Today’s teenagers are generally steering clear of risky behaviors compared to young people in years past, but they still face hazards, especially if they identify as LGBTQ. The biennial Youth Risk Behavior survey from the Centers for Disease Control and Prevention looks at key risk factors that can make high schoolers more susceptible to diseases, violence, and death.
“You don’t have to know Excel to find story hooks in here,” said Daniel Willis, education journalist and session moderator.
Participants who contributed to this advice:
Main points of the presentation
Underwood’s presentation included information about how the Youth Risk Behavior Surveillance System is conducted, related surveys, and key findings about youth behaviors from the latest survey data.
- How the YRBSS works: The CDC samples a nationally representative subset of public and private high school students (grades 9-12) in all 50 states and the District of Columbia. Students are selected randomly at the county/district, school and classroom level. All responses are anonymous, and controls are in place for teens who just mark every question the same answer or overstate their risk behaviors. The survey should take 45 minutes (a traditional high school class period) to complete. Questions address various health and risk behaviors: accidents, diet and exercise, violence, sexual behavior, alcohol, tobacco and drug use, asthma, etc.
- Related surveys: There are similar surveys conducted by state, territorial, and local education and health agencies, as well as tribal governments. Those surveys use many of the YRBSS questions, but can substitute locally designed questions for up to one-third of the CDC questions. The District of Columbia health department created its own question about “exchange sex”—the exchange of something of value for sex—that led to data for a WAMU story (see “Key Coverage”).
- School profiles: The CDC also surveys public middle and high school principals and “lead health teachers” to assess school health policies in states, large urban districts, territories and tribal jurisdictions. That survey of educators is conducted every two years by state and local health and education agencies with CDC support.
Sample findings from 2017 YRBSS data:
Sexual intercourse: The share of high school students who have ever had sex declined significantly between 2007 and 2017. This held true for black, white and Hispanic students, and black students saw the sharpest decline.
Opioid misuse: For the first time, the 2017 survey included a question about misuse of opioids, and 14% of high school students reported having ever misused them.
Mental health/suicide: While less than 10% of high school students overall report having attempted suicide and the number has held steady, related experiences are increasing. In 2017, nearly one-third had experienced persistent feelings of sadness or hopelessness; 17% said they had “seriously considered” suicide; and 14% reported having made a suicide plan—all trending upward from 2007. Students who had had same-sex partners or identified their sexual orientation as LGBTQ or “not sure” were much more likely to have attempted suicide.
Forced sex: Students who identified as LGBTQ reported having experienced forced sex at much higher rates than heterosexual students: 22% versus 5%.
- Condom use among teens is declining, sparking an increase in STDs: In 2017, the number of high school students reporting they have ever had sex stood at 39.5%, down nearly 10 percentage points from a decade earlier. In 2017, about 54% of high school students reported they had used a condom during their most recent sexual intercourse, and 15- to 24-year-olds accounted for half of all new STDs. In 2007, about 62% of high school students reported having used a condom the last time they had intercourse. Decreasing use of condoms and decreasing discussion in schools about HIV prevention/safer sex could be contributing to these changes. Underwood flagged the decline in condom use among teens as “very concerning for us. We’re seeing it across race and ethnicity. We’re trying to uncover what’s behind it.”
- Sex education is inadequate in many schools. The CDC’s School Health Profile surveys asked whether secondary schools taught 11 key topics related to HIV, STDs, and pregnancy prevention in a required course during the 2017-18 school year. Responses from only 13 states showed that large numbers of schools (75% or higher) were teaching these topics.
- Health and sex education for LGBTQ students is inadequate. School Health Profile surveys asked whether the lead health education teacher had received professional development about teaching students of different gender identities or sexual orientations. Lead health educators had gotten any such training in only 19 states, and in those states, the share of those who received training ranged from about half to three-quarters. Only 15 states showed large numbers of schools (75% or higher) providing curriculum or supplementary materials that give LGBTQ youth relevant information on HIV, STDs or pregnancy prevention.
The CDC released a report on survey results and trends, available here.
WAMU reported on results from Washington, D.C.’s version of the Youth Risk Behavior Survey that showed that 7.4% of teens in the nation’s capital were exchanging sex for money, housing or other things of value.
The most recent available YRBSS is the 2017 survey, released in June 2018. In spring 2019, the CDC surveyed students to gather 2019 data; those survey results are expected to be released in summer 2020.