Access to Health Care
Of all children age 0-17, 93% had continuous health insurance for at least 12 months in 2015-2016, while 5% were insured for less than 12 months and 2% had no insurance at all [1]. In 2017, 3% (115,100) of New York State children 18 and under were without health insurance [2]. Through public and private insurance, adolescents have a high rate of coverage (95% for younger adolescents age 10-14 and 92% for teens age 15-18) [3]. Insurance coverage and doctor visits have increased since implementation of the Affordable Care Act, especially among minority and low-income youth [4].Most adolescents (98%) have a usual source of preventive care such as a physician, clinic, or HMO [5]. 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 [6].
Most adolescents age 10-17 visited a dentist in 2014 (88%) [5]; however, dental care drops as adolescents become young adults [7]. In 2012, 7% of adolescents did not receive needed dental care [7].
Dietary Behaviors
Of all children age 0-17, 18% experienced food insecurity at times during 2015 [8]. In the 2017 Youth Risk Behavior Survey, 27% of high school students reported eating vegetables at least twice a day, while 31% reported eating fruits or drinking 100% fruit juice two or more times a day [9].A large, nationally representative interview study of adolescents age 13-18 found that in a single year, about one in 60 teens have symptoms of an eating disorder [10].
In 2015-16, 21% of adolescents age 12-19 were obese [11]. Dieting, which is a risk factor for both obesity and eating disorders [12] is quite common among youth. In 2017, 60% of high school girls and 34% of high school boys were trying to lose weight [9].
Physical Activity and Sleep
Just under half (47%) of high school students reported a high level of physical activity in 2017 (at least 60 minutes a day for five or more days in the week before the survey). There is a significant gender disparity: 37% of girls and 57% of boys reported this level of activity. Many youth (54%) play on at least one sports team, including nearly half of girls (49%) and 60% of boys. The great majority (85%) of high school students reported being physically active for at least an hour at least once during the week before the survey (81% of girls and 89% of boys) [9].About one in four 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 35% and 18%, respectively [9].
Mental Health
While most adolescents experience good mental health, many youth struggle with mental health symptoms at some point. A large, nationally representative study published in 2010 found that half of youth age 13-18 report having had mental health symptoms, with a lifetime prevalence of 22% for symptoms that are classified as severe [13]. The same study found that anxiety disorders are experienced by 32% of this age group, behavior disorders by 19%, mood disorders by 14%, and substance use disorders by 11%. For more statistics, see the sidebar.Across cultures, the majority of adolescents report positive life satisfaction [14]. In much of Europe and North America, boys rate their life satisfaction more highly than girls, according to a 2013/2014 survey by the World Health Organization [15]. High life satisfaction tends to decrease by the middle teen years [15]. Research has linked adolescent happiness with positive family relationships (including an authoritative and supportive parenting style and communication between parent and child), being extraverted and social, having a best friend, playing sports, school safety, and believing one is doing well at school [16].
In 2017, 32% 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 (41% and 21%, respectively) [17]. Among high school students, lesbian, gay, and bisexual students were much more likely to have experienced this level of depression than heterosexual students [17]:
- lesbian and bisexual females, 69%
- females who were not sure of their sexual orientation, 52%
- gay and bisexual males, 46%
- heterosexual females, 37%
- males who were not sure, 36%
- heterosexual males, 20%
The number of high school students who report serious thoughts of suicide dropped dramatically -- from 29% in 1991 to 14% in 2009 -- and then increased to 17% by 2017 [21]. In 2017, 7% of students reported suicide attempts [21].
- In 2017, high school girls (22%) were more likely to seriously consider suicide than high school boys (12%) [17]. They were also more likely to attempt suicide (9% vs. 5%) [17]. Historically, boys have completed suicide more often than girls [21].
- 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 32% of not sure/questioning students seriously considered suicide (compared to 13% of heterosexual students). Among LGB students, 23% attempted suicide (compared to 14% of not sure/questioning students and 5% heterosexual students) [17].
Injury, Violence, and Mortality
Mortality
Fighting
The number of high school students who report having been in at least one physical fight in the past year decreased from 43% in 1991 [25] to 24% in 2017 [9]. Black males are especially likely to have been in a fight (37%) [9].Weapons
In 2017, 16% of high school students reported having carried a weapon on at least one of the last 30 days [9]. Nearly 8% of male students carried a gun on at least one day during the 12 months before the survey, and nearly the same percentage were threatened or injured with a weapon in that same period [9].Violent Crime
The juvenile arrest rate declined 68% between 1996 and 2016. Following a steep decline, the juvenile arrest rate for murder has increased since 2012, but remains near its historic low. Similarly, the juvenile robbery arrest rate, which had fallen since 2008, increased in 2016 but remained low compared to its 1994 peak. Aggravated assault, which accounts for more than half of juvenile arrests, fell to its lowest point since 1980 [26].In 2017, 11% of female high school students and 4% of male high school students reported (on an anonymous survey) that they had been raped at some point in their lives [9]. Lesbian, gay, and bisexual youth, as well as students questioning their sexual orientation, are more likely to have been raped than heterosexual youth (22% of bisexual students, 21% of lesbian or gay students, 13% questioning students, 5% heterosexual students) [9].
Dating Violence
Among high school students who dated, 7% experienced unwanted sexual contact from a dating partner in 2017. In addition, 9% 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 [17].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, about 16% of LGB students and 14% of questioning students and had experienced sexual dating violence. In that same group, 17% of LGB students and 14% of questioning students and had been intentionally hit, slammed into something, or injured with an object or weapon by a dating partner. Black girls who date are also especially vulnerable: 13% had experienced this type of dating violence in the past 12 months [17].
Endnotes
[1] | Federal Interagency Forum on Child and Family Statistics. (2018). America's children: Key national indicators of well-being, 2018. Retrieved April 2, 2019, from
childstats.gov/americaschildren/ |
[2] | Kaiser Family Foundation. (n. d.). State health facts: Health insurance coverage of children 0-18: New York. Retrieved April 2, 2019, from
kff.org/other/state-indicator/children-0-18/?state=NY |
[3] | Spencer, D. L., McManus, M., Call, K. T., Turner, J., Harwood, C., White, P., & Alarcon, G. (2018). Health care coverage and access among children, adolescents, and young adults, 2010-2016: Implications for future health reforms. Journal of Adolescent Health, 62, 667-673.
doi.org/10.1016/j.jadohealth.2017.12.012 |
[4] | Adams, S. H., Park, M. J., Twietmeyer, L., Brindis, C. D., & Irwin, C. E. (2018). Association between adolescent preventive care and the role of the Affordable Care Act. JAMA Pediatrics, 172, 43-48.
doi.org/10.1001/jamapediatrics.2017.3140 |
[5] | Black, L. I., Nugent, C. N., & Vahratian, A. (2016, May). Access and utilization of selected preventive health services among adolescents aged 10-17 [NCHS Data Brief No. 246]. Retrieved April 2, 2019, from
cdc.gov/nchs/products/databriefs/db246.htm |
[6] | Cullen, E. & Salganicoff, A. (2011, October). Adolescent health: Coverage and access to care. Women's issue brief. Retrieved April 2, 2019, from Kaiser Family Foundation website:
kff.org/womenshealth/8236.cfm |
[7] | Park, M. J., Scott, J. T., Adams, S. H., Brindis, C. D., & Irwin Jr., C. E. (2014). Adolescent and young adult health in the United States in the past decade: Little improvement and young adults remain worse off than adolescents. Journal of Adolescent Health, 55(1). doi:10.1016/j.jadohealth.2014.04.003
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[8] | Federal Interagency Forum on Child and Family Statistics. (2018). America's children: Key national indicators of well-being, 2017. Food security. Retrieved April 2, 2019, from
childstats.gov/americaschildren17/eco4.asp |
[9] | Centers for Disease Control and Prevention. (2018). Youth Online: High School Youth Risk Behavior Survey (YRBS). Retrieved April 2, 2019 from
nccd.cdc.gov/youthonline/ |
[10] | Psych Central. (2011). Prevalence of eating disorders among teens. Retrieved April 2, 2019, from
psychcentral.com/news/2011/03/07/prevalence-of-eating-disorders-a mong-teens/24188.html |
[11] | Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2017, October). Prevalence of obesity among adults and youth: United States, 2015-16 [NCHS Data Brief no. 288]. Retrieved April 2, 2019, from
cdc.gov/nchs/data/databriefs/db288.pdf |
[12] | Golden, N. H., Schneider, M., & Wood, C. (2016). Preventing obesity and eating disorders in adolescents. Pediatrics, 138, e20161649.
doi.org/10.1542/peds.2016-1649 |
[13] | Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L.,...Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey replication - Adolescent supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980-989. doi:10.1016/j.jaac.2010.05.017
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[14] | Proctor, C. L., Linley, P. A., & Maltby, J. (2009). Youth life satisfaction: A review of the literature. Journal of Happiness Studies, 10(5), 583-630. doi:10.1007/s10902-008-9110-9
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[15] | World Health Organization. (2016). Growing up unequal: Gender and socioeconomic differences in young people's health and well-being. Retrieved April 2, 2019, from
euro.who.int/__data/assets/pdf_file/0003/303438/HSBC-No.7-Growing -up-unequal-Full-Report.pdf |
[16] | van de Wetering, E. J., van Exel, N. J. A., & Brouwer, W. B. F. (2010). Piecing the jigsaw puzzle of adolescent happiness. Journal of Economic Psychology, 31(6), 923-935. doi:10.1016/j.joep.2010.08.004
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[17] | Kann, L., McManus, T., Harris, W. A., et al. (2018, June 15). Youth risk behavior surveillance - United States, 2017. Morbidity and Mortality Weekly Report. Retrieved April 2, 2019, from
cdc.gov/mmwr/volumes/67/ss/ss6708a1.htm?s_cid=hy-yrbs2017-mmwr |
[18] | Center for Behavioral Health Statistics and Quality. (2012, July 19). Depression triples between the ages of 12 and 15 among adolescent girls. Data Spotlight. Retrieved April 2, 2019, from
samhsa.gov/data/sites/default/files/NSDUH-SP77-AdolescentGirlsDep ression-2012/CBHSQ-NSDUH-Spotlight-077-AdolescentGirlsDepression- 2012.pdf |
[19] | Bose, J., Hedden, S. L., Lipari, R. N., & Park-Lee, E. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Retrieved April 2, 2019, from
samhsa.gov/data/report/2017-nsduh-annual-national-report |
[20] | Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children. The Journal of Pediatrics, 206, 256-267.e3.
doi.org/10.1016/j.jpeds.2018.09.021 |
[21] | Child Trends. (2019). Suicidal teens. Retrieved April 2, 2019, from
childtrends.org/?indicators=suicidal-teens |
[22] | Heron, M. (2018). Deaths: Leading causes for 2016. National Vital Statistics Reports, 67. Retrieved April 2, 2019, from
cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_06.pdf |
[23] | Curtin, S. C., Heron, M., Mini˜o, A. M., & Warner, M. (2018). Recent increases in injury mortality among children and adolescents aged 10-19 years in the United States: 1999-2016. National Vital Statistics Reports, 67. Retrieved April 2, 2019, from
cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_04.pdf |
[24] | Centers for Disease Control and Prevention. (2018). Leading causes of death (LCOD) in males and females, United States. Retrieved April 2, 2019, from
cdc.gov/healthequity/lcod/ |
[25] | Centers for Disease Control and Prevention. (n.d.). Trends in the prevalence of behaviors that contribute to violence. Retrieved April 2, 2019, from
cdc.gov/healthyyouth/data/yrbs/pdf/trends/us_violence_trend_yrbs. |
[26] | Puzzanchera, C. (2014, December). Juvenile arrests 2012. Juvenile Offenders and Victims: National Report Series Bulletin. Retrieved April 2, 2019, from Office of Juvenile Justice and Delinquency Prevention website:
ojjdp.gov/pubs/248513.pdf |