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William F. Connell School of Nursing

Urban lit: Do books change teens' behavior?

by elizabeth dougherty

Assistant Professor Alyssa Harris
Assistant Professor Allyssa Harris at Roxbury Comprehensive Community Health Center. Photograph: Lee Pellegrini

Harris picked up her first urban lit title, B-More Careful, by Shannon Holmes, in a Barnes & Noble in 2005. It took her six months to get through it; the story was so graphic, she kept putting the book down. “Pardon my language,” she says before distilling the plot: “It’s about four girls known in the ’hood as the Pussy Pound. They trade sex for goods. So they dress all fly and have nice bags and cars.” Harris says, “It’s not my world at all. I had a middle class upbringing,” and she adds with a laugh, “While I was at BC, I lived in Bedford”—a picture-postcard New England town north of Boston.

She would learn, though, that the plot lines were readily recognizable to her patients at Roxbury Comprehensive Community Health Center, an urban community health clinic that serves patients from Roxbury and North Dorchester, two of Boston’s most impoverished neighborhoods.

Harris conducted extensive interviews with six young black women between the ages of 18 and 21, inner-city residents who had been sexually active for at least two years. The women were all longtime, avid readers of urban lit, who pass and trade the books among friends and family members. Part of the books’ appeal, they told Harris, is that they reflect real life. “The same things that happen in the books happens in the streets,” one said.

Strikingly, some of the more popular street lit titles are cautionary tales that make clear there are consequences to living the fast life. Reading The Coldest Winter Ever, in which wealthy, savvy, and sexy protagonist Winter Santiaga ends up with a 15-year prison sentence, had a profound effect on one participant, who describes her younger self as “fast,” “wearing makeup and tight pants,” “skipping school.” She told Harris, “I changed my life a lot because of that book. I was just like, I don’t want to be like that.”

Keeping it real

“From a health view, I want to know if the risky sexual behaviors in these books will turn into sexual scripts that become social norms,” says Harris. “Will young girls think this behavior”—such as having sex at a young age, selling sex, or tolerating sexual abuse (even rape)—“is what they are supposed to be doing?”

They might, she suspects, if they don’t have anyone to talk to about the books.

At age 18 or older, the study participants had no difficulty distinguishing fiction that resembles real life from life itself, according to Harris. But several expressed concern that younger readers might not be able to do the same. “They read these books and they don’t ask their parents any questions,” one interviewee said of younger family members and friends. “Or they might not even have parents to talk to or anyone to talk to. So they just go off and do what they read and hear and see.”

In the clinic, Harris has helped many an adolescent girl tell her parents about a pregnancy and coached many a young woman to tell her boyfriends about STDs. “I have to deal with the consequences of their high-risk behavior along with them,” she says. She is particularly concerned about the youngest adolescents. “They’re just developing their identities and thinking about their lives,” she says.

Harris’s aim is not to demonize urban literature, she says, but rather to identify opportunities for nurses to intervene. Indeed, she is encouraging nurses as well as parents to pick up the books and read them. “If this work can help nurses think about what their younger patients might be doing and help guide their patients and their patients’ parents,” she says, “maybe we’ll be able to change some behaviors and have better outcomes.”

Looking ahead, she is beginning to think about interventions that use the books as a way in. By talking with patients about what happens to characters in these books, either informally or as part of a discussion group, she and other nurses might open up opportunities to encourage condom use and other safer sex choices.

“My patients always think, ‘It won’t happen to me,’” says Harris. But one thing the hyper-reality portrayed in urban literature makes clear is that everybody gets caught sooner or later.

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