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.
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%.
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. …