Youth Risk Behavior Surveillance-United States, 2003 (Abridged)

Grunbaum, Jo Anne, Kann, Laura, Kinchen, Steve, Ross, James, Hawkins, Joseph, Lowry, Richard, Harris, William A., McManus, Tim, Chyen, David, Collins, Janet, Journal of School Health

In the United States, 70.8% of all deaths among youth and young adults aged 10-24 years result from only four causes: motor-vehicle crashes (32.3%), other unintentional injuries (11.7%), homicide (15.1%), and suicide (11.7%). (1) Substantial morbidity and social problems also result from the approximately 870,000 pregnancies that occur each year among females aged 15-19 years (2) and the estimated 3 million cases of sexually transmitted diseases (STDs) that occur each year among persons aged 10-19 years. (3) Among adults aged [greater than or equal to]25 years, 62.9% of all deaths in the United States result from cardiovascular diseases (39.4%) and cancer (23.5%). (1)

The Youth Risk Behavior Surveillance System (YRBSS), (4) conducted biennially since 1991, monitors six categories of priority health-risk behaviors among youth and young adults--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), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity--plus overweight. YRBSS includes a national school-based survey conducted by CDC as well as state and local school-based surveys conducted by education and health agencies. This report summarizes results from the national survey, 32 state surveys, and 18 local surveys conducted among students in grades 9-12 during February-December 2003.

In addition, this report summarizes trends from the national YRBS during 1991-2003 in selected risk behaviors. For the national YRBS, only statistically significant differences are reported in the Results section in the following order: sex, sex by race/ethnicity, sex by grade, race/ ethnicity, race/ethnicity by sex, grade, and grade by sex.

METHODS

National Youth Risk Behavior Survey

The sampling frame for the national YRBS consisted of all public and private schools with students in at least one of grades 9-12 in the 50 states and the District of Columbia.

A three-stage cluster sample design produced a nationally representative sample of students in grades 9-12 who attend public and private schools. For the national YRBS, 15,240 questionnaires were completed in 158 schools. The school response rate was 81%, and the student response rate was 83%. The school response rate multiplied by the student response rate produces an overall response rate of 67%.

State and Local Youth Risk Behavior Surveys

In 2003, each state and local school-based YRBS employed a two-stage cluster sample design to produce representative samples of students in grades 9-12 in their jurisdiction. In 2003, the student sample sizes for the state and local YRBS ranged from 968 to 9,320. School response rates ranged from 67% to 100%; student response rates ranged from 60% to 94%; and overall response rates ranged from 60% to 90%.

RESULTS

Behaviors That Contribute to Unintentional Injuries

Seat Belt Use. Nationwide, 18.2% of students had rarely or never worn seat belts when riding in a car driven by someone else. Overall, the prevalence of having rarely or never worn seat belts was higher among male (21.5%) than female (14.6%) students; higher among black male (25.6%) than black female (15.6%) students; and higher among 10th grade male (20.4%) and 12th grade male (21.1%) than 10th grade female (13.3%) and 12th grade female (10.9%) students, respectively. Prevalence of having rarely or never worn seat belts ranged from 5.6% to 23.2% across state surveys (median: 15.1%) and from 5.4% to 33.7% across local surveys (median: 12.1%).

Bicycle Helmet Use. Among the 62.3% of students nationwide who had ridden a bicycle during the 12 months preceding the survey, 85.9% had rarely or never worn a bicycle helmet. Overall, the prevalence of having rarely or never worn a bicycle helmet was higher among black (94.6%) than white (83.8%) and Hispanic (90.1%) students; higher among Hispanic (90.1%) than white students (83.8%); higher among black female (94.3%) than white female (82.0%) and Hispanic female (87.9%) students; and higher among black male (95.0%) and Hispanic male (91.4%) than white male (85.2%) students. Prevalence of having rarely or never worn a bicycle helmet ranged from 52.0% to 95.7% across state surveys (median: 86.6%) and from 75.2% to 97.1% across local surveys (median: 89.0%).

Rode with a Driver Who Had Been Drinking Alcohol During the 30 days preceding the survey, 30.2% of students nationwide had ridden in a car or other vehicle one or more times with a driver who had been drinking alcohol. The prevalence of having ridden with a driver who had been drinking alcohol was higher among Hispanic female (40.0%) than Hispanic male (32.8%) students. Overall, the prevalence of having ridden with a driver who had been drinking alcohol was higher among Hispanic (36.4%) than white (28.5%) and black (30.9%) students and higher among Hispanic female (40.0%) than white female (29.8%) and black female (29.8%) students. Overall, the prevalence of having ridden with a driver who had been drinking alcohol was higher among 12th grade (33.3%) than 9th grade (28.2%) students and higher among 12th grade male (34.0%) than 9th grade male (26.4%) and 10th grade male (27.6%) students. Prevalence of having ridden with a driver who had been drinking alcohol ranged from 17.9% to 42.8% across state surveys (median: 28.2%) and from 18.6% to 40.6% across local surveys (median: 28.8%).

Drove After Drinking Alcohol. During the 30 days preceding the survey, 12.1% of students nationwide had driven a car or other vehicle one or more times after drinking alcohol. Overall, the prevalence of having driven after drinking alcohol was higher among male (15.0%) than female (8.9%) students; higher among white male (15.2%), black male (13.4%), and Hispanic male (14.9%) than white female (10.3%), black female (4.6%), and Hispanic female (8.6%) students, respectively; and higher among 10th grade male (11.3%), 11th grade male (19.5%), and 12th grade male (25.6%) than 10th grade female (6.9%), 11th grade female (11.1%), and 12th grade female (13.6%) students, respectively. Overall, the prevalence of having driven after drinking alcohol was higher among white (12.9%) than black (9.1%) students and higher among white female (10.3%) and Hispanic female (8.6%) than black female students (4.6%). Overall, the prevalence of having driven after drinking alcohol was higher among 10th grade (9.2%), 11th grade (15.3%), and 12th grade (19.8%) than 9th grade (6.2%) students; higher among 11th grade (15.3%) and 12th grade (19.8%) than 10th grade (9.2%) students; higher among 12th grade (19.8%) than 11th grade (15.3%) students; higher among 11th grade female (11.1%) and 12th grade female (13.6%) than 9th grade female (5.1%) and 10th grade female (6.9%) students; higher among 10th grade male (11.3%), 11th grade male (19.5%), and 12th grade male (25.6%) than 9th grade male (7.2%) students; higher among 11th grade male (19.5%) and 12th grade male (25.6%) than 10th grade male (11.3%) students; and higher among 12th grade male (25.6%) than 11th grade male (19.5%) students. Prevalence of having driven after drinking alcohol ranged from 7.4% to 26.7% across state surveys (median: 11.3%) and from 4.5% to 12.3% across local surveys (median: 7.4%).

Behaviors That Contribute to Violence

Carried a Weapon. Nationwide, 17.1% of students had carried a weapon (eg, a gun, knife, or club) on [greater than or equal to]1 of the 30 days preceding the survey. Overall, the prevalence of having carried a weapon was higher among male (26.9%) than female (6.7%) students; higher among white male (27.1%), black male (24.9%), and Hispanic male (24.3%) than white female (5.5%), black female (9.8%), and Hispanic female (8.5%) students, respectively; and higher among 9th grade male (26.6%), 10th grade male (26.5%), 11th grade male (29.2%), and 12th grade male (25.2%) than 9th grade female (8.8%), 10th grade female (5.2%), 11th grade female (6.8%), and 12th grade female (5.2%) students, respectively. The prevalence of having carried a weapon was higher among black female (9.8%) and Hispanic female (8.5%) than white female (5.5%) students. The prevalence of having carried a weapon was higher among 9th grade female (8.8%) than 10th grade female (5.2%) and 12th grade female (5.2%) students. Prevalence of having carried a weapon ranged from 12.3% to 24.6% across state surveys (median: 16.9%) and from 11.3% to 25.0% across local surveys (median: 16.0%).

Carried a Gun. Nationwide, 6.1% of students had carded a gun on [greater than or equal to]1 of the 30 days preceding the survey. Overall, the prevalence of having carried a gun was higher among male (10.2%) than female (1.6%) students; higher among white male (10.0%), black male (10.6%), and Hispanic male (8.2%) than white female (1.5%), black female (1.4%), and Hispanic female (2.6%) students, respectively; and higher among 9th grade male (9.3%), 10th grade male (10.4%), 11th grade male (10.8%), and 12th grade male (10.0%) than 9th grade female (2.1%), 10th grade female (1.4%), 11th grade female (1.6%), and 12th grade female (1.0%) students, respectively. Prevalence of having carried a gun ranged from 3.4% to 10.5% across state surveys (median: 5.9%) and from 3.4% to 8.9% across local surveys (median: 5.7%).

Physical Fighting. Nationwide, 33.0% of students had been in a physical fight one or more times during the 12 months preceding the survey. Overall, the prevalence of having been in a physical fight was higher among male (40.5%) than female (25.1%) students; higher among white male (38.4%), black male (45.6%), and Hispanic male (42.6%) than white female (22.1%), black female (34.0%), and Hispanic female (29.5%) students, respectively; and higher among 9th grade male (44.8%), 10th grade male (41.8%), 11th grade male (38.5%), and 12th grade male (35.0%) than 9th grade female (31.9%), 10th grade female (25.0%), 11th grade female (23.0%), and 12th grade female (17.7%) students, respectively. Overall, the prevalence of having been in a physical fight was higher among black (39.7%) than white (30.5%) and Hispanic (36.1%) students; higher among Hispanic (36.1%) than white (30.5%) students; higher among black female (34.0%) and Hispanic female (29.5%) than white female (22.1%) students; higher among black female (34.0%) than Hispanic female (29.5%) students; and higher among black male (45.6%) than white male (38.4%) students. Overall, the prevalence of having been in a physical fight was higher among 9th grade (38.6%) than 10th grade (33.5%), 11th grade (30.9%), and 12th grade (26.5%) students; higher among 10th grade (33.5%) and 11th grade (30.9%) than 12th grade (26.5%) students; higher among 9th grade female (31.9%) than 10th grade female (25.0%), 11th grade female (23.0%), and 12th grade female (17.7%) students; higher among 10th grade female (25.0%) and 11th grade female (23.0%) than 12th grade female (17.7%) students; higher among 9th grade male (44.8%) than 11th grade male (38.5%) and 12th grade male (35.0%) students; and higher among 10th grade mate (41.8%) than 12th grade male (35.0%) students. Prevalence of having been in a physical fight ranged from 26.4% to 35.0% across state surveys (median: 30.3%) and from 27.2% to 44.3% across local surveys (median: 37.4%).

Injured in a Physical Fight. Among students nationwide, 4.2% had been in a physical fight one or more times during the 12 months preceding the survey that resulted in injuries that had to be treated by a doctor or nurse. Overall, the prevalence of having been injured in a physical fight was higher among male (5.7%) than female (2.6%) students; higher among white male (4.0%), black male (7.3%), and Hispanic male (6.5%) than white female (1.7%), black female (3.7%), and Hispanic female (3.9%) students, respectively; and higher among 10th grade male (6.2%), 11th grade male (4.9%), and 12th grade male (4.3%) than 10th grade female (2.2%), 11th grade female (2.4%), and 12th grade female (1.8%) students, respectively. Overall, the prevalence of having been injured in a physical fight was higher among black (5.5%) and Hispanic (5.2%) than white (2.9%) students; higher among black female (3.7%) and Hispanic female (3.9%) than white female (1.7%) students; and higher among black male (7.3%) and Hispanic male (6.5%) than white male (4.0%) students. Prevalence of having been injured in a physical fight ranged from 2.4% to 4.8% across state surveys (median: 3.4%) and from 2.3% to 8.6% across local surveys (median: 4.2%).

Dating Violence. During the 12 months preceding the survey, 8.9% of students nationwide had been hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend (ie, dating violence). Overall, the prevalence of dating violence was higher among black (13.9%) than white (7.0%) and Hispanic (9.3%) students; higher among Hispanic (9.3%) than white (7.0%) students; higher among black female (14.0%) than Hispanic female (9.2%) and white female (7.5%) students; and higher among black male (13.7%) than Hispanic male (9.2%) and white male (6.6%) students. Prevalence of dating violence ranged from 6.5% to 14.0% across state surveys (median: 10.0%) and from 7.3% to 16.0% across local surveys (median: 11.7%).

Forced Sexual Intercourse. Nationwide, 9.0% of students had ever been physically forced to have sexual intercourse when they did not want to. Overall, the prevalence of having been forced to have sexual intercourse was higher among female (11.9%) than male (6.1%) students; higher among white female (11.2%) and Hispanic female (13.0%) than white male (3.7%) and Hispanic male (7.6%) students, respectively; and higher among 9th grade female (11.3%), 11th grade female (13.5%), and 12th grade female (11.6%) than 9th grade male (5.0%), 11th grade male (4.8%), and 12th grade male (6.6%) students, respectively. Overall, the prevalence of having been forced to have sexual intercourse was higher among black (12.3%) and Hispanic (10.4%) than white (7.3%) students, and higher among black male (11.7%) and Hispanic male (7.6%) than white male (3.7%) students. Prevalence of having been forced to have sexual intercourse ranged from 5.4% to 11.0% across state surveys (median: 8.7%) and from 5.5% to 12.4% across local surveys (median: 8.5%).

Carried a Weapon on School Property. Nationwide, 6.1% of students carried a weapon (eg, a gun, knife, or club) on school property on [greater than or equal to]1 of the 30 days preceding the survey. Overall, the prevalence of having carded a weapon on school property was higher among male (8.9%) than female (3.1%) students; higher among white male (8.5%) and Hispanic male (7.7%) than white female (2.2%) and Hispanic female (4.2%) students, respectively; and higher among 10th grade male (8.9%), 11th grade male (10.3%), and 12th grade male (10.2%) than 10th grade female (3.0%), 11th grade female (2.7%), and 12th grade female (2.5%) students, respectively. The prevalence of having carried a weapon on school property was higher among black female (5.5%) and Hispanic female (4.2%) than white female (2.2%) students. The prevalence of having carded a weapon on school property was higher among 10th grade male (8.9%), 11th grade male (10.3%), and 12th grade male (10.2%) than 9th grade male (6.6%) students. Prevalence of having carried a weapon on school property ranged from 3.2% to 10.1% across state surveys (median: 5.8%) and from 3.5% to 10.6% across local surveys (median: 6.1%).

Threatened or Injured with a Weapon on School Property. During the 12 months preceding the survey, 9.2% of students nationwide had been threatened or injured with a weapon (eg, a gun, knife, or club) on school property one or more times. Overall, the prevalence of having been threatened or injured with a weapon on school property was higher among male (11.6%) than female (6.5%) students; higher among white male (9.6%), black male (14.3%), and Hispanic male (11.9%) than white female (5.8%), black female (7.5%), and Hispanic female (6.9%) students, respectively; and higher among 9th grade male (15.4%), 10th grade male (11.3%), 11th grade male (9.2%), and 12th grade male (8.5%) than 9th grade female (8.3%), 10th grade female (7.0%), 11th grade female (5.4%), and 12th grade female (3.9%) students, respectively. Overall, the prevalence of having been threatened or injured with a weapon on school property was higher among black (10.9%) than white (7.8%) students and higher among black male (14.3%) than white male (9.6%) students. Overall, the prevalence of having been threatened or injured with a weapon on school property was higher among 9th grade (12.1%) than 11th grade (7.3%) and 12th grade (6.3%) students; higher among 10th grade (9.2%) than 12th grade (6.3%) students; higher among 9th grade female (8.3%) than 11th grade female (5.4%) and 12th grade female (3.9%) students; higher among 10th grade female (7.0%) than 12th grade female (3.9%) students; and higher among 9th grade male (15.4%) than 11th grade male (9.2%) and 12th grade male (8.5%) students. Prevalence of having been threatened or injured with a weapon on school property ranged from 5.2% to 9.7% across state surveys (median: 7.5%) and from 6.8% to 12.7% across local surveys (median: 9.7%).

Physical Fight on School Property. Nationwide, 12.8% of students had been in a physical fight on school property one or more times during the 12 months preceding the survey. Overall, the prevalence of having been in a physical fight on school property was higher among male (17.1%) than female (8.0%) students; higher among white male (14.3%), black male (21.5%), and Hispanic male (19.3%) than white female (5.3%), black female (12.6%), and Hispanic female (13.8%) students, respectively; and higher among 9th grade male (23.3%), 10th grade male (18.1%), 11th grade male (14.2%), and 12th grade male (9.6%) than 9th grade female (12.2%), 10th grade female (7.3%), 11th grade female (6.4%), and 12th grade female (4.7%) students, respectively. Overall, the prevalence of having been in a physical fight on school property was higher among black (17.1%) and Hispanic (16.7%) than white …

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Publication information: Article title: Youth Risk Behavior Surveillance-United States, 2003 (Abridged). Contributors: Grunbaum, Jo Anne - Author, Kann, Laura - Author, Kinchen, Steve - Author, Ross, James - Author, Hawkins, Joseph - Author, Lowry, Richard - Author, Harris, William A. - Author, McManus, Tim - Author, Chyen, David - Author, Collins, Janet - Author. Journal title: Journal of School Health. Volume: 74. Issue: 8 Publication date: October 2004. Page number: 307+. © 1999 American School Health Association. COPYRIGHT 2004 Gale Group.

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