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4. Summary and Comment

A Mixed Report Card on Adolescent Health

The CDC’s Youth Risk Behavior Surveillance System tracks the health of the nation’s adolescents.

Every other year since 1991, the CDC has surveyed adolescents and young adults (9th–12th grade) on the national, state, and local levels to monitor health-risk behaviors. The 2005 Youth Risk Behavior Surveillance System represents nearly 14,000 youths who completed the survey. Results of the 2005 survey were published in the June 9, 2006 issue of the Morbidity and Mortality Weekly Report. Because JWPAM recently covered adolescent drug use based on data from the 2005 Monitoring the Future Survey, this summary focuses on student reports of other health-risk behaviors.

UNINTENTIONAL INJURIES, VIOLENCE, AND SUICIDE

• 10% of students (vs. 26% in 1991) rarely or never wear a seat belt when riding in a car with someone else (12% of males and 8% of females).
  
• 83% of students rarely or never wear a bicycle helmet.
  
• 29% of students (vs. 40% in 1991) rode at least once in the past month in a car driven by someone who had consumed alcohol, and 10% (vs. 17% in 1991) drove a car or other vehicle at least once after drinking alcohol (12% of males and 8% of females).
  
• 18% of students (vs. 26% in 1991 and 17% in 1999) reported carrying a weapon at least once in the past month (30% of males and 7% of females). Five percent reported carrying a gun (10% of males and <1% of females).
  
• 36% of students had been in a physical fight at least once in the past year (43% of males and 28% of females). The rate was 43% in 1991, decreased to 33% in 2003, and then increased again in 2005.
  
• 9% of students reported they had been hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend in the past year. Rates were comparable among black males and females (12%) and among white males and females (8%). More Hispanic males (11%) than females (9%) reported dating violence.
  
• 8% of students report ever having been physically forced to have sex (4% of males and 11% of females).
  
• In the past year, 29% of students (37% of females and 20% of males) reported having felt so sad or hopeless almost daily for at least 2 weeks that they stopped doing some usual activities. Also, 17% (vs. 29% in 1991) seriously considered suicide, 13% (vs. 19%) made a plan, and 8% (vs. 7%) attempted suicide. About 2% of suicide attempts were severe enough to warrant medical attention.
  

SEXUAL BEHAVIORS

• 47% of students (vs. 54% in 1991) reported ever having sexual intercourse. The rate was highest among 12th graders (63%) and lowest among 9th graders (34%). About 34% reported having had sex at least once in the past 3 months.
  
• 14% of students (vs. 19% in 1991) reported having had sex with at least four people during their lifetime (17% of males and 12% of females). About 6% had intercourse before age 13 (9% of males and 4% of females).
  
• 63% of sexually active students (vs. 46% in 1991) reported using a condom with their partner the last time they had sex. About 23% reported using alcohol or other drugs before that sexual encounter. Thirteen percent of females and 10% of males had been tested for HIV.
  

NUTRITIONAL/WEIGHT CONTROL BEHAVIORS

• Only 20% of students (vs. 24% in 1991) had consumed at least five servings of fruits and vegetables per day, and only 16% drank at least three glasses of milk per day in the past week.
  
• 46% of students were trying to lose weight (62% of females and 30% of males); 60% had exercised to lose or not gain weight; 12% had not eaten for 24 hours or more; 6% had taken diet pills, powders, or liquids; and 5% vomited or used laxatives. The prevalence of each of these behaviors was higher in females.
  

PHYSICAL ACTIVITY/SEDENTARY BEHAVIORS

• Only 36% of students met the currently recommended level of physical activity (60 minutes/day on 5 of the past 7 days with exercise that increases the heart rate). About 10% had not participated in any moderate or vigorous activity (unchanged from 1999).
  
• On an average school day, 21% played video or computer games for nonschool-related activities, and 37% watched television for at least 3 hours (vs. 43% in 1999).
  

Comment: For many health-related risk behaviors, adolescents have made significant improvements since 1991. However, more recent trends indicate that rates of physical violence and weapon carrying have increased. The low level of physical activity and high level of sedentary behavior mirror the rising prevalence of overweight among teenagers. Not surprisingly, many adolescents adopted unhealthy weight-control practices. The prevalence of risk behaviors at both the state and local levels vary widely, so pediatricians may want to consult the tables accompanying the report for data relevant to their practices.

— Alain Joffe, MD, MPH, FAAP

Published in Journal Watch Pediatrics and Adolescent Medicine September 20, 2006

Citation(s):

Eaton DK et al. Youth Risk Behavior Surveillance — United States, 2005. MMWR Surveill Summ 2006 Jun 9; 55:1-108. (http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5505a1.htm)

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