Youth Statistics: Health

Access to Health Care

In 2021, 35% of children age 12-17 had public health insurance, 57% had private health insurance, and 5% were uninsured [1]. Rates of insurance coverage are higher in White Non-Hispanic (NH) children (96%) compared to Black NH children (95%) and Hispanic children (92%) [1]. In New York State, 3% of children 18 and under were without health insurance [2]. Insurance coverage and doctor visits have increased since implementation of the Affordable Care Act, especially among minority and low-income youth [3].

Most children under 18 (97%) have a usual source of preventive care such as a physician, clinic, or HMO [4]. However, many clinicians report feeling ill-equipped to help youth who are dealing with issues such as substance abuse or pregnancy. Assurance of confidentiality is especially important to teens, who may not give complete information to health care providers or follow up appropriately after a diagnosis unless they feel that their privacy is secure. School-based health centers and Title X family planning centers are important sources of care for adolescents [5].

Most adolescents age 12-17 visited a dentist in 2020 (88%) [6]; however, adolescents with private insurance are much more likely to receive dental care than adolescents with public insurance [7].

Dietary Behaviors

Of all children age 0-17, 13% experienced food insecurity at times during 2021 [1]. In the 2021 Youth Risk Behavior Survey, 22% of high school students reported eating vegetables at least twice a day, while 24% reported eating fruits or drinking 100% fruit juice two or more times a day [8]. Additionally, 31% of high school students reported not drinking soda or pop, and 25% reported eating breakfast daily [8].

In 2023, an international systematic review estimated that 1 in 5 children and adolescents (age 6-18) demonstrate disordered eating behaviors, with the proportion increasing with age [9].

In 2017-2020, 22% of adolescents age 12-19 were obese [10]. Dieting, which is associated with long-term weight gain and eating disorders [11], is quite common among youth. In 2021, 57% of high school girls and 36% of high school boys were trying to lose weight [8].

Physical Activity and Sleep

Just under half (45%) of high school students reported a high level of physical activity in 2021 (at least 60 minutes a day for five or more days in the week before the survey). There is a significant gender disparity: 36% of girls and 55% of boys reported this level of activity. Almost half of youth (49%) play on at least one sports team, including 46% of girls and 52% of boys [8].

About one in four (23%) high school students reported having at least eight hours of sleep on a typical school night. Ninth grade students were more likely to have eight hours of sleep than seniors at 31% and 17%, respectively [8].

Mental Health

Mental Health Conditions

Many youth struggle with mental health symptoms and conditions at some point in their lives. In 2021, high school girls were more likely to report stress, anxiety, and/or depression than were boys (41% vs. 18%) [8]. The CDC estimates that each year 20% of all children suffer from an identified mental health condition and that 40% will have one by age 18 [12]. CDC's analysis of 2013-2019 data found that among adolescents 12-17 [13]:

• 14% had ever had a diagnosed anxiety disorder
• 21% ever had a major depressive episode
• 9% ever had behavioral or conduct problems
• 13% ever had ADHD
• 4% had past year substance use disorder

The stresses of poverty are known to affect the mental health of children and adolescents; however, children from low-income families are less likely to receive diagnosis and treatment [14].

Since the beginning of the COVID-19 pandemic, estimates of mental illness have increased worldwide. A 2021 global systematic review found that 1 in 4 youth are experiencing moderate to severe symptoms of depression and 1 in 5 youth are experiencing moderate to severe symptoms of anxiety [15]. In his 2021 advisory, the US Surgeon General warned about the impacts of COVID-19 on youth mental health, highlighting the especially high risk to racial and ethnic minority youth, LGBTQ+ youth, low-income youth, youth in rural areas, and youth in immigrant households [16].

Life Satisfaction and Well-Being

Despite the prevalence of mental health challenges, across cultures, the majority of adolescents report positive life satisfaction [17]. In 2021, most high school students (71%) reported relatively good mental health [8]. In much of Europe and North America, boys rate their life satisfaction more highly than girls, according to a 2017/2018 survey by the World Health Organization [18]. High life satisfaction tends to decrease by the middle teen years [18]. Research has linked adolescent subjective well-being with strong family relationships (including parents providing opportunities for autonomous development), social support from peers and other adults, and school connectedness [19].

Depression and Suicidality

In 2021, 42% of all high school students reported feeling sad or hopeless almost every day for two or more weeks in a row in the last year (an indicator of clinical depression). More girls than boys reported feeling sad or hopeless (57% and 29%, respectively) [8]. Among high school students, lesbian, gay, and bisexual students were much more likely to have experienced this level of depression than heterosexual students [8]:

• lesbian and bisexual females, 75%
• females who were not sure of their sexual orientation, 68%
• gay and bisexual males, 55%
• males who were not sure of their sexual orientation, 55%
• heterosexual females, 48%
• heterosexual males, 27%

From 2000 to 2021, the suicide rate for children and young adults ages 10-24 increased by 52% [20]. In 2021, 10% of high school students reported suicide attempts [8].

• In 2021, high school girls (30%) were more likely to seriously consider suicide than high school boys (14%) [8]. They were also more likely to attempt suicide (13% vs. 7%) [8]. Historically, boys have completed suicide more often than girls [20].
• High school students who are lesbian, gay, bisexual (LGB), and those who are unsure of/questioning their sexual identity, are more likely to consider, make a plan, and attempt suicide than heterosexual youth. For example, 48% of LGB students and 41% of not sure/questioning students seriously considered suicide (compared to 15% of heterosexual students). Among LGB students, 24% attempted suicide (compared to 18% of not sure/questioning students and 6% heterosexual students) [8].

Injury, Violence, and Mortality

Mortality

In 2019, among 10-14 year old adolescents, accidents (unintentional injuries) are the leading cause of death (25% of all deaths in this age group), followed by suicide (17%) and cancer (13%). Unintentional injury (35%) is the leading cause of death for adolescents age 15-19, followed by suicide (22%), homicide (18%), and cancer (6%) [21]. Males have a much higher mortality rate than females in this age group [21]. Among adolescents and young adults age 15-24, death by unintentional injury stems largely from motor vehicle crashes, followed distantly by poisoning — which includes drug overdose — and drowning [22]. Homicide is the leading cause of death for African Americans males age 15-34 [21].

Fighting

The number of high school students who report having been in at least one physical fight in the past year decreased from 36% in 2007 to 18% in 2021 [8]. Black males (30%) and American Indian or Alaskan Native males (41%) are especially likely to have been in a fight [8].

Weapons

In 2021, 3% of high school students reported having carried a weapon on school property on at least one of the last 30 days, and 7% of high school students reported being threatened or injured by a weapon on school property [8]. Nearly 5% of male students carried a gun on at least one day during the 12 months before the survey [8].

Violent Crime

The juvenile arrest rate declined 58% between 2010 and 2019. After peaking in 1994, the juvenile arrest rate for violent crimes and robbery reached new lows in 2019. Following a steep decline, the juvenile arrest rate for murder has increased since 2012, but remains near its historic low. Aggravated assault, which accounts for more than half of juvenile arrests, fell to its lowest point since 1980 [23].

In 2021, 14% of female high school students and 4% of male high school students reported (on an anonymous survey) that they had been physically forced to have sexual intercourse at some point in their lives [8]. Lesbian, gay, and bisexual youth, as well as students questioning their sexual orientation, are more likely to have been physically forced to have sexual intercourse than heterosexual youth (23% of bisexual students, 17% of lesbian or gay students, 16% questioning students, 5% heterosexual students) [8].

Dating Violence

Among high school students who dated, 15% of girls and 4% of boys experienced unwanted sexual contact from a dating partner in 2021. In addition, 10% of girls and 7% of boys who dated reported that they were purposely hit, slammed into something, or injured with an object or weapon by a dating partner in the 12 months preceding the survey. The rates of both sexual and physical dating violence have been decreasing since 2013 [24].

Dating violence is more prevalent among high school students who are lesbian, gay, or bisexual, as well as those who are questioning their identity. Among those who dated, 12% of lesbian and gay students, 21% of bisexual students, and 16% of questioning students had experienced sexual dating violence compared to 7% of heterosexual students. In that same group, 14% of lesbian or gay students, 16% of bisexual students, and 13% of questioning students had been intentionally hit, slammed into something, or injured with an object or weapon by a dating partner compared to 6% of heterosexual students [24].