Health Status of Youth in the United States

Healthy People 2000 identified goals and objectives focused on improving health by the year 2000. These goals and objectives allow us to measure the state of adolescent health in the United States. The leading indicators of health assessed with regard to adolescents related to physical activity and fitness, nutrition, tobacco, alcohol and other drugs, family planning, mental health and mental disorders, violent and abusive behavior, unintentional injuries, sexually transmitted diseases and clinical preventive services. Table B provides a brief overview of the findings discussed in the Healthy People 2000 Final Review (National Center of Health Statistics, 2001). Overall, the report found that while some goals were successfully met, there are still many opportunities to intervene on behalf of adolescents'.

Most of the outcomes measured in Healthy People 2010 are related to behavior choices. Nurses have traditionally focused on patient education and health promotion and are positioned to positively influence adolescent health behaviors via health initiatives designed to meet the objectives of Healthy People 2010.

Table B. Summary of Findings from Healthy People 2000 for Adolescents
Physical Activity and Fitness	Regular participation in stretching and strengthening exercises met 2000 target. Fewer young people are taking part in physical education classes.
Nutrition	Prevalence of overweight increased over all populations with greatest increase in adolescents. Increased low fat choices for breakfast and lunch, but only 1 in 5 schools offered low fat lunches. Not meeting calcium needs or minimum fruit and vegetable requirements.
Tobacco	Average age at time of first smoke is increasing and proportion of adolescents who smoked within past month has dramatically decreased, as did use of smokeless tobacco. Tobacco free environment at schools and anti-smoking education have increased, but < 5% of schools use CDC curriculum guidelines.
Substance Abuse: Alcohol and other drugs	Alcohol use substantially declined. High school and college students are still heavy drinkers. Alcohol related MVA deaths declined dramatically meeting the original HP2000 goal, but fell short of the adjusted target set in 1995. Cocaine use declined. Anabolic steroid use decreased, meeting 2000 target. Marijuana use more prevalent than a decade ago, but decreasing since 1997.
Family Planning	Teen pregnancy rate declined considerably. The percentage of young people who report ever having had sex has declined but the goal has not been met. Reported condom use is increasing and there has been a substantial decrease in unintended pregnancies.
Sexually Transmitted Diseases	Gonorrhea remains high among adolescents. Chlamydia declined, as did incidence of PID. Concern that HPV is much more common and may be most common STD of sexually active youth.
Mental Health and Mental Disorders	Suicide rates among young people declined below the target. However, there was an increase in suicide attempts.
Violent and Abusive Behavior	Firearm deaths decreased for all populations. Rape and attempted rape decreased but did not meet 2000 goal.
Unintentional Injuries	Decline in MVA crashes exceeded target. Drowning deaths decreased, but have not yet reached the target. Use of protective equipment, including helmets, for sports has increased but has not met target.
Oral Health	Substantial decrease in number of adolescents who had ever had dental decay, almost reaching target. Decrease in the use of smokeless tobacco among 12-17 year old males met target.
Clinical Preventive Services	Because neither baseline nor accurate current data was collected, it is extremely difficult to know if this has been met. Adolescents and young adults are most likely to not have a regular health care provider.

Table C. Leading Health Indicators for Healthy People 2010
Leading Health Indicator	Selected Objectives	Baseline	2010 Target
Physical Activity	Increase the proportion of adolescents who engage in vigorous physical activity that promotes cardiorespiratory fitness 3 or more days per week for 20 or more minutes per occasion.	65%	85%
Overweight and Obesity	Reduce the proportion of children and adolescents who are overweight or obese.	11%	5%
Tobacco Use	Reduce cigarette smoking by adolescents.	35%	16%
Substance Abuse	Increase the proportion of adolescents not using alcohol or illicit drugs during the past 30 days.	79%	89%
Responsible Sexual Behavior	Increase the proportion of adolescents who abstain from sexual intercourse or use condoms if currently sexually active.	85%	95%
Mental Health	Reduce the incidence of suicide attempts by adolescents.	2.6%	1%
Injury and Violence	1) Reduce deaths caused by motor vehicle crashes. 2) Reduce the incidence of rape and sexual assault in persons12 years of age and older 3) Reduce proportion of persons living in homes with firearms that are loaded and unlocked.	1) 15.6 per 100,000 persons 2) 0.6 per 100,000 persons 3) 19%	1) 9.2 per 100,000 persons 2) 0.4 per 100,000 persons 3) 16%
Environmental Quality	Reduce the proportion of families living in housing units that are substandard.	6.2%	3%
Immunization	Improve vaccination coverage levels of adolescents.		Developmental
Access to Quality Health Care	1) Increase the proportion of persons who have a specific source of ongoing care. 2) Increase the proportion of persons appropriately counseled about health behaviors.	1) 87%	1) 96% 2) Developmental