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Key Findings of Health Risk Behaviors among Young Adults with Spina Bifida in Arkansas

Two men in a wheelchair playing football.

Arkansas teens and young adults with spina bifida exhibit unhealthy behaviors that continue as they age into their late 20s. These unhealthy behaviors may include eating less healthy diets, smoking cigarettes, drinking alcohol, using illegal drugs, and substance abuse. Nearly 90% of those aged 16-31 from Arkansas had a doctor visit in the year prior to the survey, indicating that the potential for screening and counseling for health risk behaviors and depression is large. These findings highlight the need to increase awareness and offer mental health screenings and professional counseling to those affected by spina bifida.


Each year about 1,500 babies are born with spina bifida.1 Individuals with spina bifida live longer now than ever before because of advances in medical science and care.2 At least 75% of children born with this birth defect can be expected to reach their early twenties.3

The findings reported here are based on a study of individuals with spina bifida who participated in a survey conducted by the Arkansas Spinal Cord Commission in 2005. This is the first population-based study to examine health risk behaviors among young adults with spina bifida in Arkansas. The results were published in Developmental Medicine & Child Neurology.

Main Study Findings

Physical activity and diet

  1. Compared with young adults from the general population4, young adults with spina bifida tend to eat less healthy diets, do less exercise, and engage more frequently in sedentary activities such as watching television for long hours.
  2. Young adults with spina bifida were three times more likely to report being overweight as adolescents with spina bifida.

Substance abuse

  1. Overall and at any age, substance abuse among young adults with spina bifida was lower than that reported for the Arkansas general population.5
  2. Substance use was higher among adults with spina bifida aged 25-31 years compared to younger age groups (16-19 and 20-24 year olds).
  3. Alcohol drinking and history of illegal drug use increased significantly with age among those affected by spina bifida.


  1. About half of the study population with spina bifida experienced mild or major depressive symptoms, independent of age.
  2. Those who experienced major depressive symptoms were nearly five times more likely to report drinking alcohol as those who did not experience these symptoms.
  3. The frequency of depressive symptoms among those with spina bifida (48%) was higher than the frequency estimated for people aged 18 to 34 years from the general population (10%).
Women sitting eating fruit.

Spina Bifida

Spina bifida is one of the most common permanently disabling birth defects in the United States. Spina bifida happens when the spine and back bones do not close all the way in a fetus (a baby still in the mother’s womb). A sac of fluid comes through the opening in the baby’s back. Much of the time, part of the spinal cord is in this sac, and it is damaged. This damage may occur within the first few weeks of pregnancy, often before a woman knows she is pregnant.

Among people with spina bifida, health issues can range from mild to severe. The amount of damage depends on the size and location of the opening in the spine, and which part of the spinal cord and nerves are affected.

Spina Bifida and CDC’s Work

National Spina Bifida Patient Registry: Medical care for patients with spina bifida varies throughout the country. Researchers in this program analyze anonymous data from 17 spina bifida clinics across the country to identify the health care services that may be most beneficial to patients. In collaboration with CDC’s nonprofit partners, researchers will share their findings with those who serve the spina bifida community, working towards a national standard of care.

Spina Bifida and End Stage Renal Disease: Most children with spina bifida have normal kidney function at birth. However, most also have a neurogenic bladder (a bladder that does not function correctly because of damaged nerves in the spine). This impairment can affect kidney function. Existing literature indicates that without appropriate monitoring and intervention, approximately 50 percent of children with a neurogenic bladder will experience renal (kidney) deterioration within the first five years of life.6 CDC is analyzing information to describe the health status of persons who have both spina bifida and end stage renal disease.

South Carolina Study for Adolescents and Young Adults with Rare Conditions: This project will answer important questions about the health and well-being of young adults with rare conditions aged 15-24 years. Data from health, education, and social service agencies in South Carolina will be merged and analyzed to create a picture of health status, employment, education, and health care needs. Interviews of young adults and their families will also be included. Spina bifida is one of three conditions included in this project.

More Information

To learn more about spina bifida and CDC’s work on spina bifida, please visit

  1. National Estimates and Race/Ethnic-Specific Variation of Selected Birth Defects in the United States, 1999-2001
    Birth Defects Research (Part A); Clinical and Molecular Teratology; 2006 July;76:747-756.
    Canfield MA, Honein MA, Yuskiv N, Xing J, Mai CT, et al.
  2. Rehabilitation and Medical Management of the Adult with Spina Bifida
    American Journal of Physical Medicine & Rehabilitation; 2008 Dec;87(12):1027-50.
    Dicianno BE, Kurowski BG, Yang JM, et al.
  3. Spina Bifida Outcome: A 25-year Prospective
    Pediatric Neurosurgery; 2001 Mar;34(3):114-20.
    Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA.
  4. 2005 Behavioral Risk Factor Surveillance System Survey. [Internet] Atlanta, GA: Centers for Disease Control and Prevention. Available from
  5. Substance Abuse and Mental Health Services Administration.
    Results from the 2005 National Survey on Drug Use and
    Health: National Findings. [Internet] Washington, DC: US
    Department of Health & Human Services, Office of Applied
    Studies. Available from
  6. Current Approaches to the Urologic Care of Children with Spina Bifida
    Current Urology Reports; 2008 Mar;9(2):151-7.
    Joseph DB