MMWR Surveill Summ. 2018 Jun 15;67(8):1-114. doi: 10.15585/mmwr.ss6708a1.
Health-risk behaviors contribute to the leading causes of morbidity and mortality among youth and adults in the United States. In addition, significant health disparities exist among demographic subgroups of youth defined by sex, race/ethnicity, and grade in school and between sexual minority and nonsexual minority youth. Population-based data on the most important health-related behaviors at the national, state, and local levels can be used to help monitor the effectiveness of public health interventions designed to protect and promote the health of youth at the national, state, and local levels.
September 2016-December 2017.
The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-related behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of other health-related behaviors, obesity, and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. Starting with the 2015 YRBSS cycle, a question to ascertain sexual identity and a question to ascertain sex of sexual contacts were added to the national YRBS questionnaire and to the standard YRBS questionnaire used by the states and large urban school districts as a starting point for their questionnaires. This report summarizes results from the 2017 national YRBS for 121 health-related behaviors and for obesity, overweight, and asthma by demographic subgroups defined by sex, race/ethnicity, and grade in school and by sexual minority status; updates the numbers of sexual minority students nationwide; and describes overall trends in health-related behaviors during 1991-2017. This reports also summarizes results from 39 state and 21 large urban school district surveys with weighted data for the 2017 YRBSS cycle by sex and sexual minority status (where available).
Results from the 2017 national YRBS indicated that many high school students are engaged in health-risk behaviors associated with the leading causes of death among persons aged 10-24 years in the United States. During the 30 days before the survey, 39.2% of high school students nationwide (among the 62.8% who drove a car or other vehicle during the 30 days before the survey) had texted or e-mailed while driving, 29.8% reported current alcohol use, and 19.8% reported current marijuana use. In addition, 14.0% of students had taken prescription pain medicine without a doctor's prescription or differently than how a doctor told them to use it one or more times during their life. During the 12 months before the survey, 19.0% had been bullied on school property and 7.4% had attempted suicide. Many high school students are engaged in sexual risk behaviors that relate to unintended pregnancies and STIs, including HIV infection. Nationwide, 39.5% of students had ever had sexual intercourse and 9.7% had had sexual intercourse with four or more persons during their life. Among currently sexually active students, 53.8% reported that either they or their partner had used a condom during their last sexual intercourse. Results from the 2017 national YRBS also indicated many high school students are engaged in behaviors associated with chronic diseases, such as cardiovascular disease, cancer, and diabetes. Nationwide, 8.8% of high school students had smoked cigarettes and 13.2% had used an electronic vapor product on at least 1 day during the 30 days before the survey. Forty-three percent played video or computer games or used a computer for 3 or more hours per day on an average school day for something that was not school work and 15.4% had not been physically active for a total of at least 60 minutes on at least 1 day during the 7 days before the survey. Further, 14.8% had obesity and 15.6% were overweight. The prevalence of most health-related behaviors varies by sex, race/ethnicity, and, particularly, sexual identity and sex of sexual contacts. Specifically, the prevalence of many health-risk behaviors is significantly higher among sexual minority students compared with nonsexual minority students. Nonetheless, analysis of long-term temporal trends indicates that the overall prevalence of most health-risk behaviors has moved in the desired direction.
Most high school students cope with the transition from childhood through adolescence to adulthood successfully and become healthy and productive adults. However, this report documents that some subgroups of students defined by sex, race/ethnicity, grade in school, and especially sexual minority status have a higher prevalence of many health-risk behaviors that might place them at risk for unnecessary or premature mortality, morbidity, and social problems (e.g., academic failure, poverty, and crime).
YRBSS data are used widely to compare the prevalence of health-related behaviors among subpopulations of students; assess trends in health-related behaviors over time; monitor progress toward achieving 21 national health objectives; provide comparable state and large urban school district data; and take public health actions to decrease health-risk behaviors and improve health outcomes among youth. Using this and other reports based on scientifically sound data is important for raising awareness about the prevalence of health-related behaviors among students in grades 9-12, especially sexual minority students, among decision makers, the public, and a wide variety of agencies and organizations that work with youth. These agencies and organizations, including schools and youth-friendly health care providers, can help facilitate access to critically important education, health care, and high-impact, evidence-based interventions.
在美国，健康风险行为是导致青年和成年人发病和死亡的主要原因之一。此外，在性别、种族/族裔和学校年级等方面，青年群体存在显著的健康差异，性少数群体青年和非性少数群体青年之间也存在健康差异。基于全国、州和地方各级的最重要的与健康相关的行为的人群数据可用于帮助监测旨在保护和促进全国、州和地方各级青年健康的公共卫生干预措施的有效性。
2016 年 9 月至 2017 年 12 月。
青少年风险行为监测系统（YRBSS）监测 6 类与青年和年轻人有关的优先健康相关行为：1）导致意外伤害和暴力的行为；2）烟草使用；3）酒精和其他药物使用；4）与非意愿怀孕和性传播感染（STI）相关的性行为，包括人类免疫缺陷病毒（HIV）感染；5）不健康的饮食行为；和 6）身体活动不足。此外，YRBSS 还监测其他健康相关行为、肥胖和哮喘的流行情况。YRBSS 包括由疾病预防控制中心进行的全国性学校青少年风险行为调查（YRBS）和由州和地方教育及卫生机构进行的州和大型城市学区的学校青少年风险行为调查。从 2015 年 YRBSS 周期开始，在全国 YRBS 问卷和各州及大型城市学区作为问卷起点的标准 YRBS 问卷中增加了一个确定性取向的问题和一个确定性接触者性别的问题。本报告总结了 2017 年全国 YRBS 针对 121 项与健康相关的行为以及肥胖、超重和哮喘的调查结果，这些结果是根据性别、种族/族裔和学校年级以及性少数群体身份对 9-12 年级学生进行的人口统计学细分；更新了全国性少数群体学生的数量；并描述了 1991-2017 年期间与健康相关的行为的总体趋势。本报告还总结了 2017 年 YRBSS 周期中 39 个州和 21 个大型城市学区的调查结果，这些结果是基于加权数据得出的，涉及性别和性少数群体身份（如有）。
2017 年全国 YRBS 的结果表明，许多高中生参与了与美国 10-24 岁人群死亡的主要原因相关的健康风险行为。在调查前 30 天，全国 39.2%的高中生（在调查前 30 天开车或其他车辆的 62.8%的学生中）在开车时发短信或发电子邮件，29.8%报告目前饮酒，19.8%报告目前使用大麻。此外，14.0%的学生曾未经医生处方或未按医生指示服用处方止痛药，在其一生中曾有过一次或多次此类行为。在调查前 12 个月，19.0%的学生在学校财产上遭受过欺凌，7.4%曾试图自杀。许多高中生从事与非意愿怀孕和性传播感染（包括 HIV 感染）相关的性风险行为。全国范围内，39.5%的学生曾有过性行为，9.7%的学生在一生中曾与 4 人或更多人发生过性行为。在目前有性活跃的学生中，53.8%的学生报告称他们或他们的伴侣在最近一次性行为中使用了避孕套。2017 年全国 YRBS 的结果还表明，许多高中生从事与心血管疾病、癌症和糖尿病等慢性疾病相关的行为。全国范围内，8.8%的高中生吸烟，13.2%的学生在调查前 30 天内至少有 1 天使用过电子烟。平均上学日，43%的学生玩视频或电脑游戏或使用电脑，每天 3 小时或以上，且不是为了完成学校作业，15.4%的学生在调查前 7 天内没有进行至少 60 分钟的身体活动。此外，14.8%的学生肥胖，15.6%的学生超重。大多数健康相关行为的流行率因性别、种族/族裔以及性少数群体身份和性接触者的性别而异。具体而言，与非性少数群体学生相比，许多健康风险行为在性少数群体学生中更为普遍。尽管如此，对长期时间趋势的分析表明，大多数健康风险行为的总体流行率已经朝着理想的方向发展。
大多数高中生成功地度过了从童年到青春期再到成年的过渡时期，成为健康和富有成效的成年人。然而，本报告指出，一些学生群体，按性别、种族/族裔、年级和性少数群体身份来定义，他们存在更高的许多健康风险行为的流行率，这些行为可能使他们面临不必要的或过早的死亡、发病和社会问题（例如，学业失败、贫困和犯罪）的风险。
YRBS 数据被广泛用于比较不同学生群体之间与健康相关的行为的流行率；评估随时间推移的健康相关行为趋势；监测实现 21 项国家健康目标的进展情况；提供可比的州和大型城市学区数据；并采取公共卫生行动，减少青年的健康风险行为，改善青年的健康结果。使用这些和其他基于科学合理数据的报告，对于提高决策者、公众和各种与青年合作的机构和组织对 9-12 年级学生（特别是性少数群体学生）的健康相关行为的流行率的认识非常重要。这些机构和组织，包括学校和青年友好型医疗保健提供者，可以帮助促进获得至关重要的教育、医疗保健和高影响力、基于证据的干预措施。
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