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Surveillance Summaries
MMWR Vol. 49 (SS-5), June 9, 2000

Contact: Katie Baer
CDC, National Center for Chronic Disease 
Prevention & Health Promotion
(770) 488–5131

Youth Risk Behavior Surveillance — United States, 1999

Since 1991, the prevalence of many injury-related behaviors and sexual behaviors have improved among high school students throughout the United States, according to the 1999 Youth Risk Behavior Surveillance System (YRBSS) report released today by CDC. Behaviors that show a significant decreasing trend during the past decade include the percentage of students who never or rarely wore seatbelts (37 percent decrease), carried a weapon (34 percent decrease), and ever had sexual intercourse (8 percent decrease). Further, the percentage of sexually active students who used a condom at last intercourse continued to increase (26 percent increase).

Nonetheless, too many high school students continue to practice behaviors that place them at risk for serious health problems. In the United States, nearly three fourths of all deaths among persons aged 10 to 24 result from only four causes: motor vehicle crashes (31 percent), other unintentional injuries (11 percent), homicide (18 percent), and suicide (12 percent). Results from the YRBSS suggest that many high school students practice behaviors that may increase their likelihood of death from these causes — such as drinking and driving and carrying a weapon. Also, substantial health and social problems among youth result from unintended pregnancies and sexually transmitted diseases. Having sexual intercourse and not using a condom are two behaviors which increase risk for these health outcomes.

The YRBSS also measures risk behaviors such as physical inactivity, poor nutrition, and tobacco use because they are often initiated during adolescence and can result in chronic diseases, such as heart disease, cancer, and stroke. Two-thirds of all deaths among adults result from these diseases.

"There is reason to feel optimistic about many of the trends in risk behaviors among our young people," said CDC Director Jeffrey Koplan, M.D., M.P.H. "However, we have much left to do. Too many of our children are still engaging in activities that put them at risk for health problems now and into adulthood."

The Youth Risk Behavior Surveillance System monitors six areas of priority health-risk behaviors among youth, including behaviors that lead to intentional and unintentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, dietary behaviors, and physical activity. This report includes data for the nation, 33 states and 16 large cities.

The survey is administered every two years to scientifically selected samples of high school students throughout the United States. For the 1999 national YRBSS, 15,349 questionnaires were completed by students in grades 9-12. Parental permission was obtained, student participation was voluntary, and responses were anonymous. States could modify the YRBSS questionnaire to meet their needs.

"It is important to monitor risk behaviors among young people so we can develop better prevention programs and policies," said Laura Kann, PhD, chief of the Surveillance and Evaluation Research Branch at CDC’s Division of Adolescent and School Health. "This is the only surveillance system that monitors a wide range of health risk behaviors among adolescents at the national, state, and local levels."

Nationwide, half of students (50 percent) reported current alcohol use, one third (35 percent) reported current cigarette use, and one fourth (27 percent) reported current marijuana use. Half (50 percent) of students reported having had sexual intercourse. One third (36 percent) of students had participated in a physical fight and 17 percent had carried a weapon.

Nearly 1 in 10 high school students were overweight, and 16% were at risk of being overweight. Less than one quarter of high school students ate the recommended daily allowance of fruits and vegetables.

Some risk behaviors vary considerably among states, cities, and particular subgroups of students. For example, the percentage of high school students attending a physical education class daily varied ninefold, from 7 to 61 percent (median: 27 percent), across state surveys. Nationwide, 8 percent of students reported current smokeless tobacco use; however, among white male students, the rate was 19 percent.

The full report will be available online after 4 PM, EST at 


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This page last reviewed Friday, April 28, 2000

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