This lecture once again addresses some of those important social contexts that shape the health and development of young people, their families, schools and local community. Whether this be a village in a rural setting or a neighbourhood suburb in an urban setting. I previously introduced the social development model from David Hawkins and Richard Catalano of the University of Washington as a useful one for understanding how risk and protective factors may operate in each of those settings, families, schools, local neighbourhoods. At the core of the protective influence in each of these institutions and settings is a sense of connection. In families, that is evident in a young person having feelings of emotional closeness and support with parents and schools. It's around having a feeling of being safe in the sense that education has a purpose and feeling committed to that purpose. And in local communities, it's again about feeling safe and getting involved and being part, and feeling part of one's community. In each of these settings that sense of connection is dependent on good communication. Having opportunities to engage. And having any contribution to the family, to the school, to the community, recognised and valued. It's also about feeling safe and secure in each of these places and with, with ones peers. Where all this goes well and the young person has an experience of being nurtured, the likelihood is that their health and social development will be positive. Conversely, where a young person has little sense of connection or is growing up in a background of conflicts in relationships, the effects on health are likely to be profound. Implicit in the social development model is an idea that positive connection to families, schools and communities with healthy values will have multiple benefits. Where the opposite occurs, this creates multiple risks. This is illustrated in this next slide around community risk factors. Community norms, favorable to risky behaviours, so attitudes to violence, or perhaps drug use powerfully influence young people within those communities. In addition the extent to which a community is disrupted and disorganised, perhaps by high levels of mobility, affects the sense of connection that a young person might have with that community and is associated with multiple risks. In schools we see a similar pattern of influences. This slide derives from a Melbourne based study. It was the Gate House Project that demonstrated the powerful effects of enhancing the social milieu, or the social environment in schools. Really that's about making schools a better place for young people to be. The model has, again at its core, a sense of connection to teachers and other students. That sense of connection arises where a student feels safe from victimisation and bullying. Has the scope and the opportunity to communicate with teachers and where there is also an opportunity to participate in school life beyond simply doing the work and in the classroom. This project demonstrated that getting this right has profound effects on the health risks, ranging from substance abuse, to sexually risky behaviour, and extended even to anti-social behaviour such as engaging in stealing, or interpersonal violence. It's important to remember that schools and education systems are changing, with young people spending a longer time in school in many parts of the world. The benefits for health, particularly for adolescent girls, are profound. As young people spend longer in education, attention in many places has shifted to the transition into the workplace. In many places, where there are high levels of youth unemployment, this transition has become difficult. We also see that in parallel with these changes in the school to workplace transition, young people are also delaying marriage. And delaying the creation of families of their own. So, this means that their relationship with their family of origin is also changing with young people staying at home for much longer during this transitional phase. So turning to families, they remain the most important setting. The one that shapes the health and development of adolescents more than any other. Families come in many different shapes and sizes. Extended families such as the one shown on the top left are common in many poorer, less developed and rural parts of the world. In such settings the transition from family of origin to the next generation often takes place during the adolescent years, that is, at a comparatively young age. With economic development and urbanisation, families commonly change in shape. The picture in these settings is more commonly that of the nuclear family of parents and immediate children, with a more distant connection often with other family members, including grandparents. As I mentioned, the transition to new families often differs in more developed countries in that it takes place at an older age, typically in the 20s, but in some high income countries, this extends into the 30s. In general, this has had benefits both in health and attaining the skills necessary for functioning in a more complex workforce and society. However, it does commonly mean that young people spend many more years making that transition from their own family of origin to having a family of their own. If we consider again some of the ways in which family risk factors may affect health and social development, it's clear that the effects are profound. Having a family or parental history of a problem whether this be mental health, substance abuse, alcohol and tobacco use, anti-social behaviour, and offending, violence or any pregnancy, are all profound risk factors for the same thing happening to young people. And family dysfunction, whether this be disengagement from family, conflict, lack of clarity about family rules and values. These are again profound risk factors for a whole range of adolescent health and social problems. In this series of lectures on risk and protective factors, I've attempted to stress how effective responses to many adolescent health problems lie in the settings in which young people are growing up. Whatever the actions we're seeking to make, to improve the health of young people, our success will be determined by the extent to which we can affect those settings in which young people are living, working, and growing up.