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PubMed1998

Primary care providers' responsiveness to health-risk behaviors reported by adolescent patients.

OBJECTIVE: To assess clinicians' responsiveness to health-risk behaviors reported by adolescent patients during a comprehensive clinical preventive services visit. DESIGN: Nonprobability sample of adolescent patients scheduled for a routine physical examination. SETTING: Seven clinical sites in the Chicago, Ill, area. PARTICIPANTS: Fifteen primary care providers and 95 adolescent patients between 11 and 18 years of age. INTERVENTION: Providers delivered comprehensive clinical preventive services to adolescent patients using the Guidelines for Adolescent Preventive Services model. This model includes screening, guidance, a physical examination, and immunizations. Prior to the visit, adolescent patients completed a screening questionnaire that included a 52-item health-risk behavior profile. Responses on the screening questionnaire were discussed during the visit. MAIN OUTCOME MEASURES: Each provider's responsiveness to reported health-risk behaviors was determined by comparing the adolescent patient's responses on the screening questionnaire with those reported during a debriefing interview with the adolescent about whether specific subjects were discussed. Responsiveness to highly sensitive behaviors was determined by comparing the screening questionnaire and the medical record. RESULTS: On average, each adolescent patient reported 10 risk behaviors, of which 7 were discussed. The severity of the reported risk behavior, the number of reported biological health concerns, and the adolescent patient's sex were significant predictors of the provider's responsiveness. The number of reported health-risk behaviors, visit duration, provider's professional role and sex, whether the adolescent was a new patient, and the adolescent patient's age were unrelated to responsiveness. CONCLUSIONS: Providers addressed most health-risk behaviors reported during a single visit, but responsiveness declined when 3 or more biological health concerns or relatively severe problems were reported. Steps can be taken to increase providers' responsiveness.

Adolescent↗
PubMed1998

Gambling and other risk behaviors among 8th- to 12th-grade students.

OBJECTIVE: To examine the associations between a self-reported history of gambling or problems related to gambling and health risk behaviors in adolescence. DESIGN: An anonymous risk behavior survey was administered to 21 297 8th- through 12th-grade students in 79 public and private schools in Vermont. Gambling or problems related to gambling were the outcome variables of interest. Demographic variables and 13 target risk behaviors related to substance use, sexual activity, and violence were tested for association with gambling and problems related to gambling. RESULTS: Of the students, 53% reported gambling in the past 12 months, and 7% reported problems attributable to gambling. Male gender, any use of alcohol, infrequent use of cigarette smoking, any marijuana use, any inhalant use, infrequent steroid use, frequent illegal drug use, seatbelt nonuse, driving after drinking alcohol, being threatened, carrying a weapon, being involved in a fight, and years of sexual activity were all significantly associated with reported gambling in the past 12 months. Among the students who gambled, younger age, male gender, daily marijuana use, frequent use of cocaine, frequent use of inhalants, any steroid use, never wearing seatbelts, carrying a weapon for up to 3 days a month, fighting, and years of sexual activity were all significantly associated with reported problems with family and friends as a consequence of gambling. There was an increase in the absolute number of risk behaviors reported between those who had not gambled, those who had gambled, and those for whom gambling had created problems. CONCLUSIONS: Risk behaviors are associated with gambling in adolescence. The typology of risk behaviors was different for adolescents who reported gambling compared with those for whom gambling had created problems. Both gambling and problems related to gambling were significantly associated with the absolute number of risk behaviors reported by adolescents in a graded manner. Involvement in gambling should be assessed as part of the health encounter. Assessment may provide a nonthreatening entry into the evaluation of other risk behaviors. Furthermore, it may identify youth who are at risk of developing additional risk behaviors or pathological gambling. Interventions then could be targeted toward prevention of these undesirable outcomes.

Adolescent↗
PubMed2002

Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men--six U.S. cities, 1994-1998.

The incidence of human immunodeficiency virus (HIV) infection among young black men who have sex with men (BMSM) is among the highest of all risk groups in the United States. Two important strategies to reduce HIV transmission among young BMSM are to increase the proportion of men who are aware of their HIV infection and to increase the consistent use of condoms among sexually active men. However, limited information is available to help develop HIV-testing and condom-promotion programs for young BMSM. To address this need, data from CDC's Young Men's Survey (YMS) were used to evaluate the prevalence of unrecognized HIV infection, barriers to testing, and reasons for nonuse of condoms among BMSM aged 15-22 years. This report summarizes the results of the survey, which indicated that of the 16% of young BMSM participants who were infected with HIV, nearly all were unaware of their infection. Few young BMSM reported testing frequently for HIV, and many reported engaging in behaviors that could transmit HIV because they perceived themselves or their partners to be at low risk for infection. These findings underscore the urgency of expanding and improving prevention efforts for young BMSM by increasing the demand for and availability of HIV-testing services and by providing high-quality prevention counseling that includes assessment and clarification of perceived risks for infection.

Adolescent↗
PubMed1997

Behavioral risk factors among physicians working at Faculty of Medicine - Ain Shams University.

BACKGROUND: Behavioral factors and lifestyle are increasingly recognized as underlying causes of preventable morbidity and premature death. Physicians frequently advise their patients about quitting smoking, losing weight, and increasing physical activity; so what about their own personal behavioral choices? PURPOSE: To determine the prevalence of behavioral risk factors that physicians are currently practicing and its relation to some demographic variables. METHODS: 616 staff physicians, of both sexes, were randomly selected to fill a questionnaire inquiring about major behavioral risks. Among the behavioral risks investigated were smoking, physical inactivity, overweight, non-use of seatbelts. Univariate and multivariate analysis were done in which all behavioral risks were dichotomized into at risk or no risk and related to different demographic factors. RESULTS: 382 physicians participated (response rate 62%). Current smoking among male physicians was 26.6%, past smokers 12.1%, 51% of current smokers reported smoking in front of patients or in clinic. Among all participants, 84% were sedentary (no, or irregular physical activity), 59.9% were overweight (Body Mass Index > or = 25). Regular use of seatbelts was only followed by 11.2%. Routine checkup within the past year was reported by 18.6%, blood cholesterol checkup by 15.4%. Regarding aspects of women's health, a clinical breast examination was done in 32.5% of women physicians > or = 40 years, a cervical smear in 10%, and a mammogram in 7.5%. Different behavioral risks were found to be associated with different sets of demographic variables. CONCLUSION: Efforts are necessary to promote physicians to quit smoking, increase physical activity, lose weight, use seatbelts, screen for chronic diseases, to minimize preventable disorders.

Adult↗
PubMed2006

Variations in associations of health risk behaviors among ethnic minority early adolescents.

PURPOSE: To investigate patterns of vulnerability and protection factors associated with risk behaviors and the co-occurrence of risk behaviors in minority ethnicity early adolescents. METHODS: Analysis of data from the Research with East London Adolescents Community Health Survey (RELACHS), a school-based study of a representative sample of 2789 adolescents age 11-14 in 2001 (sample 73% non-Caucasian, 21% born outside the United Kingdom). Questionnaire data were obtained on sociodemographic variables, ethnicity, smoking, drinking, drug use, psychological well-being, physical health, and social support from family and peers. Models of associations for each behavior and co-occurrence of risk behaviors (defined as engaging in > or = 2 behaviors) were developed by hierarchical stepwise logistic regression. RESULTS: Two hundred ninety-two (10.9%) reported 1 risk behavior, 84 (3.1%) reported 2, and 25 (0.9%) reported 3 behaviors. In multivariate models, psychological morbidity was associated with higher risk of all behaviors and co-occurrence, while higher family support was associated with lower risk in all models. Non-Caucasian ethnicity was associated with lower risk of regular smoking and co-occurrence but not drinking or drugs. Birth outside the United Kingdom was associated with lower risk for individual behaviors but not co-occurrence. Religion and religious observance were associated with lower risk of smoking and drinking but not drug use or co-occurrence. Peer connectedness was associated with drug use, but with increased risk. Socioeconomic status was associated only with smoking. CONCLUSIONS: Patterns of associations of personal, family, and environmental factors appear to differ between smoking, drinking, lifetime drug use, and the co-occurrence of these behaviors. Hypotheses regarding common factors related to health risk behaviors may be misleading in ethnic minorities and immigrants. Co-occurrence may represent a distinct behavioral domain of risk that is partly culturally determined.

Adolescent↗
PubMed2005

HIV-specific social support predicts less sexual risk behavior in gay male couples.

Gay male couples (N = 47) completed self-administered questionnaires at 2 time points (6 months apart) regarding their levels of general and HIV-specific social support and sexual behavior. HIV-specific social support measured partner support pertaining to HIV risk behavior. The sexual-risk-behavior outcome encapsulated monogamy, serostatus, and unprotected anal sex for each partner. The authors used an analytic approach that maintained the couple as the unit of analysis. General social support was an inconsistent predictor of HIV risk behavior. However, couples that reported greater levels of HIV-specific social support engaged in less HIV risk behavior at each time point as well as longitudinally. This study demonstrated the utility of measuring HIV-specific social support and its predictive ability related to HIV risk behavior.

Adolescent↗
PubMed1998

Youth risk behavior survey: the Alaskan perspective.

The Youth Risk Behavior Survey (YRBS) is a national school-based survey used to monitor health risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults in the United States. Both high school and middle school surveys were administered to a representative group of Alaska high school and middle school students for the first time in 1995. Surveys were administered in a confidential and anonymous manner, taking care to assure student privacy. A total of 1,634 high school students and 1,265 middle school students completed surveys. The survey revealed that, for the most part, Alaska students are similar to U.S. students. Among high school students, 23.2% of boys and 15.4% of girls seldom or never used seat belts; 36.4% of boys and 36.5% of girls had smoked cigarettes in the previous 30 days; 23.5% of boys and 6.7% of girls had used smokeless tobacco in the previous 30 days; 48.7% of boys and 48.0% of girls reported having had sexual intercourse at least once; 23.7% of boys and 59.5% of girls were trying to lose weight; and 77.9% of boys and 65.6% of girls had exercised vigorously on three of the previous seven days. The middle school survey was somewhat different than the high school survey, so that results are not directly comparable. Nonetheless, the data indicate that high-risk behaviors, such as tobacco use, drug use, and early sexual intercourse, do occur at the middle school level. The survey also showed that Alaska teens have desirable health behaviors as well, such as frequent exercise and eating fruits and vegetables. The 1995 Alaska YRBS was the first time that representative data on Alaska students were collected on a statewide basis. The YRBS provides Alaska with baseline data that can be compared to national data.

Adolescent↗
PubMed2000

State-specific prevalence of selected health behaviors, by race and ethnicity--Behavioral Risk Factor Surveillance System, 1997.

PROBLEM/CONDITION: In the United States, disparities in risks for chronic disease (e.g., diabetes, cardiovascular disease, and cancer) and injury exist among racial and ethnic groups. This report summarizes findings from the 1997 Behavioral Risk Factor Surveillance System (BRFSS) of the distribution of access to health care, health-status indicators, health-risk behaviors, and use of clinical preventive services across five racial and ethnic groups (i.e., whites, blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders) and by state. REPORTING PERIOD COVERED: 1997. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (i.e., persons aged > or = 18 years) population. In 1997, all 50 states, the District of Columbia, and Puerto Rico participated in the BRFSS. RESULTS: Variations in risk for chronic disease and injury among racial and ethnic groups exist both within states and across states. For example, in Arizona, 11.0% of whites, 26.2% of Hispanics, and 50.5% of American Indians or Alaska Natives reported having no health insurance. Across states, the median percentage of adults who reported not having this insurance ranged from 10.8% for whites to 24.5% for American Indians or Alaska Natives. Other findings are as follows. Blacks, Hispanics, American Indians or Alaska Natives, and Asians or Pacific Islanders were more likely than whites to report poor access to health care (i.e., no health-care coverage and cost as a barrier to obtaining health care). Blacks, Hispanics, and American Indians or Alaska Natives were more likely than whites and Asians or Pacific Islanders to report fair or poor health status, obesity, diabetes, and no leisure-time physical activity. Blacks were substantially more likely than other racial or ethnic groups to report high blood pressure. Among all groups, American Indians or Alaska Natives were the most likely to report cigarette smoking. Except for Asians or Pacific Islanders, the median percentage of adults who reported not always wearing a safety belt while driving or riding in a car was > or = 30%. The Papanicolaou test was the most commonly reported screening measure: > or = 81% of white, black, and Hispanic women with an intact uterine cervix reported having had one in the past 3 years. Among white, black, and Hispanic women aged > or = 50 years, > or = 63% reported having had a mammogram in the past 2 years. Approximately two thirds of white, black, and Hispanic women aged > or = 50 years reported having had both a mammogram and a clinical breast examination in the past 2 years; this behavior was least common among Hispanics and most common among blacks. Screening for colorectal cancer was low among whites, blacks, and Hispanics aged > or = 50 years: in each racial or ethnic group, < or = 20% reported having used a home-kit blood stool test in the past year, and < or = 30% reported having had a sigmoidoscopy within the last 5 years. INTERPRETATION: Differences in median percentages between racial and ethnic groups, as well as between states within each racial and ethnic group, are likely mediated by various factors. According to published literature, socioeconomic factors (e.g., age distribution, educational attainment, employment status, and poverty), lifestyle behaviors (e.g., lack of physical activity, alcohol intake, and cigarette smoking), aspects of the social environment (e.g., educational and economic opportunities, neighborhood and work conditions, and state and local laws enacted to discourage high-risk behaviors), and factors affecting the health-care system (e.g., access to health care, and cost and availability of screening for diseases and health-risk factors) may be associated with these differences. ACTION TAKEN: States will continue to use the BRFSS to collect information about health-risk behaviors among various racial and ethnic groups. (ABSTRACT TRUNCATED)

Black or African American↗
PubMed2001

Patterns of health-risk behavior among Japanese high school students.

This study explored patterns of health-risk behaviors among Japanese high school students and examined if a cluster and an accumulation of health-risk behaviors existed. Self-administered questionnaires were employed in 1999 using a sample of 1,466 students (male 50.5%, female 49.5%) in grades 10 through 12 at seven public senior high schools in Okinawa, Japan. Health-risk behaviors studied included cigarette smoking, alcohol use, thinner use, nonuse of seat belts, suicide ideation, sexual intercourse, weight loss practices, and physical inactivity. Among male and female students, cigarette smoking, alcohol use, and sexual intercourse clustered. Accumulation of these risk behaviors also occurred because the observed proportion was greater than the expected proportion assuming independent occurrence. Vocational high school students and upper graders were strongly associated with accumulation of health risk behaviors. These findings identify a high-risk target group among Japanese adolescents and suggest that preventive intervention strategies should take into consideration the cluster and accumulation of health-risk behaviors.

Adolescent↗
PubMed1994

Predictors of high-risk behavior in unmarried American women: adolescent environment as risk factor.

BACKGROUND: Heterosexual intercourse with two or more partners in a short time period represents a high-risk behavior for acquisition and transmission of sexually transmitted pathogens (STDs). Identification of factors that may predict high-risk sexual behavior can help to focus primary prevention strategies on women at risk for future acquisition of infection. METHODS: We analyzed survey data obtained in 1988 from a nationally representative sample of 8,450 American women of reproductive age in order to identify such factors. RESULTS: Of all sexually experienced unmarried women, 6.6% reported having had two or more sexual partners in the preceding three months. Earlier age at first sexual intercourse was associated with multiple recent partners, and with lower reports of abstinence. Birth region in the West, lack of attendance at religious services as an adolescent, and having a mother who had her first child before she was 25 years of age were factors associated with multiple recent partners. Among unmarried white women having a mother who worked full time and not living with both parents during adolescence were associated with multiple recent partners; among unmarried black women, the inverse was true (p for racial difference < .05). Multivariate analysis showed western birth region and earlier age at first sexual intercourse to be significant predictors of having multiple recent sex partners. CONCLUSIONS: Early environment and race influence later sexual behavior. These factors should be considered in targeting and planning education for STD prevention.

Adolescent↗
PubMed2006

Adolescent risk behaviors and religion: findings from a national study.

Too few studies have assessed the relationship between youth risk behaviors and religiosity using measures which captured the varied extent to which youth are engaged in religion. This study applied three measures of religiosity and risk behaviors. In addition, this study ascertained information about youths' participation in religious activities from a parent or caretaker. Based on a national random sample of 2004 teens (ages 11-18), this study indicates that youth perceive religion as important, are active in religious worship and activities, and further shows that perceived importance of religion as well as participation in religious activities are associated with decreased risk behaviors. Looking at ten risk behaviors, religiosity variables were consistently associated with reduced risk behaviors in the areas of: smoking, alcohol use, truancy, sexual activity, marijuana use, and depression. In the case of these six risk variables, religiosity variables were significantly associated with reduced risk behaviors when controlling for family background variables and self-esteem. The study highlights the importance of further understanding the relationship between religious variables, background variables, self-esteem, and youth risk behaviors.

Adolescent↗
PubMed1997

HIV risk behavioral surveillance in Bangkok, Thailand: sexual behavior trends among eight population groups.

OBJECTIVE: To assess trends in HIV risk behaviors over a 3-year period in eight population groups in Bangkok, Thailand. DESIGN AND SUBJECTS: Using a repeated cross-sectional survey design with a structured questionnaire, we collected five sets of self-reported sexual behavior data related to HIV risk from the following subject groups at the same sampling sites during 1993-1996: direct and indirect female sex workers, male attenders of sexually transmitted disease (STD) clinics, female attenders of antenatal care clinics, male and female vocational students, and male and female factory workers. RESULTS: Reported patronage of commercial sex by the three male groups declined by an overall average of 48% over the 3-year period. Other non-regular sexual partnerships declined among male STD clinic attenders and vocational students. Condom use during most recent sexual intercourse between sex workers and clients peaked at high levels (>90%) in the early data waves, while among indirect sex workers and their clients, consistent condom usage increased from 56% to 89%. Low condom use persisted among sex workers and their non-paying sex partners. Single women reported low levels of sexual activity and condom use with no signs of an increase. Similarly, married women from antenatal clinics reported low condom use with their husbands, with no change throughout the period of the study. CONCLUSIONS: HIV risk behavioral surveillance is a useful way of determining whether behavior change has occurred in specific population groups. The results here confirm and add to a growing set of evidence of risk behavior reduction in Thailand. The behavioral changes did not occur uniformly but varied depending on the sexual dyad and the population group under study. Behavioral surveillance should be promoted and its methodologies strengthened in attempts to understand the local dynamics of HIV epidemics.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The relationship of resiliency to decision making and risk behaviors of cancer-surviving adolescents.

Adolescents with a history of cancer frequently engage in risk behaviors. The purpose of this correlational study was to explore factors that affect decision making and risk behaviors (smoking, alcohol use, and illicit drug use) of cancer-surviving adolescents. A sample of 52 teen survivors participated at two cancer centers. In addition to a medical record review and IQ testing, several psychosocial measures were administered in a semistructured interview with the teen survivor. Three antecedent factors (cognitive function, resiliency, and role modeling of risk behaviors by parents and peers) were examined in a hierarchical regression model to predict decision making. These same factors, with an additional mediating variable (decision making), were examined in a hierarchical logistic regression model to predict risk behaviors in teen survivors. In the decision-making model, adjusted for demographic covariates, resiliency was a marginally significant predictor of decision making. As non-resiliency increases, quality of decision making may decrease for teen survivors. In the model to predict risk behaviors, four factors (cognitive function, resiliency, role modeling, and decision making) were added to the basic model, controlling for the same covariates. Resiliency and decision making were highly significant predictors of one or more risk behaviors. Non-resilient teen survivors with poor-quality decision making are more likely to engage in risk behaviors of substance use and need intervention that is aimed at improving decision-making skills to reduce these behaviors.

Adolescent↗
PubMed1999

Health risk behaviors of Texas students attending dropout prevention/recovery schools in 1997.

This study determined prevalence of health risk behaviors of 9th through 12th grade students attending dropout prevention/recovery alternative schools in Texas in 1997. Participants were 470 youth whose health risk behaviors were assessed using the Youth Risk Behavior Survey in an anonymous, self-administered format. Behaviors measured included frequency of weapon-carrying and fighting, suicide-related behaviors, substance use, and sexual behaviors. A substantial percentage of alternative school students reported participating in behaviors that placed them at acute or chronic health risk. Differences in the prevalence of risk behaviors were noted by gender, racial/ethnic, and age subgroups. In addition, alternative school students frequently engaged in multiple risk behaviors. These findings suggest a need for comprehensive school-based health education/intervention programs to reduce the prevalence of risk behaviors in populations of alternative school students.

Adolescent↗
PubMed2005

Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women.

Sexual risk behavior interventions in sub-Saharan Africa focus predominantly on individual and couples counseling. This cognitive-behavioral group intervention was adapted from an urban US context to urban Zambia. Preliminary data analyses assessed the influence of partner participation on sexual risk behavior among HIV-positive Zambian women. Female participants (n=180) attended four group intervention sessions and received sexual behavior skill training and male and female condoms; male partners (n=152) were randomly assigned to high- or low-intensity gender-concordant group intervention sessions. Sexual risk behavior, strategies, attitudes, and knowledge were assessed at baseline, 6, and 12 months. At baseline, 19% of males reported using alcohol before sex, 10% reported using alcohol to cope, and negative coping was associated with sexual risk behavior. In contrast, 1% of women reported using alcohol before sex, and 15% used alcohol as an HIV-coping strategy. Consistent barrier use was reported by 48% of women and 74% of men. After intervention, female high intensity participants reported higher rates of condom use (F=5.68, P=.02), more positive condom attitudes, safer sex intentions, and less alcohol use. These findings highlight the influence of male partners in implementation of effective risk reduction interventions.

Adult↗
PubMed2000

Youth Risk Behavior Surveillance--United States, 1999. State and local YRBSS Coordinators.

Priority health-risk behaviors, which contribute to the leading causes of mortality and morbidity among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults--behaviors that contribute to unintentional and intentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs) (including human immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; and physical inactivity. The YRBSS includes a national school-based survey conducted by CDC as well as state, territorial, and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 33 state surveys, and 16 local surveys conducted among high school students during February through May 1999. In the United States, approximately three fourths of all deaths among persons aged 10-24 years result from only four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1999 national Youth Risk Behavior Survey demonstrate that numerous high school students engage in behaviors that increase their likelihood of death from these four causes--16.4% had rarely or never worn a seat belt; during the 30 days preceding the survey, 33.1% had ridden with a driver who had been drinking alcohol; 17.3% had carried a weapon during the 30 days preceding the survey; 50.0% had drunk alcohol during the 30 days preceding the survey; 26.7% had used marijuana during the 30 days preceding the survey; and 7.8% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 1999, nationwide, 49.9% of high school students had ever had sexual intercourse; 42.0% of sexually active students had not used a condom at last sexual intercourse; and 1.8% had ever injected an illegal drug. Two thirds of all deaths among persons aged > or = 25 years result from only two causes--cardiovascular disease and cancer. The majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 1999, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey; 76.1% had not eaten > or = 5 servings/day of fruits and vegetables during the 7 days preceding the survey; 16.0% were at risk for becoming overweight; and 70.9% did not attend physical education class daily. These YRBSS data are already being used by health and education officials at national, state, and local levels to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The YRBSS data also are being used to measure progress toward achieving 16 national health objectives for 2010 and 3 of the 10 leading health indicators.

Adolescent↗
PubMed1996

Youth Risk Behavior Surveillance--United States, 1995.

PROBLEM/CONDITION: Priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems among youth and adults often are established during youth, extend into adulthood, and are interrelated. REPORTING PERIOD: February through May 1995. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes both a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education agencies. This report summarizes results from the national survey, 35 state surveys, and 16 local surveys conducted among high school students from February through May 1995. RESULTS AND INTERPRETATION: In the United States, 72% of all deaths among school-age youth and young adults result from four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Results from the 1995 YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these four causes: 21.7% had rarely or never used a safety belt, 38.8% had ridden with a driver who had been drinking alcohol during the 30 days preceding the survey, 20.0% had carried a weapon during the 30 days preceding the survey, 51.6% had drunk alcohol during the 30 days preceding the survey, 25.3% had used marijuana during the 30 days preceding the survey, and 8.7% had attempted suicide during the 12 months preceding the survey. Substantial morbidity and social problems among school-age youth and young adults also result from unintended pregnancies and sexually transmitted diseases, including human immunodeficiency virus infection. YRBSS results indicate that in 1995, 53.1% of high school students had had sexual intercourse, 45.6% of sexually active students had not used a condom at last sexual intercourse, and 2.0% had ever injected an illegal drug. Among adults, 65% of all deaths result from three causes: heart disease, cancer and stroke. Most of the risk behaviors associated with these causes of death are initiated during adolescence. In 1995, 34.8% of high school students had smoked cigarettes during the 30 days preceding the survey, 39.5% had eaten more than two servings of foods typically high in fat content during the day preceding the survey, and only 25.4% had attended physical education class daily. ACTIONS TAKEN: YRBSS data are being used nationwide by health and education officials to improve national, state, and local policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity. YRBSS data also are being used to measure progress toward achieving 21 national health objectives and one of eight National Education Goals.

Accidents↗