Social Issues Affecting America's Children - Youth Risk Behaviors
As early as 1991 the CDC identified six priority health-risk behaviors that were linked to disease and death among all age groups:
- Behaviors that contribute to unintentional injuries and violence
- Tobacco use
- Alcohol and other drug use
- Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs)
- Unhealthy dietary behaviors
- Physical inactivity and overweight
The CDC determined that health-risk behaviors were often established during youth and continued into adulthood. Furthermore, the CDC concluded that these behaviors were interrelated and preventable. As educational initiatives were developed to help youth change these behaviors, the CDC established methods, such as the Youth Risk Behavior Survey (YRBS), to monitor progress. This school-based, biennial survey tracked health-risk behaviors of students in grades nine through twelve.
Risk-Behavior for Leading Causes of Death among Youth
Results of the 2003 survey demonstrated that, during the thirty days preceding the survey, numerous high school students engaged in behaviors that increased their likelihood of death from one of the four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. In addition, many students had developed health-risk behaviors that, if continued, could contribute to cardiovascular disease and cancer in their adult years. For example, 22% of high school students had smoked cigarettes, 78% had not eaten five or more servings per day of fruits and vegetables, 33% had participated in insufficient physical activity, and 14% were overweight.
Motor Vehicles, Seatbelts, and Alcohol
Motor-vehicle crashes were the leading cause of death in the ten to twenty-four age group in 2003. Alcohol and failure to use seatbelts were significant contributing factors. According to the 2003 YRBS, female students appeared to be less likely to ignore seat belt safety than male students. While 17.6% of ninth-grade females reported that they never or rarely used seatbelts when riding as a passenger in a car, just 10.9% of twelfth-grade females said they did not buckle up. Among male students, however, 22.9% of ninth graders and 21.1% of twelfth graders rarely or never wore seat belts as a passenger. Drinking and driving habits also differed among male and female students surveyed. Female students were more likely to ride with a driver who had been drinking alcohol (31.1%) than to drive a vehicle after drinking (8.9%). An average 15% of male students admitted they had driven a car after drinking.
A related study by the HHS revealed that youth and young adults in the seventeen to twenty-four age range were most likely to drive a motor vehicle while under the
FIGURE 4.6
influence of illegal drugs. Seven percent of sixteen-yearolds reported using drugs and driving, while 18% of twenty-one-year-olds did, which was the highest out of all age groups. (See Figure 4.6.)
Fights and Weapons
Fighting and carrying weapons increased risks of unintentional injuries and homicides among students. In the 2003 YRBS, an average 25% of female students and 40.5% of male students reported they had been in one or more fights in the twelve months preceding the survey. As students matured, the number involved in fights decreased. While 31.9% of ninth-grade females and 44.8% of ninth-grade males reported being in fights, by twelfth grade only 17.7% of females and 35% of males were involved in fights. Injuries resulted from fights for 2.6% of female students and 5.7% of male students. Carrying a weapon was more common among male students (26.9%) than female students (6.7%). More specifically, only 1.6% of female students reported carrying a gun compared to 10.2% of male students. As students matured, carrying weapons became less frequent for female students but slightly more frequent for male students.
Tobacco, Alcohol, and Drugs
The YRBS revealed reductions in use of tobacco and alcohol among youth. The percentage of students who reported current cigarette smoking had dropped from a high of 36% in 1997 to 22% in 2003. There was little difference in cigarette use between male and female students. In the thirty days prior to the survey, 21.9% of female students and 21.8% of male students had smoked one or more cigarettes. While 75% of high school students had tried alcohol, 44.9% had one or more alcoholic drinks within the thirty days preceding the survey, and 28.3% had five or more drinks in a row during the same period. Just over 40% of students reported they had tried marijuana, while 22.4% reported current marijuana use.
Although 8.7% of all students reported they had tried some form of cocaine (including powder, "crack", or "freebase") at least once, only 4.1% reported current use. Just over 3% of students reported they had used a needle to inject illegal drugs. When asked about use of inhalants (sniffing glue, breathing paint, or breathing the contents of aerosol spray cans), 12.1% of students had experimented at least once and 3.9% reported current use. Just over 6% of students also reported they had used illegal steroids. Just over 3% of students had tried heroin at least once, 7.6% had tried methamphetamines, and 11.1% had tried ecstasy.
More than one-fourth of high school students experimented with drinking alcohol and close to one-fifth smoked at least one cigarette before age thirteen. Marijuana may have been less easily obtained, yet 10% of students tried that substance at young ages. A greater percentage of male than female students reported they had tried each of these substances prior to age thirteen.
Teen Suicide
The YRBS also studied depression among teens. Abandoning usual activities due to feeling sad or hopeless almost every day for two or more weeks was more common among female students (35.5%) than male students (21.9%). But when it came to seriously considering a suicide attempt or actually making a suicide plan, the gap between male and female narrowed, with 18.9% of girls and 14.1% of boys reported having made a suicide plan in the twelve months prior to responding to the YRBS. While the percentage of males who made a suicide plan was fairly constant at all grade levels, the proportion of female students who planned suicide declined steadily from 20.9% of ninth graders to 16.2% of twelfth graders. The decrease in actual suicide attempts by grade level was even more dramatic for female students. Among ninth-grade females 14.7% had attempted suicide during the twelve months preceding the survey compared to 6.9% of twelfth-grade females. About one-fourth of the suicide attempts reported by female students required medical attention. Less than half the percentage of male students (5.4%) attempted suicide compared to female students (11.5%) and the decrease in attempts by grade level was far less significant.
National Health Objectives
In January 2000 the HHS released a statement of national health objectives called Healthy People 2010. This comprehensive set of disease prevention and health promotion objectives was designed to guide the nation's health achievement over the first decade of the new century. Created by scientists both inside and outside of government, it identified a wide range of public health priorities and specific, measurable objectives. The results from the 2003 YRBS were measured against the Healthy People 2010 goals for youth. Some objectives had much room for improvement, such as the 28.4% of teens who participated in daily school physical education compared to the 2010 target of 50%. The proportion of teens who said they rode with a driver who had been drinking alcohol had decreased to 30.2%, nearly matching the 30% target for 2010. Physical fighting among teens had also dropped to within one percentage point of the target.
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