivity circumscription to interaction with the world beyond themselves, an area where power dynamics become public^{14, 15}. When they are moved away from the margin on to the center of discussion, active participation can be understood as a method of awareness and reflexivity.

The kernel of the participatory process is centered on the dialogic dynamics of interaction and interpersonal exchanges that translate into new perceptions, symbols, and personal and collective meanings. Youth participation, therefore, is part of a conscious and propositional socialization process that acts as democratic values and practices' locus of learning, thereby outgrowing an authoritarian and centralized civic culture.

The citizenship results of the integration process in social reality and is manifested through the dynamics of learning, discussion and debate, listening to and respecting other opinions and building consensus and common projects^{9, 15, 16}. As youths learn to combine individual suffering and social inequality, a holistic world view is built. The making of a critical awareness is crucial in establishing an authorial and voiceful way of being. Indeed, a critical consciousness is a generative scheme that shapes, organizes and guides social praxis.

At this point, participation becomes an instrument of social change and status quo⁴ transformation, representing a civic engagement pointed toward activities in the public sphere. In the exercise of democratic practices, young people establish cooperation and reciprocity^{13, 15} relationships that give rise to sociability and solidarity ties. The ties made contribute to members forging the notion of common good and the sense of belonging and sense of community that engender the citizen. Youth social recognition leads to the creation of an expanded citizenship's social realm, and incurs in the active inclusion of the building process of the self, of others and of the society^10,14.

Promoting skills: youth participation as formative mechanism

Experiences of the self and of others are fostered by group relationships, and stimulate a person's formative mechanism. This dynamics promotes personal skills such as the self-accomplishment and self-efficacy by the perceptions that emerge from successful activity fulfillment; self knowledge as prompted by intersubjectivity; the autonomy forged in the process of collective building for definitions concerning ethical and moral values; and the shaping of a positive self image^{3, 17, 18}.

The set of skills developed, therefore, allows for young individuals to metamorphose into a way of being that gives them the option to conceive of, and realize, a life project. From this perspective, responsible youths are those endowed with the self-confidence arising from the ability to rally the knowledge and experience needed to solve a given situation at the moment they present themselves necessary. Knowing how to be and what to do triggers assertiveness, an affection of self that engenders self-esteem.

Self-esteem is understood as the subjective perception that one has about himself. It involves exercising self-knowledge and self-acceptance, that is, knowing one's own identity¹⁹. Youths form an image of themselves, of who they are as persons and how others see them. These qualitative judgments stem from shared feelings, experiences, values, rules, behaviors. Self-esteem is permeated by a person's dialog with the settings of which he is part^{19, 20}. Peer interaction allows for the generational building of values and concepts appropriate to their own moral understanding and world views. In this domain of sociability are engendered reference frames, rules of conduct and symbolic systems that shape youth cultures. In so doing, young individuals emancipate themselves from socially hegemonic ideologies, which usually give their specificities a negative assessment.

The experience of a context based on solidarity, respect and freedom contributes to learning to relate to as part of attitudes and values. Youths who know how to live together are able to interact, communicate and negotiate, developing more equitable and harmonious relationships whose bedrock lies in the acknowledgement of others, affection, commitment to the environment and the collective, and the awareness to rights and duties^{16, 21}.

The skills developed by youths during participatory processes engender their autonomy. Supported by the stream of a hermeneutics duo, individuals build themselves as cognizant beings, and in this context of subjectivity co-building, they strengthen their thinking through argumentation. It is a crucible that functions as an instrument of self-determination, as it prepares youths to exercise their social role.

Autonomy, then, is like a didactic guide^{9, 22} for personal emancipation, decisive when one is young, and therefore constantly challenged to organize daily life, set priorities, goals and plan ahead, evaluate and regulate one's actions. To be able to conceive oneself able to control one's own life, to be responsible for one's own actions and thoughts, is to define a position of authorship before the world.

Self-care: building a life project

The development and the way it is processed is the result of human activity in social relationship contexts²³; an interactive game in which young people build lifestyles that arise as mediators for their way of being. Studies on youth participation have shown the awakening of reflection about the meaning of one's own presence in the social world^{11, 18, 24}. This search for a totality of existential allows for the building, and giving meaning to, one's life project.

Projects represent a direction in life: an orderly conduct to achieve specific purposes²⁵. In youth plans outline future life. They guide building actions of the self that can trigger a driving process of self-care practices. According to Ayres²⁶, care would be the self-reflexive ability to attend to one's health, as defined and established from the practices that engender the project²⁷. Care, therefore, is the human beings' immanent ability of self-making and self-management, whereby one's way of being is a structuring action element in him own project.

A series of researches have highlighted that in participation processes, peers and instructors adults who function as a resource for learning concepts of healthy eating and hygiene, and encourage physical and cultural activities. In addition to allowing access to knowledge pertaining to society, history, politics, and democracy rules and procedures^{8,17,19,22,28,29}. Expanding one's knowledge works as a resource to care, behavior and perspective change relatively to one's place in the world, to community engagement and the sharing of values related to the common good, solidarity and justice.

Care for oneself is to define one's very existence, one's way of life in an individual's constitution's structuring process. Foucault³⁰ states that the technology of the self comprises a set of knowledge and practices that shape one's way of being. The participation process constitutes a self-reflexive pedagogy that drives young people to organize a way to live, so as to meet their expectations of well-being and life purposes.

To experience a lifestyle allows young people to assert themselves with an identity and subjectivity of their own²⁰. They develop attitudes and behaviors that let them to engage the self³⁰ in a way that their existential project can be set in motion. It is an action that promotes health through the nurturing of a good quality of life, and which, in turn, depends on the skills acquired in participatory processes to be effective^{31, 32}. Caring for the self is, then, project realization itself as an ideal of well-being that is developed and pursued by any given individual. This exercise of power forges autonomy, thereby garnering libertarian possibilities as it broadens the ability to self-manage life.

Concluding Remarks

Youth participation in activities, programs and services provides a better understanding about the extent that learning can be associated with cognitive reflexivity as mediation for an individual's autonomy and authorship. The learning that comes from being, doing and living together provides the transition through different dimensions that support the discovery of new meanings, encouraging self reinventions and metamorphoses.

As an formative process that engenders a more holistic awareness of one's own existence, youth participation emerges as the field of individual self-promotion. Project building is then transformed into criteria for individuals to analyze and shape their way of living. By acting with a view to their happiness, youths adopt care strategies that promote health, and draw a ladder by which they wish to achieve their goal.

Participating is an essential condition to emancipation, wellness and to the overcoming of the status quo. It assists young people in the building of a dimension of future and hope, teaching them ways to implement their projects: how to work so as to positively operate around certain challenges, how to solve problems, develop strategies to achieve the goals they set, that is, how to control their destiny.

Destiny control is the ability to manage the forces that affect one's life: it is empowerment itself. For the young, owning their own destiny is both a process and a requirement that calls for learning skills, whereby empowerment exerts a structural position in the changes that constitute the care and the citizen way of being.

Participation can be seen as a means to something greater: education and power. It is simultaneously a pedagogical device and a political process that embodies the direction of civic education through the practice of democratic performance in educational contexts. It has, in the participation process, the condition of self-agency locus and co-building of meanings, values and practices, allowing young people to engage in a reconstruction process in the public sphere as well as of their social role.

 

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Correspondence to:
Jamile Silva Guimarães
Rua Waldemar Falcão, portão 389, casa 19-b
Brotas, Salvador, Bahia
CEP: 40296-710. Telefone: 71-3335-0897
Email: jamile_sguimaraes@hotmail.com

Manuscript submitted mar 05 2011, accepted for publication Sep 20 2011.
Apoio: CNPq

 

 

* Youth is expressed in different age ranges. Whereas the World Health Organization considers 'youth' as the age period between 15 and 24 years of age, in Brazil it comprises the period between 15 and 29 years of age. The adopted age range (15 - 29 years of age) is the same with which the Secretariat and the National Youth Council work, the same one used by the National Youth Policy and by the Youth Statute bill under discussion in the Brazilian House of Representatives.