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      Youth Risk Behavior Surveillance — United States, 2017

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          Abstract

          Problem

          Health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults in the United States. In addition, significant health disparities exist among demographic subgroups of youth defined by sex, race/ethnicity, and grade in school and between sexual minority and nonsexual minority youth. Population-based data on the most important health-related behaviors at the national, state, and local levels can be used to help monitor the effectiveness of public health interventions designed to protect and promote the health of youth at the national, state, and local levels.

          Reporting Period Covered

          September 2016–December 2017.

          Description of the System

          The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-related behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of other health-related behaviors, obesity, and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. Starting with the 2015 YRBSS cycle, a question to ascertain sexual identity and a question to ascertain sex of sexual contacts were added to the national YRBS questionnaire and to the standard YRBS questionnaire used by the states and large urban school districts as a starting point for their questionnaires. This report summarizes results from the 2017 national YRBS for 121 health-related behaviors and for obesity, overweight, and asthma by demographic subgroups defined by sex, race/ethnicity, and grade in school and by sexual minority status; updates the numbers of sexual minority students nationwide; and describes overall trends in health-related behaviors during 1991–2017. This reports also summarizes results from 39 state and 21 large urban school district surveys with weighted data for the 2017 YRBSS cycle by sex and sexual minority status (where available).

          Results

          Results from the 2017 national YRBS indicated that many high school students are engaged in health-risk behaviors associated with the leading causes of death among persons aged 10–24 years in the United States. During the 30 days before the survey, 39.2% of high school students nationwide (among the 62.8% who drove a car or other vehicle during the 30 days before the survey) had texted or e-mailed while driving, 29.8% reported current alcohol use, and 19.8% reported current marijuana use. In addition, 14.0% of students had taken prescription pain medicine without a doctor’s prescription or differently than how a doctor told them to use it one or more times during their life. During the 12 months before the survey, 19.0% had been bullied on school property and 7.4% had attempted suicide. Many high school students are engaged in sexual risk behaviors that relate to unintended pregnancies and STIs, including HIV infection. Nationwide, 39.5% of students had ever had sexual intercourse and 9.7% had had sexual intercourse with four or more persons during their life. Among currently sexually active students, 53.8% reported that either they or their partner had used a condom during their last sexual intercourse. Results from the 2017 national YRBS also indicated many high school students are engaged in behaviors associated with chronic diseases, such as cardiovascular disease, cancer, and diabetes. Nationwide, 8.8% of high school students had smoked cigarettes and 13.2% had used an electronic vapor product on at least 1 day during the 30 days before the survey. Forty-three percent played video or computer games or used a computer for 3 or more hours per day on an average school day for something that was not school work and 15.4% had not been physically active for a total of at least 60 minutes on at least 1 day during the 7 days before the survey. Further, 14.8% had obesity and 15.6% were overweight. The prevalence of most health-related behaviors varies by sex, race/ethnicity, and, particularly, sexual identity and sex of sexual contacts. Specifically, the prevalence of many health-risk behaviors is significantly higher among sexual minority students compared with nonsexual minority students. Nonetheless, analysis of long-term temporal trends indicates that the overall prevalence of most health-risk behaviors has moved in the desired direction.

          Interpretation

          Most high school students cope with the transition from childhood through adolescence to adulthood successfully and become healthy and productive adults. However, this report documents that some subgroups of students defined by sex, race/ethnicity, grade in school, and especially sexual minority status have a higher prevalence of many health-risk behaviors that might place them at risk for unnecessary or premature mortality, morbidity, and social problems (e.g., academic failure, poverty, and crime).

          Public Health Action

          YRBSS data are used widely to compare the prevalence of health-related behaviors among subpopulations of students; assess trends in health-related behaviors over time; monitor progress toward achieving 21 national health objectives; provide comparable state and large urban school district data; and take public health actions to decrease health-risk behaviors and improve health outcomes among youth. Using this and other reports based on scientifically sound data is important for raising awareness about the prevalence of health-related behaviors among students in grades 9–12, especially sexual minority students, among decision makers, the public, and a wide variety of agencies and organizations that work with youth. These agencies and organizations, including schools and youth-friendly health care providers, can help facilitate access to critically important education, health care, and high-impact, evidence-based interventions.

          Related collections

          Most cited references 17

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          Reliability and validity of self-reported height and weight among high school students.

          To assess the reliability and validity of self-reported height and weight, and variables calculated from these values, in a diverse sample of adolescents. A convenience sample of students (n = 4619) in grades 9 through 12 reported their height and weight on two questionnaires administered approximately 2 weeks apart. Using a standard protocol, a subsample of these students (n = 2032) also were weighed and had their height measured following completion of the first questionnaire. Self-reported heights at Time 1 and Time 2 were highly correlated, and the mean difference between height at Time 1 and Time 2 was small. Results were similar for self-reported weight at Time 1 and Time 2 and body mass index (BMI) calculated from these values. Although self-reported values of height, weight, and BMI were highly correlated with their measured values, on average, students overreported their height by 2.7 inches and underreported their weight by 3.5 pounds. Resulting BMI values were an average of 2.6 kg/m(2) lower when based on self-reported vs. measured values. The percentages of students classified as "overweight" or "at risk for overweight" were therefore lower when based on self-reported rather than on measured values. White students were more likely than those in other race/ethnic groups to overreport their height, and the tendency to overreport height increased by grade. Female students were more likely than male students to underreport their weight. Self-reported height, weight, and BMI calculated from these values were highly reliable but were discrepant from measured height, weight, and BMIs calculated from measured values. BMIs based on self-reported height and weight values therefore underestimate the prevalence of overweight in adolescent populations.
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            A critique of research on sexual-minority youths.

             Mary C Savin (2001)
            Developmental scientists should seriously reconsider traditional empirical and theoretical paradigms that narrowly define sexual-minority adolescents in terms of those who adopt a culturally defined sexual identity label. A broader consideration of youth populations who have same-sex desires but who might not necessarily identify as gay, lesbian or bisexual, lead one to a very different understanding of sexual-minority youths than is apparent in most published studies. First, they are in most regards just like all other adolescents with similar developmental needs and concerns. Second, they are not a homogeneous group but vary among themselves in predictable ways. Third, this expanded definition allows us to conclude that same-sex attraction per se does not lead to pathology or to problematic behavior such as drug abuse, suicide, prostitution or HIV infection. Indeed, researchers and clinicians should focus on the resiliency that often characterizes sexual-minority youths. Copyright 2001 The Association for Professionals in Services for Adolescents.
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              Methodology of the Youth Risk Behavior Surveillance System--2013.

               ,  Shari Shanklin,   (2013)
              Priority health-risk behaviors (i.e., interrelated and preventable behaviors that contribute to the leading causes of morbidity and mortality among youths and adults) often are established during childhood and adolescence and extend into adulthood. The Youth Risk Behavior Surveillance System (YRBSS), established in 1991, monitors six categories of priority health-risk behaviors among youths and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) sexual behaviors that contribute to human immunodeficiency virus (HIV) infection, other sexually transmitted diseases, and unintended pregnancy; 3) tobacco use; 4) alcohol and other drug use; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma among this population. YRBSS data are obtained from multiple sources including a national school-based survey conducted by CDC as well as schoolbased state, territorial, tribal, and large urban school district surveys conducted by education and health agencies. These surveys have been conducted biennially since 1991 and include representative samples of students in grades 9-12. In 2004, a description of the YRBSS methodology was published (CDC. Methodology of the Youth Risk Behavior Surveillance System. MMWR 2004;53 [No RR-12]). Since 2004, improvements have been made to YRBSS, including increases in coverage and expanded technical assistance.This report describes these changes and updates earlier descriptions of the system, including questionnaire content; operational procedures; sampling, weighting, and response rates; data-collection protocols; data-processing procedures; reports and publications; and data quality. This report also includes results of methods studies that systematically examined how different survey procedures affect prevalence estimates. YRBSS continues to evolve to meet the needs of CDC and other data users through the ongoing revision of the questionnaire, the addition of new populations, and the development of innovative methods for data collection.
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                Author and article information

                Journal
                MMWR Surveill Summ
                MMWR Surveill Summ
                SS
                MMWR Surveillance Summaries
                Centers for Disease Control and Prevention
                1546-0738
                1545-8636
                15 June 2018
                15 June 2018
                : 67
                : 8
                : 1-114
                Affiliations
                Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA; ICF International, Rockville, Maryland; Westat, Rockville, Maryland
                Author notes
                Corresponding author: Laura Kann, PhD, Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Telephone: 678-315-2406; E-mail: lkk1@ 123456cdc.gov .
                Article
                ss6708a1
                10.15585/mmwr.ss6708a1
                6002027
                29902162
                9c43126d-761c-4f15-b850-4361cf43cf45

                All material in the MMWR Series is in the public domain and may be used and reprinted without permission; citation as to source, however, is appreciated.

                Categories
                Surveillance Summaries

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