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Suggested citation

MacKay AP, Duran C. Adolescent Health in the United States, 2007.

National Center for Health Statistics. 2007.

Library of Congress Catalog Number

MacKay, Andrea P. Adolescent health in the United States, 2007.

p. ; cm. — (DHHS publication ; no. 2008–1034)
 

‘‘December 2007.’’
 

Prepared by Andrea P. MacKay and Catherine Duran.
 

Includes bibliographical references.
 

ISBN-13: 978-0-8406-0618-1
 

ISBN-10: 0-8406-0618-4
 

1. Teenagers—Health and hygiene—United States—Statistics.

2. Teenagers—Medical care—United States—Statistics. 3. Health behavior

in adolescence—United States—Statistics. I. Duran, Catherine. II. National

Center for Health Statistics (U.S.) III. Title. IV. Series.

[DNLM: 1. Health Status—United States—Statistics. 2. Vital Statistics—

United States. 3. Adolescent—United States. 4. Adolescent Behavior—

United States—Statistics. WA 900 AA1 M153a 2007]

RA407.3M228 2007

362.10835—dc22 2007037705

National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Acting Co-Deputy Director

Michael H. Sadagursky, Acting Co-Deputy Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Jennifer H. Madans, Ph.D., Acting Associate Director for

Planning, Budget, and Legislation

Michael H. Sadagursky, Associate Director for

Management and Operations

Lawrence H. Cox, Ph.D., Associate Director for Research

and Methodology

Linda B. Torian, Acting Director for Information Technology

Linda B. Torian, Acting Director for Information Services

Linda T. Bilheimer, Ph.D., Associate Director for Analysis

and Epidemiology

Charles J. Rothwell, M.S., Director for Vital Statistics

Jane E. Sisk, Ph.D., Director for Health Care Statistics

Jane F. Gentleman, Ph.D., Director for Health Interview

Statistics

Clifford L. Johnson, M.S.P.H., Director for Health and

Nutrition Examination Surveys

Office of Analysis and Epidemiology

Linda Bilheimer, Ph.D., Associate Director for Analysis and

Epidemiology

Diane M. Makuc, Dr. P.H., Associate Director for Science
Acknowledgments

Adolescent Health in the United States, 2007 was prepared

by Andrea P. MacKay and Catherine Duran of the Office of

Analysis and Epidemiology, National Center for Health

Statistics (NCHS), Centers for Disease Control and

Prevention (CDC), under the general direction of Linda

Bilheimer and Diane Makuc. Data analysis, technical

assistance, and content review for specific charts were

provided by Joyce C. Abma, Robert Anderson, Gwen Bergen,

Stephen J. Blumberg, Heather N. Brown, Anjani Chandra,

Alan J. Cohen, La-Tonya D. Curl, Lois A. Fingerhut, Virginia

M. Freid, Deborah D. Ingram, Jo Jones, Richard J. Klein,

Patricia Pastor, Mitchell B. Pierre, Jr., Cynthia A. Reuben,

Susan E. Schober, and Stephanie J. Ventura of NCHS; Steve

Kinchen and Shari L. Shanklin of the National Center for

Chronic Disease Prevention and Health Promotion, CDC;

Stuart Berman of the National Center for HIV/AIDS, Viral

Hepititis, STD, and TB Prevention, CDC; William A. Carroll

and Doris C. Lefkowitz of the Agency for Healthcare

Research and Quality; and Stephen Provasnik of the National

Center for Education Statistics. Editorial review was provided

by Demarius V. Miller and Megan M. Cox, CDC/CCHIS/

NCHM/Division of Creative Services, Writer-Editor Services

Branch, and Laura Drescher, Office of Information Services,

Information Design and Publishing Staff, NOVA contractor.

This report was typeset by Zung T. Le, CDC/CCHIS/NCHM/

Division of Creative Services, and graphics were produced by

Jarmila G. Ogburn, CDC/CCHIS/NCHM/Division of Creative

Services, and Kyung M. Park, CDC/CCHIS/NCHM/Division of

Creative Services, NOVA contractor.

Adolescent Health in the United States, 2007

iii

Acknowledgment
Contents

Acknowledgments ............................... iii 
 

List of Figures ................................ vi 
 

Introduction ................................. 1 
 

Population................................... 8 
 

Race and Ethnicity .......................... 8 
 

Poverty and Family Structure................... 10 
 

Dropout Rates.............................. 12 
 

Health Status ................................ 14 
 

Limitation of Activity.......................... 14 
 

Overweight ................................ 16 
 

Untreated Dental Caries ...................... 18 
 

Suicide Ideation and Attempts .................. 20 
 

Emergency Department Visits, Hospital Discharges,
 

and Death Rates ........................... 22 
 

Emergency Department Visits for Injury ........... 24 
 

Emergency Department Visits for Selected External
 

Causes of Injury ........................... 26 
 

Emergency Department Visits for Selected Injury
 

Diagnoses ................................ 28 
 

Emergency Department Visits for Selected
 

Diagnoses ................................ 30 
 

Alcohol-related Emergency Department Visits ....... 32 
 

Hospital Discharge Rates...................... 34 
 

Hospital Discharge Rates for Selected Diagnoses.... 36 
 

Death Rates .............................. 38 
 

Motor Vehicle- and Firearm-Related Deaths ....... 40 
 

Violence and Victimization ....................... 42 
 

Violent Crime Victimization .................... 42 
 

Dating Violence and Forced Intercourse .......... 44 
 

Reproductive Health ........................... 46 
 

Contraceptive Use .......................... 46 
 

Pregnancy Rates............................ 48 
 

Birth Rates ............................... 50 
 

Sexually Transmitted Diseases.................. 52 
 

Acquired Immunodeficiency Syndrome (AIDS) and
 

Human Immunodeficiency Virus (HIV) ........... 54 
 

Risk Behaviors ............................... 56 
 

Sexual Contact ............................ 56 
 

Sexual Partners ............................ 58 
 

Cigarette Smoking .......................... 60 
 

Alcohol Use................................ 62 
 

Drinking and Driving and Seatbelt Use............ 64 
 

Use of Marijuana and Other Illicit Drugs .......... 66 
 

Weapon Carrying............................ 68 
 

Physical Activity ............................ 70 
 

Dietary Risk Behavior ........................ 72 
 

Health Care Access and Utilization ................ 74 
 

Health Care Coverage ....................... 74 
 

Health Care Visits .......................... 76 
 

Health Care Expenses ....................... 78 
 

Medical Prescription Expenses ................. 80 
 

Unmet Health Care Needs for Adolescents with
 

Special Health Care Needs .................. 82 
 

Family Planning and Reproductive Health Medical
 

Services ................................. 84 
 

Dental Visits ............................... 86 
 

Data Tables for Figures 1–40 ..................... 88 
 

Technical Notes............................... 126 
 

Appendixes

Appendix I: Healthy People 2010 .................. 129 
 

Appendix II: Data Sources ...................... 131 
 

Adolescent Health in the United States, 2007

v

Contents
List of Figures

List of Figures

Population

1.	 Race and Hispanic origin of adolescents 10–19

years of age: United States, 1980–2050 ........ 9

2.	 Poverty status among adolescents 10–17 years of

age, by family structure and race and Hispanic

origin: United States, 2005 .................. 11

3.	 Status dropout rates among adolescents and young

adults 16–24 years of age, by age and race and

Hispanic origin: United States, 2004 ........... 13

Health Status

4.	 Limitation of activity caused by selected chronic

health conditions among adolescents 10–17 years

of age, by gender: United States, average annual

2004–2005 .............................. 15

5a.	 Overweight among adolescents 12–19 years of age:

United States, selected years 1966–1970 through

2003–2004 .............................. 16

5b.	 Overweight among adolescents 12–19 years of

age, by gender, race and Hispanic origin, and

poverty status: United States, average annual

2001–2004 .............................. 17

6.	 Untreated dental caries among adolescents 12–19

years of age and young adults 20–24 years of age, by

age group, race and Hispanic origin, and poverty

status: United States, average annual 2001–2004 . . . 19

7.	 Suicide ideation and attempts among students in

grades 9–12, by gender and race and Hispanic origin:

United States, 2005 ........................ 21

8.	 Emergency department visit rates, hospital discharge

rates, and death rates among adolescents 10–19

years of age, by age and gender: United States,

average annual 2002–2004 .................. 23

9.	 Initial emergency department visit rates for injury

among adolescents 10–19 years of age, by age

and gender: United States, average annual

2002–2004 .............................. 25

10.	 Initial emergency department visit rates for selected

external causes of injury among adolescents 10–19

years of age, by age and gender: United States,

average annual 2002–2004 .................. 27

11.	 Initial emergency department visit rates for selected

injury diagnoses among adolescents 10–19 years of

age, by age and gender: United States, average

annual 2002–2004 ......................... 29

12.	 Emergency department visit rates for selected noninjury

diagnoses among adolescents 10–19 years of age, by

age and gender: United States, average annual

2002–2004 .............................. 31

13.	 Alcohol-related emergency department visit rates

among adolescents 14–20 years of age and young

adults 21–24 years of age, by age group and gender:

United States, average annual 2002–2004 ....... 33

14.	 Short-stay hospital discharge rates for injury, noninjury,

and pregnancy-related diagnoses among adolescents

10–19 years of age, by age and gender: United States,

average annual 2002–2004 .................. 35

15.	 Short-stay hospital discharge rates for selected

diagnoses among adolescents 10–19 years of age, by

age and gender: United States, average annual

2002–2004 .............................. 37

16.	 Death rates for injury, by intent of injury and natural

causes among adolescents 10–19 years of age, by

age and gender: United States, average annual

2002–2004 .............................. 39

17.	 Death rates for motor vehicle traffic-related and

firearm-related injuries among adolescents 10–19 years

of age, by age and gender: United States, average

annual 2002–2004 ......................... 41

Violence and Victimization

18a.	 Violent crime victimization rates among adolescents

12–19 years of age and young adults 20–24 years of

age, by gender, age group, and type of victimization:

United States, 2004 ........................ 42

18b.	 Violent crime victimization rates among adolescents

12–19 years of age and young adults 20–24 years of

age, by age group: United States, 1985–2005 .... 43

19.	 Dating violence and being forced to have sexual

intercourse among students in grades 9–12, by gender

and grade level: United States, 2005 ........... 45

Reproductive health

20.	 Contraceptive use among never-married female

adolescents 15–19 years of age who have had sexual

intercourse in the past 3 months, by specified method

used at last sexual intercourse and race and Hispanic

origin: United States, 2002................... 47

21a.	 Pregnancy rates among adolescents 15–19 years of

age: United States, 1990–2002 ............... 48

21b.	 Pregnancy rates among adolescents 15–19 years of

age, by age, race and Hispanic origin, and outcome of

pregnancy: United States, 2002 ............... 49

vi Adolescent Health in the United States, 2007
22.	 Birth rates among adolescents 10–19 years of age,

by birth order, age group, and race and Hispanic

origin: United States, 2004................... 51

23.	 Sexually transmitted disease rates reported for

adolescents 15–19 years of age, by gender and

race and Hispanic origin: United States, 2004 .... 53

24.	 Acquired Immunodeficiency Syndrome (AIDS) and

Human Immunodeficiency virus (HIV) transmission

categories for adolescents 13–19 years of age, by

gender: United States and 33 states with confidential

reporting, 2001–2005 ....................... 55

Risk Behaviors

25a.	 Adolescents 15–19 years of age who have ever had

sexual intercourse, by age and gender: United States,

1988–2002 .............................. 56

25b.	 Ever had any sexual contact among adolescents

15–19 years of age, by type of contact, age, and

gender: United States, 2002.................. 57

26.	 Number of sexual partners in lifetime among

adolescents 15–19 years of age, by gender and

race and Hispanic origin: United States, 2002 .... 59

27.	 Current cigarette smoking among students in

grades 9–12 by grade level, gender, and race and

Hispanic origin: United States, 2005............ 61

28.	 Alcohol use, binge alcohol use, and heavy alcohol

use in the past 30 days among adolescents 12–20

years of age, by gender and race and Hispanic

origin: United States, 2005................... 63

29a.	 Drinking and driving and seatbelt use among students

in grades 9–12: United States, 1991–2005 ....... 65

29b.	 Drinking and driving and seatbelt use among

students in grades 9–12, by race and Hispanic

origin: United States, 2005................... 65

30.	 Marijuana use in the past 30 days and lifetime use

among students in grades 9–12, by grade level,

gender, and race and Hispanic origin: United States,

2005 ................................... 67

31.	 Weapon carrying in the past 30 days among

students in grades 9–12, by gender, grade level, and

race and Hispanic origin: United States, 2005 .... 69

32.	 Participation in physical activity among students in

grades 9–12, by gender and race and Hispanic

origin: United States, 2005................... 71

33.	 Dietary risk behavior in the past 30 days among

students in grades 9–12, by gender and race and

Hispanic origin: United States, 2005............ 73

Health Care Access and Utilization

34.	 Current health care coverage of adolescents

10–19 years of age, by age and poverty status:

United States, 2005 ........................ 75

35.	 Lack of a health care visit in the past 12 months

among adolescents 10–19 years of age, by age,

gender, race and Hispanic origin, and insurance

status: United States, 2005 .................. 77

36.	 Any out-of-pocket expenses for health care incurred

by adolescents 10–21 years of age, by gender,

race and Hispanic origin, and insurance status:

United States, 2004 ........................ 79

37.	 Any out-of-pocket expenses for prescribed medicine

incurred by adolescents 10–21 years of age, by

gender, race and Hispanic origin, and insurance

status: United States, 2004 .................. 81

38a.	 Unmet health service needs among adolescents

10–17 years of age with special health care needs,

by number of services needed but not obtained and

insurance status: United States, 2001 .......... 83

38b.	 Selected health service needs among adolescents

10–17 years of age with special health care needs,

by type of service needed: United States, 2001 . . . 83

39.	 Receipt of at least one family planning or

reproductive health medical service in the past

year among female adolescents 15–19 years of

age and young adults 20–24 years of age, by type of

provider and age group: United States, 2002 ..... 85

40.	 At least one dental visit in the past year among

adolescents 10–19 years of age and young adults

20–24 years of age, by age group, race and Hispanic

origin, and poverty status: United States, 2005.... 87

Adolescent Health in the United States, 2007

vii

List of Figures
Introduction

Adolescent Health in the United States, 2007 describes the

health of the population 10–19 years of age. Because the

transition to adulthood often continues through ages 20–24

years (young adults), data for young adults are presented in

topic areas when comparable data were available and in

charts where space allowed. For many figures, additional

information on gender, race and Hispanic origin, and age is

available in the accompanying data table to supplement the

characteristics highlighted in the figure.

Adolescence is a period of accelerated growth and change

that bridges the complex transition from childhood to

adulthood. The second decade of life is often a turbulent

period in which adolescents experience hormonal changes,

physical maturation, and, frequently, opportunities to engage

in risk behaviors. The patterns of behavior they adopt may

have long-term consequences for their health and quality of

life. Because of the rapid physical, cognitive, and emotional

developments that take place during this age period,

adolescence is also a time when many health problems may

first emerge (1). Moreover, adolescents also experience

special vulnerabilities, health concerns, and barriers to

accessing health care.

Definitions of adolescence and the years encompassed vary.

Adolescence is generally regarded as the period of life from

puberty to maturity, the meanings of which, however, are

often debated by health professionals. Many children begin

puberty by the age of 10, although there is considerable

individual variation in the developmental and maturation time

line. During their teenage years, adolescents are learning

financial, social, and personal independence, and they are

expected to become capable of adult behavior and response.

By the age of 19, most young people have completed high

school and are experiencing new living situations and

embarking on widely divergent paths—from college to military

service to employment. They are completing their teenage

years and entering the young adult realm, with new legal

standing, responsibilities, and independence. The transition to

adulthood can continue during the early twenties.

Adolescents have remarkable creativity, energy, and potential,

and the teenage years are also a time of exploration,

idealism, and cynicism. This period offers adolescents an

opportunity to begin planning for their futures, to adopt

healthy attitudes about risk behaviors, and to develop

meaningful roles in their communities. More teenagers now

than ever before are making commitments to community

service through volunteer activities. Some recent studies have

found that adolescents who volunteer do better in school, feel

more positive about themselves, and avoid risky behaviors

such as using drugs (2).

Organization of Adolescent Health in the United

States, 2007

This report from the Centers for Disease Control and

Prevention’s (CDC) National Center for Health Statistics

(NCHS) presents data on the current status of adolescent

health. Many of the measures of health status are shown by

single year of age or by 2- or 3-year age intervals to highlight

the changes that occur in health status as adolescents move

through this important developmental period. Summary

measures combining 5- or 10-year age groups (the standard

for analyses of childhood health events) do not adequately

capture the wide variation in health status and the vast

developmental differences between younger and older

adolescents.

Racial and ethnic variation in adolescent health is discussed

when the data sources allow for such analysis. Differences

between sexes in some aspects of health status among

adolescents become more apparent with age. These

differences are presented when the data allow for such

analysis and the differences are notable.

Socioeconomic status, as measured by family income, poverty

status, or level of parents’ education, is as strongly

associated with the health of adolescents as it is with the

health of persons of all ages in the United States (3).

Differences in the life circumstances of high- and lowsocioeconomic status adolescents and their families influence

health and health risk behavior in a number of ways. Low

family income decreases the ability to afford comfortable

housing, healthy food, and appropriate health care, and it

also reduces the opportunity to live in a safe and healthy

environment. To fully assess the impact of socioeconomic

factors on the health of adolescents, the examination of

adolescent school and family environments should be

included, as well as their broader sociostructural

environments (4). A comprehensive presentation on

socioeconomic status and adolescent health is beyond the

scope of this report. However, information on selected social

determinants of health (Figures 2 and 3) and the strong

Adolescent Health in the United States, 2007

1

Introduction
Introduction

relationship between socioeconomic status and adolescent

health has been documented in several charts (Figures 5, 6,

34, and 40).

Characterizing the health of adolescents requires not only

measuring mortality and morbidity but also describing other

indicators of adolescent health. Risk behaviors—including

tobacco use, alcohol and other drug use, sexual behavior,

physical inactivity, unhealthy dietary behaviors, and behaviors

that contribute to unintentional and intentional injuries—may

have a profound effect on current and future health.

Reproductive health is a key element in adolescent health.

The decision to become sexually active can have long-term

and permanent consequences for some adolescents.

Healthy People 2010, a nationwide health promotion and

disease prevention agenda that sets specific health objectives

for the year 2010, includes objectives related to adolescent

health (5). Of the 107 objectives that pertain to adolescents

and young adults, 21 objectives have been designated as

critical adolescent objectives. Appendix I, Healthy People

2010, discusses objectives for adolescent health in Healthy

People 2010 and includes a table that lists these objectives

with baseline and current measures. The table also

references the related Adolescent Health in the United States,

2007 figures.

This report is divided into sections on population

characteristics, health status, violence and victimization,

reproductive health, risk behaviors, and health care access

and utilization. The 40 figures and accompanying text are

followed by technical notes and data tables for each figure.

Data tables include estimates in the figures plus standard

errors when available, and, for some charts, additional related

data are presented. The technical notes describe in further

detail information about methods used that is not covered in

Appendix II, Data Sources.

Population Characteristics

The first section of this report describes selected

sociodemographic characteristics of the adolescent population.

One of the most notable characteristics is the changing racial

and ethnic composition of this population (Figure 1). Today,

approximately 61 percent of adolescents are non-Hispanic

white. By 2050, this proportion is estimated to have

decreased to 44 percent. Other sociodemographic measures,

including family structure, poverty status, and dropout rates

describe the economic circumstances of adolescents. Family

structure affects adolescents’ economic well-being (Figure 2),

and adolescents who drop out of high school will have fewer

opportunities to succeed in the work force than their peers

who complete high school (Figure 3). Educational

achievement is one of the most important indicators of

lifetime economic opportunity and is also associated with

health status.

Health Status

The second section of Adolescent Health in the United

States, 2007 presents selected measures of physical, dental,

and mental health status. Although adolescents do have

physical health problems, they are at greatly reduced risk for

life-threatening illnesses that affect the very young or very

old. Some adolescents experience chronic health conditions

that limit their activity or require special education services

(Figure 4), and a rapidly increasing percentage of the

adolescent population is overweight (Figure 5a). The negative

effects of poverty on dental health status as measured by

untreated dental caries are apparent in Figure 6.

Many of the normal transitions of life, such as the adjustment

to the physical and biological changes to their bodies and

new levels of independence and responsibility, can be

stressful for teenagers. Although mood swings are a common

feature of adolescence, more serious suicidal thoughts or

suicide attempts are indicators of a mental or emotional

health problem (Figure 7). To further assess adolescent health

status, data on selected aspects of health care utilization

were analyzed (Figures 8–13). These sources identify health

events for which emergency department (ED) care or

inpatient hospital care was received and also provide

information on leading diagnoses among adolescents.

Injuries are a major cause of ED visits among adolescents. In

2002–2004, four external causes of injury accounted for over

60 percent of all initial injury-related ED visits: falls, being

struck by or against an object or person, cuts, and motor

vehicle crashes (Figure 10). The most common injury

diagnoses were fractures, sprains and strains, open wounds,

and contusions (Figure 11). Upper respiratory conditions,

asthma, and abdominal or gastrointestinal conditions were

among the leading diagnoses for adolescents’ ED visits not

related to an injury in 2002–2004 (Figure 12). Alcohol-related

visits to EDs increase with age and are substantially higher

for male adolescents and young adults than for their female

counterparts (Figure 13).

2 Adolescent Health in the United States, 2007
Hospital discharge rates vary by gender, chiefly because of

the large number of hospitalizations for pregnancy-related

causes among female adolescents (Figure 14). Pregnancyrelated discharges accounted for almost one-half of all

hospital discharges among female adolescents in 2002–2004

(Figure 14). Asthma, psychoses, fractures, and poisoning were

among the leading first-listed diagnoses for hospitalized

adolescents in 2002–2004, and accounted for almost one-fifth

of all hospital discharges (Figure 15).

Mortality rates are a measure of the most serious adolescent

health events. Leading causes of injury mortality are

presented in Figures 16–17. Motor vehicle traffic-related

injuries and firearm-related injuries are the two leading causes

of death among adolescents 10 to 19 years of age

(Figure 17). Changes in mortality by single year of age across

the adolescent period are significant and striking.

Violence and Victimization

The third section of this report presents selected measures

on violence and victimization. Adolescents are the victims of

violent acts, including rape or sexual assault, aggravated and

simple assault, and robbery (Figure 18a). Over the past two

decades, crime victimization rates among adolescents and

young adults have changed considerably, declining almost

two-thirds between 1995 and 2005 (Figure 18b). Adolescents

of both sexes are victims of dating violence (being hit,

slapped, or physically hurt on purpose by a boyfriend or

girlfriend) (Figure 19), and both sexes report having had

forced intercourse (Figure 19).

Reproductive Health

The onset of puberty is one of the benchmarks of

adolescence. For the first time in their lives, adolescents are

facing issues and decisions about their own sexuality. The

majority of today’s adolescents become sexually active during

their teenage years and are at risk for health consequences

associated with sexual activity, such as pregnancy or sexually

transmitted disease. An important measure of adolescent

reproductive health is contraceptive use (Figure 20). Oral

contraceptives and condoms are the most common methods

of contraception used by female adolescents. Trends in

pregnancy rates among female adolescents are shown in

Figure 21a, and pregnancy rates by race and Hispanic origin

and pregnancy outcome are shown in Figure 21b. Birth rates

among adolescents increase with age and vary considerably

by race and Hispanic origin (Figure 22). Birth rates among

adolescents have declined markedly between 1991 and 2004.

Sexually transmitted diseases (STDs) are the most commonly

reported infectious diseases among sexually active

adolescents, and chlamydia and gonorrhea are the most

common bacterial causes of STDs (Figure 23). Young people

in the United States are at persistent risk for human

immunodeficiency virus (HIV) infection, and sexual activity

and drug use among adolescents place them at high risk for

HIV transmission (Figure 24) (6).

Risk Behaviors

Adolescents today are confronting societal and peer-related

pressures to have sex at earlier ages and to use tobacco,

alcohol, or other drugs. Many adolescents are engaging in

risk behaviors that are harmful or dangerous to themselves

and others, with consequences to their health and well-being

that may be immediate or long term. Many of the patterns of

behavior initiated during the adolescent years are associated

with adult morbidity and mortality.

Approximately one-half of adolescents engage in some form

of sexual contact, most commonly oral sex or vaginal

intercourse (Figure 25b). The likelihood that an adolescent

has ever had heterosexual vaginal intercourse increases with

age (Figure 25a). Among those adolescents who have been

sexually active, a majority have had intercourse with more

than one partner in their life (Figure 26).

Smoking has serious long-term effects on health. Most adults

who are addicted to tobacco began smoking as

adolescents (7). Current and frequent smoking among high

school students is shown in Figure 27. Alcohol is the most

commonly used psychoactive substance during adolescence.

Alcohol use, including heavy alcohol use and binge alcohol

use, are shown in Figure 28.

Drug use by adolescents can have immediate and long-term

health consequences. Marijuana is the most commonly used

illicit drug among high school students. In 2005, almost 4 in

10 high school students had used marijuana in their lifetime

(Figure 30).

As adolescents become more independent, they are at risk

from behaviors associated with riding in and driving cars.

Among high school students in 2005, riding with a driver who

had been drinking was more common than driving after

drinking alcohol (Figure 29b).

3

Introduction

Adolescent Health in the United States, 2007
Introduction

Weapon carrying is associated with the most serious injuries

resulting from violence. Carrying a gun or other weapon (for

example, a knife or club) is more common among male high

school students than among female high school students

(Figure 31).

Physical activity provides important health and emotional

benefits for adolescents. Physical activity, along with a healthy

diet, plays an important role in the prevention of overweight

and obesity. Participation by high school students at the

currently recommended level of physical activity and

participation in moderate to vigorous physical activity are

shown in Figure 32.

Dietary risk behaviors can have serious health consequences

for adolescents. Adolescents who go on extreme diets are

more likely to smoke, drink alcohol, use marijuana, and

attempt suicide, and they are less likely to make healthy

choices, such as exercising moderately and eating five

servings of fruits and vegetables each day (8). Dietary risk

behaviors include fasting (for 24 hours or more), vomiting,

and taking laxatives to lose weight or keep from gaining

weight (Figure 33).

Health Care Access and Utilization

Lack of health insurance is associated with diminished access

to and use of preventive health services. Adolescents from

poor and near poor families are more likely to be uninsured

than those from nonpoor families (Figure 34). Routine health

care for adolescents includes physical examinations,

preventive interventions and education, observations,

screening, and sick care. Uninsured adolescents are less

likely to receive health care than those with coverage

(Figure 35).

The out-of-pocket cost associated with receiving health care

is an important measure of health care access. Out-of-pocket

expenses for health care and prescribed medicine are shown

in Figures 36 and 37. For adolescents with special health

care needs (SHCN), consistent access to a wide range of

health care services is particularly important. Among the most

commonly needed services are dental care, specialist care,

preventive care, prescription medication, and eyeglasses or

vision care (Figure 38b). Insurance status is strongly

associated with the proportion of adolescents with SHCN who

have one or more unmet health care needs (Figure 38a).

Adolescents and young adults use routine family planning and

reproductive health medical services in a variety of settings,

including private physicians’ offices and clinics (Figure 39).

Sexual and reproductive health services encompass three

main areas: contraceptive services, maternal health services,

and services related to sexually transmitted diseases.

Oral health is an important component of adolescent health.

Professional dental care on a routine basis may prevent oral

disease or disclose existing disease in its early stages. The

proportion of adolescents who had at least one dental visit in

the past year varies by race and Hispanic origin and

insurance status (Figure 40).

Chartbook Data Sources

The data presented in Adolescent Health in the United

States, 2007 are from nationally representative health surveys

or vital statistics. One of the data sources, the Youth Risk

Behavior Survey (YRBS), is a survey of high school students

in grades 9 through 12. Figures that are based on the YRBS

present data for adolescents by grade level rather than by

age. Measures of risk behavior in YRBS are limited to the

population of adolescents enrolled in and attending high

school. Consequently, the measures of risk behaviors in this

report may be lower than if all high school-aged adolescents

were included in the survey. In 2004, 10 percent of

adolescents and young adults 16–24 years of age were not

enrolled in school and had not earned a high school

credential (i.e., diploma or equivalent, such as a General

Educational Development (GED) certificate). These

adolescents and young adults are at increased risk of alcohol,

drug, and tobacco use and are more likely to engage in

violence-related behavior (9).

For data from the following systems, multiple years are

combined to increase the reliability of estimates: the NCHS’s

National Hospital Ambulatory Medical Care Survey

(2002–2004), National Hospital Discharge Survey (2002–

2004), National Vital Statistics System, Mortality (2002–2004),

National Health Interview Survey (2004–2005—for chronic

health conditions causing limitation of activity), and the

National Health and Nutrition Examination Surveys

(2001–2004), and CDC’s National Center for HIV, STD, and

TB Prevention AIDS Surveillance System (2000–2004).

In national surveys that are not specifically designed to study

adolescents, the number of observations may not be large

enough to analyze differences among age, gender, and race

4 Adolescent Health in the United States, 2007
or ethnicity groups. For certain topics, data are presented for

all races combined in the chart, and significant race

differences (if they exist) are discussed in the accompanying

text. See ‘‘Technical Notes’’ and Appendix II for more detailed

descriptions of data sources.

Other Sources of Data

In addition to the data sources used in this chartbook, we

would like to acknowledge other sources of available data on

adolescent health. Each of the following sources makes a

unique contribution to the collective body of knowledge on

adolescent health. The National Longitudinal Study of

Adolescent Health (National Institutes of Health) was

designed to study the influences on adolescent health and

health behaviors, with an emphasis on the social contexts in

which adolescents live (10). Monitoring the Future (National

Institute on Drug Abuse) is a nationally representative, annual

survey of 8th-, 10th-, and 12th-grade students’ values,

behaviors, and lifestyle orientations (11). The National

Adolescent Health Information Center (NAHIC) at the

University of California, San Francisco, serves as a national

resource for adolescent health information and research (12)

and is funded by a grant from the Maternal and Child Health

Bureau, Health Resources and Services Administration.

NAHIC works to ensure the integration, synthesis,

coordination, and dissemination of adolescent health-related

information. The Kaiser Family Foundation has published two

recent reports on adolescents. The first report, Generation M:

Media in the Lives of 8–18 Year-olds, examined adolescent

media use using a nationally representative survey of young

people (13). The second report, Generation Rx.com: How

Young People Use the Internet for Health Information, found

that a majority of teenagers and young adults (ages 15–24

years) use the Internet to search for health information (14).

Web pages designed for teenagers are available from several

sources, including Medline (15) and the U.S. Food and Drug

Administration (16). The Centers for Disease Control and

Prevention provides an informative website on adolescent

health with links to key resources (17).

Data Gaps

Available data sources present several limitations for studying

adolescent health. In some sources of data, adolescents may

not be considered a separate group. They may be included in

tabulations for children under 15 or under 18 years of age, or

they may be included with young adults ages 15–24 years. In

such cases, trends pertaining specifically to adolescents

cannot be separated from those pertaining to children or

young adults. In data sources that do categorize adolescents

separately, inconsistencies are present in the age ranges

employed, making comparisons of data sources difficult.

Furthermore, data for adolescents are often not available by

single year of age. A major focus of this chartbook is to

address this limitation by presenting data by single year of

age when possible.

Another obstacle in assessing the health status of the

adolescent population is the lack of information on detailed

racial and ethnic minority groups. The socioeconomic status

and cultures of racial and ethnic groups may vary widely and

have important health consequences. In this report, the most

detailed race and ethnicity categories available are presented,

given the constraints of numbers of observations. For many

data sources on adolescent health, information on the

socioeconomic status of adolescents is not available.

Educational attainment is often used as a measure of

socioeconomic status for adults, but it is not a useful

measure for an age group comprising people who have not

yet completed their education. School-based surveys may

collect health information directly from adolescents who are

not knowledgeable about their family’s income or other

measures of socioeconomic status.

Several areas exist in which the special needs or problems of

adolescents have been recognized. However, national data

are not available to more fully explore these areas. Some of

those issues are briefly discussed here.

Adolescents have an increased sensitivity about their

bodies and the changes in shape and weight that

accompanies maturation. Some adolescents may develop

eating disorders, such as anorexia or complications, yet these

disorders often go undetected and untreated. The prevalence

of eating disorders is particularly difficult to measure because

of the underlying denial and secretive nature of the behavior.

Although adolescent sexual activity has been welldocumented, the extent to which sex is consensual has not

been fully evaluated. Because many myths concerning rape

persist among adolescents, acquaintance rape and date rape

are often unreported and untreated (18).

Adolescents who are runaways and ‘‘living on the streets’’

are not included in national survey data. These young people

are especially vulnerable and may have unique health care

Adolescent Health in the United States, 2007

5

Introduction
Introduction

needs. Similarly, incarcerated youth are not included in

national survey data.

Adolescents with alternative lifestyles and sexual identity

(i.e., gay, lesbian, bisexual, and transgender) face unique

social and health issues. National data are not available for

these populations.

Conclusion

The health and risk behaviors of adolescents have

consequences for their current and long-term well-being as

well as consequences for society. Today’s adolescents are the

future parents, leaders, and work force of the United States.

This report examines a variety of current measures of health

status, risk behavior, and health care from national data

sources. The differences in health status between younger

and older adolescents are documented. The health of the

adolescent population also varies by gender, race and

ethnicity, and socioeconomic status. Understanding patterns of

health among adolescents requires attention to differences in

the population and recognition of the economic and racial

disparities that exist.

Overall, the majority of adolescents are healthy when

assessed by traditional measures of morbidity and mortality.

Many of the health threats for adolescents are primarily social

and behavioral. Health-risk behaviors often are established

during youth, extend into adulthood, and are interrelated (19).

The most costly and widespread adolescent health

problems—unintended pregnancy, sexually-transmitted

infections, violence, suicide, unintended injuries, and the use

of alcohol, tobacco, and other drugs— are potentially

preventable (1). Adolescent risk behaviors have been linked

to subsequent morbidity or mortality. Intervention and

prevention strategies may prevent or reduce adolescent and

adult morbidity and mortality and promote a healthier

transition from childhood to adulthood.

References

1.	 Park MJ, Macdonald TM, Ozer EM, Burg SJ, Millstein SG,

Brindis CD, et al. Investing in clinical preventive health

services for adolescents. San Francisco, CA: University of

California, San Francisco, Policy Information and Analysis

Center for Middle Childhood and Adolescence and National

Adolescent Health Information Center. 2001.

2.	 Moore CW, Allen JP. The effects of volunteering on the young

volunteer. J Prim Prev 17(2):231–58. 1996.

3.	 Pamuk E, Makuc D, Heck K, Reuben C, Lochner K.

Socioeconomic status and health chartbook. Health, United

States, 1998. Hyattsville, MD: National Center for Health

Statistics. 1998.

4.	 Goodman E. The role of socioeconomic status gradients in

explaining differences in U.S. adolescents’ health. Am J Public

Health 89:1522–8. 1999.

5.	 U.S. Department of Health and Human Services. Healthy

people 2010. Volumes 1 and 2. Washington, DC: U.S.

Government Printing Office. 2000.

6.	 CDC. HIV/AIDS surveillance in adolescents and young adults

(through 2005) [cited 2007 June 20]. Available from:

www.cdc.gov/hiv/topics/surveillance/resources/slides/

adolescents/index.htm. 2007.

7.	 U.S. Department of Health and Human Services, Office on

Smoking and Health. Preventing tobacco use among young

people: A report of the Surgeon General. Atlanta, GA: Centers

for Disease Control and Prevention. Available from:

http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_1994/

index.htm. 1994.

8.	 Rafiroiu AC, Sargent RG, Parra-Medina D, Drane WJ, Valois

RF. Covariations of adolescent weight-control, health-risk, and

health-promoting behaviors. Am J Health Behav 27(1):3–14.

2003.

9.	 CDC. Youth risk behavior surveillance—National alternative

high school youth risk behavior survey, United States, 1998.

MMWR 48(SS–7):1–44. 29 Oct 1999.

10.	 The National Longitudinal Study of Adolescent Health [cited

2007 June 20]. Available from: www.cpc.unc.edu/addhealth.

2003.

11.	 Monitoring the Future [cited 2007 June 20]. Available from:

www.monitoringthefuture.org/. 2007.

12.	 National Adolescent Health Information Center [cited 2007

June 20]. Available from: http://nahic.ucsf.edu/. 2007.

13.	 Roberts DF, Foehr UG, Rideout V, for Kaiser Family

Foundation. Generation M: Media in the lives of

8–18 year-olds [cited 2007 June 20]. Available from:

www.kff.org/entmedia/7251.cfm. 2005.

6 Adolescent Health in the United States, 2007
14.	 Rideout V, for Kaiser Family Foundation. Generation Rx.com:

How young people use the Internet for health information

[online]. [cited 2007 June 20]. Available from:

www.kff.org/entmedia/20011211a-index.cfm. 2001.

15.	 National Institutes of Health. Medline Plus—Teen’s

page [cited 2007 June 20]. Available from:

www.nlm.nih.gov/medlineplus/teenspage.html. 2007.

16.	 U.S. Food and Drug Administration. Health information

for teens [cited 2007 June 20]. Available from:

www.fda.gov/oc/opacom/kids/html/7teens.htm. 2007.

17.	 CDC. Adolescent health [cited 2007 June 20]. Available from:

www.cdc.gov/node.do/id/0900f3ec801e457a. 2007.

18.	 Rape, Abuse, and Incest National Network. Are victims

reporting the crime of rape [cited 2007 June 20]. Available

from: www.rainn.org/statistics/reporting-rape.html. 2007.

19.	 CDC. Youth risk behavior surveillance—United States, 2005.

MMWR 55(SS-5). 9 June 2006.

Adolescent Health in the United States, 2007

7

Introduction
Population

Population

Race and Ethnicity

Changes in the racial and ethnic composition of the

population have important consequences for the health of the

adolescent population because many of the measures of risk

behavior, health status, and disease differ significantly by race

and ethnicity.

In 2005, over 42 million residents of the United States

were adolescents 10–19 years of age, constituting

approximately 14 percent of the U.S. population. Three-fifths

of the adolescent population was non-Hispanic white, and

two-fifths consisted of other racial and ethnic groups

(Figure 1).

The race and Hispanic origin distribution of the adolescent

population, like that of the general population, changed

considerably over the past 20 years, and projections of the

population indicate that certain racial and ethnic groups will

continue to expand. Hispanic, black or African American,

American Indian or Alaska Native, and Asian or Pacific

Islander adolescents, as well as adolescents who are of two

or more races, will constitute 56 percent of the adolescent

population by the year 2050.

Increasing racial and ethnic diversity in the general

population is reflected in changes in the adolescent

population. Hispanic adolescents have recently surpassed

black adolescents as the largest minority group of

adolescents, and the proportion of adolescents who are

Hispanic is expected to increase considerably by 2050.

A large influx of immigrants has contributed to changes in

the population distribution. In 1990, 19 percent of adolescents

lived in immigrant families—that is, the adolescent was an

immigrant or had immigrant parents (1). By 2004, the

proportion of adolescents in immigrant families had increased

to 22 percent (2). Most future growth in the U.S. population is

expected to occur primarily through immigration and higher

fertility rates among minority populations (1,3).

References

1.	 Hernandez DJ, Chamey C, editors. From generation to

generation. The health and well-being of children in immigrant

families. Washington, DC: National Academy Press. 1998.

2.	 U.S. Bureau of the Census. Foreign-born population of the

United States: Current Population Survey—March 2004.

Detailed tables (PPL-176) [cited 2007 June 8]. Available from:

www.census.gov/population/www/socdemo/foreign/ppl-176.html.

2007.

3.	 Council of Economic Advisers for the President’s Initiative on

Race. Changing America: Indicators of social and economic

well-being by race and Hispanic origin. Washington, DC: U.S.

Government Printing Office. 1998.

8 Adolescent Health in the United States, 2007
Figure 1. Race and Hispanic origin of adolescents 10–19 years of age: 

United States, 1980–2050 

100 

80 

White, not Hispanic 

60 

1980 1990 2000 2010 2020 2030 2040 2050 

Projected 

Percent 

40 

Hispanic 

20 

Black 

Asian or Pacific Islander Asian 

American Indian or Alaska Native
 

0
 

Year 

NOTES: Data for 1980–1995 are for Asian or Pacific Hispanic origin may be of any race. See data table for 


Islander persons; data for 2000–2050 are for Asian data points and additional notes.
 

person only. Population projections are not available for 


American Indian or Alaska Native persons. Persons of SOURCE: U.S. Census Bureau. 


Adolescent Health in the United States, 2007

9

Population
Population

Poverty and Family Structure

Poverty during adolescence has immediate and lasting

negative consequences. Adolescents in families who are poor

are more likely than adolescents in other families to drop out

of school (1), to become teenage parents (2), and to earn

less and be unemployed more frequently as adults (3).

Furthermore, poverty is strongly associated with reduced

access to health care and poorer health status for

adolescents. The structure of an adolescent’s family is

generally linked to the economic resources and support

available to that adolescent.

In 2005, almost 16 percent of all adolescents 10–17 years

of age lived in families with incomes below the poverty

threshold ($19,971 a year in 2005, for a family of four),

whereas an additional 20 percent of adolescents lived in

families near poverty (one to two times the poverty threshold)

(Figure 2).

Adolescents who live in a household with one parent only

are substantially more likely to have a family income near or

below the poverty line than are adolescents living in a

household with two parents.

One-parent households headed by women experience the

highest rates of poverty for a variety of reasons, including pay

differentials and lack of paternal financial support. In 2005,

36 percent of all adolescents in female head-of-household

families were living in poverty, compared with 7 percent of

adolescents in two-parent families. Non-Hispanic black and

Hispanic adolescents in female head-of-household families

were 1.7 times as likely to have a family income below the

poverty line as their non-Hispanic white counterparts.

In 2005, 25 percent of non-Hispanic white adolescents

lived with a single parent (mother or father), compared with

60 percent of non-Hispanic black adolescents and 35 percent

of adolescents of Hispanic origin (4).

References

1.	 Livingston A. The condition of education 2006 in brief.

Washington, DC: U.S. Department of Education, National

Center for Education Statistics. 2006.

2.	 Sawhill IV. Teen pregnancy prevention: Welfare reform’s

missing component. Washington, DC: The Brookings Institution.

Policy brief 38:1–8. 1998.

3.	 Duncan G, Brooks-Gunn J, editors. Consequences of growing

up poor. New York, NY: Russell Sage Press. 1997.

4.	 U.S. Census Bureau. Current Population Survey, March

supplement 2006. Unpublished analysis. 2006.

10 Adolescent Health in the United States, 2007
All adolescents 

All races and origins Poor Near poor 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Adolescents in married couple families 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Adolescents in female householder families 

All races and origins 

White only, not Hispanic 

Figure 2. Poverty status among adolescents 10–17 years of age, by family structure 

and race and Hispanic origin: United States, 2005 

Black only, not Hispanic 

Hispanic 

0 20 40 60 80 100

Percent 

Population

NOTES: Poverty status is derived from the 

ratio of the family’s income to the federal 

poverty threshold, given family size. Poor 

families have income less than 100 percent of 

the poverty threshold; near poor families 


have income from 100 to less than 200 

percent of the poverty threshold; nonpoor 

families have income of 200 percent of the 

poverty threshold or more. Persons of 

Hispanic origin may be of any race. See data 

table for data points. 


SOURCE: U.S. Census Bureau, Current
 

Population Survey, March Supplement 2006. 


Adolescent Health in the United States, 2007

11
Population

Dropout Rates

Although the majority of adolescents complete high school,

students who drop out of school have fewer opportunities

than students who complete high school to succeed in the

work force or to assume a fully functional place in society.

High school dropouts have lower earnings, experience more

unemployment, and are more likely to receive government

assistance or be in prison than their peers who complete high

school or college (1). Out-of-school adolescents are more

likely than those in school to smoke; use alcohol, marijuana,

or cocaine; be involved in a physical fight; and be sexually

active (2). Among adults aged 25 years and over, dropouts

reported worse health than did those who completed high

school, regardless of income (3).

The status dropout rate is a measure of the proportion of the

civilian noninstitutionalized population 16–24 years of age who

are not in high school and who have not earned a high

school credential—either a diploma or an equivalency

credential such as a GED certificate. Status dropout rates

measure the extent of the dropout problem for a population

and can be used to estimate the need for further education

and training in that population.

In 2004, 10.3 percent of adolescents and young adults

16–24 years of age were not enrolled in school and did not

have a high school credential (Figure 3). Dropout rates

declined gradually between 1972 and 2004, from 15 percent

to a low of 10 percent in 2003, where the rate remained in

2004 (3).

The status dropout rate increases with age. In 2004,

adolescents 18 years of age and over were two to three

times as likely to have dropped out as were those ages

16–17 years.

The status dropout rate is higher for males than for

females. In 2004, almost 12 percent of males ages 16–24

years were high school dropouts, compared with 9 percent of

females (data table for Figure 3). Although males constitute

one-half of the population, they account for 57 percent of the

dropouts in this age group.

Non-Hispanic black and Hispanic adolescents and young

adults are more likely than non-Hispanic white adolescents

and young adults to have dropped out of high school. In

2004, 7 percent of non-Hispanic white adolescents 16–24

years of age were not enrolled in school and had not

completed high school, compared with 12 percent of

non-Hispanic black and 24 percent of Hispanic adolescents.

Asian and Pacific Islander adolescents had the lowest dropout

rate among all racial and ethnic groups in 2004, with a

dropout rate of less than 4 percent.

The majority of students who drop out of high school go

on to earn a high school diploma or alternative credential

within 8 years (4).

References

1.	 Caspi A, Wright BE, Moffit TE, Silva PA. Childhood predictors

of unemployment in early adulthood. Am Sociol Rev

63(3):424–51. 1998.

2.	 CDC. CDC surveillance summaries. MMWR 48(SS–7).

29 Oct 1999.

3.	 Livingston A. The condition of education 2006 in brief.

Washington, DC: U.S. Department of Education, National

Center for Education Statistics. 2006.

4.	 Hurst D, Kelly D, Princiotta D. Educational attainment of

high school dropouts 8 years later. Washington, DC:

U.S. Department of Education, National Center for Education

Statistics. 2004.

12 Adolescent Health in the United States, 2007
Figure 3. Status dropout rates among adolescents and young adults 16–24 years of 

age, by age and race and Hispanic origin: United States, 2004 

Age 

16 years 

17 years 

18 years 

19 years 

20–24 years 

Race and Hispanic origin 

All races and origins 

Hispanic 

White, not Hispanic 

Black, not Hispanic 

Asian or Pacific Islander 

Two or more races 

0 10 20 30 40

Percent 

50

Population

NOTES: The status dropout rate is the 

percentage of civilian noninstitutional 

population 16–24 years of age who are not in 

high school and have not earned a high 

school credential, irrespective of when they 

dropped out. Persons who reported only 

one race are included in single-race 

categories; persons who reported more than 

one race shown as having two or more and 

are not included in single categories. 

Persons of Hispanic origin may be of any race 

or racial combination. See data table for data 

points, data by gender and region, standard 

errors, and additional notes. 

SOURCE: U.S. Census Bureau, Current 

Population Survey, October Supplement 

2004. Tabulated by the U.S. Department of 

Education, National Center for Education 

Statistics. 

Adolescent Health in the United States, 2007

13
Health Status

Health Status

Limitation of Activity

Limitation of activity due to chronic physical, mental, or

emotional conditions is a broad measure of health and

functioning that gauges an adolescent’s ability to undertake

age-appropriate activities. Schoolwork is the primary activity

for adolescents 10–17 years of age.

The National Health Interview Survey (NHIS) identifies

adolescents with activity limitation through questions about

specific limitations in walking, memory, self-care, and other

activities, and also through a question concerning current use

of special education services. An adolescent is classified as

having an activity limitation due to a chronic condition if the

limitation is caused by a chronic physical, mental, or

emotional problem. Estimates of the number of adolescents

with an activity limitation may differ depending on the type of

limitations included and the methods used to identify

them (1).

In 2004–2005, approximately 9 percent of adolescents

10–17 years of age had a limitation of activity due to a

chronic health condition.

Learning disabilities and Attention Deficit Hyperactivity

Disorder (ADHD or ADD) were among the most frequently

mentioned chronic conditions causing activity limitation

(Figure 4) in 2004–2005. Learning disabilities are disorders

that affect the ability to understand or use spoken or written

language, do mathematical calculations, coordinate

movements, or direct attention (2). The most common

treatment for learning disabilities is special education.

Adolescents with ADHD may have impaired functioning in

multiple settings, including at home, at school, and in

relationships with peers. This disorder can have long-term

adverse effects (3).

Approximately one-fifth of adolescents with an activity

limitation had more than one condition causing activity

limitation. The most common combinations of causal

conditions were learning disability and ADHD; learning

disability and speech problems; and ADHD and other mental,

emotional, or behavioral problems.

Limitation of activity varies by gender. In 2004–2005, male

adolescents were more than three times as likely to have

limitations due to ADHD as were female adolescents, and

males were more than twice as likely to have limitations due

to mental, emotional, or other behavioral problems.

Physiological, maturational, behavioral, and social differences

between boys and girls have been suggested as explanations

for the higher prevalence of activity limitation in boys (4).

References

1.	 Newacheck PW, Strickland B, Shonkoff JP, et al. An

epidemiologic profile of children with special health care needs.

Pediatrics 102(1):117–23. 1998.

2.	 National Institute of Neurologic Disorders and Stroke. NINDS

learning disabilities information page [online]. [cited 2007 June

8]. U.S. Department of Health and Human Services, National

Institutes of Health. Available from: www.ninds.nih.gov/

disorders/learningdisabilities/learningdisabilities.htm. 2007.

3.	 National Institute of Mental Health. Attention Deficit

Hyperactivity Disorder. Bethesda, MD: National Institutes of

Health. Available from: http://www.nimh.nih.gov/health/topics/

attention-deficit-hyperactivity-disorder-adhd/index.shtml. 2003.

4.	 Gissler M, Jarvelin M-R, Louhiala P, Hemminki E. Boys have

more health problems in childhood than girls: Follow-up of the

1987 Finnish birth cohort. Acta Paediatr 88:310–4. 1999.

14 Adolescent Health in the United States, 2007
Figure 4. Limitation of activity caused by selected chronic health conditions among 

adolescents 10–17 years of age, by gender: United States, average annual 2004–2005 

0 

10 

20 

30 

40 

50 

60 Learning disability Attention Deficit/ 

Hyperactivity Disorder 

Other mental, emotional, 

or behavioral problem 

Mental retardation or 

other developmental 

problem 

Asthma or breathing 

problem 

Speech problem 

Number of adolescents with limitation of activity caused by

selected chronic health conditions per 1,000 population 

Male Female 

NOTES: Data are for noninstitutionalized adolescents. may have more than one chronic health condition. See 

Adolescents with limitation of activity caused by data table for data points, data by race, origin, and 

chronic health conditions were either identified by poverty status, standard errors, and additional notes. 

current use of special education or by a limitation in 

their ability to perform activities because of a chronic SOURCE: Centers for Disease Control and Prevention, 

physical, mental, or emotional problem. These National Center for Health Statistics, National Health 

conditions are not mutually exclusive: an adolescent Interview Survey. 

Adolescent Health in the United States, 2007

15

Health Status
Health Status

Overweight

Overweight and obesity have serious health consequences

among adolescents, increasing the risk of high cholesterol,

hypertension, and diabetes (1). Diet, physical inactivity,

genetic factors, environment, and health conditions all

contribute to overweight in adolescents.

In 2001–2004, 17 percent of adolescents 12–19 years of

age were overweight (Figure 5a). The percentage of

adolescents who are overweight has more than tripled since

1980.

The percentage of adolescents who are overweight varies

by race, Hispanic origin, and gender (Figure 5b). In

2001–2004, non-Hispanic black female adolescents were

more likely to be overweight than non-Hispanic white and

Mexican American female teenagers. Among male

adolescents, there were no significant differences in

overweight by race and Hispanic origin.

Overweight adolescents have a 70 percent chance of

becoming overweight or obese adults. This probability

increases to 80 percent if at least one parent is overweight or

obese (2). Overweight or obese adults are at risk for a

number of health problems including heart disease, type 2

diabetes, high blood pressure, and some forms of cancer.

Type 2 diabetes, previously considered an adult disease, has

increased in children and adolescents (2).

References

1.	 Dietz WH. Health consequences of obesity in youth: Childhood

predictors of adult disease. Pediatrics 101(3 Supplement):518–

25. 1998.

2.	 Department of Health and Human Services. The Surgeon

General’s call to action to prevent and decrease overweight

and obesity [online]. [cited 2007 June 8]. Available from:

www.surgeongeneral.gov/topics/obesity/calltoaction/
 

fact_adolescents.htm. 2007.
 

Figure 5a. Overweight among adolescents 12–19 years of age: United States, 

selected years 1966–1970 through 2003–2004 

1966–1970 1971–1974 1976–1980 1988–1994 

1999–20002001–20022003–2004 

40
 

30
 

0 

Percent 20
 

10
 

Years 

NOTES: Overweight is defined as body mass index (BMI) SOURCE: Centers for Disease Control and Prevention, 


at or above the gender- and age-specific 95th percentile National Center for Health Statistics, National Health and 


BMI cutoff points from the 2000 CDC Growth Charts. See Nutrition Examination Survey. 


data table for data points, standard errors, and additional 


notes.
 

16 Adolescent Health in the United States, 2007
d 

es 

tatus

40

Health

S

Figure 5b. Overweight among adolescents 12–19 years of age, by gender, race an

Hispanic origin, and poverty status: United States, average annual 2001–2004 

Race and Hispanic origin 

White only, not Hispanic 

Male 

Female 

Both sex

Black only, not Hispanic 

0 10 20 30

Percent 

Mexican 

Poverty status 

Poor 

Near poor 

Nonpoor 

NOTES: Overweight is defined as body 

mass index (BMI) at or above the genderand age-specific 95th percentile BMI cutoff 

points from the 2000 CDC Growth Charts. 

Persons of Mexican origin may be of any 

race. Poverty status is derived from the ratio 

of the family’s income to the federal poverty 

threshold, given family size. Poor families 

have income less than 100 percent of the 

poverty threshold; near poor families have 

income from 100 to less than 200 percent of 

the poverty threshold; nonpoor families 

have income of 200 percent of the poverty 

threshold or more. See data table for data 

points, standard errors, and additional notes. 

SOURCE: Centers for Disease Control 

and Prevention, National Center for 

Health Statistics, National Health and 

Nutrition Examination Survey. 

Adolescent Health in the United States, 2007

17
Health Status

Untreated Dental Caries

Untreated dental caries or tooth decay can negatively affect

the overall quality of life for adolescents. Dental caries are

bacterial infections, which, if left untreated, can advance and

cause severe pain and possible tooth loss. Untreated cavities

may also cause dysfunction, absence from school,

underweight, and poor appearance (1).

In 2001–2004, 23 percent of adolescents and young

adults had at least one untreated caries lesion or active tooth

infection. The proportion of young adults 20–24 years with

untreated dental caries was higher than that of adolescents

12–15 and 16–19 years of age (Figure 6).

Lower family income is associated with a higher rate of

untreated dental caries. In 2001–2004, poor and near poor

adolescents were twice as likely to have untreated dental

caries as nonpoor adolescents.

Racial differences are also apparent in the proportion of

adolescents and young adults with untreated dental caries.

Non-Hispanic black and Mexican American adolescents and

young adults were more likely to have untreated dental caries

than their non-Hispanic white counterparts.

Dental visits are necessary to treat decayed teeth. In

2005, 71 percent of adolescents and young adults had a

dental visit in the past year (see Figure 40).

Reference

1. CDC. Oral health: Preventing cavities, gum disease, and tooth

loss—At a glance 2008 [online]. [cited 2008 April 22]. Available

from: www.cdc.gov/nccdphp/publications/aag/doh.htm. 2008.

18 Adolescent Health in the United States, 2007
Health

Sta

Figure 6. Untreated dental caries among adolescents 12–19 years of age and 

tus

young adults 20–24 years of age, by age group, race and Hispanic origin, and poverty 

status: United States, average annual 2001–2004 

Total 

Race and Hispanic origin 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Poverty status 

Poor 

Near poor 

Nonpoor 

12–15 years 

16–19 years 

20–24 years 

0 20 40 60

Percent 

NOTES: Data are based on dental 

examinations of a sample of the civilian 

noninstitutionalized population. Persons of 

Mexican origin may be of any race. 

Poverty status is derived from the ratio of 

the family’s income to the federal poverty 

threshold, given family size. Poor families 

have income less than 100 percent of the 

poverty threshold; near poor families have 

income from 100 to less than 200 percent 

of the poverty threshold; nonpoor families 

have income of 200 percent of the poverty 

threshold or more. See data table for data 

points, data by gender, standard errors, and 

additional notes. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Health 

Statistics, National Health and Nutrition 

Examination Survey. 

Adolescent Health in the United States, 2007

19
Health Status

Suicide Ideation and Attempts

In 2004, suicide was the third leading cause of death among

adolescents 13–19 years of age. In addition, many teenagers

seriously consider suicide without attempting it, or they

attempt but do not complete suicide. Factors influencing

suicidal thoughts may include depression, feelings of

hopelessness or worthlessness, and a preoccupation with

death (1). Factors that may contribute to adolescent’s

attempting suicide include a history of previous suicide

attempts, a family history of suicide, alcohol or drug abuse,

and a stressful life event or loss (2). Substance abuse or

dependence can escalate suicidal thoughts to suicide

attempts (3).

In 2005, about one-fifth of all high school students

reported seriously considering suicide or attempting suicide

during the previous 12 months (data table for Figure 7). About

one-half of all students who seriously considered suicide

actually attempted suicide (8 percent of all students). About

2 percent of all students reported having an injurious suicide

attempt that resulted in an injury, poisoning, or overdose that

was treated by a doctor or nurse.

Female students were substantially more likely to consider

suicide than male students in all racial or ethnic and grade

level subgroups (Figure 7).

Among students in grades 9–11, female students were

significantly more likely to attempt suicide than male students

were. There was no significant difference in the rate of

suicide attempts between male and female students in 12th

grade. In contrast, the rate of completed suicides was

significantly higher for male adolescents than for female

adolescents (see Figure 16).

Among female students, Hispanic students were

significantly more likely to report a suicide attempt than

non-Hispanic white or black students were. No difference by

race and ethnicity was present among male students.

In 2005, 20 percent of male students and 37 percent of

female students reported feeling so sad or hopeless almost

every day for two or more consecutive weeks during the past

12 months that they stopped doing some usual activities (4).

References

1.	 Behman RE, Kliegman RM, Arvin AM, editors. Nelson textbook

of pediatrics. 15th ed. Philadelphia, PA: W. B. Saunders

Company. 1996.

2.	 CDC, National Center for Injury Prevention and Control. Youth

suicide [online]. [cited 2007 October 2]. Available from:

www.cdc.gov/ncipc/dvp/Suicide/youthsuicide.htm. 2007.

3.	 Gould MS, King R, Greenwald S, et al. Psychopathology

associated with suicidal ideation and attempts among children

and adolescents. J Am Acad Child Adolesc Psychiatry

37(9):215–23. 1998.

4.	 CDC. Youth risk behavior surveillance—United States, 2005.

MMWR 55(SS–5):1–108. 9 June 2006.

20 Adolescent Health in the United States, 2007
Figure 7. Suicide ideation and attempts among students in grades 9–12, by gender 

and race and Hispanic origin: United States, 2005 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Injurious suicide attempt 

Male students 

Female students 

Suicide attempt 

Seriously considered suicide 

0 10 20 30 40 50

Percent 

NOTES: Response is for the 12 months 

preceding the survey. Some students who 

seriously considered suicide may also have 

attempted suicide. An injurious suicide 

attempt resulted in an injury, poisoning, or 

overdose that was treated by a doctor or 

nurse. Persons of Hispanic origin may be of 

any race. See data table for data points, data 

by grade level, standard errors, and additional 

notes. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Chronic 

Disease Youth Risk Behavior Survey. 

Adolescent Health in the United States, 2007

21

Health Status
Health Status

Emergency Department Visits, Hospital

Discharges, and Death Rates

Morbidity and mortality data for adolescents provide a more

complete picture of the health status of that population than

mortality data alone. Emergency department (ED) and

inpatient hospital utilization data provide information on

morbidity that results in health care utilization from these

sources.

EDs provide unscheduled care for reasons that range from

life-threatening conditions to problems that could be treated in

a primary care setting. Use of the ED may be influenced by

underlying health status, the severity of the current illness or

injury, access to other sources of health care, and health

insurance status.

Hospitalization is dependent not only on a person’s medical

condition, but also on ambulatory care access and

utilization (1).

In 2002–2004, adolescents 10–19 years of age had about

13 million ED visits annually. ED visit rates increased with

age for both male and female adolescents (Figure 8). Visit

rates for male adolescents 18–19 years of age were about

one-third higher than those for males 10 years of age. Among

female adolescents, ED visit rates were relatively stable at

ages 10–13 years but began to increase rapidly at age 14

years. Visit rates more than doubled between ages 10–13

years and 18–19 years, in part because of conditions related

to pregnancy and sexual activity (see Figure 12).

In 2002–2004, adolescents 10–19 years of age averaged

1.8 million hospital stays annually. Among male adolescents

10–19 years, the hospital discharge rate remained fairly

stable across the age range. In contrast, the discharge rate

for female adolescents 19 years of age was seven times the

rate for those 10 years of age. For male and female

adolescents 10–14 years of age, discharge rates were similar,

but from ages 15–19 years, the discharge rate for females

was higher than that for males, with differences increasing by

age. Hospitalization for pregnancy-related diagnoses was the

primary cause of those differences (see Figure 14).

In 2002–2004, almost 18,000 adolescents died each year.

Mortality among male and female adolescents did not follow

the same patterns observed for ED and hospital utilization.

Death rates for male adolescents exceeded those for female

adolescents at each age, and the difference increased with

age. These differences were primarily due to the age-related

increases in injury mortality among male adolescents (see

Figures 16 and 17).

The death rate for male adolescents 19 years of age was

eightfold that of males 10 and 11 years of age. In contrast,

the death rate for female adolescents 18 and 19 years of age

was threefold that of females 10 and 11 years of age.

Note: Death rates are generally shown as per 100,000

population, but for comparability to morbidity measures, they

are shown only in Figure 8 as per 10,000.

Reference

1.	 Weisman JS, Epstein AM. Falling through the safety net.

Baltimore, MD: Johns Hopkins University Press. 1994.

22 Adolescent Health in the United States, 2007
Figure 8. Emergency department visit rates, hospital discharge rates, and death 

rates among adolescents 10–19 years of age, by age and gender: United States, 

average annual 2002–2004 

Deaths, discharges, and visits per 10,000 adolescents 

10,000 

1,000 

100 

10 

1 

NOTES: Data are presented on a log scale. See SOURCE: Centers for Disease Control and Prevention, 

“Technical Notes” for discussion of emergency National Center for Health Statistics, National Hospital 

department visits, hospital discharges, and death rates. Ambulatory Medical Care Survey, National Hospital 

See data table for data points and standard errors. Discharge Survey, and National Vital Statistics System, 

10 11 12 13 14 15 16 17 18 19 

Years of age 

Emergency department visits 

Hospital discharges 

Deaths 

Female 

Female 

Female 

Male 

Male 

Male 

Mortality File. 

Adolescent Health in the United States, 2007

23

Health Status
Health Status

Emergency Department Visits for Injury

Injuries are a major cause of ED visits. The morbidity

associated with injuries is costly on an individual and a

societal level (1). An ED visit is classified as an injury visit if

it is the initial ED visit for that injury. Follow-up visits for the

same injury are not classified as injury visits in this

analysis (2).

In 2002–2004, initial visits for injuries constituted

42 percent of all ED visits for adolescents 10–19 years of

age. Among male adolescents, about one-half of all ED visits

were injury-related; among female adolescents, one-third of

ED visits were injury-related.

Initial injury-related ED visits were higher among male

adolescents than among female adolescents, but the

difference decreased with age (Figure 9). Among male

adolescents, injury-related visit rates remained fairly level

between ages 12–13 and 18–19 years. In contrast,

injury-related visit rates among female adolescents increased

70 percent between ages 12–13 and 18–19 years.

Four of the most common external causes of injury

among adolescents include being struck by or against an

object or person, falls, motor vehicle traffic-related injuries,

and being cut or pierced by a sharp object (see Figure 10).

The four most common injury diagnoses for ED visits

among adolescents are fractures, sprains and strains, open

wounds, and contusions (see Figure 11).

References

1.	 Burt CW, Fingerhut LA. Injury visits to hospital emergency

departments: United States, 1992–95. National Center for

Health Statistics. Vital Health Stat 13(131). 1998.

2.	 Fingerhut L. Recommended definition of initial injury

visits to emergency departments for use with the

NHAMCS-ED data. National Center for Health Statistics.

Health E-Stat. [cited 2007 June 8]. Available from:

www.cdc.gov/nchs/products/pubs/pubd/hestats/injury/injury.htm.

2007.

24 Adolescent Health in the United States, 2007
Figure 9. Initial emergency department visit rates for injury among adolescents 

10–19 years of age, by age and gender: United States, average annual 2002–2004 

Visits per 10,000 adolescents 

0 

400 

800 

1,200 

1,600 

2,000 

Male 

Female 

10–11 12–13 14–15 16–17 18–19 

Years of age 

NOTES: See “Technical Notes” for discussion of SOURCE: Centers for Disease Control and Prevention, 

emergency department visits. See data table for data National Center for Health Statistics, National Hospital 

points and standard errors. Ambulatory Medical Care Survey. 

Adolescent Health in the United States, 2007

25

Health Status
Health Status

Emergency Department Visits for

Selected External Causes of Injury

Four external causes of injury—being struck by or against an

object or person (being struck), falls, motor vehicle

traffic-related injuries, and being cut by a sharp object—

accounted for over 60 percent of all initial injury visits to EDs

among adolescents in 2002–2004. Of these four causes, only

motor vehicle traffic-related injuries are a significant source of

mortality among adolescents (see Figure 17).

One in four initial injury-related ED visits among

adolescents resulted from being struck. In 2002–2004, at

each age, the rate for male adolescents was about twice the

rate for female adolescents (Figure 10). Sports-related injuries

are a common cause of these ED visits.

Initial ED visit rates for falls were similar for male and

female adolescents. Falls accounted for about 18 percent of

all injury-related visits.

Initial injury visits associated with motor vehicle

traffic-related injuries (13 percent of all injury-related visits)

were similar for male and female adolescents age 10–11

through 16–17 years. Among adolescents 18–19 years of

age, female adolescent traffic-related injury visit rates were

60 percent higher than those for male adolescents. However,

death rates for motor vehicle traffic-related injuries for those

18–19 years of age were about twice as high for males as

for females (Figure 17).

Initial ED visits from being cut accounted for 8 percent of

all injury-related visits among adolescents.

26 Adolescent Health in the United States, 2007
Figure 10. Initial emergency department visit rates for selected external causes of 

injury among adolescents 10–19 years of age, by age and gender: United States, 

average annual 2002–2004 

Visits per 10,000 adolescents Visits per 10,000 adolescents 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Years of age Years of age 

0 

100 

200 

300 

400 

500 

600 

700 

0 

100 

200 

300 

400 

500 

600 

700 

Male 

Female 

Struck by or against 

Female 

Male 

Cut or pierced 

0 

100 

200 

300 

400 

500 

600 

700 

Female 

Male 

Fall Motor vehicle traffic

0 

100 

200 

300 

400 

500 

600 

700 

Male 

Female 

NOTES: See “Technical Notes” for discussion of SOURCE: Centers for Disease Control and Prevention, 

emergency department visits. See data table for data National Center for Health Statistics, National Hospital 

points and standard errors. Ambulatory Medical Care Survey. 

Adolescent Health in the United States, 2007

27

Health Status
Health Status

Emergency Department Visits for

Selected Injury Diagnoses

In 2002–2004, fractures, sprains and strains, open

wounds, and contusions were the four most common injury

diagnoses for initial ED visits among adolescents 10–19 years

of age. These four injury diagnoses accounted for 72 percent

of all first-listed diagnoses for initial injury visits by

adolescents. Open wounds were the most often reported

diagnoses for male adolescents, and sprains and strains were

most often reported for female adolescents.

The pattern for initial ED visit rates for fractures varied by

gender and age (Figure 11). Male and female visit rates for

fractures were similar among both younger (aged 10–11

years) and older (aged 16–19 years) adolescents. In contrast,

rates increased sharply among male adolescents 12–13 and

14–15 years of age and decreased among female

adolescents in the same age groups. Injuries resulting from

falls and being struck were the primary causes of fractures.

The initial ED visit rate for open wounds among

adolescents 10–17 years of age did not vary with age. Open

wound injury visit rates for female adolescents 10–17 years of

age were about one-half the rates for males at each age.

Among adolescents 18–19 years of age, rates increased

significantly for males but remained level among females.

Open wound injuries are caused primarily by knives and other

instruments for cutting or piercing.

Sprains, strains, and contusions were the most commonly

reported diagnoses in the ED for female adolescents 10–19

years, accounting for 45 percent of all first-listed injury

diagnoses. There were no significant gender differences in

initial visit rates for sprains and strains or contusions. Among

the leading external causes of these injuries were motor

vehicle traffic crashes, falls, being struck, and overexertion.

28 Adolescent Health in the United States, 2007
Figure 11. Initial emergency department visit rates for selected injury diagnoses 

among adolescents 10–19 years of age, by age and gender: United States, average 

annual 2002–2004 

Visits per 10,000 adolescents Visits per 10,000 adolescents 

700
 

Male 

Female 

Fractures 

600
 600
 

500
 500
 

400
 400
 

300
 300
 

200
 200
 

100
 100
 

0 0 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Female 

Male 

Sprains or strains 

700
 

Female 

Male 

Open wounds 

700
 

600
 600
 

500
 500
 

400
 400
 

300
 300
 

200
 200
 

100
 100
 

0 0 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Male 

Female 

Contusions 

Years of age Years of age 

700
 

NOTES: See “Technical Notes” for discussion of 

emergency department visits. See data table for data 

points and standard errors. 

SOURCE: Centers for Disease Control and Prevention, 


National Center for Health Statistics, National Hospital 


Ambulatory Medical Care Survey. 


Adolescent Health in the United States, 2007
 29
 

Health Status
Health Status

Emergency Department Visits for

Selected Diagnoses

Asthma, upper respiratory conditions, and abdominal or

gastrointestinal (GI) conditions are among the leading

principal diagnoses made in EDs for adolescents 10–19 years

of age.

In 2002–2004, these three groups of conditions accounted

for more than one-fourth of all first-listed diagnoses for ED

visits unrelated to an injury among male and female

adolescents 10–19 years of age. Among female adolescents,

visits for sexually transmitted diseases, urinary tract infections,

and pregnancy-related conditions accounted for another

15 percent of female adolescent visits.

Upper respiratory conditions, predominantly colds and ear

infections, were the most common cause of ED visits

unrelated to an injury among adolescents. The rate of ED

visits for upper respiratory conditions was similar for male and

female adolescents (Figure 12).

Asthma is a disease that affects the lungs, causing

repeated episodes of wheezing, breathlessness, chest

tightness, and nighttime or early morning coughing. The need

for urgent treatment of asthma symptoms may be related to

acute exposure to specific precipitating factors, such as poor

air quality or pets, or may be due to chronically suboptimal

treatment of existing asthma. In 2002–2004, ED visit rates for

the treatment of asthma did not vary by age or gender.

ED visits for abdominal or GI symptoms were primarily

due to stomach pains, gastroenteritis, and colitis. Among

female adolescents, the visit rate for abdominal or GI

conditions increased with age between ages 12–13 years and

18–19 years.

Among female adolescents, the rate of ED visits for

treatment of sexually transmitted diseases, urinary tract

infections, and pregnancy-related conditions increased

markedly with age. Sexual intercourse is a common cause of

urinary tract infections in young women.

30 Adolescent Health in the United States, 2007
Figure 12. Emergency department visit rates for selected noninjury diagnoses 

among adolescents 10–19 years of age, by age and gender: United States, 

average annual 2002–2004 

Visits per 10,000 adolescents Visits per 10,000 adolescents 

0 

100 

200 

300 

400 

500 

600 

700 

0 

100 

200 

300 

400 

500 

600 

700 

Female 

Male 

Upper respiratory infections 

Male 

Female 

Asthma 

0 

100 

200 

300 

400 

500 

600 

700 

0 

100 

200 

300 

400 

500 

600 

700 

Male 

Female 

Pregnancy related 

Urinary 

tract 

infections 

Sexually 

transmitted 

diseases 

Abdominal symptoms or diagnoses Females only 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Years of age Years of age 

NOTES: Data points are not shown in figure when rates are SOURCE: Centers for Disease Control and Prevention, 


unreliable. See “Technical Notes” for discussion of National Center for Health Statistics, National Hospital 


emergency department visits. See data table for data Ambulatory Medical Care Survey.
 

points and standard errors.
 

Adolescent Health in the United States, 2007

31

Health Status
Health Status

Alcohol-related Emergency Department

Visits

Alcohol is the most widely used drug among youth (1) and

causes serious and potentially life-threatening problems for

adolescents and young adults. Research indicates that

drinking is associated with risk-taking and sensation-seeking

behavior, and alcohol has disinhibiting effects that may

increase the likelihood of unsafe activities. In 1984, the

Uniform Drinking Age Act mandated reduced federal

transportation funds to those states that did not raise the

minimum legal drinking age to 21; by 1988, all states had

increased the legal drinking age to 21 years (2).

The National Hospital Ambulatory Medical Care Survey

(NHAMCS) collects data on alcohol-related visits to hospital

EDs. In the NHAMCS, an ED visit was considered

alcohol-related by reviewing the ED record, including the

patient’s reason for the ED visit and the diagnoses and the

injury codes recorded (see data table for Figure 13 for

detailed information related to the definition of an

alcohol-related visit).

During 2002–2004, there were, on average each year,

over 230,000 alcohol-related ED visits among underage

adolescents 14–20 years of age. Alcohol-related ED visits

among underage adolescents accounted for 2% of all ED

visits for this age group (3).

Alcohol-related ED visit rates differed by gender and age

for both underage and legal drinkers. Visit rates among males

were higher than those among females. Alcohol-related ED

visit rates increased with age from early to late adolescence

and remained at that level through young adulthood

(Figure 13). In 2002–2004, rates for older male adolescents

18–20 years of age were more than twice those of younger

male adolescents 14–17 years of age, and rates for older

female adolescents were more than three times those of

younger female adolescents. Alcohol-related ED visit rates did

not differ significantly between young adults who had reached

legal drinking age and late adolescent drinkers 18– 20 years

of age.

Most (89 percent) alcohol-related ED visits resulted in

patients being treated and released from the ED; 5 percent of

patients were admitted to inpatient units, and a small number

of patients were transferred to other health facilities, left

before being seen, or left against medical advice (3).

References

1.	 Substance Abuse and Mental Health Services Administration.

Consequences of underage alcohol use [online]. [cited 2007

June 8]. Available from: ncadi.samhsa.gov/govpubs/rpo992/.

2007.

2.	 French MT, Maclean JC. Underage alcohol use, delinquency,

and criminal activity. Health Econ 15: 1261–81. 2006.

3.	 NCHS. National Hospital Ambulatory Medical Care Survey.

Unpublished analysis. 2006.

32 Adolescent Health in the United States, 2007
Figure 13. Alcohol-related emergency department visit rates among adolescents 

14–20 years of age and young adults 21–24 years of age, by age group and gender: 

United States, average annual 2002–2004 

14–17 years 

Male 

Female 

18–20 years 

Male 

Female 

21–24 years 

Male 

Female 

0 100 200 300
 

Emergency department visits per 10,000 population 

NOTES: An emergency department visit was SOURCE: Centers for Disease Control and 

considered alcohol-related if the checkbox for Prevention, National Center for Health Statistics, 

alcohol was indicated, the physician ’s diagnosis was National Hospital Ambulatory Medical Care Survey. 

alcohol-related, an alcohol-related external 

cause-of-injury code was present, or the patient ’s 

reason for visit was alcohol-related. See data table 

for data points, standard errors, and additional notes. 

Adolescent Health in the United States, 2007

33

Health Status
Health Status

Hospital Discharge Rates

Hospitalization is dependent not only on a person’s medical

condition, but also on ambulatory care access and

utilization (1). A person who delays or does not receive timely

and appropriate care for chronic conditions and other health

problems may contract more serious health conditions that

require hospitalization.

Adolescents are among the least likely of all persons to

be hospitalized (2). Younger children and adolescents have

similar hospitalization rates. For noninjury and nonpregnancy

causes, adolescents have the lowest rates of hospitalization,

which are followed by those for younger children and young

adults. Adolescents have higher hospital discharge rates for

injuries than those for younger children but have lower rates

than those of older persons (3).

Hospital discharge rates vary by gender, in large part

because of hospitalizations for pregnancy-related causes

(including deliveries and diagnoses associated with

pregnancy) among female adolescents. In 2002–2004,

noninjury-related causes, excluding pregnancy, accounted for

about 49 percent of all hospital discharges among female

adolescents and 81 percent among male adolescents. Injuries

accounted for 5 percent of all hospital discharges among

female adolescents and 19 percent among males. Among

female teenagers, pregnancy-related causes accounted for

46 percent of all discharges.

In 2002–2004, hospitalizations for injury and noninjury

causes increased with age for both sexes (Figure 14). The

noninjury discharge rate among males increased marginally.

In contrast, the noninjury (nonpregnancy-related) discharge

rate among females increased by 50 percent between ages

10–11 years and 18–19 years. Hospital discharge rates for

pregnancy-related causes increased dramatically by age

among female adolescents.

The injury hospital discharge rate for adolescent males

18–19 years of age was 2.5 times the rate for males 10–11

years of age. Similarly, the rate for female adolescents 16–19

years of age was more than double that of females aged

10–13 years.

The expected principal method of payment varied among

hospital discharges. Among injury and noninjury diagnoses,

the expected source of payment for more than one-half

(53–56 percent) was private insurance; public coverage was

the expected source for 34 percent of injury discharges and

25 percent of noninjury discharges (2). In contrast, among

pregnancy-related discharges, the expected payment source

was private insurance for 24 percent of discharges and public

coverage for two-thirds of discharges. In the 1980s and

1990s, federal and state policy expanded Medicaid eligibility

to provide greater health insurance coverage for pregnant

women by expanding income eligibility requirements.

Adolescent reproductive health coverage is also available

through the State Children’s Health Insurance Program

(SCHIP), Title XXI of the Social Security Act.

References

1.	 Weisman JS, Epstein AM. Falling through the safety net.

Baltimore, MD: Johns Hopkins University Press. 1994.

2.	 NCHS. National Hospital Discharge Survey. Unpublished

analysis. 2006.

3.	 Kozak LJ, Lees KA, DeFrances CJ. National Hospital

Discharge Survey: 2003 annual summary with detailed

diagnosis and procedure data. National Center for Health

Statistics. Vital Health Stat 13(160). 2006.

34 Adolescent Health in the United States, 2007
Figure 14. Short-stay hospital discharge rates for injury, noninjury, and 

pregnancy-related diagnoses among adolescents 10–19 years of age, by age and 

gender: United States, average annual 2002–2004 

Discharges per 10,000 adolescents Discharges per 10,000 adolescents 

0 

200 

400 

600 

800 

1,000 

Female Male 

Pregnancy-related 

Noninjury1 

Injury 

Noninjury 

Injury 

0 

200 

400 

600 

800 

1,000 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Years of age Years of age 

1

Noninjury discharge rates for female adolescents do not “Technical Notes” for discussion of hospital diagnoses. 

include pregnancy-related discharges. See data table for data points and standard errors. 

NOTES: Data points are not shown in figure when rates SOURCE: Centers for Disease Control and 

are unreliable. Cause-specific hospital discharge data are Prevention, National Center for Health Statistics, National 

defined based on the first-listed diagnosis. See Hospital Discharge Survey. 

Adolescent Health in the United States, 2007

35

Health Status
Health Status

Hospital Discharge Rates for Selected

Diagnoses

Asthma, psychoses, fractures, and poisoning were among the

leading first-listed diagnoses in 2002–2004, accounting for

18 percent of all hospital discharges among adolescents.

Patterns by age and gender differ for each of these

diagnoses.

Asthma is a disease that affects the lungs, causing

repeated episodes of wheezing, breathlessness, chest

tightness, and nighttime or early morning coughing. Asthma

can be controlled by taking medicine and avoiding the

triggers that can cause an attack. In 2002–2004, asthma

hospital discharge rates for male adolescents declined by

two-thirds with age, and rates for female adolescents declined

by about 50 percent with age (Figure 15).

Psychoses hospitalizations among adolescents increased

sharply through ages 14–15 years; for adolescents 16–17 and

18–19 years of age, rates leveled off among males and

declined among females. The leading diagnosis for this group

is ‘‘major depressive disorder, single episode,’’ which accounts

for 23 percent of all male and 31 percent of all female

psychoses diagnoses (International Classification of Diseases,

Ninth Revision, Clinical Modification (ICD–9–CM) codes

include those for all psychoses, ICD 290–299).

In 2002–2004, fractures were the leading cause of

injury-related hospitalizations. Hospital discharge rates for

fractures increased with age among male adolescents.

Adolescents are at risk for both intentional and

unintentional poisoning. About one-half of all poisonings

among teenagers are classified as suicide attempts (1).

Female adolescents were significantly more likely than male

adolescents to be hospitalized for poisoning in 2002–2004.

Reference

1.	 Litovitz TL, Klein-Schwartz W, White S, et al. 2000 Annual

report of the American Association of Poison Control Centers

Toxic Exposures Surveillance System. Am J Emerg Med

19(5):337–96. 2001.

36 Adolescent Health in the United States, 2007
Figure 15. Short–stay hospital discharge rates for selected diagnoses among 

adolescents 10–19 years of age, by age and gender: United States, average 

annual 2002–2004 

Discharges per 10,000 adolescents Discharges per 10,000 adolescents 

100 100 

Asthma 

80 80 

60 60 

40 40 

Male 20 20 

Female 

0 0 

Psychoses 

Male 

Female 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19
 

100 100 

Fractures 

80 80 

60 60 

40 40 

Male 20 20 

Female 

0 0 

Poisoning 

Male 

Female 

10–11 12–13 14–15 16–17 18–19 10–11 12–13 14–15 16–17 18–19 

Years of age Years of age 

NOTES: Data points are not shown in figure when rates are 

unreliable. Cause-specific hospital discharge data are 

defined based on the first-listed diagnosis. See “Technical 

Notes” for discussion of hospital diagnoses. See data table 

for data points and standard errors. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Health Statistics, National 

Hospital Discharge Survey. 

Adolescent Health in the United States, 2007

37

Health Status
Health Status

Death Rates

Deaths are categorized by the cause of death: injury or

natural causes (natural is a term similar to noninjury that is

used to categorize causes of death). Injury data are

presented using the external cause of injury mortality matrix

for ICD–10, which takes into account the manner or intent of

the injury. The manner or intent of the injury involves whether

the injury was inflicted purposefully or not (in some cases,

intent cannot be determined) and, when intentional, whether

the injury was self-inflicted (suicide) or inflicted upon another

person (homicide) (1).

Injuries cause more than twice as many deaths among

adolescents as do natural causes. For the period 2002–2004,

almost 13,000 adolescents died annually from injuries

compared with about 5,000 adolescents who died from

natural causes; that is, 71 percent of all deaths among

adolescents 10–19 years of age were caused by an injury.

The proportion of deaths that were due to injury increased

with age, from 42 percent at 10 years of age to 80 percent at

18 years of age.

Death rates varied by gender. In 2002–2004, the injury

death rate for males 10–19 years of age was 2.6 times that

of females, whereas the death rate for natural causes for

male adolescents was 1.3 times that for females (Figure 16).

Among male adolescents, death rates for natural causes

exceeded those for injury among male adolescents 10–11

years of age. Beginning at 12 years of age, injury death rates

exceeded natural cause death rates at each age through 19

years, and the difference increased with age. Among male

adolescents 19 years of age, the injury death rate was almost

15 times the rate of those 10 years of age. Compared with

death rates for injuries, death rates for natural causes

increased more slowly with age. Among male adolescents 19

years of age, the natural cause death rate was about 2.5

times that of males 10 years of age.

Among female adolescents 10–13 years of age, death

rates for natural causes exceeded those for injuries; among

females 14–19 years of age, injury death rates were higher

than natural cause death rates. Injury death rates for female

adolescents did not increase as sharply with age as did the

rates for male adolescents. Among female adolescents 19

years of age, the injury death rate was six times the rate for

females 10 years of age, whereas the natural cause death

rate doubled between ages 10 and 19 years.

In 2002–2004, unintentional injuries constituted the

majority of injury deaths: 63 percent among male adolescents

and 78 percent among female adolescents. For both sexes,

the proportion of injury deaths that were unintentional

declined with age, whereas homicide and suicide deaths

increased with age.

Reference

1.	 Hoyert DL, Heron MP, Murphy SL, Kung H. Deaths: Final data

for 2003. National vital statistics reports; vol 54 no 13.

Hyattsville, MD: National Center for Health Statistics. 2006.

38 Adolescent Health in the United States, 2007
Figure 16. Death rates for injury, by intent of injury and natural causes among 

adolescents 10–19 years of age, by age and gender: United States, 

average annual 2002–2004 

Discharges per 10,000 adolescents 

1,000 

Female 

100
 

Injury
 

10
 

Natural causes 

1
 

0.1 

1,000 

Female 

100
 

Unintentional injury
 

10
 

Suicide
 

Homicide 1
 

0.1 

Years of age 

10 11 12 13 14 15 16 17 18 19
 

10 11 12 13 14 15 16 17 18 19
 

Discharges per 10,000 adolescents 

1,000 

Male 

Injury 

100
 

Natural causes 

10
 

1
 

0.1 

1,000 

Male 

100
 

Unintentional injury 

10
 

Suicide 

Homicide 

1
 

0.1 

Years of age 

10 11 12 13 14 15 16 17 18 19
 

10 11 12 13 14 15 16 17 18 19
 

NOTES: Death rates are graphed on a log scale to clearly 

illustrate how rates change across the entire span 10–19 

years. Data points are not shown in figure when rates are 

unreliable. See “Technical Notes” for discussion of 

cause-of-death coding. See data table for data points and 

standard errors. 

SOURCE: Centers for Disease Control and Prevention, 

National Center for Health Statistics, National Vital 

Statistics System, Mortality File. 

Adolescent Health in the United States, 2007
 39
 

Health Status
Health Status

Motor Vehicle- and Firearm-Related

Deaths

Motor vehicle traffic-related injuries and firearm-related injuries

are the two leading causes of injury death among

adolescents 10–19 years of age.

For the period 2002–2004, motor vehicle traffic-related

injuries were the leading cause of injury death for adolescents

10–19 years of age (averaging 6,360 deaths per year),

followed by injuries from firearms (averaging 2,740 per year).

Together, these two causes accounted for 51 percent of all

deaths and 72 percent of all injury deaths for adolescents. By

comparison, malignant neoplasms, the leading natural cause

of death for this age group, accounted for 7 percent of all

deaths (1).

For motor vehicle traffic-related injury deaths, rates

increased markedly with age for male and female adolescents

(Figure 17). Notably, between ages 15 and 16 years, the

rates for males and females doubled. A similar increase at

these ages was noted in the ED visit rates for motor vehicle

traffic-related injuries (see Figure 10).

Disparities by race and ethnicity were apparent in rates of

death from motor vehicle injuries for male and female

adolescents (data table for Figure 17). Among males and

females, motor vehicle injury rates were highest among

American Indian or Alaska Native adolescents and lowest

among Asian or Pacific Islander adolescents.

The high rates of death from motor vehicle traffic-related

injuries are partially attributable to risk behavior among

adolescents. In 2005, almost 29 percent of high school

students reported that in the previous 30 days, they rode in a

car with a driver who had been drinking alcohol, and

15 percent reported that they drove after drinking alcohol (see

Figure 28). Ten percent of students surveyed had rarely or

never worn seat belts when riding in a car or truck driven by

someone else.

The risk of a motor vehicle crash is particularly high

during the first year that teenagers are eligible to drive (2).

The presence of teenage passengers increases the crash risk

of unsupervised teenage drivers, and the risk also increases

with the number of teenage passengers (3).

A crash is considered speeding-related if the driver was

charged with a speeding-related offense or if an officer

indicated that racing, driving too fast for conditions, or

exceeding the posted speed limit was a contributing factor to

the crash. Among male drivers 15–20 years of age who were

involved in fatal crashes in 2003, 39 percent were speeding

at the time of the crash (4).

Firearm-related injury death rates also increase

substantially with age; the rate for males 19 years of age was

59 times the rate for those 10 and 11 years of age. In

contrast, the firearm death rate for 19-year-old females was

nine times the rate for 11-year-old females.

Differences exist in firearm-related injury death rates by

race and ethnicity for male and female adolescents. Rates

were remarkably higher among black adolescents than among

other racial and ethnic groups. Firearm-related injury death

rates were lower for non-Hispanic white and Asian or Pacific

Islander adolescents compared with other race and ethnicity

groups (data table for Figure 17).

References

1. NCHS. National Vital Statistics System. Unpublished analysis.

2006.

2. Insurance Institute for Highway Safety. Fatality facts 2006:

Teenagers [online]. [cited 2008 April 22]. Available from:

www.iihs.org/research/fatality_facts_2006/teenagers.html.

3. Chen L, Baker SP, Braver ER, Li G. Carrying passengers as a

risk factor for crashes fatal to 16- and 17-year old drivers.

JAMA 283(12):1578–82. 2000.

4. National Highway Traffic Safety Administration. Traffic safety

facts 2003: Overview. Washington, DC: U.S. Department of

Transportation. 2004.

40 Adolescent Health in the United States, 2007
Figure 17. Death rates for motor vehicle traffic-related and firearm-related injuries 

among adolescents 10–19 years of age, by age and gender: United States, 

average annual 2002–2004 

Deaths per 100,000 adolescents 

60 

Motor vehicle traffic 

Male

40 

20 

 Female 

0 

10 11 12 13 14 15 16 17 18 19 

Years of age

Deaths per 100,000 adolescents 

60 

Firearm 

40 

Male

20 

 Female 

0 

10 11 12 13 14 15 16 17 18 19 

Years of age

NOTES: The firearm death rates for females 10–12 years of 

age are unreliable and are not shown. Firearm rates for 

female adolescents begin at 13 years of age. See “Technical 

Notes” for discussion of cause-of-death coding. See data 

table for data points, standard errors, and data on race and 

ethnicity. 

SOURCE: Centers for Disease Control and Prevention, 

National Center for Health Statistics, National Vital Statistics 

System. 

Adolescent Health in the United States, 2007

41

Health Status
Violence and Victimization

Violence and Victimization

Violent Crime Victimization

Adolescents are the victims of violent acts in the home, at

school, and in the community. Violent crimes include rape or

sexual assault, aggravated and simple assaults, and robbery.

In 2004, approximately 1.6 million adolescents 12–19

years of age were reported as victims of violent crime. Almost

900,000 young adults ages 20–24 were also victims of violent

crime.

Among younger adolescents—those 12–15 years of

age—males were almost twice as likely as females to be

victims of serious crimes (Figure 18a). By age 20–24 years,

the crime victimization rates for males and females were

similar.

Among female adolescents and young adults, the rates

for rape and sexual assault were similar across age groups.

Overall, female adolescents and young adults are four times

more likely to be the victims of sexual assault than are

women in all other age groups (1).

Over the past two decades, crime victimization rates for

adolescents and young adults have changed considerably.

Rates generally increased for adolescents and young adults

from 1985 through 1995 and then declined between 1995 and

2005 to levels well below those in 1985 (Figure 18b).

In 2004, 5 percent of adolescent victims of violent crimes

received hospital care and 10 percent of adolescent victims of

robbery received hospital care (1).

Reference

1.	 U.S. Department of Justice. Criminal victimization in

the United States, 2004 statistical tables [online].

NCJ 213257. [online]. [cited 2007 June 8]. Available from

www.ojp.gov/bjs/pub/pdf/cvus0403.pdf. 2006.

Figure 18a. Violent crime victimization rates among adolescents 12–19 years of 

age and young adults 20–24 years of age, by gender, age group, and type of 

victimization: United States, 2004 

Victimizations per 1,000 population Rape or sexual assault 

80 Robbery 

60 

40 

20 

0 

Simple assault 

Aggravated assault 

12–15 16–19 20–24	 12–15 16–19 20–24
 

Male Female 

Age in years 

NOTES: Violent crimes include simple and aggravated SOURCE: U.S. Department of Justice, Bureau of Justice 


assault, robbery, rape and sexual assault. See data table Statistics, National Crime Victimization Survey.
 

for data points.
 

42 Adolescent Health in the United States, 2007
Figure 18b. Violent crime victimization rates among adolescents 12–19 years of 

age and young adults 20–24 years of age, by age group: United States, 

1985–2005 

Victimizations per 1,000 population in age group 

200 

Age 12–15 years 

Age 16–19 years 

Age 20–24 years 

150 

100 

50 

0 1985 1990 1995 2000 2005 

NOTES: Violent crimes include simple and 

aggravated assault, robbery, rape and sexual assault. 

See data table for data points. 

SOURCE: U.S. Department of Justice, Bureau of 

Justice Statistics, National Crime Victimization Survey. 

Adolescent Health in the United States, 2007

43

Violence and Victimization
Violence and Victimization

Dating Violence and Forced Intercourse

Physical dating violence (PDV) is defined as physical violence

within a dating relationship. Each year, 1 in 11 adolescents

reports being a victim of PDV (1). In addition to the risk for

injury and death, victims of dating violence are more likely to

engage in risky sexual behavior, unhealthy dieting behaviors,

substance use, episodic heavy drinking, physical fighting, and

suicidal ideation or attempts (1). Dating violence victimization

can be a precursor for intimate partner violence victimization

in adulthood, especially among women (1,2).

In the Youth Risk Behavior Survey, PDV victimization was

defined as a response of ‘‘yes’’ to a single question: ‘‘During

the past 12 months, did your boyfriend or girlfriend ever hit,

slap, or physically hurt you on purpose?’’ Students were not

asked whether they had had a boyfriend or girlfriend during

the 12 months preceding the survey; therefore, a response of

‘‘no’’ might have included students who had not been dating.

In 2005, about 9 percent of male and female students

reported dating violence (data table for Figure 19). Overall,

dating violence increased from 7 percent to 11 percent for

students between 9th and 12th grade.

In 2005, almost 8 percent of students had ever been

physically forced to have sexual intercourse when they did

not want to. The prevalence of having been forced to have

sexual intercourse was higher among female students than

among male students in each of grades 9 through 12

(Figure 19).

References

1.	 CDC. Physical dating violence among high school students—

United States, 2003. MMWR 55:532–5. 2006.

2.	 Smith PH, White JW, Holland LJ. A longitudinal perspective on

dating violence among adolescent and college-age women.

Am J Public Health 93:1104–9. 2003.

44 Adolescent Health in the United States, 2007
Figure 19. Dating violence and being forced to have sexual intercourse among 

students in grades 9–12, by gender and grade level: United States, 2005 

12th 

11th 

10th 

9th 

12th 

11th 

10th 

9th 

12th 

11th 

10th 

9th 

12th 

11th 

10th 

9th 

Dating violence 

Male 

Female 

Forced intercourse 

Grade level 

0 10 20 30 40 

Percent 

NOTES: Dating violence is the percentage of students table for data points, data by race and Hispanic origin, 


who were hit, slapped, or physically hurt on purpose and standard errors.
 

by their boyfriend or girlfriend during the past 12 


months; forced intercourse is the percentage of SOURCE: Centers for Disease Control and Prevention, 


students who have ever been physically forced to National Center for Chronic Disease Prevention and 


have intercourse when they did not want to. See data Health Promotion, Youth Risk Behavior Survey. 


Adolescent Health in the United States, 2007

45

Violence and Victimization
Reproductive Health

Reproductive Health

Contraceptive Use

Contraceptive use among sexually active teenagers increased

between 1995 and 2002, and contracepting teenagers chose

more effective contraceptive methods (1). Among

contraceptive methods most frequently used by teenagers, the

injectable (Depo-ProveraT) and oral contraceptive (the ‘‘pill’’)

are the most reliable methods, with a failure rate of

0.3 percent with perfect use, followed by the male condom at

2 percent. Methods with higher failure rates with perfect use

include periodic abstinence (1–9 percent) and withdrawal

(4 percent) (2). Consistency and correctness of use may vary,

increasing the failure rates.

In 2002, 83 percent of never-married female adolescents

who had sexual intercourse in the past 3 months had used at

least one method of contraception (Figure 20). The most

common methods were condoms and oral contraceptives.

Nine percent of sexually experienced teenagers with recent

intercourse used other hormonal methods. These methods

include injectables (such as Depo-ProveraT and LunelleT

injectables), Norplant (a contraceptive patch), and emergency

contraception (the use of high-dose oral contraceptives shortly

after intercourse).

Contraceptive use among non-Hispanic white and

non-Hispanic black adolescents differs. Ninety percent of

non-Hispanic white female adolescents used some method of

contraception at their last intercourse compared with

75 percent of non-Hispanic black female adolescents. Oral

contraceptives were used more often among non-Hispanic

white teenagers than among non-Hispanic black teenagers,

whereas use of other hormonal methods was more common

among non-Hispanic black teenagers than among

non-Hispanic white teenagers.

Of all sexually experienced females 15–19 years of age in

2002, 26 percent had not used any method of contraception

at their first intercourse, and among those who had their first

intercourse before 15 years of age, 35 percent did not use a

method of contraception at their first intercourse (1). Among

male adolescents 15–19 years of age, condom use at first

intercourse was reported by 71 percent, and 18 percent did

not use any method (1).

In 2002, the probability of a female adolescent giving birth

before age 20 was 18 percent (2). The probability of a first

birth increases with age and is associated with contraceptive

use at first intercourse. Among young women 15–24 years of

age, the probability of a first birth by age 15 was 1 percent

compared with 13 percent by age 19. Among those who did

not use a method of contraception at first intercourse, the

probability of a first birth between ages 17 and 20 years was

twice as high at each age level as that of adolescents using

a method of contraception at first intercourse (1).

Between 1995 and 2002, notable increases in some

methods of contraception were observed. The percentage of

adolescent women who had ever used the pill increased from

52 percent to 61 percent, and those who had ever used the

very effective injectable methods increased from 10 percent to

21 percent over the time period (1).

References

1.	 Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J.

Fertility, family planning, and reproductive health of U.S.

women: Data from the 2002 National Survey of Family Growth.

National Center for Health Statistics. Vital Health Stat 23(25).

2005.

2.	 Abma JC, Martinez GM, Mosher WD, Dawson BS. Teenagers

in the United States: Sexual activity, contraceptive use, and

childbearing, 2002. National Center for Health Statistics.

Vital Health Stat 23 (24). 2004.

46 Adolescent Health in the United States, 2007
Figure 20. Contraceptive use among never-married female adolescents 15–19 

years of age who have had sexual intercourse in the past 3 months, by specified 

method used at last intercourse and race and Hispanic origin: United States, 2002 

Any method Condom Oral contraceptive (pill) 

Other hormonal Dual methods No method 

Percent 

(hormonal and condom) 

0 

20 

40 

60 

80 

100 

All never-married females White only, not Black only, not
 

reported who had sexual Hispanic Hispanic
 

intercourse in past 3 months
 

NOTES: Categories are not mutually exclusive. Condom 

includes condom use alone or in combination with any 

other method. Oral contraceptive (pill) includes pill use 

alone or in combination with any other method. Other 

hormonal includes Depo-Provera® injectable, Lunelle® 


injectable, Norplant implants, emergency contraception, 

and contraceptive patch. Data are not shown separately for 

“other methods,” which include all other methods besides 

condom and hormonal methods. Estimates for Hispanic 


adolescents did not meet standards of reliability and 


precision, and are not shown. See data table for data 


points, standard errors, and additional notes.
 

SOURCE: Centers for Disease Control and Prevention, 


National Center for Health Statistics, National Survey of 


Family Growth.
 

Adolescent Health in the United States, 2007

47

Reproductive Health
Reproductive Health

Pregnancy Rates

Approximately 750,000 adolescents 15–19 years of age

become pregnant annually. The majority of teen pregnancies

are unplanned (82 percent), accounting for more than one-fifth

of all unintended pregnancies each year (1). The

consequences of unintended pregnancy for adolescents

include unintended births, reduced educational attainment,

fewer employment opportunities, increased likelihood of

welfare receipt, and poorer health and developmental

outcomes among their infants (2). About 40 percent of

unintended pregnancies among adolescents 15–19 years of

age end in induced abortion (1).

The number of pregnancies is estimated as the sum of

live births, induced abortions, and fetal losses (miscarriages

and still births). In 2002, the pregnancy rate was 76.4

pregnancies per 1,000 young women 15–19 years of age

(Figure 21a).

Teenage pregnancy rates vary by race and Hispanic

origin. In 2002, pregnancy rates were more than twice as

high among non-Hispanic black and Hispanic teenagers as

among non-Hispanic white teenagers (Figure 21b). The

proportion of pregnancies that ended in induced abortion was

higher among non-Hispanic black teenagers than among

either Hispanic or non-Hispanic white teenagers.

By 2002, the teenage pregnancy rate for young women

15–19 years of age had decreased 35 percent from a peak of

116.8 pregnancies per 1,000 young women in 1990 (3).

Between 1988 and 2002, the percentage of teenagers

15–19 years of age who ever had sexual intercourse

decreased from 55 percent to 46 percent (4). Moreover,

contraceptive use among sexually active teenagers increased

over those years, and contracepting teenagers chose more

effective contraceptive methods. These factors contributed to

the decrease in pregnancy rates among teenagers.

References

1.	 Finer LB, Henshaw SK. Disparities in rates of unintended

pregnancy in the United States, 1994 and 2001. Perspect Sex

Reprod Health 38(2):90–6. 2006.

2.	 Alan Guttmacher Institute. Sex and America’s teenagers.

New York, NY: Alan Guttmacher Institute. 1994.

3.	 Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Recent

trends in teenage pregnancy in the United States, 1990–2002.

National Center for Health Statistics. Health E-Stat.

Available from: www.cdc.gov/nchs/products/pubs/pubd/hestats/

teenpreg1990-2002/teenpreg1990-2002.htm.

2006.

4.	 Abma JC, Martinez GM, Mosher WD, Dawson BS. Teenagers

in the United States: Sexual activity, contraception use, and

childbearing, 2002. National Center for Health Statistics.

Vital Health Stat 23(24). 2004.

Figure 21a. Pregnancy rates among adolescents 15–19 years of age: United States, 

1990–2002 

Pregnancies per 1,000 female adolescents 

150 

100 

50 

0 

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 

Year 

NOTES: See “Technical Notes” for a discussion of 	 SOURCE: Ventura SJ, Abma JC, Mosher WD, Henshaw 

pregnancy rate estimation. See data table for data points. 	 SK. Recent trends in teenage pregnancy in the United 

States, 1990–2002. Health E-stat. National Center for 

Health Statistics. 2006. 

48 Adolescent Health in the United States, 2007
Figure 21b. Pregnancy rates among adolescents 15–19 years of age, by age, race 

and Hispanic origin, and outcome of pregnancy: United States, 2002 

0 

50 

00 

50 

00 

Fetal loss 

Induced abortion 

Live birth 

15–17 18–19 15–17 18–19 15–17 18–19 

years years years 

White, not Hispanic Black, not Hispanic Hispanic 

Per 1,000 female adolescents 

1

1

2

250 

NOTES: See “Technical Notes” for discussion of 

pregnancy rate estimation. Persons of Hispanic origin may 

be of any race. See data table for data points. 

SOURCE: Ventura SJ, Abma JC, Mosher WD, Henshaw 

SK. Recent Trends in Teenage Pregnancy in the United 

States, 1990–2002. Health E-stat. National Center for 

Health Statistics. 2006. 

Adolescent Health in the United States, 2007

49

Reproductive Health
Reproductive Health

Birth Rates

Adolescent mothers are at greater risk of adverse health

consequences compared with older mothers (1). Second and

higher order births further increase the risk of poor outcomes

for young women and their children (2). Most teenage

mothers are not prepared for the emotional, psychological,

and financial responsibilities and challenges of parenthood (3).

Compared with peers who delay childbearing, teenage

mothers are less likely to complete high school or have

steady employment and are more likely to receive public

assistance and experience marital instability (4).

In 2004, there were approximately 422,000 births to

adolescents 10–19 years of age, accounting for 10 percent of

all births. The birth rate for adolescent women 15–19 years of

age was 41.1 births per 1,000 adolescent women, whereas

the birth rate for very young adolescents (10–14 years of

age) was 0.7 (5).

Among adolescents, birth rates increase with maternal

age, regardless of race or ethnicity (Figure 22). Overall,

teenagers aged 18–19 years were three times as likely to

give birth as those aged 15–17 years.

Birth rates vary considerably by race and Hispanic origin.

In 2004, Hispanic and non-Hispanic black teenagers had the

highest birth rates, followed by American Indian or Alaska

Native teenagers; Asian or Pacific Islander teenagers had the

lowest birth rates. Among women 18–19 years of age, birth

rates among non-Hispanic black (103.9 births per 1,000) and

Hispanic teenagers (133.5) were three to four times those of

Asian or Pacific Islander teenagers (29.6).

Birth rates among adolescent women steadily declined

during 1991–2004; birth rates fell 33 percent among

adolescents 15–19 years of age and 50 percent among

adolescents 10–14 years of age during this period(5). Birth

rates for black teenagers fell more steeply between 1991and

2004 (declining 47 percent) than did rates for other population

groups (5).

Adolescent mothers are much less likely than older

women to receive timely prenatal care and are more likely to

commence care in the third trimester or have no care at

all (1). They are also more likely to smoke during pregnancy.

In 2004, 14 percent of adolescent mothers 15–19 years of

age smoked during pregnancy (6).

Characteristics of adolescents’ mothers influence their

timing of a first birth. For female adolescents whose mother

also had an adolescent birth, 23 percent had a birth before

age 20 compared with 8 percent whose mother delayed

childbearing until after age 20 (7).

References

1.	 Ventura SJ, Mathews TJ, Hamilton BE. Births to teenagers in

the United States, 1940–2000. National vital statistics reports;

vol 49 no 10. Hyattsville, MD: National Center for Health

Statistics. 2001.

2.	 Klerman LV. Another chance: Preventing additional births to

teen mothers. Washington, DC: National Campaign to Prevent

Teen Pregnancy. 2004.

3.	 Maynard RA, editor. Kids having kids: Economic costs and

social consequences of teen pregnancy. Washington, DC:

The Urban Institute Press. 1997.

4.	 Alan Guttmacher Institute. Sex and America’s teenagers.

New York, NY: Alan Guttmacher Institute. 1994.

5.	 Martin JA, Hamilton BE, Sutton PD, et al. Births: Final data for

2004. National vital statistics reports; vol 55 no 1. Hyattsville,

MD: National Center for Health Statistics. 2006.

6.	 NCHS. Health, United States, 2006, with chartbook on trends

in the health of Americans. Table 12. Hyattsville, MD: National

Center for Health Statistics. 2006.

7.	 Abma JC, Martinez GM, Mosher WD, Dawson BS. Teenagers

in the United States: Sexual activity, contraceptive use, and

childbearing, 2002. National Center for Health Statistics.

Vital Health Stat 23(24). 2004.

50 Adolescent Health in the United States, 2007
Figure 22. Birth rates among adolescents 10–19 years of age, by birth order, 

age group, and race and Hispanic origin: United States, 2004 

Years of age 

Less than 15 

15–17 

18–19 

Less than 15 

15–17 

18–19 

Less than 15 

15–17 

18–19 

Less than 15 

15–17 

18–19 

Less than 15 

15–17 

18–19 

0 25 50 75 100 125 150 175 

Live births per 1,000 female adolescents 

White, not Hispanic First births

Black, not Hispanic 

American Indian or Alaska Native 

Asian or Pacific Islander 

Hispanic 

* 

* 

* 

* 

Second and higher births 

*Rates based on fewer than 50 events are considered 

unreliable; rates based on fewer than 20 events are 

considered highly unreliable and are not shown. 

NOTES: Live births of unknown birth order are 

distributed proportionally. Persons of Hispanic origin 

may be of any race. See data table for data points 

and data for ages 20–24 years. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Health Statistics, 

National Vital Statistics System, Birth File. 

Adolescent Health in the United States, 2007

51

Reproductive Health
Reproductive Health

Sexually Transmitted Diseases

Sexually transmitted diseases (STDs) are the most

commonly reported infectious diseases among sexually active

adolescents. Compared with older adults, sexually active

adolescents (10–19 years of age) and young adults (20–24

years of age) are at higher risk for acquiring STDs for a

combination of behavioral, biological, and cultural reasons (1).

Adolescents are more likely to have multiple sexual partners

and short-term relationships, to engage in unprotected

intercourse, and to have partners who are themselves at high

risk for STDs (1,2). Adolescent women may have a

physiologically increased susceptibility to infection because of

increased cervical ectopy (1).

Sexually active adolescents often face barriers to

receiving STD prevention services, such as concern about

confidentiality, discomfort with facilities and services designed

for adults, lack of insurance or ability to pay, and lack of

transportation (1).

Chlamydia, gonorrhea, and syphilis are the most common

bacterial causes of STDs and are curable with antimicrobials.

Syphilis is relatively rare among adolescents. When left

untreated, chlamydia and gonorrhea can cause pelvic

inflammatory disease, abscesses in the fallopian tubes and

ovaries, and chronic pelvic pain; they may also result in

ectopic pregnancy or infertility (3). In young men, untreated

infections can cause urethritis and epididymitis. STDs may

also increase susceptibility to HIV infections two to five

times (3).

Chlamydia remains the most commonly reported infectious

disease in the United States. In 2004, female adolescents

15–19 years of age had higher reported rates of chlamydial

infections than those of adolescent males and older persons

of either gender; rates among young women 20–24 years of

age were nearly as high (data table for Figure 23). The higher

reported rates of chlamydia among adolescents and young

women than among their male counterparts are primarily

attributable to detection of asymptomatic infection in young

women through screening, whereas chlamydia among their

sex partners may not be diagnosed or reported (1).

The availability of urine tests for chlamydia may be

contributing to increased detection of chlamydia in young

men (3); reported chlamydia rates among adolescent males

rose by 50 percent between 1998 and 2004.

Gonorrhea is the second most commonly reported

notifiable disease in the United States. In 2004, rates of

gonorrhea were also higher for female adolescents 15–19

years of age than for adolescent males and older persons (3).

Between 1998 (4) and 2004, the gonorrhea rate for

female adolescents 15–19 years of age declined almost

22 percent; among male adolescents in the same age group,

the decline was 29 percent.

Black adolescents are disproportionately affected by

chlamydia and gonorrhea. In 2004, non-Hispanic black

adolescents had higher rates of chlamydia and gonorrhea

than did adolescents in other racial and ethnic groups

(Figure 23).

References

1. CDC. Sexually Transmitted Diseases Surveillance, 2004.

Atlanta, GA: U.S. Department of Health and Human Services.

Sept 2005.

2. Gittes EB, Irwin CE. Sexually transmitted diseases in

adolescents. Pediatr Rev 14(5):180–9. 1993.

3. CDC. Trends in reportable sexually transmitted diseases in the

United States, 2004—National surveillance data for chlamydia,

gonorrhea, and syphilis [online]. [cited 2007 June 8]. Atlanta,

GA: U.S. Department of Health and Human Services. Available

from: www.cdc.gov/std/stats04/04pdf/trends2004.pdf. Nov 2005.

4. MacKay AP, Fingerhut LA, Duran CR. Adolescent health

chartbook. In: Health, United States, 2000. Hyattsville, MD:

National Center for Health Statistics. 2000.

52 Adolescent Health in the United States, 2007
Figure 23. Sexually transmitted disease rates reported for adolescents 15–19 

years of age, by gender and race and Hispanic origin: United States, 2004 

Chlamydia Female 

Male 

White, not Hispanic 

Black, not Hispanic 

Hispanic 

American Indian or 

Alaska Native 

Asian or Pacific
 

Islander
 

0 2,000 4,000 6,000 8,000 10,000 

Reported cases per 100,000 adolescents 

Gonorrhea 

Female 

White, not Hispanic Male

Black, not Hispanic 

Hispanic 

American Indian or 

Alaska Native 

Asian or Pacific
 

Islander
 

0 2,000 4,000 6,000 8,000 10,000 

Reported cases per 100,000 adolescents 

NOTES: Persons of Hispanic origin may be

of any race. See data table for data points 

and data for ages 10–14 and 20–24 years. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for HIV, STD, and 

TB Prevention, STD Surveillance. 

Adolescent Health in the United States, 2007

53

Reproductive Health
Reproductive Health

Acquired Immunodeficiency Syndrome

(AIDS) and Human Immunodeficiency

Virus (HIV)

Acquired immunodeficiency syndrome (AIDS), with its

associated morbidity and mortality, results from infection with

human immunodeficiency virus (HIV). Sexual activity and drug

use activities among adolescents place them at high risk for

HIV transmission.

Surveillance data on HIV infections provide a more complete

picture of the epidemic and the need for prevention and care

services than the picture provided by AIDS data alone.

However, the number of new HIV diagnoses does not

necessarily reflect trends in HIV incidence (i.e., new

infections) because some people with new diagnoses were

infected recently, whereas others were infected some time in

the past (1).

Among female adolescents, the most common method of

transmission of HIV infection is through high risk heterosexual

contact (Figure 24). Young women are at risk for sexually

transmitted HIV for several reasons, including biologic

vulnerability, lack of recognition of their partners’ risk factors,

inequality in relationships, and having sex with older men who

are more likely to be infected with HIV (2).

Among male adolescents, the most common method of

HIV transmission is males having sex with males (MSM).

According to a recent CDC study of young men (aged 15–22

years) who have had sex with men, more than one-half did

not let other people know they were sexually attracted to

men (3). MSM who do not disclose their sexual orientation

are less likely to seek HIV testing. If they become infected,

they are less likely to know it. Furthermore, because MSM

who do not disclose their sexual orientation are more likely to

have one or more female sex partners, MSM who become

infected may transmit the virus to women as well as to men.

The proportion of adolescents and young adults with AIDS

varies by race and ethnicity. The black population is

disproportionately affected by AIDS, accounting for 69 percent

of AIDS cases reported among adolescents aged 13–19 years

in 2005 (4).

As treatment has become more available, trends in new AIDS

diagnoses no longer accurately represent trends in new HIV

infections; these data now represent persons who are tested

late in the course of HIV infection, who have limited access

to care, or for whom treatment has failed (2).

References

1.	 CDC. HIV/AIDS Surveillance Report, 2004. Vol 16. Atlanta,

GA: U.S. Department of Health and Human Services. 2005.

2.	 CDC. HIV/AIDS among youth fact sheet [online].

[cited 2007 June 8]. Available from:

http://www.cdc.gov/hiv/resources/factsheets/youth.htm. 2007.

3.	 CDC. HIV/STD risks in young men who have sex with men

who do not disclose their sexual orientation—Six U.S. cities,

1994–2000. MMWR 52:81–5. 2003.

4.	 CDC. HIV/AIDS surveillance in adolescents and young adults

(through 2005) [online]. [cited 2007 June 20]. Available from:

www.cdc.gov/hiv/topics/surveillance/resources/slides/

adolescents/index.htm. 2007.

54 Adolescent Health in the United States, 2007
Figure 24. Acquired immunodeficiency syndrome (AIDS) and Human 

immunodeficiency virus (HIV) transmission categories for adolescents 13–19 years 

of age, by gender: United States and 33 states with confidential reporting, 

2001–2005 

Male 

Female 

Male 

Female 

AIDS cases reported, United States1 

HIV/AIDS cases reported, 33 states2 

0 20 40 60 80 100 

Percent 

Male to Injection MSM High risk Other or 

male sexual drug use and IDU heterosexual not identified 

contact (IDU) contact 

(MSM) 

1

Includes Puerto Rico and Virgin Islands. 

2

Data for HIV/AIDS cases are from 33 states with 

confidential name–based HIV infection reporting since at 

least 2001. 

NOTES: High risk heterosexual contact is contact with a 

person known to have or at high risk for HIV infection. 

Other category includes hemophilia, blood transfusion, 

perinatal, and risk factor not reported or not identified. 

Data for HIV/AIDS cases include persons with a 

diagnosis of HIV infection regardless of AIDS status at 

diagnosis. See data table for data points, estimated 

numbers of cases, data for ages 20–24 years, and 

additional notes. 

SOURCE: Centers for Disease Control and Prevention, 

National Center for HIV, STD, and TB Prevention, 

HIVAIDS Surveillance System. 

Adolescent Health in the United States, 2007

55

Reproductive Health
Risk Behaviors

Risk Behaviors

Sexual Contact

Many different factors in adolescents’ lives affect their sexual

health and responsible sexual behavior. Gender, age, and

race and ethnicity play a role, as do attitudes, involvement in

activities, academic performance, and relationships with

parents (1,2). Early puberty and early menstruation increase

the likelihood of being sexually experienced, and teenagers

who appear older or more physically developed are more

likely to be involved in sexual activity than their peers (2).

In 2002, approximately one-half of adolescents 15–17

years of age had ever engaged in some form of sexual

contact with the opposite sex during their life (Figure 25b).

By age 18–19 years, the proportion increased to 78 percent

of males and 83 percent of females. Every type of sexual

contact among adolescents and young adults increased with

age from 15–17 years of age to 20–24 years of age

(data table for Figure 25b).

Oral sex was slightly more common than vaginal

intercourse among males 15–17 and 18–19 years of age and

females 15–17 years of age.

In 2002, 46 percent of never-married female and male

adolescents 15–19 years of age had ever had intercourse (3).

The percentage of never-married male adolescents 15–17

and 18–19 years of age who had ever had intercourse

declined significantly between 1995 and 2002 (Figure 25a) (3).

About three-fourths of female adolescents who were

sexually active in 2002 had a first male partner who was the

same age or up to 3 years older than they were (3). Eight

percent had a first partner who was 6 or more years older.

For the majority of female teenagers, their first sexual partner

was someone with whom they were ‘‘going steady’’ (3).

References

1.	 Manlove J, Terry-Humen E, Papillo AR, Franzetta K,

Williams S, Ryan S. Preventing teenage pregnancy,

childbearing, and sexually transmitted diseases: What the

research shows [online]. [cited 2007 June 8]. Washington, DC:

Child Trends Research Brief. Available from:

www.childtrends.org/Files/K1Brief.pdf. 2002.

2.	 Resnick MD, Bearman, PS, Blum RW, et al. Protecting

adolescents from harm: Findings from the national longitudinal

study on adolescent health. J Am Med Assoc 278(10), 823–32.

1997.

3.	 Abma JC, Martinez GM, Mosher WD, Dawson BS. Teenagers

in the United States: Sexual activity, contraceptive use, and

childbearing, 2002. National Center for Health Statistics. Vital

Health Stat 23(24). 2004.

Figure 25a. Adolescents 15–19 years of age who have ever had sexual intercourse, 

by age and gender: United States, 1988–2002 

Percent 1988 1995 2002 

100 

75 

50 

25 

0 

Male 

15–17 18–19	 15–17 18–19
 

Female 

NOTES: Percentages reflect heterosexual vaginal 

intercourse only, not other types of sexual activity. See data 

table for data points and standard errors. 

56

SOURCE: Centers for Disease Control and Prevention, 

National Center for Health Statistics, National Survey of 

Family Growth. 

Adolescent Health in the United States, 2007
Figure 25b. Ever had any sexual contact among adolescents 15–19 years of age, 

by type of contact, age, and gender: United States, 2002 

Percent 

0 

20 

40 

60 

80 

100 Any 

opposite 

sex contact 

Anal 

sex with 

opposite sex 

Vaginal 

intercourse 

Same–sex 

sexual 

contact 

Oral 

sex with 

opposite sex 

15–17 years 18–19 years 15–17 years 18–19 years 

Male Female 

NOTES: Same–sex contact was measured with 

substantially different questions for males and females. 

See data table for data point, standard errors, and 

additional notes.
 

SOURCE: Centers for Disease Control and Prevention, 


National Center for Health Statistics, National Survey of 


Family Growth. 


Adolescent Health in the United States, 2007

57

Risk Behaviors
Risk Behaviors

Sexual Partners

Sexually active adolescents increase their risks of becoming

HIV infected, contracting other STDs, and becoming pregnant

unintentionally. Teenagers who begin having sex at younger

ages are exposed to these risks over a longer period of time.

Those who have had multiple sex partners further increase

their risk of becoming pregnant and acquiring sexually

transmitted diseases, including HIV infection.

In 2002, just under one-third of male and female

adolescents 15–17 years of age had ever had heterosexual

vaginal intercourse (were sexually experienced). Among

adolescents 18–19 years of age, approximately two-thirds had

ever had sexual intercourse (Figure 25a).

Among adolescents who have had heterosexual vaginal

intercourse, the majority have had intercourse with more than

one partner in their lifetime (Figure 26). In 2002, the

distribution of the number of lifetime sexual partners was

similar for male and female adolescents within each age

group (data table for Figure 26).

The number of lifetime sexual partners varied by race and

ethnicity. Among never-married male adolescents 15–19 years

of age, 29 percent of non-Hispanic black and 25 percent of

Hispanic males had more than three sexual partners,

compared with 12 percent of non-Hispanic white males. In

contrast, among female adolescents, 15 percent of

non-Hispanic white teenagers and non-Hispanic black

teenagers had more than three sexual partners, compared

with only 7 percent of Hispanic teenagers.

Age at first intercourse is an important factor in the level

of sexual risk behaviors among adolescents. Adolescents who

begin having intercourse at an earlier age are more likely to

have a higher number of partners (1).

Reference

1.	 Abma JC, Martinez GM, Mosher WD, Dawson BS. Teenagers

in the United States: Sexual activity, contraceptive use, and

childbearing, 2002. National Center for Health Statistics.

Vital Health Stat 23(24). 2004.

58 Adolescent Health in the United States, 2007
Figure 26. Number of sexual partners in lifetime among adolescents 15–19 years 

of age, by gender and race and Hispanic origin: United States, 2002 

None 1 2–3 4–6 7 or more 

Male
 

All races and origins
 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Female
 

All races and origins
 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

0 20 40 60 80 100 

Percent 

NOTES: Percentages reflect heterosexual 

vaginal intercourse only, not other types of 

sexual activity. Persons of Hispanic origin may 

be of any race. See data table for data points, 


data by age group, and standard errors.
 

SOURCE: Centers for Disease Control 

and Prevention, National Center for Health 

Statistics, National Survey of Family Growth. 


Adolescent Health in the United States, 2007

59

Risk Behaviors
Risk Behaviors

Cigarette Smoking

Smoking has serious long-term effects on health, including

the risk of nicotine addiction, smoking-related diseases, and

premature death (1). Most young people who smoke regularly

continue to smoke throughout adulthood. Over 80 percent of

adults who are addicted to tobacco began smoking as

adolescents (2).

In 2005, almost one-fourth of all high school students

reported smoking cigarettes on one or more days in the

previous 30 days (current smoking), and about 9 percent

reported smoking frequently (that is, on 20 or more days).

The percentage of students who reported current cigarette

smoking increased with grade level, as did the percentage

who reported frequent smoking (Figure 27). The proportion of

frequent smokers nearly doubled between 9th and 12th

grades.

Many adolescents begin smoking cigarettes before

reaching 9th grade. In 2005, 16 percent of students had

smoked a whole cigarette before 13 years of age (3).

Rates of cigarette smoking differ substantially among

racial and ethnic groups. In 2005, non-Hispanic white and

Hispanic students were more likely to smoke cigarettes than

non-Hispanic black students were.

Among the 23 percent of students who reported current

cigarette use, 55 percent had tried to quit smoking cigarettes

during the 12 months preceding the survey (3).

The trend in cigarette smoking among adolescents has

changed over the past 15 years. The percentage of students

who reported current cigarette use increased between 1991

and 1997 (from 28 percent to 36 percent) and then decreased

during the 1997 to 2005 period (from 36 percent to

23 percent). Similarly, the percentage of students who

reported frequent cigarette use increased between 1991 and

1999 (from 13 percent to 17 percent) and then fell between

1999 and 2005 (from 17 percent to 9 percent) (3).

In addition to cigarettes, adolescents are at risk from

other forms of tobacco use. In 2005, 8 percent of students

used smokeless tobacco in the past month (14 percent of

male students and 2 percent of female students), and

14 percent smoked cigars (19 percent of male students and

9 percent of female students) (3).

References

1.	 U.S. Department of Health and Human Services, Office on

Smoking and Health. 2004 Surgeon General’s report—The

health consequences of smoking. Atlanta, GA: Centers for

Disease Control and Prevention. 2004.

2.	 U.S. Department of Health and Human Services, Office on

Smoking and Health. Preventing tobacco use among young

people: A report of the Surgeon General. Atlanta, GA: Centers

for Disease Control and Prevention. 1994.

3.	 CDC. Youth risk behavior surveillance—United States, 2005.

MMWR 55(SS–5). 9 June 2006.

60 Adolescent Health in the United States, 2007
Figure 27. Current cigarette smoking among students in grades 9–12 by 

grade level, gender, and race and Hispanic origin: United States, 2005 

Grade level Current use 

9th grade Lifetime use 

10th grade Male 

11th grade Female 

12th grade 

9th grade
 

10th grade
 

11th grade
 

12th grade
 

Race and Hispanic origin 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

0 20 40

Percent 

60

NOTES: Current smokers are students who 

smoked cigarettes on one or more of the 

past 30 days; frequent smokers are students 

who smoked cigarettes on 20 or more of the 

past 30 days. Persons of Hispanic origin 

may be of any race. See data table for data 

points, standard errors, and additional notes. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, 

Youth Risk Behavior Survey. 

Adolescent Health in the United States, 2007

61

Risk Behaviors
Risk Behaviors

Alcohol Use

Alcohol is the most commonly used psychoactive substance

during adolescence, even though the minimum legal drinking

age is 21 years. Alcohol use is associated with motor vehicle

crashes, injuries, and deaths; problems in school and the

workplace; and fighting, crime, and other activities with

serious consequences (1). Binge alcohol use (binge drinking),

in which five or more drinks are consumed on one occasion,

and heavy drinking, in which binge drinking occurs on 5 or

more days in the past month, increase the likelihood of

negative outcomes (2).

In 2005, 28 percent of adolescents 12–20 years of age

reported drinking alcohol in the past month. Binge drinking

was reported by 19 percent of adolescents and heavy alcohol

use was reported by 6 percent (data table for Figure 28).

Alcohol use, binge alcohol use, and heavy alcohol use

increased significantly between ages 12–13 years and 18–20

years. One-half of all persons 18–20 years of age had used

alcohol in the past month and more than one-third reported

binge drinking in the past month.

Alcohol use varies by race and ethnicity. In 2005,

non-Hispanic white adolescents were significantly more likely

to engage in alcohol use than were non-Hispanic black

adolescents (Figure 28).

Adolescents who combine drinking and driving are at an

increased risk of injury or death. In 2005, 15 percent of

students in the 11th and 12th grades reported driving after

drinking alcohol (data table for Figure 29b) (3).

Adolescents who begin drinking before age 15 are four

times as likely to be alcohol dependent as those who delay

drinking until at least age 21 (2).

References

1.	 National Institute on Alcohol Abuse. Ninth special report to the

U.S. Congress on alcohol and health. Secretary of Health and

Human Services. Bethesda, MD: National Institutes of Health.

2000.

2.	 Department of Health and Human Services. Surgeon General’s

call to action to prevent and reduce underage drinking

[online]. [cited 2007 June 18]. Available from:

http://www.surgeongeneral.gov/topics/underagedrinking/about.html.

2007.

3.	 Centers for Disease Control and Prevention, National Center

for Chronic Disease Prevention and Health Promotion, Youth

Risk Behavior Survey. Unpublished analysis. 2006.

62 Adolescent Health in the United States, 2007
Hispanic 

White only, not Hispanic Male 

emale 

Binge alcohol use 

Male 

emale 

Heavy alcohol use 

Male 

emale 

0 10 20 30 40

Percent 

Figure 28. Alcohol use, binge alcohol use, and heavy alcohol use in the past 

30 days among adolescents 12–20 years of age, by gender and race and 

Hispanic origin: United States, 2005 

Alcohol use Black only, not Hispanic 

F

F

F

50

Risk Behaviors

NOTES: Binge alcohol use is defined as drinking five or 

more drinks on the same occasion (i.e., at the same 

time or within a couple of hours of each other) on at 

least 1 day in the past 30 days. Heavy alcohol use is 


defined as drinking five or more drinks on the same 

occasion on each of 5 or more days in the past 30 days; 

all heavy alcohol users are also binge alcohol users. 

Persons of Hispanic origin may be of any race. See data 


table for data points, data on age and detailed race, 


standard errors, and additional notes.
 

SOURCE: Substance Abuse and Mental Health Services 


Administration (SAMHSA), Office of Applied Studies, 


National Survey on Drug Use and Health. 


Adolescent Health in the United States, 2007

63
Risk Behaviors

Drinking and Driving and Seatbelt Use

Between 1970 and 2004, death rates for motor vehicle-related

injuries for teenagers and young adults 15–24 years of age

decreased by 81 percent. Yet, teenagers and young adults

15–24 years of age have among the highest death rates for

motor vehicle traffic-related injuries of any age group (1).

Research has shown that seatbelts, when properly used,

reduce the risk of moderate to critical injury and fatal

injury (2). In states with strict seatbelt laws, teenage seatbelt

use is consistently higher (3).

Alcohol use and driving a vehicle are a deadly combination.

In 2005, almost one-fifth of young drivers 16–20 years of age

involved in fatal motor vehicle traffic-related crashes were

intoxicated (4). Young drivers are less likely to use restraints

if they have been drinking alcohol. In 2004, three-fourths of

young drivers who had been drinking and were killed in a

crash were not wearing seatbelts (5).

Among high school students, riding with a driver who had

been drinking was more common than not using a seatbelt or

drinking and driving (Figure 29a). The percentage of high

school students in grades 9 through12 who rode with a driver

who had been drinking alcohol decreased from 40 percent to

29 percent between 1991and 2005. In 2005, male and female

high school students were equally likely to ride with a driver

who had been drinking (data table for Figure 29b). Hispanic

students were significantly more likely than their non-Hispanic

white and black counterparts to ride with a driver who had

been drinking (Figure 29b).

The percentage of high school students in 11th and 12th

grade who drove after drinking alcohol declined from almost

17 percent to 10 percent between 1991 and 2005. In 2005,

non-Hispanic black 11th- and 12th-grade students were less

likely to drive after drinking than non-Hispanic white or

Hispanic students.

Between 1991 and 2005, the percentage of high school

students in grades 9 through 12 who never or rarely wore

seatbelts while riding in a car driven by someone else

decreased from 26 percent to 10 percent. Although the

percentage of students not wearing seatbelts declined for

both males and females, almost 13 percent of male high

school students compared with 9 percent of female high

school students rarely or never used a seatbelt in 2005.

Seatbelt use did not differ significantly by race and ethnicity.

References

1.	 NCHS. Health, United States, 2006, with chartbook on trends

in the health of Americans. Hyattsville, MD: National Center for

Health Statistics. 2006.

2.	 National Highway Traffic Safety Administration. Motor vehicle

traffic crash fatality and injury estimates for 2000. Washington,

DC: U.S. Department of Transportation. 2001.

3.	 McCartt AT, Shabanova VI. Teenage seat belt use: White

paper [online]. The National Safety Council’s Air Bag & Seat

Belt Safety Campaign. [cited 2007 June 8]. Available from:

www.nsc.org/public/teen0702.pdf. 2002.

4.	 National Highway Traffic Safety Administration, National Center

for Statistics and Analysis. Alcohol-related fatalities and alcohol

involvement among drivers and motorcycle operators in 2005

[online]. DOT HS 810 644. [cited 2007 June 8]. Available from:

www-nrd.nhtsa.dot.gov/pubs/810644.pdf.2006.

5.	 National Highway Traffic Safety Administration. 2004

motor vehicle occupant protection facts. Washington, DC:

U.S. Department of Transportation. Available from:

www.nhtsa.dot.gov/people/injury/airbags/MVOP2004/.

2004.

64 Adolescent Health in the United States, 2007
Figure 29b. Drinking and driving and seatbelt use among students in grades 

9–12, by race and Hispanic origin: United States, 2005 

Rode with a driver who had been drinking alcohol
 

All races and origins
 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Drove after drinking alcohol (grades 11 and 12 only)
 

All races and origins
 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Rarely or never wore a seatbelt as a passenger
 

All races and origins
 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

0 20 40 Percent 60

Figure 29a. Drinking and driving and seatbelt use among students in grades 

9–12: United States, 1991–2005 Percent 

60 

40 

20 

0 

Rode with a driver who had been drinking 

Drove after drinking alcohol (grades 11 and 12 only) 

Rarely or never wore a seatbelt as a passenger 

1991 1993 1995 1997 1999 2001 2003 2005 

Year 

NOTES: Rode with a driver who had been 

drinking alcohol is defined as students who 

during the past 30 days rode one or more 

times in a car or other vehicle driven by 

someone who had been drinking alcohol; 

drove after drinking is defined as students who 

during the past 30 days drove a car or other 

vehicle one or more times when they had been 

drinking alcohol; rarely or never wore a 

seatbelt is defined as students who rarely or 

never wore a seatbelt when riding in a car 

driven by someone else. Persons of Hispanic 

origin may be of any race. See data table for 

data points, data by grade level and gender, 

and standard errors. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, 

Youth Risk Behavior Survey. 

Adolescent Health in the United States, 2007

65

Risk Behaviors
Risk Behaviors

Use of Marijuana and Other Illicit Drugs

Drug use by adolescents can have immediate and long-term

health and social consequences. Marijuana is the most

commonly used illicit drug among high school students.

The use of marijuana can produce adverse physical, mental,

emotional, and behavioral changes, and it can be

addictive (1). Marijuana use can also impair short-term

memory, verbal skills, and judgment, as well as distort

perception (1). Research has shown that marijuana use may

weaken the immune system and possibly increase a user’s

likelihood of cancer (1). Marijuana smoke, like cigarette

smoke, can damage the lungs (1). Increasing use of

marijuana by very young teenagers may have a profoundly

negative effect on their development (1).

In 2005, one-fifth of students in grades 9 through 12

reported using marijuana one or more times in the past

month (data table for Figure 30). Among male students,

current use increased significantly by grade level (Figure 30).

Male students were slightly more likely than female students

to have used marijuana in the past 30 days.

Among all students in grades 9 through 12, the

prevalence of marijuana use in the past month has declined

by 24 percent overall since 1999 (2).

In 2005, almost 4 in 10 students reported having used

marijuana one or more times during their life. Lifetime use of

marijuana increased significantly between grades 9 and 12 for

both male and female students.

Adolescents face health consequences from other illicit drug

use as well, particularly stimulants such as cocaine and

amphetamines. Stimulants are drugs that increase the activity

of the sympathetic nervous system and produce a sense of

euphoria or the feeling of being more awake. Cocaine is a

powerfully addictive stimulant drug associated with acute

cardiovascular or cerebrovascular emergencies, such as a

heart attack or stroke.

In 2005, almost 8 percent of students in grades 9–12

reported using some form of cocaine (powder, crack, or

freebase) during their lifetime and more than 3 percent

reported using cocaine in the past 30 days (2).

Amphetamines (including methamphetamines) are synthetic

stimulants. Regular use of amphetamines can cause chronic

sleep problems, mood swings, irregular heartbeat, high blood

pressure, weight loss, and nutritional problems. High doses of

the drug can result in nerve damage, chronic psychosis,

paranoia, and hallucinations.

In 2005, 6 percent of students in grades 9–12 reported

using methamphetamines during their lifetime and 4 percent

reported using amphetamines in the past 30 days (2).

References

1.	 National Institute on Drug Abuse. Marijuana abuse. National

Institute on Drug Abuse Research Report Series. NIH Pub No

05–3859. Bethesda, MD: National Institutes of Health. 2005.

2.	 CDC. Youth risk behavior surveillance—United States, 2005.

MMWR 55(SS–5). 9 June 2006.

66 Adolescent Health in the United States, 2007
Figure 30. Marijuana use in the past 30 days and lifetime use among students in 

grades 9–12, by grade level, gender, and race and Hispanic origin: 

United States, 2005 

Current use 

Lifetime use Grade level 

Male 9th grade 

Female 10th grade
 

11th grade
 

12th grade
 

9th grade
 

10th grade
 

11th grade
 

12th grade
 

Race and Hispanic origin 

All races and origins 

White only, not Hispanic
 

Black only, not Hispanic
 

Hispanic
 

All races and origins 

White only, not Hispanic
 

Black only, not Hispanic
 

Hispanic
 

0 10 20 30 40 50 60 70 8

Percent 

0

Risk Behaviors

NOTES: Current marijuana use is defined 

as students who used marijuana one or more 

times in the past 30 days; lifetime marijuana 

use is defined as students who have used 

marijuana one or more times during their life. 


Persons of Hispanic origin may be of any 


race. See data table for data points, standard 


errors, and additional notes.
 

SOURCE: Centers for Disease Control and 


Prevention, National Center for Chronic 


Disease Prevention and Health Promotion, 


Youth Risk Behavior Survey. 


Adolescent Health in the United States, 2007

67
Risk Behaviors

Weapon Carrying

Weapon carrying is associated with the most serious injuries

resulting from violence. Carrying a weapon significantly

increases the risk that a violent argument will result in death,

disability, or other serious injury (1). Although weapon carrying

does not always lead to injury, it is strongly associated with

exposure to intimidation and threats as well as perceptions of

fear and vulnerability (2,3).

In 2005, 19 percent of high school students reported

carrying a gun or other weapon, such as a knife or club, in

the past 30 days (data table for Figure 31). Five percent of

high school students reported carrying a gun.

Male students were significantly more likely than female

students to report carrying a gun or other weapon (Figure 31).

Among both male and female students, the percentage of

students who reported carrying a weapon did not differ

significantly between 9th and 12th grade.

The proportion of students who reported bringing a

weapon on school property was smaller than the overall

proportion of students who carried weapons. In 2005, almost

7 percent of all students brought a weapon to school;

10 percent of male students carried a weapon on school

property compared with less than 3 percent of female

students (4).

Not all violence-related behavior involves weapons. In

2005, 36 percent of students were involved in a physical fight

one or more times in the past 12 months (4). The prevalence

of having been in a physical fight was 43 percent for male

students compared with 28 percent for female students.

The percentage of students who carried a weapon

decreased between 1991and 1999 (from 26 percent to

17 percent) and then did not change significantly between

1999 and 2005 (17–18 percent). The percentage of students

who were in a physical fight decreased between 1991 and

2003 from 43 percent to 33 percent and then increased in

2005 to 36 percent (4).

References

1.	 CDC. Measuring the health behavior of adolescents: The Youth

Risk Behavior Surveillance System and recent public health

reports on high-risk adolescents. Public Health Rep 108

(Suppl 1):1–96. 1993.

2.	 Lowry R, Powell KE, Kann L, Collins JL, Kolbe LJ.

Weapon-carrying, physical fighting and fight related injury

among U.S. adolescents. Am J Prev Med 14:122–9. 1998.

3.	 Forrest K, Zychowski AK, Stuhldreher WK, Ryan WJ.

Weapon-carrying in school: Prevalence and association with

other violent behaviors. Am J Health Stud 16:133–40. 2000.

4.	 CDC. Youth risk behavior surveillance—United States, 2005.

MMWR 55(SS–5). 9 June 2006.

68 Adolescent Health in the United States, 2007
Figure 31. Weapon carrying in the past 30 days among students in grades 

9–12, by gender, grade level, and race and Hispanic origin: United States, 2005 

Current use 

Grade level Lifetime use

9th grade Male 

10th grade Female 

11th grade 

12th grade 

9th grade
 

10th grade
 

11th grade
 

12th grade
 

Race and Hispanic origin 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

0 10 20 30 40 50 60

Percent 

NOTES: Weapon carrying includes carrying 

weapons such as a gun, knife, or club on 

one or more of the past 30 days. Persons of 

Hispanic origin may be of any race. See data 

table for data points and standard errors.
 

SOURCE: Centers for Disease Control and 


Prevention, National Center for Chronic 


Disease Prevention and Health Promotion, 


Youth Risk Behavior Survey. 


Adolescent Health in the United States, 2007

69

Risk Behaviors
Risk Behaviors

Physical Activity

Physical activity provides important health and emotional

benefits for adolescents. It helps build and maintain healthy

bones, muscles, and joints; helps control weight, build lean

muscle, and reduce fat; prevents or delays the development

of high blood pressure; and helps reduce blood pressure in

some adolescents with hypertension (1). Physical activity,

along with a healthy diet, plays an important role in the

prevention of overweight and obesity.

Additionally, participation in physical activity and sports is

associated with social well-being, as well as physical and

mental health, among young people. Studies have found

participation in physical activity increases adolescents’

self-esteem and reduces anxiety and stress (2). Students who

participate in interscholastic sports are less likely to be

regular and heavy smokers or use drugs (1), and they are

more likely to stay in school and have good conduct and high

academic achievement (1). In contrast, low levels of physical

activity among adolescents have been associated with other

negative health behaviors (1).

In 2005, 36 percent of adolescents in grades 9–12

engaged in the currently recommended levels of physical

activity; that is, they participated in physical activity that

increased their heart rate and made them breathe hard some

of the time for a total of at least 60 minutes per day on 5 or

more of the 7 days preceding the survey (data table for

Figure 32).

Adolescents’ participation in physical activity at the

currently recommended level differs by gender. Male students

were substantially more likely than female students to have

participated in physical activity at the currently recommended

level (Figure 32).

Adolescents’ participation in physical activity at

recommended levels also differs by race and ethnicity.

Overall, non-Hispanic white students were more likely than

non-Hispanic black students to have participated in physical

activity at the currently recommended level.

Although the currently recommended level of physical

activity produces the greatest health benefits, adolescents can

also benefit from moderate to vigorous physical activity, which

is 20 minutes of vigorous activity three or more times a week

or 30 minutes of moderate activity five or more times a week.

In 2005, 69 percent of students in grades 9–12 participated in

moderate to vigorous physical activity.

In 2005, non-Hispanic white and Hispanic students were

more likely than non-Hispanic black students to participate in

moderate to vigorous physical activity.

In 2005, participation in moderate to vigorous physical

activity among students decreased from 74 percent for

9th grade students to 62 percent for 12th grade students

(data table for Figure 32).

References

1.	 Department of Health and Human Services and the

Department of Education. Promoting better health for young

people through physical activity and sports: A report to the

President from the Secretary of Health and Human Services

and the Secretary of Education. Fall 2000.

2.	 U.S. Department of Health and Human Services. Physical

activity and health: A report of the Surgeon General. Atlanta,

GA: Centers for Disease Control and Prevention, National

Center for Chronic Disease Prevention and Health Promotion.

1996.

70 Adolescent Health in the United States, 2007
Figure 32. Participation in physical activity among students in grades 9–12, 

by gender and race and Hispanic origin: United States, 2005 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Meeting currently recommended level of physical activity 

Participation in moderate to vigorous physical activity 

Male 

Female 

0 20 40 60 80 100

Percent 

NOTES: The currently recommended level of 

physical activity for students is defined as any 

kind of physical activity that increased their 

heart rate and made them breathe hard some 

of the time for a total of at least 60 minutes per 

day on 5 or more of the past 7 days; 

moderate to vigorous physical activity is 

defined as participation in at least 20 minutes 

of vigorous physical activity on 3 or more of 

the past 7 days and/or at least 30 minutes of 

moderate physical activity on 5 or more of the 

past 7 days. See data table for data points, 

data by grade level, and standard errors. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, 

Youth Risk Behavior Survey. 

Adolescent Health in the United States, 2007

71

Risk Behaviors
Risk Behaviors

Dietary Risk Behavior

Eating is controlled by many factors, including appetite, food

availability, and family, peer, and cultural practices, as well as

attempts at voluntary control. Dieting to a body weight leaner

than what is needed for health is often promoted by current

fashion trends, sales campaigns for special foods, and in

some activities and professions (1).

Teenagers who practice extreme dieting—such as fasting,

making themselves throw up, taking diet pills, or using

laxatives—are more likely to smoke, drink alcohol, use

marijuana, exercise intensely, and attempt suicide (2).

Despite taking extreme measures to lose weight, extreme

dieters are less likely to make healthy choices, such as

exercising moderately and eating five servings of fruits and

vegetables each day (2). In 2005, 12 percent of high school

students reported not eating for 24 hours or more in the

past 30 days to lose weight or to keep from gaining weight

(data table for Figure 33). Almost 5 percent of high school

students reported vomiting or taking a laxative for the same

purpose.

Female students were more than twice as likely to report

these dietary risk behaviors as male students were

(Figure 33).

Among female students, non-Hispanic black students were

significantly less likely to report vomiting or taking a laxative

than were their non-Hispanic white and Hispanic counterparts.

The proportion of male students who reported dietary risk

behaviors was similar across racial and ethnic groups.

References

1.	 Spearing M. Eating disorders: Facts about eating disorders

and the search for solutions. NIH Publication No 01–4901.

Bethesda, MD: National Institute of Mental Health. 2001

2.	 Rafiroiu AC, Sargent RG, Parra-Medina D, Drane WJ, Valois

RF. Covariations of adolescent weight-control, health-risk, and

health-promoting behaviors. Am J Health Behav 27(1): 3–14.

2003.

72 Adolescent Health in the United States, 2007
Figure 33. Dietary risk behavior in the past 30 days among students in grades 

9–12, by gender and race and Hispanic origin: United States, 2005 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Went without eating for 24 hours or more 

Vomited or took laxatives 

Male 

Female 

0 10 20 30

Percent 

40

Risk Behaviors

NOTES: Went without eating for 24 hours or 

more is defined as students who went without 

eating for 24 hours or more to lose weight or 

to keep from gaining weight during the past 

30 days; vomited or took laxatives is defined 

as students who vomited or took laxatives to 

lose weight or to keep from gaining weight 

during the past 30 days. Persons of Hispanic 

origin may be of any race. See data table for 

data points, data by grade level, and standard 

errors. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Chronic 

Disease Prevention and Health Promotion, 

Youth Risk Behavior Survey. 

Adolescent Health in the United States, 2007

73
Health Care Access and Utilization

Health Care Access and Utilization

Health Care Coverage

Access to and use of health care services for adolescents is

dependent, to a great degree, on the ability to pay for

services. Compared with their insured counterparts, the

uninsured are more likely to lack a usual source of care,

have unmet health care needs, and go without contact with a

physician during the course of the year (1).

Family income is a key factor in the likelihood that an

adolescent will be uninsured. The large majority of poor and

near poor adolescents under age 19 are eligible for public

coverage through Medicaid or State Children’s Health

Insurance Program (SCHIP). Nonetheless, in 2005, one-fifth

of adolescents in families below the poverty level had no

health insurance, compared with 8 percent of adolescents in

families with income at twice the poverty threshold or greater

(data table for Figure 34).

Adolescents 18–19 years of age are more likely to be

uninsured than younger adolescents, reflecting lower rates of

both public and private coverage (Figure 34).

Reference

1. NCHS. Health, United States, 2006, with chartbook on trends

in the health of Americans. Hyattsville, MD: National Center for

Health Statistics. 2006.

74 Adolescent Health in the United States, 2007
Figure 34. Current health care coverage of adolescents 10–19 years of age, by age 

and poverty status: United States, 2005 

Poor 

10–12 

13–15 

16–17 

18–19 

Near poor 

10–12 

13–15 

16–17 

18–19 

Nonpoor 

10–12 

13–15 

16–17 

18–19 

Uninsured Medicaid Private Other 

0 20 40 60 80 100

Percent 

ss and Utilization

NOTES: Insurance status is at the time of interview. 

Poverty status is derived from the ratio of the family’s 

income to the federal poverty threshold, given family 

size. Poor families have income less than 100 percent 

of the poverty threshold; near poor families have 

income from 100 to less than 200 percent of the 

poverty threshold; nonpoor families have income of 

200 percent of the poverty threshold or more. See 

data table for data points, data by age group, standard 

errors, and additional notes. 

SOURCE: Centers for Disease Control and Prevention, 

National Center for Health Statistics, National Health 

Interview Survey. 

Adolescent Health in the United States, 2007

75

Health Care Acce
Health Care Access and Utilization

Health Care Visits

Adolescents have lower rates of health care utilization than

those of younger and older persons, despite the health

problems that affect the adolescent population, such as

sexually transmitted diseases, emotional and behavioral

health problems, unintended pregnancy, drug and alcohol

abuse, injuries, and violence (1). Routine health care for

adolescents includes physical examinations, preventive

interventions and education, observations, and screening, as

well as sick care (2).

Among female adolescents 10–19 years of age, the

percentage without a recent health care visit varied slightly by

age (Figure 35). In contrast, older male adolescents (18–19

years of age) were more likely than their younger

counterparts to lack a recent health care visit.

Uninsured adolescents are less likely to receive care than

those with coverage. In 2005, the proportion of adolescents

who had not visited a physician or other health professional

in the past year was more than three times as high for

adolescents without health insurance as for those with health

insurance. Among uninsured adolescents, the proportion that

did not have at least one health care visit in the past year

was similar for white non-Hispanic, black non-Hispanic, and

Hispanic teenagers.

Having health insurance did not always assure that an

adolescent would have at least one health care visit in the

past year. Hispanic adolescents with health insurance were

less likely to have at least one health care visit than

non-Hispanic white and non-Hispanic black adolescents with

health insurance.

Adolescents 10–19 years of age are less likely to have

had a recent health care visit than children less than 10

years of age. In 2005, 83 percent of adolescents had one or

more contacts with a physician or other health care

professional compared with 91 percent of children less than

10 years of age (3).

References

1.	 Irwin CE, Brindis C, Langlykke K, editors. Health care reform:

Opportunities for improving adolescent health. Arlington, VA:

National Center for Education in Maternal and Child Health.

1994.

2.	 Green M, editor. Bright futures: Guidelines for health

supervision of infants, children, and adolescents. Arlington, VA:

National Center for Education in Maternal and Child Health.

1994.

3.	 CDC. National Center for Health Statistics, National Health

Interview Survey. Unpublished analysis. 2006.

76 Adolescent Health in the United States, 2007
Figure 35. Lack of a health care visit in the past 12 months among adolescents 

10–19 years of age, by age, gender, race and Hispanic origin, and insurance status: 

United States, 2005 

10–12 years 

13–15 years 

16–17 years 

18–19 years 

10–12 years 

13–15 years 

16–17 years 

18–19 years 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Male 

Female 

Insured 

Uninsured 

0 10 20 30 40 50 60

Percent 

NOTES: Health care visit is defined as being 

seen by a physician or other health professional 

in a doctor’s office, clinic, or some other place. 


Excluded are visits to emergency rooms, 

hospitalization, home visits, and telephone 

calls. Persons of Hispanic origin may be of any 

race. See data table for data points, standard 


errors, and additional notes.
 

SOURCE: Centers for Disease Control and 


Prevention, National Center for Health Statistics, 


National Health Interview Survey. 


Adolescent Health in the United States, 2007

77

Health Care Access and Utilization
Health Care Access and Utilization

Health Care Expenses

In 2004, 80 percent of adolescents 10–21 years of age

incurred out-of-pocket expenses for health care (Figure 36).

Adolescents with expenses incurred, on average, $1,514 of

out-of-pocket expenses annually (data table for Figure 36).

Female adolescents (83 percent) were more likely to have

incurred out-of-pocket health care expenses than their male

counterparts (76 percent).

The proportion of adolescents with out-of-pocket health

care expenses decreased with age (data table for Figure 36).

Out-of-pocket health care expense varied by race and

ethnicity. In 2004, 86 percent of non-Hispanic white

adolescents 10–21 years of age had out-of-pocket expenses

compared with 71 percent of non-Hispanic black adolescents

and 65 percent of Hispanic adolescents.

Out-of-pocket health care expenses also varied by

insurance coverage. In 2004, adolescents with public or

private health insurance were considerably more likely to

have incurred out-of-pocket expenses than those without

health insurance; only one-half of the uninsured had incurred

out-of-pocket expenses compared with more than

three-fourths of those with public or private coverage.

Among those with out-of-pocket expenses, the average

annual amount spent out-of-pocket was higher for insured

adolescents than for those who were uninsured; on average,

adolescents with any private insurance spent $1,581

out-of-pocket annually, and adolescents with only public

insurance spent $1,439 annually, compared with $1,087 spent

by adolescents who were uninsured (data table for Figure 36).

78 Adolescent Health in the United States, 2007
Figure 36. Any out-of-pocket expenses for health care incurred by adolescents 

10–21 years of age, by gender, race and Hispanic origin, and insurance status: 

United States, 2004 

All 

Gender 

Male 

Female 

Race and Hispanic origin 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Insurance status 

Private 

Public only 

Uninsured 

0 20 40 

Percent 

60 80

Health Care Access and Utilization

NOTES: Expenses include inpatient hospital 


and physician services, ambulatory physician 


and nonphysician services, home health 


services, dental services, and other medical 


equipment, supplies, and services that were
 

purchased or rented during 2004. Persons of 


Hispanic origin may be of any race. See data 


100

table for data points, data by age groups, and 

standard errors. 

SOURCE: Agency for Healthcare Research 

and Quality, Center for Cost and Financing 

Studies, Medical Expenditure Panel Survey. 

Adolescent Health in the United States, 2007

79
Health Care Access and Utilization

Medical Prescription Expenses

In 2004, 45 percent of adolescents 10–21 years of age

incurred out-of-pocket expenses for prescribed medication

during the calendar year (Figure 37). The proportion of

adolescents with prescription drug expenses was similar

across all age groups. Female adolescents (49 percent) were

more likely than males (41 percent) to have out-of-pocket

prescription expenses.

The proportion of adolescents with out-of-pocket

prescription expenses varied by race and ethnicity. In 2004,

more than one-half of non-Hispanic white adolescents 10–21

years of age had out-of-pocket prescription expenses

compared with about one-third of non-Hispanic black and

Hispanic adolescents.

Out-of-pocket prescription expenses also varied by

insurance status. In 2004, the proportion of adolescents who

had out-of-pocket expenses in the past year was almost twice

as high for adolescents with private or public health insurance

as for those without health insurance.

In 2004, the average out-of-pocket prescription expense

for adolescents with expenses was $389 (data table for

Figure 37).

The average annual amount spent out-of-pocket for

prescribed medication among those with any expense was

twice as high for insured adolescents as for those who were

uninsured. Adolescents with any private insurance spent, on

average, $394 annually on prescriptions, and adolescents with

only public insurance spent $432 annually, compared with

$204 spent by adolescents who were uninsured.

80 Adolescent Health in the United States, 2007
Figure 37. Any out-of-pocket expenses for prescribed medicine incurred by 

adolescents 10–21 years of age, by gender, race and Hispanic origin, and 

insurance status: United States, 2004 

All 

Gender 

Male 

Female 

Race and Hispanic origin 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Insurance status 

Private 

Public only 

Uninsured 

0 20 40 60 80

Percent 

100

Health Care Access and Utilization

NOTES: Expenses include all prescribed 

medications that were purchased or refilled 

during 2004. Persons of Hispanic origin may 

be of any race. See data table for data points 

graphed, data by age groups, and standard 

errors. 

SOURCE: Agency for Healthcare Research 

and Quality, Center for Cost and Financing 

Studies, Medical Expenditure Panel Survey. 

Adolescent Health in the United States, 2007

81
Health Care Access and Utilization

Unmet Health Care Needs for

Adolescents with Special Health Care

Needs

Consistent access to a wide range of health care services is

particularly important for adolescents with special health care

needs (SHCN) (1). Adolescents with SHCN are defined as

‘‘those who have a chronic physical, developmental,

behavioral, or emotional condition and who also require health

and related services of a type or amount beyond that

required by [adolescents] generally’’ (1). Adolescents meeting

the definition represent a wide range of levels of functional

abilities, and they need access to a broad array of medical

and support services to maintain their physical, mental, and

emotional health and development.

Sixteen percent of adolescents 10–17 years of age had

SHCN in 2001. Male adolescents were more likely to have

special needs (18 percent) than female adolescents were

(13 percent) (1).

Need for a particular service was based on parental

report of the perceived need for that service. Among the most

commonly needed services for adolescents with SHCN are

dental care, specialist care, preventive care, prescription

medication, and eyeglasses or vision care (Figure 38b). The

services that parents most commonly perceived as being

needed among adolescents with SHCN were prescription

medications (87 percent) and dental care (85 percent).

A specific service need was considered unmet if the

parent reported that an adolescent did not receive all of the

service that the parent perceived as being needed.

Adolescents may not receive services they need for various

reasons, including financial barriers, lack of access to

providers, competing demands on families’ time, and

adolescents’ willingness to receive care (1).

In 2001, 19 percent of adolescents with SHCN were

reported to have an unmet need for one or more health care

services (Figure 38a). Almost 11 percent of those needing

dental care did not receive all that was needed, whereas only

2 percent who needed prescription medication did not receive

all the medications needed.

Services needed but not obtained were most common

among uninsured adolescents; almost one-half of uninsured

adolescents had at least one unmet need.

References

1.	 U.S. Department of Health and Human Services, Health

Resources and Services Administration, Maternal and Child

Health Bureau. The National survey of children with special

health care needs: Chartbook 2001. Rockville, MD: U.S.

Department of Health and Human Services. 2004.

82 Adolescent Health in the United States, 2007
Figure 38a. Unmet health service needs among adolescents 10–17 years of age 

with special health care needs, by number of services needed but not obtained and 

insurance status: United States, 2001 

All 

Uninsured 

Private and public 

Public only 

Private only 

More than one service One service

0 10 20 30 40 50

Percent 

Figure 38b. Selected health service needs among adolescents 10–17 years of age

 0

 60

0 


with special health care needs, by type of service needed: United States, 2001 

Dental care 

Mental health care 

Specialist care 

PT/OT/Speech therapy 

Preventive care 

Eyeglasses or vision care 

Prescription medication 

Medical supplies 

Unmet need 

0 10 20 30 40 50 60 70 80 90 1

Percent needing service 

Health Care Access and Utilization

NOTES: Unmet need is defined as not 

receiving all of the service that was needed 

and is based on parents’ perceived need. PT 

is physical therapy and OT is occupational 

therapy. See data table for data points, 

standard errors, and additional notes. 

SOURCE: Centers for Disease Control and 

Prevention, National Center for Health 

Statistics, National Survey of Children with 

Special Health Care Needs. 

Adolescent Health in the United States, 2007

83
Health Care Access and Utilization

Family Planning and Reproductive Health

Medical Services

To meet reproductive health care needs of adolescents and

young adults, routine family planning and reproductive health

care services are available in a wide range of settings,

including community-based clinics, school-based and

school-linked health clinics, family planning clinics, and

physicians’ offices. These services are also available through

health maintenance organizations (HMOs). Sexual and

reproductive health services encompass three main areas:

contraceptive services, maternal health services, and services

related to STDs, including HIV or AIDS.

The Family Planning Program, authorized under Title X of the

Public Health Act, is the only federal program that is solely

for the provision of family planning and reproductive health

care. Title X was designed to make contraceptive supplies

and services available to low-income and uninsured

women (1). Title X clinics also provide a number of preventive

health services such as pelvic exams, STD and HIV

screening, and pregnancy diagnosis and counseling. Women

served by the clinic system are generally young and low

income (2). Those who are employed often work at entry-level

jobs that offer no health benefits, and many are still in school.

In 2002, the percentage of young women who received at

least one family planning or reproductive health service in the

past year increased with age from 38 percent at ages 15–17

years to 81 percent at ages 20–24 years (Figure 39).

Among young women 15–24 years of age who received

at least one family planning or reproductive health service,

the proportion who received services from a private doctor or

HMO increased with age. In contrast, the proportion who

received services at a Title X clinic decreased with age, from

30 percent of 15–17 year-olds to 18 percent of 20–24

year-olds.

References

1. Office of Population Affairs. Office of Family Planning

homepage. [cited 2007 June 8]. Available from:

www.hhs.gov/opa/familyplanning/index.html. 2007.

2. Alan Guttmacher Institute. Fullfilling the promise: Public policy

and U.S. family planning clinics. New York, NY: Alan

Guttmacher Institute. [cited 2007 June 8]. Available from:

http://www.guttmacher.org/pubs/fulfill.pdf. 2000.

84 Adolescent Health in the United States, 2007
Figure 39. Receipt of at least one family planning or reproductive health medical 

service in the past year among female adolescents 15–19 years of age and young 

adults 20–24 years of age, by type of provider and age group: United States, 2002 

100 

80 

60 

At least one family planning 

or medical service 

Private doctor or HMO 

Title X clinics only 

Any clinic (includes 

Title X clinics) 

Other 

15–17 years 18–19 years 20–24 years 

Percent 

40 

20 

0 

Age 

Health Care Access and Utilization

NOTES: Family planning services include sterilizing 

operation, birth control method, checkup or medical test 

related to birth control, counseling about birth control, 

counseling about getting sterilized, mergency 

contraception, or counseling about mergency 

contraception. Medical services include Pap smear, pelvic 

exam, prenatal care, postpartum care, counseling, testing 

or treatment for sexually transmitted infections, abortion, 

or pregnancy test. Percent in Title X clinics is also 

included in any clinic. HMO is health maintenance 

organization. Other is any other place not listed. 

Percentages for provider types do not add to total who 

“received at least one family planning or medical service” 

because women may have received more than one 

service and reported more than one provider. See data 

table for data points. 

SOURCE: Centers for Disease Control and Prevention, 

National Center for Health Statistics, National Survey of 

Family Growth. 

Adolescent Health in the United States, 2007

85
Health Care Access and Utilization

Dental Visits

Professional preventive dental care on a routine basis may

prevent oral disease or disclose existing disease in its early

stages. The adolescent patient whose oral health has not

been monitored routinely by a dentist may have advanced

caries, periodontal disease, or other oral involvement in need

of professional evaluation and treatment (1).

Good nutrition and oral hygiene care practiced at home are

particularly important during the teen years. Proper diet,

brushing, and flossing play an important role in maintaining

and preserving healthy teeth. Dental sealants—plastic

coatings applied by a dentist to the chewing surfaces of the

back teeth—and use of fluoride are also effective preventive

measures (2).

In 2005, 71 percent of adolescents 10–19 years and

young adults 20–24 years had at least one dental visit in the

past year. The proportion with a recent dental visit decreased

with age, from 84 percent for adolescents 10–15 years of age

to 73 percent for those 16–19 years of age, and 54 percent

for young adults 20–24 years of age (data table for

Figure 40).

The proportion of adolescents and young adults with a

recent dental visit varied by race and Hispanic origin.

Non-Hispanic white adolescents and young adults were more

likely to have a dental visit than their non-Hispanic black and

Hispanic counterparts (Figure 40). The disp

groups.

arities were

apparent in all age

Disparities in the proportion with a recent dental visit were

also apparent by socioeconomic status. Adolescents from

families with incomes at 200 percent of the poverty threshold

or more were significantly more likely to have a dental visit

than were adolescents in families near or below the poverty

threshold.

References

1. American Academy of Pediatric Dentistry, Clinical Affairs

Committee. Guideline on adolescent oral health care. Clinical

Guidelines 2005.

2. CDC. Oral health: Preventing cavities, gum disease, and tooth

loss—At a glance 2008 [online]. [cited 2008 April 22]. Available

from: www.cdc.gov/nccdphp/publications/aag/doh.htm. 2008.

86 Adolescent Health in the United States, 2007
Figure 40. At least one dental visit in the past year among adolescents 10–19 years 

of age and young adults 20–24 years of age, by age group, race and Hispanic origin, 

and poverty status: United States, 2005 

10–15 years 16–19 years 20–24 years 

Race and Hispanic origin 

All races and origins 

White only, not Hispanic 

Black only, not Hispanic 

Hispanic 

Poverty status 

Poor 

Near poor 

Nonpoor 

0 25 50 75 100 

Percent 

NOTES: Poverty status is derived from the 

ratio of the family’s income to the federal 

poverty threshold, given family size. Poor 

families have income less than 100 percent of 


the poverty threshold; near poor families have 

income from 100 to less than 200 percent of 

the poverty threshold; nonpoor families have 

income of 200 percent of the poverty 


threshold or more. Persons of Hispanic origin 


may be of any race. See data table for data 


points and standard errors.
 

SOURCE: Centers for Disease Control and 


Prevention, National Center for Health 


Statistics, National Health Interview Survey.
 

Adolescent Health in the United States, 2007

87

Health Care Access and Utilization
Data Tables for Figures 1–40

Data table for Figure 1. Distribution of adolescents 10–19 years of age by race and Hispanic origin

(percent): United States, 1980–2050

Race and Hispanic origin Race

White, Black, American Asian or Two or

not not Indian or Pacific more

Year Hispanic Hispanic Hispanic White Black Alaska Native Asian Islander races

1980 .................... 75.6 14.2 7.9 83.1 14.5 0.8 --­ 1.6 --­

1985 .................... 72.5 14.5 9.7 81.5 15.0 1.0 --­ 2.6 --­

1990 .................... 69.4 14.7 11.7 80.1 15.3 1.1 --­ 3.4 --­

1995 .................... 67.0 14.8 13.4 79.4 15.5 1.2 --­ 3.9 --­

2000 .................... 63.3 14.7 15.5 77.5 15.3 1.3 3.7 --­ 2.0

2005 .................... 60.7 15.0 17.5 76.6 15.8 1.3 3.8 --­ 2.4

Projected

2010 .................... 57.8 --­ 20.0 76 15.5 --­ 4.2 --­ --­

2020 .................... 53.7 --­ 23.1 74.6 15.3 --­ 4.9 --­ --­

2030 .................... 51.0 --­ 24.7 73.2 15.5 --­ 5.4 --­ --­

2040 .................... 47.6 --­ 27.0 71.7 15.4 --­ 6.2 --­ --­

2050 .................... 44.3 --­ 28.9 69.8 15.7 --­ 7.0 --­ --­

- - - Category not applicable.

NOTES: Standard errors are not available. Data are for the resident population. Persons of Hispanic origin may be of any race. Race data for 2000 and beyond

conform to the 1997 Office of Management and Budget Standards for Federal Data on Race and Ethnicity and are not directly comparable with data for earlier

years. Individuals could report only one race in 1980–1995, and more than one race beginning in 2000. Persons who selected only one race in 2000 and

beyond are shown in single-race categories; persons who selected more than one race in 2000 and beyond are shown as having 2 or more races and are not

included in the single-race categories. In 1980–1995, the Asian category includes Asian and Native Hawaiian or other Pacific Islander; in 2000 and beyond this

category included only Asian.

SOURCES: U.S. Census Bureau. Population data for 1980 and 1985 are from: U.S. population estimates by age, sex, race, and Hispanic origin: 1980–1991.

Current Population Reports. Series P-25, No. 1095. Washington: U.S. Government Printing Office, Feb 1993.

Population data for 1990 and 1995 are from: National Center for Health Statistics. Bridged-race intercensal estimates of the July 1, 1990–July 1, 1999,

United States resident population by county, single-year of age, sex, race, and Hispanic origin, prepared by the U.S. Census Bureau with support from the

National Cancer Institute. 2004. [cited 2007 June 24]. Available from: www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm.

Population data for 2000–2005 are from: U.S. population estimates by age, sex, race, and Hispanic origin: July 1, 2005. [cited 2007 June 24]. Available from:

www.census.gov/ipc/www/usinterimproj/.

Population estimates for 2010–2050 are from: U.S. interim projections by age, sex, race, and Hispanic origin (internet). Available from:

www.census.gov/population/www/usinterimproj.html.

88 Adolescent Health in the United States, 2007
Data table for Figure 2. Poverty status among adolescents 10–17 years of age, by family structure and

race and Hispanic origin: United States, 2005

Family structure, race, and Hispanic origin Poor Near poor

Percent

All adolescents:

All races and origins ................................

White only, not Hispanic .............................

Black only, not Hispanic .............................

Hispanic ........................................

15.5

8.6

31.1

25.9

20.3

15.0

26.4

32.8

Adolescents in married couple families:

All races and origins ................................

White only, not Hispanic .............................

Black only, not Hispanic .............................

Hispanic ........................................

7.2

3.5

12.8

17.6

16.6

11.6

19.8

34.1

Adolescents in female householder families:

All races and origins ................................

White, not Hispanic ................................

Black, not Hispanic ................................

Hispanic ........................................

36.1

26.5

44.2

45.8

29.1

26.4

30.9

32.3

NOTES: Standard errors are not available. Poverty status is derived from the ratio of the family’s income to the federal poverty threshold, given family size.

Poor families have income less than 100 percent of the poverty threshold; near poor families have income from 100 to less than 200 percent of the poverty

threshold; nonpoor families have income of 200 percent of the poverty threshold or more. Persons of Hispanic origin may be of any race.

SOURCE: U.S. Census Bureau, Current Population Survey, March Supplement 2006.

Adolescent Health in the United States, 2007

89

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 3. Status dropout rates among adolescents and young adults 16–24 years of age,

by age, gender, and race and Hispanic origin, and region: United States, 2004

Percent

Status distribution

dropout of all

Characteristic rate SE1 dropouts SE1

Age

16 years .............................. 3.8 0.4 4.5 0.5

17 years .............................. 5.2 0.5 5.6 0.6

18 years ............................. 10.6 0.7 10.6 0.7

19 years ............................. 11.2 0.7 11.7 0.8

20–24 years ........................... 12.6 0.3 67.6 1.1

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 0.2 100.0 n/a

Gender

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.6 0.3 56.8 1.2

Female ............................... 9.0 0.3 43.2 1.2

Race and Hispanic origin

Hispanic .............................. 23.8 0.7 39.8 1.3

Not Hispanic:

White .............................. 6.8 0.2 40.6 1.2

Black or African American ............... 11.8 0.7 15.8 0.9

Asian/Pacific Islander ................... 3.6 0.9 1.5 0.3

More than one race .................... 6.1 1.5 1.0 0.3

Region

Northeast ............................. 8.8 0.5 16.3 0.8

Midwest .............................. 8.0 0.4 17.8 0.9

South ............................... 11.4 0.4 39.1 1.2

West ................................ 12.2 0.6 26.9 1.1

1

SE is standard error.

NOTES: Status dropout rate is the percentage of the civilian noninstitutionalized population 16–24 years of age who are not in high school and have not earned

a high school credential (either a diploma or equivalency credential such as a General Education Development [GED] certificate), irrespective of when they

dropped out. Beginning in 2003, respondents were able to identify themselves as being more ‘‘than one race.’’ Persons who reported only one race are included

in single-race categories; persons who reported more than one race are shown as having two or more races and are not included in single-race categories.

Persons of Hispanic origin may be of any race. Due to small sample size, American Indians or Alaska Natives are included in the total but are not shown

separately.

SOURCE: U.S. Census Bureau, Current Population Survey, October 2004.

90 Adolescent Health in the United States, 2007
Data table for Figure 4. Limitation of activity caused by selected chronic health conditions among

adolescents 10–17 years of age, by gender, race and Hispanic origin, and poverty status: United States,

average annual 2004–2005

Total

Gender

Male Female

Type of chronic health condition Rate SE1 Rate 1 SE Rate SE1

Conditions per 1,000 population

Any chronic condition ......................... 8.6 0.2 10.7 0.3 6.4 0.3

Learning disability ............................ 26.1 1.2 29.4 1.7 22.7 1.6

Attention Deficit/Hyperactivity Disorder ............. 23.0 1.2 34.8 1.9 10.7 1.1

Other mental, emotional, or behavioral problem ...... 14.4 0.9 20.0 1.4 8.6 1.0

Mental retardation or other developmental problem..... 11.0 0.8 12.9 1.1 9.0 1.0

Asthma or breathing problem . . . . . . . . . . . . . . . . . . . . 5.8 0.6 6.0 0.8 5.5 0.8

Speech problem ............................. 7.4 0.6 9.7 1.0 5.0 0.7

Race and Hispanic origin

White only, not Hispanic Black only, not Hispanic Hispanic

Any chronic condition .........................

Rate 1 1 SE Rate SE 1 Rate SE

9.0 0.3 9.9 0.6 6.8 0.4

Learning disability ............................ 26.3 1.6 28.3 3.0 23.7 2.2

Attention Deficit/Hyperactivity Disorder ............. 24.0 1.5 28.6 3.3 14.7 1.8

Other mental, emotional, or behavioral problem ...... 13.3 1.1 21.2 2.8 12.1 1.5

Mental retardation or other developmental problem .... 10.9 1.0 12.9 2.1 10.2 1.4

Asthma or breathing problem . . . . . . . . . . . . . . . . . . . . 5.0 0.7 9.6 1.8 4.8 1.1

Speech problem ............................. 7.8 0.8 6.3 1.4 6.9 1.2

Poverty status

Poor Near poor Not poor

Any chronic condition .........................

Rate 1 1 SE Rate SE 1 Rate SE

12.1 0.6 10.0 0.6 7.3 0.3

Learning disability ............................ 34.6 3.3 31.3 3.2 22.0 1.5

Attention Deficit/Hyperactivity Disorder ............. 30.7 3.5 26.4 2.8 19.9 1.4

Other mental, emotional, or behavioral problem ...... 23.8 2.7 17.7 2.1 10.7 1.0

Mental retardation or other developmental problem .... 15.4 2.2 13.2 2.0 9.0 0.9

Asthma or breathing problem . . . . . . . . . . . . . . . . . . . . 11.1 2.1 5.7 1.3 4.3 0.6

Speech problem ............................. 7.7 1.6 8.8 1.5 6.8 0.8

1

SE is standard error.

NOTES: Data are for noninstitutionalized adolescents. Adolescents with limitation of activity caused by chronic health conditions were either identified by current

use of special education or by a limitation in their ability to perform activities usual for their age group because of a physical, mental, or emotional problem.

Conditions refer to response categories in the National Health Interview Survey. The selected health conditions are classified as chronic in this analysis. These

conditions are not mutually exclusive: adolescents who were reported to have more than one chronic health condition as the cause of their activity limitation

were counted in each reported category. Persons of Hispanic origin may be of any race. The income groups are derived from the ratio of the family’s income to

the federal poverty threshold, given family size. Poor families have income less than 100 percent of the poverty threshold; near poor families have income from

100 to less than 200 percent of the poverty threshold; nonpoor families have income of 200 percent of the poverty threshold or more.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Adolescent Health in the United States, 2007

91

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 5a. Overweight among adolescents 12–19 years of age: United States, selected

years 1966–1970 through 2003–2004

Year Percent SE1

1966–1970 ............................ 4.6 0.3 
 

1971–1974 ............................ 6.1 0.6 
 

1976–1980 ............................ 5.0 0.5 
 

1988–1994 ............................ 10.5 0.9 
 

1999–2000 ............................ 14.9 0.9 
 

2001–2002 ............................ 16.7 1.1 
 

2003–2004 ............................ 17.4 1.7 
 

1

SE is standard error.

NOTES: Overweight is defined as body mass index (BMI) at or above the gender- and age-specific 95th percentile BMI cutoff points from the 2000 CDC Growth

Charts: United States. Advance data from vital and health statistics; no 314. Hyattsville, Maryland: National Center for Health Statistics. 2000. Age is at the time

of examination at mobile examination center. Estimates for females exclude pregnant adolescents.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.

Data table for Figure 5b. Overweight among adolescents 12–19 years of age, by gender, race and

Hispanic origin, and poverty status: United States, average annual 2001–2004

Male Female

Race and Hispanic origin Percent 1 SE Percent 1 SE

ll races and origins .......................... 17.9 1.2 16.0 1.5 
 

ot Hispanic:

White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 1.7 14.6 2.0

Black only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 1.4 23.8 1.6

exican ................................... 20.0 1.5 17.1 1.7 
 

Poverty status

All adolescents

Percent SE

oor ..................................... 18.2 1.5

ear poor.................................. 17.0 1.8

onpoor................................... 16.3 1.4

A

N

M

P

N

N

1

SE is standard error.

NOTES: Overweight is defined as body mass index (BMI) at or above the gender- and age-specific 95th percentile BMI cutoff points from the 2000 CDC Growth

Charts: United States. Advance data from vital and health statistics; no 314. Hyattsville, Maryland: National Center for Health Statistics. 2000. Age is at the time

of examination at mobile examination center. Estimates for females exclude pregnant adolescents. All races category includes adolescents of all races and

Hispanic origins, not just those shown separately. The two non-Hispanic race categories shown in the table conform to the 1997 OMB Standards for Federal

Data on Race and Ethnicity; estimates are for persons who reported only one racial group. Persons of Mexican origin may be of any race. The income groups

are derived from the ratio of the family’s income to the federal poverty threshold, given family size. Poor families have income less than 100 percent of the

poverty threshold; near poor families have income from 100 to less than 200 percent of the poverty threshold; nonpoor families have income of 200 percent of

the poverty threshold or more.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey

92 Adolescent Health in the United States, 2007
Data table for Figure 6. Untreated dental caries among adolescents 12–19 years of age and young adults

20–24 years of age, by age, race and Hispanic origin, poverty status, and gender: United States, average

annual 2001–2004

12–15 years 16–19 years 20–24 years

Race and Hispanic origin,

poverty status, and gender Percent SE1 Percent SE1 Percent SE1

Total................................. 16 1.2 21.2 1.7 29.9 2.4

Not Hispanic:

White only .......................... 13.3 2.0 17.0 2.1 25.5 3.8

Black only ........................... 20.5 1.7 30.4 2.3 41.0 4.3

Mexican .............................. 22.0 2.6 27.9 2.3 35.4 4.3

Poor................................. 26.1 3.4 28.8 3.2 34.6 5.9

Near poor ............................. 22.6 2.4 27.3 3.4 33.4 3.7

Nonpoor .............................. 10.0 1.2 13.5 1.6 22.6 3.3

Male ................................ 15.2 1.4 22.4 1.8 32.9 3.2

Female ............................... 16.8 1.8 19.9 2.3 27.2 2.8

1

SE is standard error.

NOTES: Untreated dental caries refers to untreated coronal caries, that is caries on the crown or enamel surface of the tooth. Root caries are not included.
 

Total category includes adolescents of all races and Hispanic origins, not just those shown separately. The two non-Hispanic race categories shown in the table
 

conform to the 1997 OMB Standards for Federal Data on Race and Ethnicity; estimates are for persons who reported only one racial group. Persons of Mexican
 

origin may be of any race. The income groups are derived from the ratio of the family’s income to the federal poverty threshold, given family size. Poor families
 

have income less than 100 percent of the poverty threshold; near poor families have income from 100 to less than 200 percent of the poverty threshold;
 

nonpoor families have income of 200 percent of the poverty threshold or more.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey.
 

Adolescent Health in the United States, 2007

93

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 7. Suicide ideation and attempts among students in grades 9–12, by grade level,

gender, and race and Hispanic origin; United States, 2005

Grade level, race, and

Hispanic origin

All students

Percent SE1

Male

Percent SE1

Female

Percent SE1

Seriously considered suicide

All students, grades 9–12 .................

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . .

10th grade...........................

11th grade ...........................

12th grade...........................

16.9

17.9

17.3

16.8

14.8

0.5

1.1

0.8

0.9

0.9

12.0

12.2

11.9

11.9

11.6

0.5

1.4

1.0

1.0

1.1

21.8

23.9

23.0

21.6

18.0

0.7

1.3

1.0

1.5

1.4

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

16.9

12.2

17.9

0.6

0.8

0.9

12.4

7.0

11.9

0.7

0.9

1.1

21.5

17.1

24.2

0.9

1.1

1.6

Suicide attempt

All students, grades 9–12 .................

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . .

10th grade...........................

11th grade ...........................

12th grade...........................

8.4

10.4

9.1

7.8

5.4

0.4

0.8

0.7

0.8

0.6

6.0

6.8

7.6

4.5

4.3

0.6

1.3

1.1

0.8

0.8

10.8

14.1

10.8

11.0

6.5

0.5

0.9

0.9

1.3

0.8

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

7.3

7.6

11.3

0.5

1.1

0.8

5.2

5.2

7.8

0.6

1.4

1.2

9.3

9.8

14.9

0.8

1.2

1.1

Injurious suicide attempt

All students, grades 9–12 .................

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . .

10th grade...........................

11th grade ...........................

12th grade...........................

2.3

3.0

2.3

2.2

1.6

0.2

0.4

0.3

0.4

0.3

1.8

2.1

2.2

1.4

1.0

0.2

0.6

0.5

0.4

0.3

2.9

4.0

2.4

2.9

2.2

0.3

0.6

0.4

0.6

0.4

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

2.1

2.0

3.2

0.2

0.4

0.5

1.5

1.4

2.8

0.3

0.6

0.7

2.7

2.6

3.7

0.4

0.5

0.7

1

SE is standard error.

NOTES: Response is for the 12 months preceding the survey. Among students attempting suicide, 13 percent did not report seriously considering suicide. A

subset of those attempting suicide had an injurious suicide attempt. An injurious suicide attempt resulted in an injury, poisoning or overdose that was treated by

a doctor or nurse. Students with an injurious suicide attempt are also included in the category ‘‘suicide attempt.’’ Persons of Hispanic origin may be of any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

94 Adolescent Health in the United States, 2007
Data table for Figure 8. Emergency department visit, hospital discharge, and death rates among

adolescents 10–19 years of age, by age and gender: United States, average annual 2002–2004

Male Female

Age Rate SE1 Rate SE1

Emergency department visits

10 years .............................

11 years .............................

12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 years .............................

14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,552.4

2,663.6

2,945.7

2,487.1

2,829.4

2,972.0

2,768.4

3,060.0

3,413.9

3,482.0

Visits per 10,000 adolescents

165.0 2423.5

196.9 2,482.5

192.6 2,144.1

178.2 2,305.8

170.1 3,005.0

168.4 2,833.9

164.8 3,864.2

192.2 4,423.7

170.2 5,346.8

192.3 5,444.4

170.0

171.0

170.7

137.4

213.0

175.3

218.4

233.6

263.3

276.2

Hospital discharges

10 years .............................

11 years .............................

12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

245.8

234.5

255.0

255.0

299.6

342.8

322.8

331.6

330.6

309.7

Discharges per 10,000 adolescents

27.3 190.8

24.1 234.6

29.9 214.1

28.5 271.5

30.5 349.8

33.2 477.3

29.2 632.1

24.9 863.9

20.6 1078.8

20.6 1362.0

26.6

31.4

24.0

29.2

33.3

36.3

39.6

46.6

54.7

64.6

Deaths

10 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

14 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

16 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.7

1.7

2.2

2.5

3.2

4.4

7.2

9.1

12.0

13.6

Deaths per 10,000 adolescents

0.0 1.3

0.1 1.3

0.1 1.4

0.1 1.7

0.1 2.0

0.1 2.5

0.1 3.7

0.1 4.2

0.1 4.8

0.2 4.7

0.0

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.0 Quantity more than zero but less than 0.05.
 

1

SE is standard error.
 

NOTE: See ‘‘Technical Notes’’ for discussion of emergency department visits, hospital discharges, and death rates.
 

SOURCES: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey, National
 

Hospital Discharge Survey, and National Vital Statistics System, Mortality File.
 

Adolescent Health in the United States, 2007

95

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 9. Initial emergency department visit rates for injury among adolescents 10–19

years of age, by age and gender: United States, average annual 2002–2004

Injury

Age and gender Rate SE1

Male Visits per 10,000 adolescents

10–11 years .......................................

12–13 years .......................................

14–15 years .......................................

16–17 years .......................................

18–19 years .......................................

1,295.7

1,502.0

1,606.3

1,539.0

1,608.9

72.5

88.9

91.9

86.7

88.0

Female

10–11 years .......................................

12–13 years .......................................

14–15 years .......................................

16–17 years .......................................

18–19 years .......................................

949.7

839.2

1,179.0

1,329.3

1,403.3

78.4

69.0

85.6

80.0

95.0

1

SE is standard error.
 

NOTE: See ‘‘Technical Notes’’ for discussion of emergency department visits.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.
 

96 Adolescent Health in the United States, 2007
Data table for Figure 10. Initial emergency department visit rates for selected external causes of injury

among adolescents 10–19 years of age, by age and gender: United States, average annual 2002–2004

Male Female

Age and cause of injury Rate SE1 Rate SE1

Struck by or against Visits per 10,000 adolescents

10–11 years ........................... 363.9 38.5 163.5 25.2

12–13 years ........................... 456.9 42.8 171.8 25.6

14–15 years ........................... 558.2 48.1 287.0 41.8

16–17 years ........................... 435.2 42.1 252.9 33.7

18–19 years ........................... 435.9 40.2 221.3 31.9

Cut or pierce

10–11 years ........................... 92.4 19.5 77.3 17.0

12–13 years ........................... 97.1 16.9 43.5 9.9

14–15 years ........................... 168.7 25.4 60.8 12.0

16–17 years ........................... 126.3 18.5 109.8 20.4

18–19 years ........................... 207.7 29.3 69.7 14.5

Fall

10–11 years ........................... 250.1 27.3 260.4 29.0

12–13 years ........................... 322.9 34.5 209.0 26.9

14–15 years ........................... 280.9 30.6 216.4 27.6

16–17 years ........................... 240.6 34.8 185.1 28.2

18–19 years ........................... 195.2 25.3 169.3 28.6

Motor vehicle traffic

10–11 years ........................... 96.4 21.2 66.1 16.4

12–13 years ........................... 76.5 14.2 70.0 17.5

14–15 years ........................... 80.7 18.3 141.9 23.5

16–17 years ........................... 262.6 35.2 316.5 35.9

18–19 years ........................... 247.3 38.6 390.6 42.4

1

SE is standard error.
 

NOTE: See ‘‘Technical Notes’’ for discussion of emergency department visits.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.
 

Adolescent Health in the United States, 2007

97

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 11. Initial emergency department visit rates for selected injury diagnoses among

adolescents 10–19 years of age, by age and gender: United States, average annual 2002–2004

Male Female

Age and injury diagnosis Rate SE1 Rate SE1

Fractures Visits per 10,000 adolescents

10–11 years ........................... 204.7 26.0 165.3 26.1

12–13 years ........................... 305.7 38.1 116.6 21.8

14–15 years ........................... 351.9 34.8 85.3 18.2

16–17 years ........................... 148.8 23.2 120.1 21.6

18–19 years ........................... 161.6 23.5 80.4 20.5

Sprains and strains

10–11 years ........................... 157.6 26.1 172.8 29.7

12–13 years ........................... 267.0 33.8 215.4 26.1

14–15 years ........................... 321.2 38.8 364.7 49.3

16–17 years ........................... 303.4 34.9 358.6 51.8

18–19 years ........................... 297.3 33.8 386.9 45.2

Open wounds

10–11 years ........................... 340.8 44.3 176.5 25.2

12–13 years ........................... 343.0 34.0 123.7 22.5

14–15 years ........................... 316.1 30.6 132.0 24.2

16–17 years ........................... 322.7 35.0 171.8 26.6

18–19 years ........................... 475.5 45.9 163.3 21.8

Contusions

10–11 years ........................... 305.1 37.5 193.7 32.2

12–13 years ........................... 226.4 27.4 169.5 27.3

14–15 years ........................... 263.8 30.8 219.1 26.6

16–17 years ........................... 298.3 34.8 249.3 34.2

18–19 years ........................... 237.3 30.5 263.5 40.9

1

SE is standard error.
 

NOTE: See ‘‘Technical Notes’’ for a discussion of emergency department visits.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.
 

98 Adolescent Health in the United States, 2007
Data table for Figure 12. Emergency department visit rates for selected noninjury diagnoses among

adolescents 10–19 years of age, by age and gender: United States, average annual 2002–2004

Age and diagnosis

Male

Rate

Female

1 Rate SE 1 SE

Upper respiratory infections Visits per 10,000 adolescents

10–11 years ........................... 268.4 45.6 311.7 37.5
 

12–13 years ........................... 163.4 22.9 292.7 35.7
 

14–15 years ........................... 196.9 31.9 244.2 33.8
 

16–17 years ........................... 181.3 25.5 288.3 41.7
 

18–19 years ........................... 223.2 33.0 345.5 37.7
 

Asthma

10–11 years ........................... 94.0 21.1 66.6 15.2 
 

12–13 years ........................... 57.3 15.2 52.4 13.7 
 

14–15 years ........................... 61.7 15.0 61.8 13.8 
 

16–17 years ........................... 75.9 20.3 90.0 24.0 
 

18–19 years ........................... 42.7 11.7 65.0 15.3 
 

Abdominal symptoms

10–11 years ........................... 156.1 24.8 222.2 30.4
 

12–13 years ........................... 138.4 24.3 154.0 26.1
 

14–15 years ........................... 73.6 17.3 209.3 28.8
 

16–17 years ........................... 91.0 22.0 301.3 34.7
 

18–19 years ........................... 133.4 21.5 377.1 41.0
 

Sexually transmitted diseases

10–11 years ........................... * * * * 
 

12–13 years ........................... * * * *
 

14–15 years ........................... * * * *
 

16–17 years ........................... * * 61.4 14.8 
 

18–19 years ........................... * * 134.0 23.8
 

Urinary tract infections

10–11 years ........................... * * 77.0 21.2 
 

12–13 years ........................... * * * *
 

14–15 years ........................... * * 77.1 17.8 
 

16–17 years ........................... * * 145.6 26.1
 

18–19 years ........................... * * 386.6 49.1
 

Pregnancy-related diagnoses

10–11 years ........................... ... ... * * 
 

12–13 years ........................... ... ... * * 
 

14–15 years ........................... ... ... 54.4 13.8 
 

16–17 years ........................... ... ... 162.7 21.8
 

18–19 years ........................... ... ... 493.0 51.2
 

* Figure does not meet standards of reliability or precision; relative standard error is greater than 30 percent.
 

. . . Category not applicable.
 

1

SE Standard error.
 

NOTE: See ‘‘Technical Notes’’ for discussion of emergency department visits.
 

SOURCE: Centers for Disease Control and Prevention. National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.
 

Adolescent Health in the United States, 2007

99

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 13. Alcohol-related emergency department visit rates among adolescents 14–20

years of age and young adults 21–24 years of age, by age group and gender: United States, average

annual 2002–2004

Age Total SE1 Male SE1 Female SE1

Emergency department visits per 10,000 population

14–20 years ...................... 82.1 6.7 99.9 9.6 63.7 8.4

14–17 years ..................... 49.0 6.5 64.7 10.7 *32.5 7.3

18–20 years ..................... 127.7 13.4 148.8 20.1 106.1 17.4

21–24 years ...................... 149.8 12.5 184.0 18.5 115.8 18.5

* Figure does not meet standards of reliability or precision.

1

SE is standard error.

NOTES: Rates are for the civilian noninstitutionalized population. An emergency department visit was considered alcohol-related if the checkbox for alcohol was

indicated, the physician’s diagnosis was alcohol-related (ICD–9–CM 291, 303, 305.0, 425.5, 535.30, 571.1–.3, 760.71, 980, or V-113), an alcohol-related related

external cause-of-injury code was present (ICD–9–CM E710 or E860), or the patient’s reason for the visit was alcohol-related.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Ambulatory Medical Care Survey.

Data table for Figure 14. Short-stay hospital discharge rates for injury, non-injury, and pregnancy-related

diagnoses among adolescents 10–19 years of age, by age and gender: United States, average annual

2002–2004

Injury Noninjury Pregnancy-related

Gender and age Rate SE1 Rate SE1 Rate SE1

Female

10–11 years ......................

12–13 years ......................

14–15 years ......................

16–17 years ......................

18–19 years ......................

17.5

18.5

33.0

40.6

42.4

3.1

2.6

3.9

3.9

4.7

Discharges per 10,000 adolescents

195.1 25.6 *

220.0 23.6 *

314.5 29.2 65.3

338.5 26.2 368.5

303.6 19.8 874.1

*

*

6.9

20.3

45.9

Male

10–11 years ......................

12–13 years ......................

14–15 years ......................

16–17 years ......................

18–19 years ......................

32.9

39.3

60.0

70.4

80.7

5.1

4.9

5.7

5.8

6.1

207.2

215.7

260.9

256.8

239.5

20.5

24.5

27.1

21.9

15.8

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

* Figure does not meet standards of reliability or precision; relative standard error is greater than 30 percent.
 

. . . Category not applicable.
 

1

SE is standard error.
 

NOTES: Cause-specific hospital discharge data are defined based on the first-listed diagnosis. Non-injury discharges exclude pregnancy-related diagnoses. See
 

‘‘Technical Notes’’ for discussion of hospital diagnoses.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Discharge Survey.
 

100 Adolescent Health in the United States, 2007
Data table for Figure 15. Short-stay hospital discharge rates for selected diagnoses among adolescents

10–19 years of age, by age and gender: United States, average annual 2002–2004

Male Female

Gender and age Rate SE1 Rate SE1

Asthma Discharges per 10,000 adolescents

10–11 years ........................... 17.7 3.3 13.9 2.9

12–13 years ........................... 18.7 3.7 10.0 1.8

14–15 years ........................... 8.7 1.5 8.6 2.1

16–17 years ........................... 7.7 1.9 11.3 1.8

18–19 years ........................... 5.4 1.3 6.7 1.4

Psychoses

10–11 years ........................... 15.9 4.0 11.7 3.7

12–13 years ........................... 26.9 6.4 42.2 10.6

14–15 years ........................... 43.3 9.5 78.2 15.5

16–17 years ........................... 53.7 10.5 70.8 11.9

18–19 years ........................... 52.8 6.6 54.9 7.8

Fractures

10–11 years ........................... 13.8 2.5 7.0 1.4

12–13 years ........................... 16.0 2.2 6.3 1.3

14–15 years ........................... 22.4 3.7 3.7 1.0

16–17 years ........................... 18.0 2.6 7.4 1.4

18–19 years ........................... 25.1 2.9 9.9 2.6

Poisoning

10–11 years ........................... * * * *

12–13 years ........................... * * 4.1 1.0

14–15 years ........................... 4.5 1.1 17.5 2.5

16–17 years ........................... 7.3 1.3 17.1 2.4

18–19 years ........................... 8.4 1.5 16.1 2.4

* Figure does not meet standards of reliability or precision; relative standard error is greater than 30 percent.
 

1

SE is standard error.
 

NOTES: Diagnoses-specific hospital discharge data are based on the first-listed diagnosis. See ‘‘Technical Notes’’ for discussion of hospital diagnoses.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Hospital Discharge Survey.
 

Adolescent Health in the United States, 2007

101

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 16. Death rates for injury, by intent of injury and natural causes among

adolescents 10–19 years of age and young adults 20–24 years of age, by age and gender: United States,

average annual 2002–2004

Injury

All injury Unintentional Suicide Homicide Natural cause

Gender and age Rate SE1 Rate SE1 Rate SE1 Rate SE1 Rate SE1

Male Deaths per 100,000 adolescents

10 years ...............

11 years................

12 years ...............

13 years ...............

14 years ...............

15 years ...............

16 years ...............

17 years ...............

18 years ...............

19 years ...............

20–24 years .............

7.8

8.0

11.5

13.9

20.9

30.8

55.8

73.0

100.6

113.7

112.0

0.4

0.4

0.4

0.5

0.6

0.7

0.9

1.1

1.3

1.3

0.6

6.5

6.6

8.9

9.6

14.1

19.0

36.7

46.5

60.9

65.6

61.6

0.3

0.3

0.4

0.4

0.5

0.5

0.8

0.9

1.0

1.0

0.4

0.6

0.7

1.3

2.5

3.7

5.7

9.1

11.2

15.5

19.5

20.5

0.1

0.1

0.1

0.2

0.2

0.3

0.4

0.4

0.5

0.6

0.3

0.6

0.5

1.0

1.4

2.7

5.4

9.2

14.3

22.4

26.2

26.6

0.1

0.1

0.1

0.1

0.2

0.3

0.4

0.5

0.6

0.6

0.3

9.2

8.6

10.1

11.0

11.4

13.4

15.9

17.3

19.6

22.3

26.8

0.4

0.4

0.4

0.4

0.4

0.5

0.5

0.5

0.6

0.6

0.3

Female

10 years ...............

11 years................

12 years ...............

13 years ...............

14 years ...............

15 years ...............

16 years ...............

17 years ...............

18 years ...............

19 years ...............

20–24 years ............

5.1

4.9

5.4

7.5

10.6

15.6

25.7

29.6

33.6

31.4

27.8

0.3

0.3

0.3

0.3

0.4

0.5

0.7

0.7

0.8

0.7

0.3

4.4

4.1

4.4

5.6

7.7

11.3

20.6

23.6

26.3

23.4

18.9

0.3

0.3

0.3

0.3

0.4

0.4

0.6

0.6

0.7

0.6

0.2

*

*

0.5

1.1

1.7

2.4

2.8

2.9

3.1

3.1

3.5

*

*

0.1

0.1

0.2

0.2

0.2

0.2

0.2

0.2

0.1

0.5

0.6

0.5

0.7

1.0

1.7

1.9

2.7

3.6

4.0

4.4

0.1

0.1

0.1

0.1

0.1

0.2

0.2

0.2

0.2

0.3

0.1

8.2

7.6

8.2

9.5

9.6

9.8

11.3

11.9

14.4

15.6

20.1

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.5

0.5

0.3

* Figure does not meet standards of reliability or precision; there are fewer than 20 deaths in this category.
 

1

SE is standard error.
 

NOTE: See ‘‘Technical Notes’’ for discussion of cause of death coding.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File.
 

102 Adolescent Health in the United States, 2007
Data table for Figure 17. Death rates for motor vehicle traffic-related and firearm-related injuries among

adolescents 10–19 years of age and young adults 20–24 years of age, by age, gender, and race and

Hispanic origin: United States, average annual 2002–2004

Motor vehicle deaths Firearm-related deaths

Female Male Female Male

Age, race, and Hispanic origin Rate SE1 Rate SE1 Rate SE Rate SE1

Deaths per 100,000 adolescents

10 years .........................

11 years .........................

12 years .........................

13 years .........................

14 years .........................

15 years .........................

16 years .........................

17 years .........................

18 years .........................

19 years .........................

20–24 years ......................

2.9

2.6

2.5

3.8

5.8

9.2

17.9

20.6

22.6

19.3

13.8

0.2

0.2

0.2

0.2

0.3

0.4

0.5

0.6

0.6

0.6

0.2

3.3

3.3

4.5

5.3

8.4

12.5

27.3

35.1

44.9

45.9

39.9

0.2

0.2

0.3

0.3

0.4

0.4

0.7

0.7

0.8

0.9

0.4

*

0.4

*

0.6

1.0

1.7

2.1

3.1

3.1

3.4

4.0

0.1

0.1

0.1

0.1

0.1

0.2

0.2

0.2

0.2

0.2

0.1

0.6

0.6

1.5

2.3

4.4

8.1

13.8

19.0

29.0

35.4

36.1

0.1

0.1

0.2

0.2

0.3

0.4

0.5

0.5

0.7

0.7

0.3

Ages 10–19 years

All races and origins. . . . . . . . . . . . . . . . .

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

American Indian or Alaska Native .......

Asian or Pacific Islander ..............

10.6

12.5

6.8

7.3

17.6

5.6

0.1

0.2

0.3

0.3

1.4

0.5

18.8

20.6

13.3

18.6

26.4

9.9

0.2

0.2

0.4

0.4

1.7

0.6

1.6

1.2

3.3

1.5

3.3

0.8

0.1

0.1

0.2

0.1

0.6

0.1

11.3

6.3

30.2

14.0

13.1

5.0

0.1

0.1

0.6

0.4

1.2

0.4

* Figure does not meet standards of reliability or precision; there are fewer than 20 deaths in this category.
 

1

SE is standard error.
 

NOTES: See ‘‘Technical Notes’’ for discussion of cause of death coding. Persons of Hispanic origin may be of any race.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Mortality File.
 

Adolescent Health in the United States, 2007

103

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 18a. Violent crime victimization rates among adolescents 12–19 years of age and

young adults 20–24 years of age, by gender, age group, and type of victimization: United States, 2004

Type of victimization

Simple Aggravated Rape/sexual

Gender and age group Total assault assault Robbery assault

Victimizations per 1,000 persons in age group

Male

12–15 years ........................... 64.7 49.4 8.2 7.2 0.0*

16–19 years ........................... 54.7 32.3 16.0 6.4 0.0*

20–24 years ........................... 44.5 26.7 12.9 4.2 0.6*

Female

12–15 years ........................... 34.1 25.1 4.1 0.4* 4.5

16–19 years ........................... 36.8 22.0 6.6 3.1* 5.1

20–24 years ........................... 41.6 29.2 6.0 2.0* 4.4

* Estimate is based on fewer than 10 events in the sample population.

NOTES: Standard errors are not available. Violent crimes include simple and aggravated assault, robbery, rape, and sexual assault.

SOURCE: U.S. Department of Justice, Bureau of Justice Statistics, National Crime Victimization Survey.

Data table for Figure 18b. Violent crime victimization rates among adolescents 12–19 years of age and

young adults 20–24 years of age, by age group: United States, 1985–2005

Age groups

Year 12–15 years 16–19 years 20–24 years

Victimizations per 1,000 persons in age group

1985 ................................ 79.6 89.4 82.0

1986 ................................ 77.1 80.8 80.1

1987 ................................ 87.2 92.4 85.5

1988 ................................ 83.7 95.9 80.2

1989 ................................ 92.5 98.2 78.8

1990 ................................ 101.1 99.1 86.1

1991 ................................ 94.5 122.6 103.6

1992 ................................ 111.0 103.7 95.2

1993 ................................ 115.5 114.2 91.6

1994 ................................ 118.6 123.9 100.4

1995 ................................ 113.1 106.6 85.8

1996 ................................ 95.0 102.8 74.5

1997 ................................ 87.9 96.3 68.0

1998 ................................ 82.5 91.3 67.5

1999 ................................ 74.4 77.5 68.7

2000 ................................ 60.1 64.4 49.5

2001 ................................ 55.1 55.9 44.9

2002 ................................ 44.4 58.3 47.6

2003 ................................ 51.6 53.1 43.5

2004 ................................ 49.7 46.0 43.2

2005 ................................ 44.0 44.3 47.1

NOTES: Standard errors are not available. Violent crimes include simple and aggravated assault, robbery, rape, and sexual assault.

SOURCE: U.S. Department of Justice, Bureau of Justice Statistics, National Crime Victimization Survey.

104 Adolescent Health in the United States, 2007
Data table for Figure 19. Dating violence and being forced to have sexual intercourse among students in

grades 9–12, by grade level, gender, and race and Hispanic origin: United States, 2005

Grade level, race, and

Hispanic origin

All students

Percent SE1

Male

Percent SE1

Female

Percent SE1

Dating violence

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

9.2

7.4

8.7

9.9

11.1

0.3

0.5

0.6

0.7

0.6

9.0

7.0

7.8

10.4

11.4

0.4

0.9

0.8

0.9

0.8

9.3

7.7

9.7

9.4

10.7

0.4

0.7

0.9

1.0

0.9

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

8.2

11.9

9.9

0.4

0.9

0.7

8.0

11.8

10.9

0.5

1.1

1.0

8.5

12.0

9.0

0.5

1.1

1.0

Forced intercourse

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

7.5

6.1

7.2

7.9

9.0

0.4

0.4

0.6

0.8

0.7

4.2

3.5

3.8

4.2

5.3

0.4

0.6

0.7

0.6

0.5

10.8

8.7

10.7

11.6

12.7

0.6

1.0

0.8

1.4

1.3

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

6.9

9.3

7.8

0.4

0.5

0.7

3.1

7.1

6.4

0.4

1.2

0.9

10.8

11.5

9.4

0.8

1.2

1.1

1

SE is standard error.

NOTES: Dating violence is the percentage of students who were hit, slapped, or physically hurt on purpose by their boyfriend or girlfriend during the past 12

months; forced intercourse is the percentage of students who have ever been physically forced to have intercourse when they did not want to. Persons of

Hispanic origin may be of any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

Adolescent Health in the United States, 2007

105

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 20. Contraceptive use among never-married female adolescents 15–19 years of age

who have had sexual intercourse in the past 3 months, by specified method used at last intercourse

and race and Hispanic origin: United States, 2002

Contraceptive use during

last intercourse

Sexually active never-married females who had

sexual intercourse in the past 3 months

All races and origins White only, not Hispanic Black only,

1 1 SE Percent SE Percent

not Hispanic

Percent 1 SE

Any method. . . . . . . . . . . . . . . . . . . . . . .

Condom........................

Pill (oral contraceptive) .............

Other hormonal method.............

Dual methods (hormonal and condom)....

No method .......................

83.2

54.3

34.2

9.1

19.5

16.8

2.2

3.0

3.0

1.8

2.5

2.2

89.7

60.8

40.7

8.0

22.5

10.3

2.0

3.3

3.7

2.0

3.0

2.0

74.8

49.9

27.8

18.6

23.3

25.2

5.8 
 

6.1 
 

6.2 
 

4.7 
 

5.3

5.8 
 

1

SE is standard error.

NOTES: Estimates do not add to 100%. Data are not shown separately for ‘‘other methods,’’ which include all other methods besides condom and hormonal

methods (i.e., withdrawal, IUD, sterilization, female condom, diaphragm, cervical cap, spermicidal foam, jelly, cream, or suppository, sponge, periodic

abstinence, and ‘‘other’’ methods). Categories are not mutually exclusive. Condom includes condom use alone or in combination with any other method. Pill

includes pill use alone or in combination with any other method. Other hormonal includes Depo-ProveraT injectable, LunelleT injectable, Norplant implants,

emergency contraception, and contraceptive patch. Total column shows persons of other or unknown race and origin groups, not shown separately. Estimates

for Hispanic adolescents did not meet standards of precision and reliability, and are not shown.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth. Abma JC, Martinez GM, Mosher

WD, Dawson BS. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. National Center for Health Statistics. Vital Health

Stat 23(24). 2004.

106 Adolescent Health in the United States, 2007
Data table for Figure 21a. Pregnancy rates among adolescents 15–19 years of age, by outcome of

pregnancy: United States, 1990–2002

Live Induced Fetal

Year Pregnancy birth abortion loss

Per 1,000 female adolescents

1990 ................................ 116.8 59.9 40.3 16.6

1991 ................................ 116.4 61.8 37.4 17.2

1992 ................................ 112.3 60.3 35.2 16.8

1993 ................................ 109.4 59.0 33.9 16.5

1994 ................................ 106.1 58.2 31.6 16.3

1995 ................................ 101.1 56.0 29.4 15.7

1996 ................................ 97.0 53.5 28.6 15.0

1997 ................................ 92.7 51.3 27.1 14.3

1998 ................................ 90.1 50.3 25.8 14.0

1999 ................................ 86.9 48.8 24.7 13.5

2000 ................................ 84.8 47.7 24.0 13.1

2001 ................................ 80.6 45.3 22.8 12.4

2002 ................................ 76.4 43.0 21.7 11.8

NOTES: Standard errors are not available. See ‘‘Technical Notes’’ for discussion of pregnancy rate estimation.

SOURCE: Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Recent Trends in Teenage Pregnancy in the United States, 1990–2002. Health E-stat. National

Center for Health Statistics. 2006.

Data table for Figure 21b. Pregnancy rates among adolescents 15–19 years of age, by outcome of

pregnancy, age, and race and Hispanic origin: United States, 2002

Live Induced Fetal

Race, Hispanic origin, and age Pregnancy birth abortion loss

Per 1,000 female adolescents

White, not Hispanic

15–17 years ........................... 25.1 13.1 7.4 4.6

18–19 years ........................... 85.3 51.9 21.0 12.4

Black, not Hispanic

15–17 years ........................... 88.4 41.1 33.1 14.2

18–19 years ........................... 217.0 110.3 80.2 26.4

Hispanic

15–17 years ........................... 85.1 50.7 16.8 17.6

18–19 years ........................... 210.9 133.0 46.2 31.8

NOTES: Standard errors are not available. Persons of Hispanic origin may be of any race. See ‘‘Technical Notes’’ for discussion of pregnancy rate estimation.

SOURCE: Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Recent Trends in Teenage Pregnancy in the United States, 1990–2002. Health E-stat.

National Center for Health Statistics. 2006. [cited 2007 August 1]. Available from: www.cdc.gov/nchs/products/pubs/pubd/hestats/teenpreg1990-2002/ 

teenpreg1990-2002.htm.

Adolescent Health in the United States, 2007

107

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 22. Birth rates among adolescents 10–19 years of age, and young adults 20–24

years of age, by birth order, age group, and race and Hispanic origin: United States, 2004

Birth order, race and

Hispanic origin 10–14 15–17

Age in years

18–19 20–24

All races

Births per 1,000 female adolescents

otal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.7 22.1 70.0 101.7
 

First birth............................ 0.6 19.7 52.3 47.8 
 

Second and higher ..................... 0.0 2.2 17.3 54.0 
 

White, not Hispanic

otal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.2 12.0 48.7 81.9 
 

First birth............................ 0.2 11.1 38.7 41.8 
 

Second and higher ..................... * 0.8 9.7 
 

Black, not Hispanic

otal ................................ 1.6 37.1 103.9 126.9
 

First birth............................ 1.6 32.6 72.9 51.3 
 

Second and higher ..................... 0.0 4.2 30.2 75.6 
 

Hispanic

otal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 49.7 133.5 165.3
 

First birth............................ 1.2 43.7 94.8 70.8 
 

Second and higher ..................... *0.0 5.8 38.1 94.5 
 

American Indian or Alaskan Native

otal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.9 30.0 87.0 109.7
 

First birth............................ 0.9 26.2 61.8 41.5 
 

Second and higher ..................... * 3.7 24.6 68.2 
 

Asian or Pacific Islander

otal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.2 8.9 29.6 59.8 
 

First birth............................ 0.2 7.9 22.9 35.6 
 

T

T

T

T

T

T

Second and higher ..................... * 0.9 6.5 24.2 
 

0.0 Quantity more than zero but less than 0.05.
 

* Figure does not meet standards of reliability or precision; rates based on fewer than 20 events are considered highly unreliable and are not shown.
 

NOTES: Live births with unknown birth order are distributed proportionally. Persons of Hispanic origin may be of any race.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, Birth File.
 

108 Adolescent Health in the United States, 2007
Data table for Figure 23. Sexually transmitted disease rates reported for adolescents 10–19 years of age

and for young adults 20–24 years of age, by age group, gender, and Hispanic origin: United States, 2004

Chlamydia Gonorrhea

Age group, race, and

Hispanic origin Female Male Female Male

Reported cases per 100,000 adolescents

10–14 years ........................... 132.0 10.8 36.9 5.8

White, not Hispanic .................... 50.7 1.9 10.0 0.7

Black, not Hispanic .................... 486.4 46.2 168.9 30.6

Hispanic ............................ 113.6 12.5 17.8 2.6

American Indian or Alaska Native........... 210.1 26.6 27.2 5.7

Asian or Pacific Islander ................. 30.9 1.3 5.6 1.2

15–19 years ........................... 2,761.5 458.3 610.9 252.9

White, not Hispanic .................... 1,408.8 147.4 201.7 37.9

Black, not Hispanic .................... 8,897.6 1,880.5 2,790.5 1,390.1

Hispanic ............................ 2,810.1 485.6 307.6 124.7

American Indian or Alaska Native .......... 4,358.2 683.1 561.2 137.4

Asian or Pacific Islander. ................ 776.4 111.1 86.3 26.2

20–24 years ........................... 2,630.7 744.7 579.1 430.6

White, not Hispanic .................... 1,434.6 354.3 209.3 90.7

Black, not Hispanic .................... 7,847.8 2,730.8 2,565.4 2,408.3

Hispanic ............................ 2,924.4 685.3 291.4 193.7

American Indian or Alaska Native........... 4,672.4 1,144.6 612.8 304.6

Asian or Pacific Islander ................. 963.3 250.3 109.7 66.0

NOTES: Standard errors are not available. Persons of Hispanic origin may be of any race.
 

SOURCE: Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, STD Surveillance.
 

Adolescent Health in the United States, 2007

109

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 24. Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency

virus (HIV) transmission categories for adolescents 13–19 years of age and young adults 20–24 years of

age, by gender: United States and 33 states with confidential reporting, 2001–2005

AIDS cases reported

(United States 1

)

HIV/AIDS

(33

cases

states

reported

2

)

Sex and transmission category 13–19 years 20–24 years 13–19 years 20–24 years

Percent of cases

Male (N= 1,201) (N= 5,324) (N= 3,031) (N= 11,259)

Male-to-male sexual contact . . . . . . . . . . . . . . . . 57 69 77 75 
 

Injection drug use (IDU) ................... 9 10 7 8 
 

Male-to-male sexual contact and IDU ......... 3 6 4 5 
 

High risk heterosexual contact .............. 12 14 11 12 
 

Other or not identified .................... 18 1 <1 <1 
 

Female (N=940) (N= 2,708) (N= 2,441) (N= 5,586)

Injection drug use (IDU) ................... 13 17 14 14 
 

High risk heterosexual contact .............. 60 81 85 85 
 

Other or not identified .................... 27 2 <1 <1 
 

1

Includes Puerto Rico and Virgin Islands.
 

2

Data for HIV/AIDS cases are from 33 states with confidential name-based HIV infection reporting since at least 2001.
 

NOTES: Standard errors are not available. High risk heterosexual contact is contact with a person known to have, or to be at high risk for, HIV infection. Other
 

category includes hemophilia, blood transfusion, perinatal, and risk factor not reported or not identified. The reported case counts are adjusted for reporting
 

delays and for redistribution of cases in persons initially reported without an identified risk factor. Cases without risk factor information were proportionally
 

redistributed. Data include persons with a diagnosis of HIV infection, regardless of AIDS status at diagnosis. This includes persons with a diagnosis of HIV 
 

infection only, a diagnosis of HIV infection and a later AIDS diagnosis, and concurrent diagnoses of HIV infection and AIDS. Data on HIV infection (not AIDS)
 

should be interpreted with caution. HIV surveillance reports may not be representative of all persons infected with HIV because not all infected persons have
 

been tested.
 

SOURCE: Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, HIVAIDS Surveillance System.
 

110
 Adolescent Health in the United States, 2007
 
Data table for Figure 25a. Adolescents 15–19 years of age who have ever had sexual intercourse, by age

and gender: United States, 1988–2002

1988 1995 2002

Sex and age Percent SE1 Percent SE1 Percent SE1

Male

15–17 years . ................. .... 50.0 2.4 43.1 1.9 31.3 2.3 
 

18–19 years . ................. .... 77.3 2.6 75.4 2.7 64.3 3.1 
 

Female

15–17 years . ................. .... 37.2 2.4 38.0 1.8 30.3 2.1 
 

18–19 years . ................. .... 72.6 2.5 68.0 2.1 68.8 2.6 
 

1

SE is standard error.

NOTE: Percentages reflect heterosexual vaginal intercourse only, not other types of sexual activity.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth. Abma JC, Martinez GM, Mosher

WD, Dawson BS. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. National Center for Health Statistics. Vital Health

Stat 23(24). 2004.

Data table for Figure 25b. Ever had any sexual contact among adolescents 15–19 years of age and

young adults 20–24 years of age, by type of contact, age, and gender: United States, 2002

Male Female

15–17 years 18–19 years 20–24 years 15–17 years 18–19 years 20–24 years

Type of sexual contact Percent 1 SE 1 Percent SE Percent 1 SE Percent 1 SE 1 Percent SE Percent 1 SE

Opposite-sex sexual contact:
 

Any sexual contact ......... 53.2 2.2 77.7 2.1 91.4 1.4 49.8 2.2 82.9 2 91.3 1.2 
 

Vaginal ................. 36.3 2.4 65.5 3 87.6 1.7 38.7 2.1 73.8 2.3 87.3 1.5 
 

Any oral. . . . . . . . . . . . . . . . . 44.0 2.2 69.5 2.3 82.3 1.8 42.0 2.3 72.3 2.6 83.1 1.5 
 

Anal ................... 8.1 1.4 15.2 2.1 32.6 2.0 5.6 1.0 18.7 1.9 29.6 1.7 
 

Same-sex sexual contact:

Any sexual contact ......... 3.9 0.8 5.1 1.2 5.5 0.9 8.4 1.3 13.8 1.8 14.2 1.3

1

SE is standard error.

NOTES: Any oral sex includes given or received. Percent reporting specified types of sexual contact may add to more than the percent reporting ‘‘any sexual

contact’’ because a respondent could report more than one type of sexual contact. Same-sex sexual contact is measured with substantially different questions

for males and females.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth. Mosher WD, Chandra A, Jones

J. Sexual behavior and selected health measures: Men and women 15–44 years of age, United States, 2002. Advance data from vital and health statistics: no

362. Hyattsville, MD: National Center for Health Statistics. 2005.

Adolescent Health in the United States, 2007

111

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 26. Number of sexual partners in lifetime among adolescents 15–19 years of age,

by age, gender, and race and Hispanic origin: United States, 2002

Number of sexual 1 partners in lifetime

0 1 2–3 4–6 7 or more

Age, sex, race, and

Hispanic origin Percent SE2 Percent SE2 Percent SE2 Percent SE2 Percent SE2

Never-married males ......... 54.4 2.1 15.5 1.5 13.5 0.9 9.4 1.2 7.2 0.8

15–17 years.............. 68.7 2.3 13.3 1.7 9.2 1.5 4.8 1.0 4.0 0.7

18–19 years ............. 35.7 3.1 18.5 2.4 19.1 2.0 15.4 2.3 11.3 1.7

White only, not Hispanic ..... 59.3 2.5 15.3 1.9 13.7 1.6 6.8 1.4 5.0 1.0

Black only, not Hispanic ..... 36.8 4.4 18.9 3.4 15.1 3.1 16.5 2.7 12.8 2.3

Hispanic ................ 45.2 4.3 17.4 3.3 12.7 2.6 15.1 3.3 9.6 2.6

Never-married females ........ 54.6 1.9 17.7 1.2 13.6 1.0 7.9 1.0 6.3 0.9

15–17 years.............. 69.7 2.1 13.7 1.4 10.0 1.4 4.5 0.9 2.2 0.8

18–19 years.............. 31.2 2.6 23.9 2.4 19.3 1.9 13.0 2.2 12.6 1.9

White only, not Hispanic ..... 54.9 2.6 17.3 1.9 12.0 1.4 7.8 1.4 7.9 1.3

Black only, not Hispanic ..... 43.1 3.0 20.6 3.2 21.0 3.1 10.8 2.4 4.5 1.8

Hispanic ................ 62.6 3.6 17.5 3.3 13.1 2.3 5.4 1.4 1.5 0.9

1

Heterosexual vaginal intercourse only, not other types of sexual activity.
 

2

SE is standard error.
 

NOTES: Percentages may not add to 100 due to rounding. Persons of Hispanic origin may be of any race.
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth. Abma JC, Martinez GM, Mosher
 

WD, Dawson BS. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. National Center for Health Statistics. Vital Health
 

Stat 23(24). 2004.
 

112 Adolescent Health in the United States, 2007
Data table for Figure 27. Current cigarette smoking among students in grades 9–12, by gender, grade

level, and race and Hispanic origin: United States, 2005

Grade level, race, and

Hispanic origin

All students

Percent SE1

Male

Percent SE1

Female

Percent SE1

Current smoker

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

23.0

19.7

21.4

24.3

27.6

1.2

1.2

1.6

1.6

1.9

22.9

18.9

21.1

24.2

29.1

1.1

1.6

2.0

1.5

1.9

23.0

20.5

21.9

24.3

26.0

1.3

1.5

1.7

2.1

2.3

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

25.9

12.9

22.0

1.5

0.9

1.8

24.9

14.0

24.8

1.4

1.3

2.6

27.0

11.9

19.2

1.9

0.9

1.5

Frequent smoker

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

9.4

6.9

7.7

10.3

13.2

0.8

0.9

0.9

1.2

1.3

9.3

6.7

7.0

10.5

13.9

0.8

1.0

1.1

1.2

1.4

9.3

7.0

8.4

10.0

12.5

0.8

1.2

1.1

1.3

1.7

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

11.2

3.7

6.5

0.9

0.6

1.0

10.6

5.1

8.1

0.9

1.1

1.5

11.7

2.4

4.7

1.2

0.5

1.1

1

SE is standard error.

NOTES: Current smokers are students who smoked cigarettes on one or more of the past 30 days; frequent smokers are students who smoked cigarettes on

20 or more of the past 30 days. Persons of Hispanic origin may be of any race. Data on cigarette use are also collected by the National Survey on Drug Use &

Health (NSDUH) and Monitoring the Future Study (MTF). Rates of substance use measured by these surveys are not directly comparable.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

Adolescent Health in the United States, 2007

113

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 28. Alcohol use, binge alcohol use, and heavy alcohol use in the past 30 days

among adolescents 12–20 years of age, by age, gender, and race and Hispanic origin: United States,

2005

Alcohol use Binge alcohol use Heavy alcohol use

Characteristic Percent SE1 Percent SE1 Percent SE1

Age

12–20 years ........................... 28.2 0.4 18.8 0.4 6.0 0.2

12–13 years.......................... 4.2 0.3 2.0 0.2 0.2 0.1

14–15 years.......................... 15.1 0.5 8.0 0.4 1.7 0.2

16–17 years.......................... 30.1 0.7 19.7 0.6 5.3 0.3

18–20 years.......................... 51.1 0.8 36.1 0.8 13.0 0.5

Gender, race, and Hispanic origin

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.9 0.5 21.3 0.5 7.6 0.3

White only, not Hispanic ................. 32.6 0.7 24.7 0.7 9.8 0.4

Black only, not Hispanic ................. 20.4 1.2 11.4 1.0 2.5 0.5

Hispanic ............................ 27.9 1.4 21.5 1.3 5.9 0.8

Female ............................... 27.5 0.5 16.1 0.4 4.3 0.2

White only, not Hispanic ................. 31.9 0.7 19.7 0.6 5.8 0.3

Black only, not Hispanic ................. 17.6 1.0 6.8 0.7 1.1 0.3

Hispanic ............................ 23.7 1.3 13.9 1.0 2.5 0.5

Detailed race and Hispanic origin

Not Hispanic ........................... 28.7 0.4 19.0 0.4 6.4 0.2

White .............................. 32.3 0.5 22.3 0.5 7.8 0.3

Black or African American ............... 19.0 0.8 9.1 0.6 1.8 0.3

American Indian or Alaska Native........... 21.7 2.9 18.1 2.6 6.0 1.7

Native Hawaiian or Other Pacific Islander ..... 12.0 3.5 * * * *

Asian .............................. 15.5 1.6 7.4 1.1 1.2 0.3

Two or more races ..................... 24.0 2.2 16.6 2.1 7.1 1.5

Hispanic .............................. 25.9 1.0 17.9 0.9 4.2 0.5

* Figure does not meet standards of reliability or precision; relative standard error is greater than 30 percent.

1

SE is standard error.

NOTES: Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on

at least 1 day in the past 30 days. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30

days; all heavy alcohol users are also binge alcohol users. Persons of Hispanic origin may be of any race. Data on alcohol use are also collected by Monitoring

the Future Study (MTF) and the Youth Risk Behavior Survey (YRBS). Rates of substance use measured by these surveys are not directly comparable.

SOURCE: Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, National Survey on Drug Use and Health.

114 Adolescent Health in the United States, 2007
Data table for Figure 29a. Drinking and driving and seatbelt use among students in grades 9–12:

United States, 1991–2005

Rode with a driver who had Drove after drinking Rarely or never wore

been drinking alcohol alcohol (grades 11–12 only) a seatbelt as a passenger

Year 1 Percent SE Percent 1 SE 1 Percent SE

1991 ... .............. ... 39.9 1.1 24.6 1.5 25.9 2.7 
 

1993 ... .............. ... 35.3 1.3 19.6 1.4 19.1 1.3 
 

1995 ... .............. ... 38.8 1.9 20.1 1.8 21.7 1.7 
 

1997 ... .............. ... 36.6 1.1 22.7 2.4 19.3 1.8 
 

1999 ... .............. ... 33.1 1.1 19.5 1.3 16.4 1.4 
 

2001 ... .............. ... 30.7 1.0 19.3 1.2 14.1 0.8 
 

2003 ... .............. ... 30.2 1.1 17.5 1.0 18.2 2.1 
 

2005 ... .............. ... 28.5 1.0 14.5 0.9 10.2 0.9 
 

1

SE is standard error.

NOTE: Rode with a driver who had been drinking alcohol is defined as students who during the past 30 days rode one or more times in a car or other vehicle

driven by someone who had been drinking alcohol; and drove after drinking is defined as students who during the past 30 days drove a car or other vehicle one

or more times when they had been drinking alcohol; rarely or never wore seatbelts is defined as students who rarely or never wore a seatbelt when riding in a

car driven by someone else.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

Adolescent Health in the United States, 2007

115

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 29b. Drinking and driving and seatbelt use among students in grades 9–12, by

grade level, gender, and race and Hispanic origin: United States, 2005

All students Male Female

Grade level, race and Hispanic origin Percent SE1 Percent SE1 Percent SE1

Rode with a driver who had been drinking alcohol (grades 9–12)

All students, grades 9–12 ............ 28.5 1.0 27.2 1.0 29.6 1.2 
 

9th grade . . . . . . . . . . . . . . . . . . . . . . . 27.9 1.3 25.8 1.7 30.1 1.9 
 

10th grade . . . . . . . . . . . . . . . . . . . . . . 27.8 1.3 26.2 1.5 29.5 1.5 
 

11th grade . . . . . . . . . . . . . . . . . . . . . . 28.0 1.5 27.7 1.9 28.1 1.9 
 

12th grade . . . . . . . . . . . . . . . . . . . . . . 30.1 1.2 29.5 1.5 30.7 1.9 
 

White only, not Hispanic ............. 28.3 1.3 26.2 1.3 30.4 1.7 
 

Black only, not Hispanic .............. 24.1 1.1 24.3 1.3 24.0 1.3 
 

Hispanic ......................... 36.1 1.7 37.4 2.3 34.7 1.4 
 

Drove after drinking alcohol (grades 11 and 12 only)

All students, grades 11–12 ............ 14.5 0.9 16.9 1.1 12.2 0.9 
 

11th grade . . . . . . . . . . . . . . . . . . . . . . 12.1 0.9 14.7 1.2 9.5 1.0 
 

12th grade . . . . . . . . . . . . . . . . . . . . . . 17.1 1.2 19.2 1.4 15.0 1.6 
 

White only, not Hispanic ............. 16.9 1.0 18.7 1.3 15.1 1.1 
 

Black only, not Hispanic .............. 7.5 1.0 10.9 1.7 4.5 1.2 
 

Hispanic ......................... 13.1 1.4 17.5 2.2 8.7 1.2 
 

Rarely or never wore a seatbelt as a passenger (grades 9–12)

All students, grades 9–12 ............ 10.2 0.9 12.5 1.1 7.8 0.8 
 

9th grade . . . . . . . . . . . . . . . . . . . . . . . 10.9 1.0 13 1.3 8.7 1.0 
 

10th grade . . . . . . . . . . . . . . . . . . . . . . 8.6 0.9 9.5 1.2 7.7 0.9 
 

11th grade . . . . . . . . . . . . . . . . . . . . . . 10.1 1.4 13.2 1.8 7.1 1.3 
 

12th grade . . . . . . . . . . . . . . . . . . . . . . 10.8 1.0 14.1 1.4 7.5 0.9 
 

White only, not Hispanic ............. 9.4 1.1 11.5 1.4 7.2 0.9 
 

Black only, not Hispanic .............. 13.4 1.7 17.7 2.4 9.4 1.5 
 

Hispanic ......................... 10.6 1.1 12.5 1.2 8.7 1.1 
 

1

SE is standard error.

NOTES: Rode with a driver who had been drinking alcohol is defined as students who during the past 30 days rode one or more times in a car or other vehicle

driven by someone who had been drinking alcohol; and drove after drinking is defined as students who during the past 30 days drove a car or other vehicle one

or more times when they had been drinking alcohol; rarely or never wore seatbelts is defined as students who rarely or never wore a seatbelt when riding in a

car driven by someone else. Persons of Hispanic origin may be of any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

116 Adolescent Health in the United States, 2007
Data table for Figure 30. Marijuana use in the past month and lifetime marijuana use among students in

grades 9–12, by grade level, gender, and race and Hispanic origin: United States, 2005

Grade level, race, and

Hispanic origin

All students

Percent SE1

Male

Percent SE1

Female

Percent SE1

Current marijuana use

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

20.2

17.4

20.2

21.0

22.8

20.3

20.4

23.0

0.8

1.2

1.3

1.2

1.2

1.1

1.1

1.2

22.1

18.6

21.5

23.5

26.1

21.3

22.1

28.1

1.0

1.6

1.6

1.6

1.2

1.3

1.5

1.9

18.2

16.2

18.9

18.5

19.5

19.2

18.8

18.0

1.0

1.4

1.4

1.5

2.0

1.4

1.5

1.0

Lifetime marijuana use

All students, grades 9–12 ............

9th grade .......................

10th grade ......................

11th grade ......................

12th grade ......................

White only, not Hispanic .............

Black only, not Hispanic ..............

Hispanic .........................

38.4

29.3

37.4

42.3

47.6

38.0

40.7

42.6

1.3

1.5

1.7

1.9

2.0

1.6

1.6

1.9

40.9

30.9

39.0

45.1

52.4

40.0

43.8

47.7

1.3

1.8

2.3

2.0

1.5

1.7

1.9

2.3

35.9

27.8

35.7

39.4

42.8

36.0

37.8

37.5

1.5

1.7

1.6

2.4

3.0

1.9

2.3

2.2

1

SE is standard error.

NOTES: Current marijuana use is defined as students who have used marijuana one or more times in the past 30 days; lifetime marijuana use is defined as

students who used marijuana one or more times during their life. Persons of Hispanic origin may be of any race. Data on marijuana use are also collected by

the National Survey on Drug Use & Health (NSDUH) and Monitoring the Future Study (MTF). Rates of substance use measured by these surveys are not

directly comparable.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

Adolescent Health in the United States, 2007

117

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 31. Weapon carrying in the past 30 days among students in grades 9–12, by

gender, grade level, and race and Hispanic origin: United States, 2005

All students Male Female

Grade level, race, and Hispanic origin Percent SE1 Percent SE1 Percent SE1

Carried a weapon

All students, grades 9–12 .................

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . .

10th grade. . . . . . . . . . . . . . . . . . . . . . . . . . .

11th grade . . . . . . . . . . . . . . . . . . . . . . . . . . .

12th grade. . . . . . . . . . . . . . . . . . . . . . . . . . .

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

18.5

19.9

19.4

17.1

16.9

18.7

16.4

19.0

0.8

1.2

1.2

1.1

0.9

1.1

0.8

1.1

29.8

31.6

30.6

28.6

27.6

31.4

23.7

29.8

1.3

1.9

1.9

1.8

1.8

1.8

1.5

1.7

7.1

8.1

7.8

6.1

6.2

6.0

9.4

7.8

0.4

0.9

0.9

0.7

0.9

0.5

1.0

0.8

Carried a gun

All students, grades 9–12 .................

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . .

10th grade. . . . . . . . . . . . . . . . . . . . . . . . . . .

11th grade . . . . . . . . . . . . . . . . . . . . . . . . . . .

12th grade. . . . . . . . . . . . . . . . . . . . . . . . . . .

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

5.4

6.2

5.3

4.9

4.9

5.3

5.0

6.5

0.4

0.6

0.6

0.6

0.6

0.7

0.5

0.8

9.9

11.3

9.4

9.1

9.0

9.7

9.4

11.6

0.7

1.1

1.1

1.0

1.2

1.1

1.0

1.5

0.9

1.0

1.0

0.9

0.8

0.9

0.9

1.3

0.2

0.4

0.3

0.3

0.2

0.3

0.2

0.4

1

SE is standard error.

NOTES: Weapon carrying includes carrying a weapon such as a gun, knife, or club on one or more of the past 30 days. Persons of Hispanic origin may be of

any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

118 Adolescent Health in the United States, 2007
Data table for Figure 32. Participation in physical activity in the past 7 days among students in grades

9–12, by grade level, gender, and race and Hispanic origin: United States, 2005

All students Male Female

Grade level, race, and Hispanic origin Percent 1 1 SE Percent SE Percent 1 SE

Meeting currently recommended level of physical activity

All students, grades 9–12 ................. 35.8 1.0 43.8 1.1 27.8 1.2 
 

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.9 1.7 42.8 1.8 30.8 2.0 
 

10th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . 38.5 1.4 46.8 1.9 30.0 1.7 
 

11th grade .......................... 34.4 1.3 43.8 1.6 25.1 1.5 
 

12th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . 32.9 1.6 41.9 1.8 24.0 1.7 
 

White only, not Hispanic .................. 38.7 1.3 46.9 1.3 30.2 1.6 
 

Black only, not Hispanic .................. 29.5 1.7 38.2 2.3 21.3 1.7 
 

Hispanic .............................. 32.9 1.6 39.0 2.0 26.5 1.8 
 

Participation in moderate to vigorous physical activity

All students, grades 9–12 ................. 68.7 0.8 75.8 0.9 61.5 1.2 
 

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . . 73.5 1.3 78.4 1.5 68.4 2.1 
 

10th grade .......................... 70.5 1.5 77.8 1.9 63.0 1.9 
 

11th grade . . . . . . . . . . . . . . . . . . . . . . . . . . . 67.4 0.8 74.2 1.4 60.7 1.3 
 

12th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . 61.8 1.4 71.9 1.5 51.7 2.3 
 

White only, not Hispanic .................. 70.2 1.1 77.0 1.2 63.3 1.5 
 

Black only, not Hispanic .................. 62.0 1.4 71.7 1.9 53.1 1.8 
 

Hispanic .............................. 69.4 1.7 76.0 1.8 62.6 2.5 
 

1

SE is standard error.

NOTES: Participation in the currently recommended level of physical activity for students is defined as any kind of physical activity that increased their heart

rate and made them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more of the past 7 days; moderate to vigorous physical

activity is defined as participation in at least 20 minutes of vigorous physical activity on 3 or more of the past 7 days and/or at least 30 minutes of moderate

physical activity on 5 or more of the past 7 days. Persons of Hispanic origin may be of any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

Adolescent Health in the United States, 2007

119

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 33. Dietary risk behavior in the past 30 days among students in grades 9–12, by

grade level, gender, and race and Hispanic origin: United States, 2005

All students Male Female

Grade level, race, and Hispanic origin Percent SE1 Percent SE1 Percent SE1

Did not eat for 24 hours or more

All students, grades 9–12 ................. 12.3 0.5 7.6 0.4 17.0 1.1

9th grade ........................... 13.3 0.7 8.1 1.0 18.4 1.1

10th grade........................... 11.7 0.8 7.4 0.9 16.2 1.0

11th grade .......................... 12.1 0.8 6.8 0.8 17.2 1.4

12th grade........................... 11.9 0.9 7.8 1.0 16.0 1.3

White only, not Hispanic .................. 12.5 0.7 7.5 0.6 17.6 1.2

Black only, not Hispanic .................. 11.4 0.9 8.6 1.1 14.0 1.2

Hispanic .............................. 12.6 0.6 7.4 0.7 17.7 1.0

Vomited or took laxatives

All students, grades 9–12 ................. 4.5 0.3 2.8 0.3 6.2 0.4

9th grade. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 0.4 2.7 0.5 5.5 0.7

10th grade........................... 5.1 0.6 3.0 0.6 7.2 0.9

11th grade ........................... 4.3 0.5 2.5 0.5 6.1 0.7

12th grade........................... 4.3 0.6 2.6 0.6 5.9 0.9

White only, not Hispanic .................. 4.4 0.4 2.3 0.4 6.7 0.6

Black only, not Hispanic .................. 3.4 0.5 2.8 0.6 4.0 0.8

Hispanic .............................. 5.4 0.5 3.9 0.8 6.8 0.6

1

SE is standard error.

NOTES: Went without eating for 24 hours or more is defined as students who went without eating for 24 hours or more to lose weight or to keep from gaining

weight during the past 30 days; vomited or took laxatives is defined as students who vomited or took laxatives to lose weight or to keep from gaining weight

during the past 30 days. Persons of Hispanic origin may be of any race.

SOURCE: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Survey.

120 Adolescent Health in the United States, 2007
Data table for Figure 34. Current health care coverage among adolescents 10–19 years of age and

young adults 20–24 years of age, by age and poverty status: United States, 2005

Private health

Uninsured Medicaid insurance Other

Family income and age Percent SE1 Percent SE1 Percent SE1 Percent SE1

Poor

10–19 years ...................... 20.1 1.2 55.5 1.7 22.7 1.9 1.7 0.4

10–12 years ..................... 13.6 1.3 67.6 2.0 17.0 1.8 1.8 0.5

13–15 years .................... 19.0 1.6 61.3 2.2 18.1 2.0 1.5 0.5

16–17 years ..................... 18.7 2.2 58.8 2.7 20.4 2.5 2.1 0.9

18–19 years ..................... 30.6 3.3 30.5 2.9 37.5 4.8 1.4 0.6

20–24 years ...................... 38.2 2.1 22.3 1.6 38.0 2.6 1.5 0.4

Near poor

10–19 years ...................... 20.9 1.1 31.1 1.2 45.9 1.4 2.1 0.4

10–12 years ..................... 16.8 1.5 36.5 1.9 43.6 2.1 3.1 0.8

13–15 years ..................... 18.1 1.5 33.7 2.0 46.8 2.1 1.5 0.5

16–17 years ..................... 19.2 1.8 30.2 2.2 49.5 2.4 1.1 0.5

18–19 years ..................... 33.7 2.8 19.0 1.8 44.5 2.7 2.8 0.8

20–24 years ...................... 41.8 1.6 12.3 1.2 43.4 1.9 2.5 0.5

Nonpoor

10–19 years ...................... 7.7 0.4 5.6 0.4 84.5 0.6 2.2 0.2

10–12 years ..................... 6.2 0.6 7.2 0.6 84.4 0.9 2.3 0.4

13–15 years ..................... 6.5 0.6 5.4 0.6 85.9 0.8 2.2 0.3

16–17 years ..................... 6.5 0.7 4.6 0.5 86.7 0.8 2.2 0.4

18–19 years ..................... 13.6 1.0 4.5 0.6 79.8 1.2 2.2 0.4

20–24 years ...................... 25.8 1.0 4.5 0.4 67.9 1.1 1.9 0.3

1

SE is standard error.

NOTES: Insurance status is at the time of interview. A person was defined as uninsured if he or she did not have any private health insurance, Medicare,

Medicaid, State Children’s Health Insurance Program (SCHIP), state-sponsored or other government-sponsored health plan, or military plan at the time of the

interview. A person was also defined as uninsured if he or she had only Indian Health Service coverage or had only a private plan that paid for one type of

service such as accidents or dental care. The health plan category ‘‘Medicaid’’ includes Medicaid, State Children’s Health Insurance Program (SCHIP), or

state-sponsored health plan. A small number of persons were covered by both public and private plans and were included in the ‘‘private’’ health plan category.

The health plan category ‘‘other’’ includes Medicare (disability), military plan, or other government-sponsored health plan. Poverty status is derived from the ratio

of the family’s income to the federal poverty threshold, given family size. Poor families have income less than 100 percent of the poverty threshold; near poor

families have income from 100 to less than 200 percent of the poverty threshold; nonpoor families have income of 200 percent of the poverty threshold or more.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Adolescent Health in the United States, 2007

121

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 35. Lack of a health care visit in the past 12 months among adolescents 10–19

years of age, by age, sex, race and Hispanic origin, and health care coverage: United States, 2005

Male Female

Age Percent SE1 Percent SE1

10–19 years ...........................

10–12 years..........................

13–15 years..........................

16–17 years..........................

18–19 years..........................

18.2

13.5

14.1

17.1

33.6

1.0

1.3

1.3

1.6

3.6

14.7

15.1

15.0

12.8

15.8

0.8 
 

1.4 
 

1.4 
 

1.4 
 

2.1 
 

Insured Uninsured

Race and Hispanic origin Percent SE1 Percent SE1

All races and origins .....................

White only, not Hispanic .................

Black only, not Hispanic .................

Hispanic ............................

12.5

9.8

13.5

20.5

0.5

0.7

1.5

1.5

41.2

37.9

43.5

44.5

2.5 
 

4.6 
 

6.0 
 

3.2 
 

1

SE is standard error.

NOTES: Health care visit is defined as being seen by a physician or other health professional in a doctor’s office, clinic, or some other place. Excluded are

visits to emergency rooms, hospitalizations, home visits, and telephone calls. Persons not covered by private insurance, Medicaid, State Children’s Health

Insurance Program (SCHIP), state-sponsored or other government-sponsored health plans, Medicare, or military plans are considered to have no health

insurance coverage. Persons of Hispanic origin may be of any race.

SOURCES: Centers for Disease Control and Prevention, National Center Health Statistics, National Health Interview Survey.

Data table for Figure 36. Any out-of-pocket expenses for health care incurred by adolescents 10–21

years of age, by age group, gender, race and Hispanic origin, and insurance status: United States, 2004

Mean annual out-of-pocket

Adolescents incurring health care expense per person

health care expense with out-of-pocket expense

Age, gender,

origin, and

race and

insurance

Hispanic

status Percent SE1 1 Amount SE

10–21 years ........................... 79.6 0.8 $1,514 $ 65 
 

10–14 years.......................... 84.6 0.9 1,390 85 
 

15–17 years.......................... 81.6 1.1 1,600 121 
 

18–21 years.......................... 71.6 1.3 1,624 132 
 

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76.2 1.0 1,372 81 
 

Female ............................... 83.3 0.8 1,651 98 
 

White only, not Hispanic .................. 86.3 0.9 1,709 81 
 

Black only, not Hispanic .................. 71.3 1.9 933 109 
 

Hispanic .............................. 64.6 1.4 1,344 258 
 

Any private insurance..................... 85.4 0.9 1,581 73 
 

Public insurance only . . . . . . . . . . . . . . . . . . . . . 78.2 1.3 1,439 168 
 

Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.1 2.1 1,087 170 
 

1

SE is standard error.

NOTES: Expenses include those for inpatient hospital and physician services, ambulatory physician and nonphysician services, home health services, dental

services, and other medical equipment, supplies, and services that were purchased or rented during 2004. Public insurance includes Medicaid, State Children’s

Health Insurance Program (SCHIP), Medicare, or other public coverage. Private insurance includes any private insurance coverage, including TRICARE.

Persons in the uninsured category were uninsured for all of 2004. Persons of Hispanic origin may be of any race.

SOURCE: Agency for Healthcare Research and Quality, Center for Cost and Financing Studies, Medical Expenditure Panel Survey.

122 Adolescent Health in the United States, 2007
2004

Data table for Figure 37. Any out-of-pocket expenses for prescribed medicine incurred by adolescents

10–21 years of age, by age group, sex, race and Hispanic origin, and insurance status: United States,

Age, race, Hispanic origin,

and insurance status

Adolescents incurring prescribed

medicine expense

Percent SE1

Mean annual out-of-pocket

expense per person with prescribed

medicine out-of-pocket expense

Amount SE1

10–21 years ...........................

10–14 years..........................

15–17 years..........................

18–21 years..........................

45.2

43.8

45.4

46.7

0.9

1.2

1.4

1.5

$389

365

421

394

$20

25

39

36

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.1 1.1 427 32

Female ............................... 49.5 1.2 355 19

White only, not Hispanic ..................

Black only, not Hispanic ..................

Hispanic ..............................

52.1

35.4

33.1

1.2

1.9

1.4

430

355

271

23

61

24

Any private insurance.....................

Public insurance only .....................

Uninsured .............................

48.1

46.7

26.1

1.1

1.7

2.0

394

432

204

25

37

22

1

SE is standard error.

NOTES: Expenses include all prescribed medications that were purchased or refilled during 2004. Public insurance includes Medicaid, State Children’s Health

Insurance Program (SCHIP), Medicare, or other public coverage. Private insurance includes any private insurance coverage, including TRICARE. Persons in the

uninsured category were uninsured for all of 2004. Persons of Hispanic origin may be of any race.

SOURCE: Agency for Healthcare Research and Quality, Center for Cost and Financing Studies, Medical Expenditure Panel Survey.

Adolescent Health in the United States, 2007

123

Data Tables for Figures 1–40
Data Tables for Figures 1–40

Data table for Figure 38a. Unmet health service needs among adolescents 10–17 years of age with

special health care needs, by number of services needed but not obtained and insurance type:

United States, 2001

Number of reported health services

needed but not obtained

One More than one

Insurance type Percent 1 SE Percent SE1

All .................................. 11.4 0.4 7.3 0.4 
 

Private only............................ 8.7 0.5 4.4 0.4 
 

Public only ............................ 17.7 1.3 10.7 1.3 
 

Private and public ....................... 14.5 1.5 9.5 1.6 
 

Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.2 2.1 28.6 2.5 
 

1

SE is standard error.

NOTES: Service need is based on parents’ perceived need. Unmet need is defined as not receiving all of the service that was needed. Public insurance
 

includes Medicaid and State Children’s Health Insurance Program (SCHIP).
 

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Children with Special Health Care Needs.
 

Data table for Figure 38b. Selected health service needs among adolescents 10–17 years of age with

special health care needs, by type of service and proportion of need that is unmet: United States, 2001

Adolescents with SHCN Adolescents with unmet

needing service need among those needing service

Type of health services needed Percent 1 SE 1 Percent SE

Dental care ............................ 84.9 0.5 10.7 0.5

Mental health care ....................... 30.5 0.6 18.3 1.0

Specialist care.......................... 50.0 0.6 8.2 0.6

Physical therapy, occupational therapy, or

speech therapy ........................ 18.1 0.5 11.5 1.1 
 

Preventive care ......................... 72.7 0.6 3.7 0.4 
 

Eyeglasses or vision care. . . . . . . . . . . . . . . . . . 45.5 0.6 6.0 0.5 
 

Prescription medication ................... 87.4 0.5 2.2 0.3 
 

Medical supplies ........................ 22.3 0.5 2.8 0.5 
 

1

SE is standard error.

NOTES: Service need is based on parents’ perceived need. Unmet need is defined as not receiving all of the service that was needed. Unmet need in Figure

38b is calculated as the percent with unmet need among those needing service times the percentage needing service. SHCN is special health care needs.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Children with Special Health Care Needs.

124 Adolescent Health in the United States, 2007
Data table for Figure 39. Receipt of at least one family planning or reproductive health medical service

in the past year among female adolescents 15–19 years of age and young adults 20–24 years of age, by

type of provider and age group: United States, 2002

At least

1 family

planning or

medical

service

Any

clinic

Clinic

Type of provider

Private

doctor

or HMO

Title X

clinic Other

Age

15–19 years ...........................

15–17 years..........................

18–19 years..........................

20–24 years ...........................

Percent

48.9

37.6

65.1

80.5

Percent

26.1

22.6

31.3

32.2

Percent

12.4

10.9

14.6

14.4

Percent

26.9

17.6

40.4

55.6

Percent

2.1

2.3

1.9

3.1

NOTES: Standard errors are not available. Family planning services include sterilizing operation, birth control method, checkup or medical test related to birth

control, counseling about birth control, counseling about getting sterilized, emergency contraception, or counseling about emergency contraception. Medical

services include Pap smear, pelvic exam, prenatal care, postpartum care, counseling, testing or treatment for sexually transmitted infections, abortion, or

pregnancy test. Percent in ‘‘Title X clinic’’ are also included in ‘‘any clinic.’’ HMO is health maintenance organization. Other is any other place not listed.

Percentages for provider types do not add to total who ‘‘received at least one family planning or medical service’’ because women may have received more than

one service and reported more than one provider.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Survey of Family Growth. Chandra A, Martinez GM,

Mosher WD, Abma JC, Jones J. Fertility, family planning, and reproductive health of U.S. women: Data from the 2002 National Survey of Family Growth.

National Center for Health Statistics. Vital Health Stat 23(25). 2005.

Data table for Figure 40. Dental visit in the past year among adolescents 10–19 years of age and

young adults 20–24 years of age, by age group, sex, race and Hispanic origin, and poverty status:

United States, 2005

10–15 years 16–19 years 20–24 years

Sex, race, Hispanic origin,

and poverty status Percent SE1 Percent SE1 Percent SE1

Total................................. 84.2 0.7 72.6 1.3 54.0 1.3

Not Hispanic:

White only ........................... 89.7 0.7 77.2 1.7 58.3 1.7

Black only ........................... 80.7 2.0 66.6 3.5 52.4 3.5

Hispanic or Latino ....................... 71.4 1.7 58.7 2.7 41.9 2.4

Poor................................. 74.3 2.0 62.5 3.9 53.5 2.7

Near poor ............................. 77.4 1.8 61.9 4.0 46.5 2.5

Nonpoor .............................. 90.0 0.7 79.2 1.6 58.7 1.9

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83.7 0.9 69.4 2.1 51.9 1.9

Female ............................... 84.7 1.0 75.9 1.6 56.1 1.7

1

SE is standard error.

NOTES: Persons of Hispanic origin may be of any race. The income groups are derived from the ratio of the family’s income to the federal poverty threshold,

given family size. Poor is less than 100 percent of the poverty threshold; near poor is between 100 and 199 percent of the poverty threshold; nonpoor is 200

percent of the poverty threshold or more.

SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.

Adolescent Health in the United States, 2007

125

Data Tables for Figures 1–40
Technical Notes

Technical Notes

Emergency Department Visit Rates

See Appendix II, National Hospital Medical Care Survey, for a

description of the data source. ED visit rates in this report are

based on initial visits for injury and all visits for other

diagnoses. Initial injury visits include initial visits to an ED for

an injury episode with either a first-listed injury diagnosis that

is based on the Barell matrix definition of an injury

(regardless of any mention of an external cause-of-injury

code) or the first-listed valid external cause-of-injury code,

which is based on the recommended framework for external

causes of injury (1). Complications of care and adverse

effects are excluded from both the diagnosis codes as well as

the external cause codes. All other diagnoses are for visits

not related to an injury except those that are pregnancy

related. See Table I for a listing of the code numbers used to

define the diagnostic categories.

The external cause of injury is defined using only the

first-listed cause. The category ‘‘being struck by or against an

object or a person’’ is a broad one that includes a specific

code for sports-related injuries. One should note that principal

diagnoses that are based on ED data are not as detailed as

discharge diagnoses from inpatient settings.

Hospital Discharge Rates

See Appendix II, National Hospital Discharge Survey (NHDS),

for a description of the data source. Cause-specific hospital

discharge data from the NHDS are defined using the

first-listed diagnosis. See Table I for a listing of the code

numbers used to define the diagnostic categories.

Mortality

See Appendix II, National Vital Statistics System, for a

description of the data source. External cause of injury codes

(V01–Y98) are assigned for all deaths for which the

underlying cause of death listed on the death certificate was

an injury. See Table II for code numbers used to define cause

of death categories. The external cause of injury codes are

designed to classify environmental events, circumstances, and

conditions that contributed to the injury. E codes have two

dimensions: cause or mechanism of injury (for example,

firearm, motor vehicle, and poisoning) and intent or manner of

death (including unintentional, suicide, homicide, intent

undetermined, and other).

Pregnancy Rates

Pregnancies are estimated as the sum of three outcomes:

live births, induced abortions, and fetal losses (miscarriages

and stillbirths) (2). See Appendix II, National Vital Statistics

System, National Survey of Family Growth, Abortion

Surveillance, and Alan Guttmacher Institute (AGI) Abortion

Provider Survey, for a description of the data sources used to

calculate the estimated number of pregnancies.

The birth data are complete counts of all live births. Induced

abortion estimates in this report are national estimates that

are based on abortion surveillance information which is

collected from most states by the CDC’s National Center for

Chronic Disease Prevention and Health Promotion

(NCCDPHP) Abortion Surveillance and which is adjusted to

national totals compiled by AGI from their surveys of all

known abortion providers. In 2002, the NCCDPHP abortion

surveillance system collected data on abortions by age for 47

states, the District of Columbia (D.C.), and New York City. No

data were available for Alaska, California, and New

Hampshire. The numbers of abortions published by

NCCDPHP tend to be lower than the numbers published by

AGI. For example, the total number of abortions reported by

NCCDPHP was about 20 percent lower in 2000 than the

number reported by AGI for the same reporting areas.

Information on fetal losses in this report is based on cycles 3

through 6 of the National Survey of Family Growth (NSFG),

conducted in 1982, 1988, 1995, and 2002 by NCHS. This

information comes from the pregnancy histories collected for

each woman in the NSFG samples. The proportions of recent

pregnancies (excluding induced abortions) ending in fetal loss

in the years preceding each survey are used to compile

estimated fetal loss rates. Data from the last four NSFG

cycles have been combined in this way to provide statistical

reliability because of small numbers of pregnancies, especially

for teenagers. The estimates for 1990–2000 in this report

have been revised to incorporate the combined fetal loss

estimates from cycles 3 through 6 of the NSFG; previous

estimates used data from cycle 5 only. The fetal loss figures

are estimates, and variations reflect in part the extent to

which pregnancies are recognized, especially at very early

gestation periods. Yet, the NSFG data are preferable to vital

statistics reports of fetal losses, because vital statistics data

126 Adolescent Health in the United States, 2007
are generally limited to losses occurring at gestations of 20

weeks or more, whereas NSFG data include all gestations.

The vast majority of fetal losses occur early in pregnancy

before the reporting requirements for fetal losses are in effect.

Even fetal losses of 20 weeks or more are underreported in

vital statistics data.

The pregnancy rates in this report are based on revised

population estimates consistent with the 2000 census. In

computing birth rates for the Hispanic population, births with

origin of mother not stated are included with non-Hispanic

births rather than being distributed. Thus, rates for the U.S.

Hispanic population are underestimates of the true rates to

the extent that the births with origin of mother not stated

(0.8 percent in 2004) were actually to Hispanic mothers. In

computing the rates, the census-based populations with origin

not stated are imputed. The effect on the rates is believed to

be small.

References

1.	 Fingerhut L. Recommended definition of initial injury

visits to emergency departments for use with the

NHAMCS-ED Data. National Center for Health Statistics.

Health E-Stat. [cited 2007 June 8]. Available from:

www.cdc.gov/nchs/products/pubs/pubd/hestats/injury/injury.htm.

2007.

2.	 Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Recent

trends in teenage pregnancy in the United States, 1990–2002.

National Center for Health Statistics. Health E-Stat. Available

from: www.cdc.gov/nchs/products/pubs/pubd/hestats/

teenpreg1990–2002/teenpreg1990–2002.htm. 2006.

Table I. Codes for diagnostic categories from the International Classification of Diseases, Ninth

Revision, Clinical Modification (ICD–9–CM)

Diagnostic category ICD–9–CM code numbers

Noninjury:

Psychoses................................ 90–299

Upper respiratory infection .................... 460–465, 381, 382, 34.0

Asthma .................................. 493

STDs ................................... 54.1, 77.98, 78.10, 78.11, 78.19, 78.88, 79.4, 90–92, 94, 98.10,

98.16–.17, 98.30, 98.36–.39, 98.86, 99.0–.2, 99.40–.41, 99.5,

112.1, 131.0, 131.8–.9, 614.0–.5, 614.7–.9, 615.0–.9, 616.10,

623.5, 628.2, 647.0–.2, 980–988

Urinary tract infection ....................... 595.0, 595.9, 599.0, 590.1, 590.8, 590.9

Abdominal/gastrointestinal .................... 789.0, 558.9, 535.0, 535.5–9, 540, 541, 531–534

Pregnancy related .......................... 630–677 or V22, V23, V27

Injury:

Fractures1 ............................... 800.0–829

Sprains and Strains ......................... 840–848

Open Wounds2 ............................ 870–884, 890–894

Contusions ............................... 920–924

Poisoning ................................ 960–989

External cause of injury:

Motor vehicle traffic ......................... E810–E819, E958.5, E988.5

Fall. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E880–E886, E888, E957, E968.1, E987

Struck by, against .......................... E916–E917, E960.0, E968.2, E973, E975

Cut/pierce ................................ E920, E956, E966, E974, E986

1

This set of ICD codes differs from the traditional categorization of fractures that has generally included ICD codes 800–829. ICD codes for skull fracture with
 

intracranial injuries and spinal fractures with spinal cord injuries are excluded. Those codes are categorized with internal organ injuries.
 

2

This set of codes differs from the traditional grouping of ICD codes 870–897. Omitted are injuries to the larynx, trachea, pharynx, and thyroid, which would be
 

categorized with internal organ injuries. In addition, codes for traumatic amputations are grouped separately.
 

Adolescent Health in the United States, 2007

127

Technical Notes
Technical Notes

Table II. Codes for cause of death categories from the International Classification of Diseases, Tenth

Revision (ICD–10)

Cause of death ICD–10 code numbers

Natural causes ..............................

Injury1 ....................................

Motor vehicle traffic .........................

Firearm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Unintentional injury..........................

Suicide ..................................

Homicide.................................

External cause of injury ........................

A00–R99

U01–U03, V01–Y36, Y85–Y87, Y89

V02–V04[.1,.9], V09.2, V12–V14[.3–.9], V19[.4–.6],

V20–V28[.3–.9], V29–V79[.4–.9], V80.3–V80.5,

V80[.3–.5], V81.1, V82.1, V83–V86[.0–.3],

V87.0– V87[.0–.8], V89.2

U01.4, W32–W34, X72–X74, X93–X95, Y22–24, Y35.0

V01–X59, Y85–86

U03, X60–X84, Y87.0

U01–U03, X85–Y09, Y87.1

U01–U03, V01–Y98
 

1

Injury codes exclude adverse effects and complications of medical care.

128 Adolescent Health in the United States, 2007
Appendix I – Healthy People 2010

Healthy People 2010 provides a comprehensive national

agenda for health promotion and prevention of disease,

disability, and premature death, and it is designed to measure

U.S. progress. The Healthy People 2010 objectives include

measures of health outcomes, contributing behaviors, and

health services. Of the 467 objectives, 107 were identified as

important for adolescents and young adults. A total of 21 of

the adolescent health objectives were identified as Critical

Health Objectives representing critical health outcomes or

contributing behaviors. These 21 objectives reflect many of

the risk behaviors of adolescents, including tobacco use,

unhealthy dietary habits, inadequate physical activity, and

alcohol and other drug use, as well as behaviors that result in

violence and unintentional injury. The objectives also address

such health status issues as selected leading causes of

mortality among adolescents and reproductive health.

Appendix Table. Critical health objectives

Progress towards meeting the 21 objectives will result in

substantial improvements in adolescent health, and meeting

the targets set by the objectives will also lead to

improvements in adult health because adult risk behaviors

often develop during adolescence and young adulthood. In

addition, adoption of healthy behaviors by adolescents will

help prevent the development of many serious chronic

diseases that occur later in adulthood, including lung and

heart disease, certain common kinds of cancer, diabetes, and

other chronic diseases.

The appendix table below lists the 21 Critical Health

Objectives for adolescents associated with the topic areas in

Adolescent Health in the United States, 2007, the baseline

measures and the most recent data, the Healthy People 2010

targets, and the figures in this report that have data related to

the objectives. The measure or data source presented in the

figure may differ from that used in Healthy People 2010.

Objective Baseline Most recent 2010 Related

number Topic area and Critical Health Objective (year) data (year) target figure

Health Status

19–3.(b) Reduce the proportion of adolescents who are overweight

12 to 19 year-olds 11% (1988–94) 17% (2003–4) 5% 5

18–2. Reduce the rate of suicide attempts requiring medical attention

9th through 12th grade students 2.6% (1999) 2.3% (2005) 1.0% 7

6–2. Reduce the proportion of children and adolescents

who are reported to be sad, unhappy, or depressed

4 to 17 year-olds 31% (1997) 27% (2005) 17%

16–03.(a–c) Reduce deaths of adolescents and young adults

10 to 14 year-olds (per 100,000 population) 21.5 (1998) 18.7 (2004) 1

16.5 8

15 to 19 year-olds(per 100,000 population) 69.5 (1998) 66.1 (2004) 1

38.0

20 to 24 year-olds (per 100,000 population) 92.7 (1998) 94.0 (2004) 1

41.5

15–15.a Reduce deaths caused by motor vehicle crashes

15 to 24 year-olds (per 100,000 population) 25.6 (1999) 25.8 (2004) NA 17

26–1.a Reduce deaths and injuries caused by alcohol-related

motor vehicle crashes

15 to 24 year-olds (per 100,000 population) 11.8 (1998) 12.4 (2002) NA

18–1. Reduce suicides

10 to 14 year-olds (per 100,000 population) 1.2 (1999) 1.3(2004) NA 16

15 to 19 year-olds (per 100,000 population) 8.0 (1999) 8.2 (2004) NA

15–32. Reduce homicides

10 to 14 year-olds (per 100,000 population) 1.2 (1999) 1.0 (2004) NA 16

15 to 19 year-olds (per 100,000 population) 10.4 (1999) 9.3 (2004) NA

Adolescent Health in the United States, 2007

129

Appendix I – Healthy People 2010
Appendix I – Healthy People 2010

Appendix Table. Critical health objectives—Con.

Objective

number Topic area and Critical Health Objective

Baseline

(year)

Most recent

data (year)

2010

target

Related

figure

Violence

15–38. Reduce physical fighting among adolescents

9th through 12th grade students 36% (1999) 36% (2005) 32%

Reproductive Health

9–7.

25–1.(a–c)

13–5.

Reduce pregnancies among female adolescents

15 to 17 year-olds (per 1,000 population )

Reduce the proportion of adolescents and young adults with

Chlamydia trachomatis infections (15 to 24 year-olds)

Females attending family planning clinics

Females attending STD clinics

Males attending STD clinics

Reduce the number of new HIV/AIDS cases diagnosed among

adolescents and young adults

67 (1996)

5.0% (1997)

12.2% (1997)

15.7% (1997)

DNC

44.4 (2002)

6.9% (2004)

15.3% (2004)

20.2% (2004)

--­

43

3.00%

3.00%

3.00%

--­

21b

23

24

Risk Behaviors

25–11.(a–b) Increase the proportion of adolescents who have never

had sexual intercourse

27–2.(a)

26–11.(d)

26–10.(b)

15–19.

26–6.

9th through 12th grade students

Increase the proportion of adolescents who have had sexual

intercourse, but not in the past 3 months

9th through 12th grade students

Reduce the proportion of adolescents who used tobacco

products in the past month

9th through 12th grade students

Reduce the proportion of persons engaging in binge drinking

alcoholic beverages in the past month

12 to 17 year-olds

Reduce use of marijuana in the past month

12 to 17 year-olds

Increase use of safety belts

9th through 12th grade students

Reduce the proportion of adolescents who report that they rode

during the previous 30 days, with a driver who had been drinking

alcohol

50% (1999)

27% (1999)

40% (1999)

10.7% (2002)

8.2% (2002)

84% (1999)

53% (2005)

27% (2005)

28% (2005)

9.9% (2005)

6.8% (2005)

90% (2005)

56%

30%

21%

2

3.1%

0.70%

92%

25a, 26

27

28

30

29a, 29b

15–39.

22–7.

9th through 12th grade students

Reduce weapon carrying by adolescents on school property

9th through 12th grade students

Increase the proportion of adolescents who engage in vigorous

physical activity

9th through 12th grade students

33% (1999)

6.9% (1999)

65% (1999)

28% (2005)

6.5% (2005)

64% (2005)

30%

4.90%

85%

29a, 29b

31

32

Health Care Access and Utilization

18–7. Increase the proportion of children with mental health problems

who receive treatment

4 to 17 year-olds 60% (2001) 64% (2005) 0.66

- - - Data are not available.

1

Baseline has been revised.

2

Target has been revised.

NOTE: NA is not applicable. The Healthy People 2010 target is not applicable for specific age groups. DNC is data for specific population are not collected.

130 Adolescent Health in the United States, 2007
Appendix II – Data Sources

Information in Adolescent Health in the United States, 2007

was obtained from data files and published reports from

several federal government agencies. In each case, the

sponsoring agency collected data using its own methods and

procedures. Therefore, data in this report vary with respect to

source, method of collection, and definitions. Although a

detailed description and comprehensive evaluation of each

data source are beyond the scope of this appendix, users

should be aware of the general strengths and weaknesses of

the different data collection systems. For example,

population-based surveys obtain socioeconomic data, data on

family characteristics, and information on the effect of an

illness, such as limitation of activity. These data are limited by

the amount of information a respondent remembers or is

willing to report. A respondent may not know detailed medical

information, such as precise diagnoses or the types of

operations performed and, therefore, cannot report it. In

contrast, record-based surveys, which collect data from

physician and hospital records, usually have good diagnostic

information but little or no information about the

socioeconomic characteristics of persons or the impact of

illnesses on persons.

The populations covered by different data collection systems

may not be the same, and understanding the differences is

critical to interpreting the data. Data on vital statistics and

national expenditures cover the entire population. Most data

on morbidity and utilization of health resources cover only the

civilian noninstitutionalized population.

All data collection systems are subject to error, and records

may be incomplete or contain inaccurate information.

Respondents may not remember essential information, a

question may not mean the same thing to different

respondents, and some institutions or persons may not

respond at all. Measuring the magnitude of these errors or

their effect on the data is not always feasible. Where

possible, table notes describe the universe and method of

data collection to assist users in evaluating data quality.

Some information is collected in more than one survey, and

estimates of the same statistic may vary among surveys

because of different survey methodologies, sampling frames,

questionnaires, definitions, and tabulation categories. For

example, information on substance use for youth is collected

in three national surveys—the National Survey on Drug Use

& Health (NSDUH), Monitoring the Future (MTF), and the

Youth Risk behavior Survey (YRBS). Rates of substance use

by these surveys are not directly comparable. In this report,

estimates of cigarette smoking, marijuana use, and drinking

and driving are based on the YRBS (Figures 27, 29a and

29b, and 30). Estimates of alcohol use, binge alcohol use,

and heavy alcohol use are based on the NSDUH (Figure 28).

Unlike this report, Health, United States, 2006 presents some

estimates of substance use that are based on all three of

these surveys.

Overall estimates generally have relatively small sampling

errors, but estimates for certain population subgroups may be

based on a small sample size and have relatively large

sampling errors. Numbers of births and deaths from the vital

statistics system represent complete counts. Therefore, they

are not subject to sampling error. When the number of events

is small and the probability of such an event is rare,

estimates may be unstable and considerable caution should

be observed in interpreting the statistics. Estimates that are

unreliable because of large sampling errors or small numbers

of events are noted with asterisks (*) in selected tables. The

criteria used to designate unreliable estimates are indicated in

notes to the applicable tables.

Data sources are listed alphabetically by data set name and

agency.

Government Sources

Abortion Surveillance

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention

and Health Promotion (NCCDPHP)

The abortion surveillance program documents the number and

characteristics of women obtaining legal induced abortions,

and it compiles abortion data by state or area of occurrence.

During 1973–1997, data were received from or estimated for

52 reporting areas in the United States: the 50 states, D.C.,

and New York City. In 1998 and 1999, CDC compiled

abortion data from 48 reporting areas. Alaska, California, New

Hampshire, and Oklahoma monitors unintended pregnancy

and assists efforts to identify and reduce preventable causes

of morbidity and mortality associated with abortions. The

surveillance data include age, race and ethnicity, marital

status, previous live births, period of gestation, and previous

Adolescent Health in the United States, 2007

131

Appendix II

– Data Sources
Appendix II

– Data Sources

induced abortions by women obtaining legal induced

abortions. For each year since 1969, the data for these states

were not estimated or reported by CDC. During 2000–2002,

Oklahoma again reported these data, increasing the number

of reporting areas to 49. In 2003, Alaska again reported these

data and West Virginia did not, maintaining the number of

reporting areas at 49. The system includes women of all

ages, including adolescents, who obtain legal induced

abortions.

Between 1998 and 2002, the total number of abortions

reported to CDC was about 34 percent less than the total

estimated by AGI. The four reporting areas (the largest of

which was California) that did not report abortions to CDC in

1998 accounted for 18 percent of all abortions tallied by the

AGI’s 1995–1996 abortion survey.

For more information, see the NCCDPHP

surveillance and research website:

www.cdc.gov/reproductivehealth/Data_Stats/index.htm.

AIDS Surveillance

Centers for Disease Control and Prevention

National Center for HIV, STD, and TB Prevention

(NCHSTP)

AIDS surveillance data are used to detect and monitor cases

of HIV disease and AIDS in the United States. The data also

help to identify epidemiologic trends, pinpoint unusual cases

requiring follow-up, and inform public health efforts to prevent

and control the disease. A growing number of states require

confidential reporting of persons with HIV infection and

participate in CDC’s integrated HIV and AIDS surveillance

system, which compiles information on the population of

persons in whom HIV has been recently diagnosed and

persons who are currently living with HIV infection. Data

collected on those reported as having contracted AIDS

include age, gender, race or ethnicity, mode of exposure, and

geographic region.

AIDS surveillance is conducted by health departments in each

state or territory and D.C. Although surveillance activities

range from passive to active, most areas employ multifaceted

active surveillance programs, which include four major

reporting sources of AIDS information: hospitals and

hospital-based physicians, physicians in nonhospital practice,

public and private clinics, and medical record systems (death

certificates, tumor registries, hospital discharge abstracts, and

132

communicable disease reports). Using a standard confidential

case report form, the health departments collect information

that is then transmitted electronically without personal

identifiers to CDC.

Adjustments of the estimated AIDS data to account for

reporting delays are calculated by a maximum likelihood

statistical procedure that takes into account the differences in

reporting delays among exposure, geography, race or

ethnicity, age, gender, and vital status categories. The

procedure is based on the assumption that reporting delays in

these categories have not changed over time. AIDS

surveillance data are provisional and are updated annually.

Although completeness of reporting of AIDS cases to state

and local health departments differs by geographic region and

patient population, studies conducted by state and local

health departments indicate that the reporting of AIDS cases

in most areas of the United States is more than 85 percent

complete. To assess trends in AIDS cases, deaths, and

prevalence, using case data adjusted for reporting delays and

presented by year of diagnosis is preferable to using straight

counts of cases presented by year of report.

Decreases in AIDS incidence and in the number of AIDS

deaths, first noted in 1996, have been ascribed to the effect

of new treatments, which prevent or delay the onset of AIDS

and premature death among HIV-infected persons and result

in an increase in the number of persons living with HIV and

AIDS.

For more information, see the NCHSTP website:

www.cdc.gov/nchstp/od/nchstp.html.

Current Population Survey (CPS)

Bureau of Labor Statistics and U.S. Census

Bureau

The Current Population Survey (CPS) provides current

estimates and trends in employment, unemployment, and

other characteristics of the general labor force, the population

as a whole, and various population subgroups. One person

generally responds for all eligible members of a household.

Estimates of poverty and health insurance coverage

presented in Adolescent Health in the United States, 2007

from the CPS are derived from the Annual Social and

Economic Supplement (ASEC), formerly called the Annual

Demographic Supplement, or simply, the March Supplement.

The ASEC collects data on family characteristics, household

Adolescent Health in the United States, 2007
composition, marital status, migration, income from all

sources, information on weeks worked, time spent looking for

work or on layoff from a job, occupation and industry

classification of the job held longest during the year, health

insurance coverage, and receipt of noncash benefits (i.e.,

food stamps, school lunch program, employer-provided group

health insurance plan, employer-provided pension plan,

personal health insurance, Medicaid, Medicare, civilian or

military health care for the members of the uniformed

services and their families, and energy assistance).

The CPS sample is located in 754 sample areas, with

coverage in every state and D.C. The adult universe (i.e., the

population of marriageable age) is composed of persons 15

years of age and over in the civilian noninstitutionalized

population for CPS labor force data. The sample for the

March CPS supplement is expanded to include members of

the Armed Forces who are living in civilian housing or with

their family on a military base, as well as additional Hispanic

households that are not included in the monthly labor force

estimates.

The basic CPS sample is selected from multiple frames using

multiple stages of selection. Each unit is selected with a

known probability to represent similar units in the universe.

The sample design is state-based, with the sample in each

state being independent of the others.

For more information, see the CPS website:

http://www.census.gov/cps/.

Medical Expenditure Panel Survey (MEPS)

Agency for Healthcare Research and Quality

The Medical Expenditure Panel Survey (MEPS) produces

nationally representative estimates of health care use,

expenditures, sources of payment, insurance coverage, and

quality of care for the U.S. civilian noninstitutionalized

population. MEPS data in Adolescent Health in the United

States, 2007 include health care expenses and prescribed

medicine expenses, presented by sociodemographic

characteristics and type of health insurance.

The U.S. civilian noninstitutionalized population is the

primary population represented. MEPS is a national

probability survey conducted on an annual basis since 1996.

The panel design of the survey features several rounds of

interviewing covering 2 full calendar years. The MEPS

consists of three components: the Household Component

(HC), the Medical Provider Component (MPC), and the

Insurance Component (IC).

The HC is a nationally representative survey of the civilian

noninstitutionalized population drawn from a subsample of

households that participated in the prior year’s National

Health Interview Survey (NHIS) conducted by NCHS. Missing

expenditure data are imputed using data collected in the MPC

whenever possible.

The MPC collects data from hospitals, physicians, and home

health providers that were reported in the HC as providing

care to MEPS sample persons. Data are collected in MPC to

improve the accuracy of expenditure estimates derived solely

from the HC. The MPC is particularly useful in obtaining

expenditure information for persons enrolled in managed care

plans and Medicaid recipients. Sample sizes for the MPC

vary from year to year depending on the HC sample size and

the MPC sampling rates for providers.

The IC consists of two subcomponent samples: a household

sample and a list sample. The household sample collects

detailed information from employers on the health insurance

held by and offered to respondents to the MEPS-HC. The

sample size for the MEPS-HC was approximately

13,000–15,000 families annually beginning in 2002. The

full-year household core response rate has generally been

about 66 percent. The list sample collects data on the types

and costs of workplace health insurance from a total of about

40,000 business establishments and government agencies

each year.

For more information, see the MEPS website:

www.meps.ahrq.gov.

National Crime Victimization Survey (NCVS)

Bureau of Justice Statistics

U.S. Department of Justice

The National Crime Victimization Survey (NCVS) is the United

States’ primary source of information on criminal victimization,

including crimes not reported to the police. The survey

collects information from persons 12 years of age and over

on the frequency, characteristics, and consequences of

criminal victimization in the United States. The survey collects

data on victimization by rape, sexual assault, robbery, assault,

theft, household burglary, and motor vehicle theft.

Adolescent Health in the United States, 2007

133

Appendix II

– Data Sources
Appendix II – Data Sources

As defined in NCVS, violent crime can be classified into three

categories: simple and aggravated assault, rape or sexual

assault, and robbery. Violent crime does not include personal

theft, such as purse snatching, or property crimes, such as

household theft. Crime victimization rates are calculated as

the number of events per 1,000 population.

For more information, see the NCVS website:

www.ojp.usdoj.gov/bjs/glance/viort.htm.

National Health and Nutrition Examination

Survey (NHANES)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Health and Nutrition Examination Survey

(NHANES) program includes a series of cross-sectional

nationally representative health examination surveys

conducted in mobile examination units or clinics (MECs). In

the first series of surveys, the National Health Examination

Survey (NHES), data were collected on the prevalence of

certain chronic diseases, the distributions of various physical

and psychological measures, and measures of growth and

development. In 1971, a nutrition surveillance component was

added and the survey name changed to NHANES. The

NHANES series of surveys are based on a highly stratified

multistage probability sample selected to represent the civilian

noninstitutionalized population. Beginning in 1999, NHANES

became a continuous annual survey.

The NHANES surveys have collected data on chronic disease

prevalence and conditions (including undiagnosed conditions)

and factors such as obesity and smoking, serum cholesterol

levels, hypertension, diet and nutritional status, immunization

status, infectious disease prevalence, health insurance, and

measures of environmental exposures. Other topics

addressed include hearing, vision, mental health, anemia,

diabetes, cardiovascular disease, osteoporosis, oral health,

mental health, pharmaceuticals used, and physical fitness.

With the exception of the Hispanic Health and Nutrition

Examination Survey, the NHES and NHANES provide

estimates of the health status of the civilian

noninstitutionalized population of the United States. NHES II

and NHES III examined probability samples of U.S.

noninstitutionalized children ages 6–11 years (NHES II) and

12–17 years (NHES III). Beginning in 1999, NHANES

oversampled low-income persons, adolescents 12–19 years of

age, persons 60 years of age and over, African American or

black persons, and persons of Mexican origin. The sample is

not designed to give a nationally representative sample for

the total population of Hispanics residing in the United States.

For the most recent survey years, NHANES 2003–2004,

6,410 households had at least one eligible sample person

identified for interviewing. A total of 12,761 eligible sample

persons were identified, of which 79 percent (10,115) were

interviewed and 76 percent (9,653) completed the health

examination component of the survey.

The NHANES includes clinical examinations, selected medical

and laboratory tests, and self-reported data. The NHANES

and previous surveys interviewed persons in their homes and

conducted medical examinations, including laboratory analysis

of blood, urine, and other tissue samples. Medical

examinations and laboratory tests follow very specific

protocols and are standardized as much as possible to

ensure comparability across sites and providers. From

1999–2002, as a substitute for MEC examinations, a small

number of survey participants received an abbreviated health

examination in their homes if they were unable to come to an

MEC.

For more information, see the NHANES website:

www.cdc.gov/nchs/nhanes.htm.

National Health Interview Survey (NHIS)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Health Interview Survey (NHIS) monitors the

health of the U.S. population through the collection and

analysis of data on a broad range of health topics. A major

strength of this survey lies in its ability to analyze health

measures by many demographic and socioeconomic

characteristics. The NHIS has been conducted annually since

1957 with a major redesign every 10 to 15 years. The NHIS

covers the civilian noninstitutionalized population of the United

States. Excluded are patients in long-term care facilities,

persons on active duty with the Armed Forces (although their

dependents are included), and U.S. nationals living in foreign

countries.

The NHIS obtains information during household interviews on

illnesses, injuries, activity limitation, chronic conditions, health

insurance coverage, utilization of health care, and other

health topics. Demographic data include age, gender,

134 Adolescent Health in the United States, 2007
education, race or ethnicity (reported by respondent or proxy),

place of birth, income, and place of residence. Other data

collected include risk factors such as lack of exercise,

smoking, and alcohol consumption, as well as use of

prevention services such as vaccinations, mammography, and

pap smears. Special modules and supplements focus on

different issues each year and have included topics such as

HIV and AIDS, aging, cancer screening, prevention,

alternative and complementary medicine, and many other

topics.

The NHIS is a cross-sectional household interview survey.

Sampling and interviewing are continuous throughout each

year. The sampling plan follows a multistage area probability

design that permits the representative sampling of

households. From each family in the NHIS, one sample adult

and, for families with children under 18 years of age, one

sample child are randomly selected to participate in the

Sample Adult Core and the Sample Child Core

questionnaires. Because some health issues are different for

children and adults, these two questionnaires differ in some

items, but they both collect basic information on health status,

use of health care services, health conditions, and health

behaviors. Since 1997, the sample numbered about 100,000

persons, with about 30,000–36,000 persons participating in

the sample adult and about 12,000–14,000 persons

participating in the sample child questionnaire. In 2005, the

total household response rate was 87 percent. Response

rates for special health topics (supplements) have generally

been lower. Since 1997, the final response rate for the

sample adult supplement was 70–80 percent and 78–

84 percent for the sample child supplement.

For more information, see the NHIS website:

www.cdc.gov/nchs/nhis.htm.

National Hospital Ambulatory Medical Care

Survey (NHAMCS)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Hospital Ambulatory Medical Care Survey

(NHAMCS) collects data on the utilization and provision of

medical care services provided in hospital EDs and outpatient

departments (OPDs). Data are collected from medical records

on type of providers seen; reason for visit; diagnoses; drugs

ordered, provided, or continued; and selected procedures and

tests performed during the visit. Patient data include age,

gender, race, and expected source of payment. Data are also

collected on selected characteristics of hospitals included in

the survey. Annual data collection began in 1992.

The survey is a representative sample of visits to EDs and

OPDs of nonfederal short-stay or general hospitals. Telephone

contacts are excluded. Data from ED visits are presented in

Adolescent Health in the United States, 2007. A four-stage

probability sample design is used in NHAMCS. For analyses

that present visit rates per population, the civilian noninstitutionalized population is used as the denominator.

However, visits to hospital EDs can also include persons who

reside in institutional settings.

Data are collected through abstraction of medical records,

completion of encounter forms, compilation of data from state

and professional associations, purchase of data from

commercial abstraction services, and surveys of providers.

Hospital staff are asked to complete patient record forms

(PRFs) for each sampled visit, but census field

representatives typically abstract data for more than one-half

of these visits. In any given year, the hospital sample consists

of approximately 500 hospitals, of which 80 percent have

EDs. The number of PRFs completed for EDs was 37,337 in

2002, 40,253 in 2003, and 36,589 in 2004. The hospital

response rate for NHAMCS for EDs was 92 percent in 2002,

85 percent in 2003, and 89 percent in 2004.

For more information, see the NHCS website:

www.cdc.gov/nchs/nhcs.htm.

National Hospital Discharge Survey (NHDS)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Hospital Discharge Survey (NHDS) collects and

produces national estimates on characteristics of inpatient

stays in nonfederal short-stay hospitals in the United States.

The NHDS has been conducted annually since 1965. Patient

information collected includes demographics, length of stay,

diagnoses, and procedures. Hospital characteristics collected

include region, ownership, and bed size.

The survey design covers the 50 states and D.C. Included in

the survey are hospitals with an average length of stay of

less than 30 days for all inpatients, general hospitals, and

children’s general hospitals. Excluded are federal, military, and

Department of Veterans Affairs hospitals, as well as hospital

units of institutions (such as prison hospitals), and hospitals

Adolescent Health in the United States, 2007

135

Appendix II

– Data Sources
Appendix II

– Data Sources

with fewer than six beds staffed for patient use. All

discharged patients from in-scope hospitals are included in

the survey.

A redesign of the NHDS was implemented for the 1988

survey. Under the redesign, hospitals were selected using a

modified three-stage stratified design. The basic unit of

estimation for NHDS is a sampled discharge. In 2004, 501

hospitals were selected: 476 were within scope, 439

participated (92 percent), and data were collected from

medical records for approximately 371,000 discharges.

Hospital utilization rates per 10,000 population were computed

using estimates of the civilian population of the United States

as of July 1 of each year. The estimates for 2002–2004 that

appear in Adolescent Health in the United States, 2007 were

calculated using estimates of the civilian population that were

based on census 2000.

For more information, see the National Health Care Survey

website at http://www.cdc.gov/nchs/nhcs.htm or the NHDS

website at www.cdc.gov/nchs/about/major/hdasd/nhds.htm.

National Survey on Drug Use & Health (NSDUH)

Substance Abuse and Mental Health Services

Administration

The National Survey on Drug Use & Health (NSDUH),

formerly called the National Household Survey on Drug Abuse

(NHSDA), collects data on substance abuse and dependence,

mental health problems, and receipt of substance abuse and

mental health treatment.

NSDUH reports on the prevalence, patterns, and

consequences of drug and alcohol use and abuse in the

general U.S. civilian noninstitutionalized population 12 years

of age and over. Data are collected on the use of illicit drugs,

the nonmedical use of legal drugs, and the use of alcohol

and tobacco products. The survey is conducted annually and

is designed to produce drug and alcohol use incidence and

prevalence estimates. Data are also collected periodically on

special topics of interest such as criminal behavior, treatment,

mental health, and attitudes about drugs.

The NHSDA survey has been conducted since 1971. In 1999,

the NHSDA underwent a major redesign affecting the method

of data collection, sample design, sample size, and

oversampling. In 2002, the survey underwent a name change

to NSDUH, as well as additional improvements and

modifications to the survey.

The survey is representative of persons 12 years of age and

over in the civilian noninstitutionalized population in the United

States. This includes civilians living on military bases and

persons living in noninstitutionalized group quarters, such as

college dormitories, rooming houses, and shelters. Persons

excluded from the survey include homeless people who do

not use shelters, active military personnel, and residents of

institutional group quarters, such as jails and hospitals. The

data collection method involves in-person interviews

conducted with a sample of persons at their place of

residence. Beginning in 1999, the interview has been carried

out with computer assisted interviewing methodology. The

survey uses a combination of computer-assisted personalinterviewing (conducted by the interviewer for some basic

demographic information) and audio computer-assisted

self-interviewing (ACASI) for most of the questions. ACASI

provides a highly private and confidential means of

responding to questions to increase the level of honest

reporting of illicit drug use and other sensitive behavior. The

2005 NSDUH employed a 50-state sample design with an

independent, multistage area probability sample for each of

the 50 states and D.C. to support the development of both

national and state-level estimates. Nationally, of the 146,912

eligible households sampled, 134,055 addresses were

successfully screened for the 2005 survey, and in these

screened households, a total of 83,805 sample persons were

selected and 68,308 completed interviews were obtained. The

survey was conducted from January to December 2005. The

weighted response rate was 91 percent for household

screening and 76 percent for interviewing.

Estimates of substance use for youth that are based on the

NSDUH are not directly comparable with estimates that are

based on Monitoring the Future (MTF) and the Youth Risk

Behavior Surveillance System (YRBSS). In addition to the fact

that the MTF excludes dropouts and absentees, rates are not

directly comparable across these surveys because of

differences in populations covered, sample design,

questionnaires, interview setting, and statistical approaches to

make the survey estimates generalizable to the entire

population. The NSDUH survey collects data in homes,

whereas the MTF and YRBSS collect data in school

classrooms. The NSDUH estimates are tabulated by age,

whereas the MTF and YRBSS estimates are tabulated by

grade, representing different ages as well as different

populations.

136 Adolescent Health in the United States, 2007
Appendix II – Data Sources

For more information, see the NSDUH website at

https://nsduhweb.rti.org/ or the Substance Abuse and Mental

Health Services Administration, Office of Applied Studies

website at oas.samhsa.gov/.

National Survey of Family Growth (NSFG)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Survey of Family Growth (NSFG) provides

national data on factors affecting birth and pregnancy rates,

adoption, and maternal and infant health. Data elements

include sexual activity, marriage, divorce and remarriage,

unmarried cohabitation, contraception and sterilization,

infertility, breastfeeding, pregnancy loss, low birthweight, and

use of medical care for family planning and infertility. Six

cycles of the survey have been completed: 1973, 1976, 1982,

1988, 1995, and 2002. In cycle 6, there were 120 Primary

Sampling Units, with 7,643 interviews completed among

eligible women (80 percent response rate) and 4,928

interviews completed among eligible men (78 percent

response rate).

Interviews are conducted in person by professional female

interviewers using a standardized questionnaire. In all cycles,

black women were sampled at higher rates than white women

so that detailed statistics for black women could be produced.

In cycles 5 and 6 (1995 and 2002), Hispanic persons were

also oversampled.

For more information, see the NSFG website:

www.cdc.gov/nchs/nsfg.htm.

National Vital Statistics System (NVSS)

Centers for Disease Control and Prevention

National Center for Health Statistics

The National Vital Statistics System (NVSS) collects and

publishes official national statistics on births, deaths, fetal

deaths, and, prior to 1996, marriages and divorces occurring

in the United States that were based on U.S. Standard

Certificates. Detailed descriptions of the two vital statistics

files used in Adolescent Health in the United States, 2007

(birth file and mortality file) are presented separately below.

The NVSS collects and presents U.S. resident data for the

aggregate of 50 states, New York City, and D.C., as well as

for each individual state and D.C. Vital events occurring in

the United States to non-U.S. residents and vital events

occurring abroad to U.S. residents are excluded.

Birth File

Vital statistics natality data are a fundamental source of

demographic, geographic, and medical and health information

on all births occurring in the United States. The data are

used to present the characteristics of babies and their

mothers, track trends (such as birth rates for teenagers

shown in this report), and compare natality trends with other

countries. The birth registration area began in 1915 with 10

states and D.C. The natality file includes characteristics about

the baby such as gender, birthweight, and weeks of gestation;

demographic information about the parents such as age, race,

Hispanic origin, parity, educational attainment, marital status,

and state of residence; medical and health information, such

as prenatal care, that is based on hospital records; and

behavioral risk factors for the birth such as mother’s tobacco

use during pregnancy.

In the United States, state laws require birth certificates to be

completed for all births. The registration of births is the

responsibility of the professional attendant at birth, generally a

physician or midwife. The birth certificate must be filed with

the local registrar of the district in which the birth occurs.

Each birth must be reported promptly—the reporting

requirements vary from state to state, ranging from 24 hours

after the birth to as much as 10 days.

Federal law mandates national collection and publication of

birth and other vital statistics data. The NVSS is the result of

cooperation between NCHS and the states to provide access

to statistical information from birth certificates. Standard forms

for the collection of the data and model procedures for the

uniform registration of events are developed and

recommended for state use through cooperative activities of

the states and NCHS. NCHS shares the costs incurred by the

states in providing vital statistics data for national use.

For more information, see the birth data website:

www.cdc.gov/nchs/births.htm.

Mortality File

Vital statistics mortality data are a fundamental source of

demographic, geographic, and cause-of-death information.

This is one of the few sources of comparable health-related

data for small geographic areas over an extended time

Adolescent Health in the United States, 2007

137
Appendix II

– Data Sources

period. The data are used to present the characteristics of

those dying in the United States, to determine life expectancy,

and to compare mortality trends with other countries.

The mortality file includes demographic information on age,

gender, race, Hispanic origin, state of residence, and

educational attainment, as well as medical information on

cause of death. The death registration area began in 1900

with 10 states and D.C.

By law, the registration of deaths is the responsibility of the

funeral director. The funeral director obtains demographic data

for the death certificate from an informant. The physician in

attendance at the death is required to certify the cause of

death. Where death is from other than natural causes, a

coroner or medical examiner may be required to examine the

body and certify the cause of death. Data for the entire

United States refer to events occurring within the United

States; data for geographic areas are by place of residence.

For more information, see the mortality data website:

http://www.cdc.gov/nchs/deaths.htm.

Population Census and Population Estimates

Bureau of the Census

Decennial Census

The United States has conducted the census of population

(decennial census) every 10 years since 1790. Since 1930,

the decennial census has enumerated the resident population

as of April 1 of the census year. Data on gender, race, age,

and marital status are collected from 100 percent of the

enumerated population. More detailed information such as

income, education, housing, occupation, and industry are

collected from a representative sample of the population.

Race Data on the 1990 Census

The question on race on the 1990 census was based on the

Office of Management and Budget’s (OMB) 1977 Statistical

Policy Directive 15, Race and Ethnicity Standards for Federal

Statistics and Administrative Reporting. This document

specified rules for the collection, tabulation, and reporting of

race and ethnicity data within the federal statistical system.

The 1977 standards required federal agencies to report

race-specific tabulations using four single-race categories:

American Indian or Alaska Native, Asian or Pacific Islander,

black, and white. Under the 1977 standards, race and

ethnicity were considered to be two separate and distinct

138

concepts. Thus, persons of Hispanic origin may be of any

race.

Race Data on the 2000 Census

The question on race on the 2000 census was based on

OMB’s 1997 Revisions to the Standards for the Classification

of Federal Data on Race and Ethnicity (see Fed Regist

62:58781–90. 1997 Oct 30).

The 1997 Standards incorporated two major changes in the

collection, tabulation, and presentation of race data. First, the

1997 standards increased the minimum set of categories to

be used by federal agencies for identification of race from

four to five: American Indian or Alaska Native, Asian, black or

African American, Native Hawaiian or Other Pacific Islander,

and white. Second, the 1997 standards included the

requirement that federal data collection programs allow

respondents to select one or more race categories when

responding to a query on their racial identity. This provision

means that there are potentially 31 race groups, depending

on whether a person selects one, two, three, four, or all five

of the race categories. The 1997 standards continue to call

for use, when possible, of a separate question on Hispanic or

Latino ethnicity and specify that the ethnicity question should

appear before the question on race. Thus, under the 1997

standards, as under the 1977 standards, Hispanics may be of

any race.

Bridged-Race Population Estimates for Census 2000

Race data on the 2000 census are not comparable with race

data on other data systems that are continuing to collect data

using the 1977 standards on race and ethnicity during the

transition to full implementation of the 1997 standards. For

example, most of the states in the Vital Statistics Cooperative

Program have revised or plan to revise their birth and death

certificates to conform to the 1997 standards after 2000.

Thus, population estimates for 2000 and beyond with race

categories comparable with the 1977 categories are needed

so that race-specific birth and death rates can be calculated.

To meet this need, NCHS, in collaboration with the U.S.

Census Bureau, developed methodology to bridge the 31 race

groups in census 2000 to the four single-race categories

specified under the 1977 standards.

The bridging methodology was developed using information

from the 1997–2000 NHIS. The NHIS provides a unique

opportunity to investigate multiple-race groups because, since

Adolescent Health in the United States, 2007
1982, the NHIS has allowed respondents to choose more

than one race but has also asked respondents reporting

multiple races to choose a primary race. The bridging

methodology developed by NCHS involved the application of

regression models relating person-level and county-level

covariates to the selection of a particular primary race by the

multiple-race respondents. Bridging proportions derived from

these models were applied by the U.S. Census Bureau to the

Census 2000 Modified Race Data Summary File. This

application resulted in bridged counts of the April 1, 2000,

resident single-race populations for four racial groups:

American Indian or Alaska Native, Asian or Pacific Islander,

black, and white. As bridged-race population estimates

continue to be needed for the calculation of vital rates, the

Census Bureau annually produces postcensal bridged-race

estimates of the July 1 resident single-race populations.

For more information about bridged-race population

estimates, see the NCHS website, ‘‘U.S. Census

Populations with Bridged Race Categories’’:

www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm.

Postcensal Population Estimates

Postcensal population estimates are estimates made for the

years following a census, before the next census has been

taken. National postcensal population estimates are derived

annually by updating the resident population enumerated in

the decennial census using a components of population

change approach. Each annual series includes estimates for

the current data year and revised estimates for the earlier

years in the decade. The following formula is used to derive

the estimates for a given year from those for the previous

year, starting with the decennial census enumerated resident

population as the base:

(1) resident population

(2) + births to U.S. resident women

(3) – deaths to U.S. residents

(4) + net international migration

(5) + net movement of U.S. Armed Forces and U.S. civilian

citizens

Estimates for the earlier years in a given series are revised to

reflect changes in the components of change data sets (for

example, births to U.S. resident women from a preliminary

natality file are replaced with counts from a final natality file).

To help users keep track of which postcensal estimate is

being used, each annual series is referred to as a vintage

and the last year in the series is used to name the series.

For example, the Vintage 2001 postcensal series has

estimates for July 1, 2000, and July 1, 2001, and the Vintage

2002 postcensal series has revised estimates for July 1,

2000, and July 1, 2001, as well as estimates for July 1,

2002. The estimates for July 1, 2000, and for July 1, 2001,

from the Vintage 2001 and Vintage 2002 postcensal series

differ.

The Census Bureau has annually produced a postcensal

series of estimates of the July 1 resident population of the

United States, which is based on census 2000 by applying

the components of change methodology to the Modified Race

Data Summary File. These series of postcensal estimates

have race data for 31 race groups, in accordance with the

1997 race and ethnicity standards. In order to compare the

race data for 2000-based postcensal estimates with race

data on vital records, the Census Bureau has applied the

NHIS bridging methodology to each 31 race group

postcensal series of population estimates to obtain

bridged-race postcensal estimates (estimates for the four

single-race categories: American Indian or Alaska Native,

Asian or Pacific Islander, black, and white). Bridged-race

postcensal population estimates are available from:

www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm.

Intercensal Population Estimates

The further from the census year on which the postcensal

estimates are based, the less accurate are the postcensal

estimates. With the completion of the decennial census at the

end of the decade, intercensal estimates for the preceding

decade were prepared to replace the less accurate

postcensal estimates. Intercensal population estimates take

into account the census of population at the beginning and

end of the decade. Thus, intercensal estimates are more

accurate than postcensal estimates because they correct for

the error of closure or difference between the estimated

population at the end of the decade and the census count for

that date. The error of closure at the national level was quite

small for the 1960s (379,000). However, for the 1970s, it

amounted to almost 5 million; for the 1980s, 1.5 million; and

for the 1990s, about 6 million. The error of closure

differentially affects age, race, gender, and Hispanic origin

subgroup populations as well as the rates that are based on

these populations. Vital rates that were calculated using

Adolescent Health in the United States, 2007

139

Appendix II

– Data Sources
Appendix II

– Data Sources

postcensal population estimates are routinely revised when

intercensal estimates become available because the

intercensal estimates correct for the error of closure.

Intercensal estimates for the 1990s with race data

comparable to the 1977 standards have been derived so that

vital rates for the 1990s could be revised to reflect census

2000. Calculation of the intercensal population estimates for

the 1990s was complicated by the incomparability of the

race data on the 1990 and 2000 censuses. The U.S.

Census Bureau, in collaboration with National Cancer

Institute and NCHS, derived race-specific intercensal

population estimates for the 1990s using the 1990 Modified

Age, Race, Sex, and Hispanic Origin File as the beginning

population base and the bridged-race population estimates for

April 1, 2000, as the ending population base. Bridged-race

intercensal population estimates are available from

www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm.

For more information, see the U.S. Census Bureau website:

www.census.gov/.

Sexually Transmitted Disease (STD) Surveillance

Centers for Disease Control and Prevention

National Center of HIV, STD, and TB Prevention

Surveillance information on incidence and prevalence of STDs

is used to inform public and private health efforts to control

these diseases. Case reporting data are available for

nationally notifiable chanchroid, chlamydia, gonorrhea, and

syphilis; surveillance of other STDs (such as genital herpes

simplex virus, genital warts or other human papillomavirus

infections, and trichomoniasis) are based on estimates of

office visits in physicians’ office practices provided by the

National Disease and Therapeutic Index. STD national

surveillance data have been collected since 1941.

Case reports of STDs are reported to CDC by STD

surveillance systems operated by state and local STD control

programs and health departments in 50 states, D.C., selected

cities, 3,139 U.S. counties, and outlying areas comprising

U.S. dependencies, possessions, and independent nations in

free association with the United States. Data from outlying

areas are not included in Adolescent Health in the United

States, 2007.

Information is obtained from the following sources of data: (1)

case reports from STD project areas; (2) prevalence data

from the Regional Infertility Prevention Program, the National

140

Job Training Program (formerly the Job Corps), the Jail STD

Prevalence Monitoring Project, the Adolescent Women

Reproductive Health Monitoring Project, the Men Who Have

Sex With Men Prevalence Monitoring Project, and the Indian

Health Service; (3) sentinel surveillance of gonococcal

antimicrobial resistance from the Gonococcal Isolate

Surveillance Project (GISP); and (4) national sample surveys

implemented by federal and private organizations. Because of

incomplete diagnosis and reporting, the number of STD cases

reported to CDC undercounts the actual number of cases

occurring among the U.S. population.

For more information, see the STD Surveillance Report

website at www.cdc.gov/std/stats/ or the STD Prevention

website at www.cdc.gov/std/default.htm.

Youth Risk Behavior Survey (YRBS)

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention

and Health Promotion

The national Youth Risk Behavior Survey (YRBS) monitors

health risk behaviors among students in grades 9 through 12

that contribute to morbidity and mortality in both adolescence

and adulthood. Data are collected on tobacco use, dietary

behaviors, physical activity, alcohol and other drug use,

behaviors that contribute to unintentional injuries and violence,

and sexual behaviors that contribute to unintended pregnancy

and sexually transmitted diseases including HIV infection.

The national YRBS of high school students was conducted in

1990, 1991, 1993, 1995, 1997, 1999, 2001, 2003, and 2005.

Data are representative of high school students in public and

private schools in the United States. The national YRBS

school-based surveys employ a three-stage cluster sample

design to produce a nationally representative sample of

students in grades 9 through12 attending public and private

high schools. A weighting factor is applied to each student

record to adjust for nonresponse and for the varying

probabilities of selection, including those resulting from the

oversampling of black and Hispanic students. The sample

size for the 2005 YRBS was 13,953 students in 159 schools.

The school response rate was 78 percent and the student

response rate was 86 percent, for an overall response rate of

67 percent.

National YRBS data are subject to at least two limitations.

First, these data apply only to adolescents who attend regular

Adolescent Health in the United States, 2007
high school. These students may not be representative of all

persons in this age group because those who have dropped

out of high school or attend an alternative high school are not

surveyed. Second, the extent of underreporting or

overreporting cannot be determined, although the survey

questions demonstrate good test-retest reliability.

Estimates of substance use for youth that are based on the

YRBS differ from the NSDUH and MTF. Rates are not directly

comparable across these surveys because of differences in

populations covered, sample design, questionnaires, interview

setting, and statistical approaches to make the survey

estimates generalizable to the entire population. The NSDUH

survey collects data in homes, whereas the MTF and YRBS

collect data in school classrooms. The NSDUH estimates are

tabulated by age, whereas the MTF and YRBS estimates are

tabulated by grade, representing different ages as well as

different populations.

For more information, see the Division of Adolescent and

School Health website: www.cdc.gov/HealthyYouth/index.htm.

Private Sources

Alan Guttmacher Institute Abortion Provider

Survey

The Alan Guttmacher Institute (AGI), a nonprofit organization

focused on reproductive health research, policy analysis, and

public education, conducts periodic surveys of abortion

providers to provide nationally representative statistics on

abortion incidence.

Thirteen provider surveys have been conducted for selected

data years 1973 to midyear 2001. Data were collected from

clinics, physicians, and hospitals identified as potential

providers of abortion services. Mailed questionnaires were

sent to all potential providers, with two additional mailings and

telephone follow-up for nonresponse. No surveys were

conducted in 1983, 1986, 1989, 1990, 1993, 1994, 1997, or

1998. For 1999–2000, a version of the survey questionnaire

was created for each of the three major categories of

providers, modeled on the survey questionnaire used for

AGI’s data collection in 1997. All surveys asked the number

of induced abortions performed at the provider’s location.

State health statistics agencies were contacted, requesting all

available data reported by providers to each state health

agency on the number of abortions performed in the survey

year. For states that provided data to AGI, the health agency

figures were used for providers who did not respond to the

survey. Estimates of the number of abortions performed by

some providers were ascertained from knowledgeable sources

in the community.

To estimate the number of abortions performed in 2001 and

2002, AGI first estimated the change in the number of

abortions between 2000 and 2001, beginning with the number

of abortions occurring in each state in each of those 2 years,

as reported by CDC. The three states without reporting

systems were excluded. AGI also eliminated the states with

very incomplete or inconsistent reporting (Arizona, Maryland,

Nevada, and D.C.). AGI summed the number of abortions

that took place in the 44 remaining states for each year. The

percentage change between 2000 and 2001 was then applied

to AGI’s more complete nationwide count of 1,312,990

abortions in 2000 to arrive at the national estimate for 2001.

The same procedure was used to estimate the change in the

number of abortions between 2001 and 2002, except that the

data for both years were collected directly from state health

departments because the CDC abortion surveillance report for

2002 was not yet available. For 2002, no data were available

for Wyoming (in addition to the states with no reporting

systems), and AGI eliminated Arizona, Colorado, D.C., and

Maryland because of inconsistent reporting. AGI used the

remaining 43 states for the calculations.

The number of abortions estimated by AGI through the midto late-1980s was about 20 percent higher than the number

reported to CDC. Between 1989 and 1997, the AGI estimates

were about 12 percent higher than those reported by CDC.

Beginning in 1998, health departments of four states did not

report abortion data to CDC. The four reporting areas (the

largest of which is California) that did not report abortions to

CDC in 1998 accounted for 18 percent of all abortions tallied

by AGI’s 1995–1996 survey. FDA approval of Mifepristone

(medical abortion) in September of 2000 accounted for a

small proportion (approximately 6 percent) of abortions

performed in nonhospital facilities during the first half of 2001.

For more information, see the AGI website: www.guttmacher.org

or write to The Alan Guttmacher Institute, 120 Wall Street,

New York, NY 10005.Appendix Table. Critical health objectives

Objective number

Topic area and Critical Health Objective

Baseline (year)

Most recent data (year)

2010 target

Adolescent Health in the United States, 2007

141

Appendix II

– Data Sources
U.S. DEPARTMENT OF

HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE $300

CS113912 (01/2008)

T30361

DHHS Pub No. 2007-1034