Youth risk behavior surveillance--United States, 2003.

PROBLEM/CONDITION: Priority health-risk behaviors, which contribute to the leading causes of morbidity and mortality among youth and adults, often are established during youth, extend into adulthood, are interrelated, and are preventable.

REPORTING PERIOD: This report covers data collected during February-December 2003.

DESCRIPTION OF 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 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.

RESULTS AND INTERPRETATION: In the United States, 70.8% 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 2003 national Youth Risk Behavior Survey demonstrated that, during the 30 days preceding the survey, numerous high school students engage in behaviors that increase their likelihood of death from these four causes: 30.2% had ridden with a driver who had been drinking alcohol; 17.1% had carried a weapon; 44.9% had drunk alcohol; and 22.4% had used marijuana. In addition, during the 12 months preceding the survey, 33.0% of high school students had been in a physical fight, and 8.5% had attempted suicide. Substantial morbidity and social problems among young persons also result from unintended pregnancies and STDs, including HIV infection. In 2003, 46.7% of high school students had ever had sexual intercourse; 37% of sexually active students had not used a condom at last sexual intercourse; and 3.2% had ever injected an illegal drug. Among adults aged > or =25 years, 62.9% of all deaths results from two causes: cardiovascular diseases and cancer. Results from the 2003 national Youth Risk Behavior Survey demonstrate that the majority of risk behaviors associated with these two causes of death are initiated during adolescence. In 2003, a total of 21.9% of high school students had smoked cigarettes during the 30 days preceding the survey; 78% had not eaten > or =5 servings/day of fruits and vegetables during the 7 days preceding the survey; 33.4% had participated in an insufficient amount of physical activity; and 13.5% were overweight.

ACTIONS TAKEN: YRBSS data are being used to measure progress toward achieving 15 national health objectives for 2010 and three of the 10 leading health indicators. In addition, education and health officials at national, state, and local levels are using these YRBSS data to improve policies and programs to reduce priority health-risk behaviors among youth.