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William F. Connell School of Nursing

Urban lit: Do books change teens' behavior?

by elizabeth dougherty

Urban fiction bestsellers: The Coldest Winter Ever reprinted with the permission of Atria Books, a division of Simon & Schuster, Inc. and Michel Legrou, PMG, from The Coldest Winter Ever, by Sister Souljah. Front cover photo by Michel Legrou. Art and design by Lisa Litwack (New York, 1999). Flyy Girl reprinted with the permission of Simon & Schuster, Inc. and Jody Hewgill from Flyy Girl, by Omar Tyree. Jacket illustration by Jody Hewgill. Jacket design by Jackie Seow (New York, 1996). Photograph: Gary Wayne Gilbert
Urban fiction bestsellers: The Coldest Winter Ever and Flyy Girl. Photograph: Gary Wayne Gilbert

Five years ago, in the waiting room of Roxbury Comprehensive Community Health Center, women’s health nurse Allyssa Harris ’94, M.S. ’99, Ph.D. ’08, noticed a number of young female patients reading novels like Flyy Girl, by Omar Tyree, and Sister Souljah’s The Coldest Winter Ever. Gritty coming of-age stories set in the contemporary urban ’hood and packed with vivid details of sexual promiscuity, abusive boyfriends, drug dealing, and other criminal behavior, the books are classics of urban fiction, a wildly popular if controversial genre sometimes called hip-hop lit, street lit, or gangsta lit.

A certified women’s health nurse practitioner and Connell School assistant professor, Harris at the time had just started work on her doctoral dissertation examining factors that influence African American women’s contraceptive choices. She began to wonder if the books—which frequently feature teen protagonists and plots packed with illicit activity, explicit sex, and violence—might influence young adolescents’ birth control decisions.

Like any good scholar, Harris did her background research. She reviewed literature on media influence on adolescents and asked patients and staff at the clinic what books they liked to read. She visited African American bookstores and went to the Harlem Book Festival. She learned that urban lit’s widespread appeal to young, mostly female readers is a source of some debate among African American educators, librarians, writers, and artists (see sidebar). But she found no studies exploring connections between reading choices and health; no clues to information that might link books to risky behaviors.

In 2008, Harris undertook a small qualitative research study that suggested that some of the themes in urban lit might indeed affect sexual health decisions among young African American women. She published her findings in the July issue of the Journal of the National Black Nurses Association and wrote a column summarizing her research for the Huffington Post.

Harris plans soon to undertake a more rigorous study that will survey hundreds of adolescent African American women about their reading choices and sexual behaviors. Ultimately, she hopes to use what she learns to find ways of communicating more effectively with young girls about their sexual habits and health.

True to life in the ’hood

Whether and to what extent media depictions of sex, violence, and crime influence children’s behavior has been a subject of public inquiry and extensive study since at least the early 1950s, when Congress held its first hearings on violence on radio and television. Evidence overall suggests that media exposure to risky behavior, such as violence or unprotected sex, makes that behavior seem normal, says Michael Rich, associate professor of pediatrics at Harvard Medical School and director of the Center on Media and Child Health at Children’s Hospital Boston. “Media exposure to risky behavior makes it appear less risky.”

But the influence of books on sexual behavior? “This is a new area of exploration,” says Joellen Hawkins, professor emeritus of maternal and child health at Boston College and Harris’s thesis advisor, who calls her former student a “gifted” nurse, particularly in her work with adolescents. As Hawkins sees it, Harris has made a signal contribution to nursing simply by raising awareness that urban lit exists. It is an area of critical importance for nurses, says Hawkins. “We’re the ones who care for adolescents as they are emerging in their sexuality.” Often, nurses don’t know what their patients are reading, she observes. “It’s important to know where the adolescents are getting their information—or misinformation, as the case may be.”

That is especially important when caring for African American adolescents, according to Harris. A Washington University School of Medicine study in 2009 found that 74 percent of African American girls under 17 were sexually active, nearly three times more than Asian girls (28 percent) and significantly higher than whites (58 percent) and Latinos (59 percent). According to the Centers for Disease Control and Prevention, African American adolescents also have higher rates of sexually transmitted infections, including HIV/AIDS.

“I’m looking for ways to change those numbers,” says Harris. In her nursing practice, she counsels young women to use condoms, to use birth control, to stop having sex with men who have multiple partners. But the young women don’t always listen. “I couldn’t understand what was driving my patients,” she said. Urban fiction gave her a glimpse, if perhaps exaggerated, into their worlds.

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