Advancing States' Child Indicator Initiatives: Promotional Indicators Forum . Federal Perspectives on Promotional Indicators

02/04/2000

Casey Hannan of the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services discussed the national initiative to improve adolescent health by the year 2000. His presentation relied in large part on a series of slides that are summarized below.

Why Are Adolescence and Young Adulthood So Important?

Pivotal and enduring changes

  • Biological
  • Intellectual
  • Emotional
  • Social

Puberty

Establish patterns of behaviors and lifestyles

Societal institutions are very influential

Young people are influenced by a number of societal institutions.

Influential Societal Institutions

  • Parents and families
  • Schools
  • Health care providers
  • Community agencies that serve youth
  • Religious organizations
  • Media
  • Postsecondary institutions
  • Employers
  • Government agencies

Proposed Age Group Parameters

Adolescents and young adults: 10-24 years old

  • Young adolescents: 10-14 years
  • Older adolescents: 15-19 years
  • Young adults: 20-24 years

Mortality Rates Among 15-19 Year-Olds in 50 Nations, 1995 U.N. Report

 

Females Rate Males Rate
(1) Netherlands 20 (1) Sweden 50
(6) Poland 30 (6) Hungary 70
(11) France 30 (11) Italy 80
(16) Romania 40 (16) Czech Republic 90
(21) Chile 40 (21) Bulgaria 100
(22) United States 50 (26) Argentina 120
    (31) United States 130

 

 

Birth Rates Among 15-19 Year-Olds in 104 Nations, 1995 U.N. Report

 

  Rate
(1) Japan 3.9
(11) Spain 11.0
(21) Ireland 16.5
(31) Austria 23.1
(41) Martinique 31.6
(51) Thailand 41.6
(61) Romania 47.6
(71) Sarawak 55.2
(79) United States 63.5

 

 

Leading Causes of Mortality Among 15-24 Year Olds in the U.S., 1997

 

Leading Causes of Mortality Among 15-24 Year Olds in the U.S., 1997
Motor Vehicle Crash 33%
Homicide 20%
Suicide 13%
HIV Infection 1%
Other Injuries 10%
Other 23%

 

Contributing Behaviors, 1997

 

Contributing Behaviors, 1997
Behaviors that result in unintentional and intentional injury
Rode with a drinking driver 36.6%
Physical fighting 36.6%
Weapon carrying 18.3%
Injurious suicide attempt 2.6%
Alcohol and drug use
Binge drinking 33.4%
Marijuana use 26.2%
Sexual risk behaviors
Engaged in intercourse 48.4%
Did not use condom at last intercourse 43.2%

 

Leading Causes of Mortality Among Adults 25 Years-Old and Older in the U.S., 1997

 

Leading Causes of Mortality Among Adults 25 Years-Old and Older in the U.S., 1997
Cardiovascular Disease 42%
Cancer 24%
Other 34%

 

Contributing Behaviors, 1997(Many of these behaviors begin in youth)

 

Contributing Behaviors, 1997(Many of these behaviors begin in youth)
Tobacco use
Use of any tobacco product 42.7%
Inadequate physical activity
Does not engage in vigorous physical activity 36.2%
Unhealthy dietary patterns
Overweight/at-risk of being overweight 24% (12-19 year-olds; 1994, NHANES)

 

Some of the most serious problems are caused by six behaviors.

Behaviors that Contribute to Education, Health, and Social Problems

  • Behaviors that result in unintentional and intentional injury
  • Alcohol and drug use
  • Sexual risk behaviors
  • Tobacco use
  • Inadequate physical activity
  • Unhealthy dietary patterns

Youth Risk Behaviors Among High School Students That Improved, 1991-1997

 

  1991 1993 1995 1997
Weapon carrying 26.1% 22.1% 20.0% 18.3%
Physical fighting 42.5 41.8 38.7 36.6
Ever had intercourse 54.1 53.0 53.1 48.4
Used condom at last intercourse 46.2 52.8 54.4 56.8

 

 

Youth Risk Behaviors Among High School Students That Worsened, 1991-1997

 

  1991 1993 1995 1997
Current cigarette use 27.5% 30.5% 34.8% 36.4%
Current marijuana use 14.7 17.7 25.3 26.2
Used birth control pills at last sexual intercourse 20.8 18.4 17.4 16.6
Participated in vigorous physical activity 66.3 65.8 63.7 63.8
Attended physical education class daily 41.6 34.3 25.4 27.4

 

More information on Healthy People 2010 is found in the HHS volume Developing Objectives for Healthy People 2010. Overall, there are some 400 objectives and 95 of those relate to youth and young adults. There are no process objectives for health outcomes or contributing behaviors, which is one place in which promotional indicators might have been featured. They were not defined for two reasons. One is that the core work group wanted to focus on behaviors. The second is that federal datasets have not been designed to accommodate promotional indicators.