Adolescents as Deliberative Citizens: Building Health Competence in Local Communities

• Author: Felton Earls,Mary Carlson
• Published date: 01 January 2011
• Date: 01 January 2011
• DOI: http://doi.org/10.1177/0002716210383648
• Subject Matter: Articles

ANNALS, AAPSS, 633, January 2011 223

Given the host of tragic events that children experi-

ence, it is often compelling for well-intended adults

to respond in a protective and charitable fashion. The

child rights approach asks for more. Building on their

collective experiences in the developmental and social

sciences, the authors present in roughly chronological

fashion a synopsis of the theoretical explorations and

scientific evaluation that completes a framework to

advance the status of c hildren as citizens. The recogni-

tion of the agency and capability of a child and the

dynamic and enduring source of socialization from and

social integration within the community are fundamental

to this project. The participatory rights enshrined in the

Convention on the Rights of the Child serve as an impe-

tus and inspiration to this project, the Young Citizens

Program. What began with small-scale deliberative groups

in Chicago matured into a cluster randomized controlled

trial in northern Tanzania.

Keywords: deliberative citizenship; communicative

action; child rights; collective efficacy;

health promotion

While Africa is rife with examples of the

tragic condition of children, there are

many reasons for optimism. The current HIV/

AIDS epidemic, disproportionately affecting

Adolescents as

Deliberative

Citizens:

Building

Health

Competence

in Local

Communities

By

MARY CARLSON

and

FELTON EARLS

Mary Carlson is an associate professor of psychiatry at

Harvard Medical School and Children’s Hospital,

Boston. Her major career transition in 1991 from devel-

opmental neurobiology to social policy was facilitated

by study at Harvard Kennedy School and with Amartya

Sen, centered on his capability approach. Her new

research focuses on early child deprivation (and enrich-

ment) and the development of methods to enable delib-

erative citizenship in adolescents to promote the health

and well-being of their communities.

Felton Earls is a professor of human behavior and

development at Harvard School of Public Health and

professor of social medicine at Harvard Medical School.

From 1990 to 2005, he was the principal investigator

of the Project on Human Development in Chicago

Neighborhoods. His current project, Ecology of HIV/

AIDS and Child Mental Health in Tanzania, is a cluster

randomized control trial that aims to strengthen adoles-

cents’ capacities to promote community health through

the Young Citizens Program.

DOI: 10.1177/0002716210383648

224 THE ANNALS OF THE AMERICAN ACADEMY

sub-Saharan Africa, has led to the popular characterization of children in this

region as “orphans and vulnerable.” Labeling children by their circumstances

rather than their capacities is unfortunate and stigmatizing (Earls, Raviola, and

Carlson 2008). It is an orientation that invites charity rather than respect. Every

energetic, knowledgeable, and joyful child represents the hope of a more posi-

tive future—an Africa that is socially and politically vibrant, economically devel-

oped, and equitable. Children cannot thrive if their communities are not capable

of providing consistent, responsive, and competent care, along with good gover-

nance and human services. Nor can communities prosper if their youngest mem-

bers are not recognized as respected and active participants. Such a hopeful

attitude for Africa and its children applies to all children and in all settings, as

envisioned by the United Nations (UN) Convention on the Rights of the Child

(CRC). This remarkable document inspires our view that children be recognized

as “young citizens” (YCs).

The first half of this article characterizes the theoretical formulation and

research that establishes our perspective on children as citizens. From a theo-

retical foundation that Amartya Sen, Jürgen Habermas, and others inform, we

developed the Young Citizens Program (YC Program). The second half of the

article presents the evolution of the YC Program from a small-scale series of

deliberative groups in Chicago and Cambridge to its rigorous evaluation in a

community-based randomized control trial in Tanzania. The objectives of the

Tanzanian study are to measure the consequences of children’s participation

in promoting community competence. The adequacy of our evolving theory is

judged by how well it addresses children of different ages and across a range

of advantaged to disadvantaged environments. The legitimacy of this approach

requires the perspectives of children and must be judged by the ethical and

practical implications such formulations have for children’s current well-being

and extended life course.

Children and Deliberative Citizenship:

A Theoretical and Pragmatic Framework

The status of children as citizens who genuinely participate in the community

requires the recognition and guidance of adult citizens. In a thought-provoking

essay, Children: Noble Causes or Worthy Citizens (1997), Swedish social scientist

Karl-Eric Knutsson argues that we must move beyond the charitable approaches

of “noble causes” to the post-CRC vision of “worthy citizens.” In his concluding

chapter, “Recognizing the Child Citizen,” he states,

To lay a basis for finally recognizing the child as citizen we must consider the larger

contexts of globalization and intergenerational perspectives as well as more immediate

political environments on the national and local levels. We must also consider the need

for new partnerships for children and with children based on the conviction that the

best interest of the child is in most cases also the best interest of the larger society.

(Knutsson 1997, 123)