Colorectal Cancer Screening* Among Adults Aged 50–75 Years, by Race and Hispanic Origin† — National Health Interview Survey,§ United States, 2000–2013
Authors: Anne Wheaton, Gabrielle Ferro, Janet Croft, Thomas Frieden, Harold Jaffe, Joanne Cono, Chesley Richards, Michael Iademarco, Sonja Rasmussen, Charlotte Kent, Jacqueline Gindler, Acting Editor, Teresa Rutledge, Douglas Weatherwax, Teresa Hood, Jude Rutledge, Martha Boyd, Maureen Leahy, Julia Martinroe, Stephen Spriggs, Brian Wood, Quang Doan, Phyllis King, Teresa Moreland, Terraye Starr, Timothy Jones, Matthew Boulton, Ann Arbor, Virginia Mi, Jonathan Caine, Los Fielding, David Angeles, William Fleming, King Halperin, Rima Khabbaz, Patricia Quinlisk, Patrick Remington, William Roper, Chapel Hill, N William
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

Adolescents who do not get enough sleep are more likely to be overweight (1); not engage in daily physical activity (2); suffer from depressive symptoms (2); engage in unhealthy risk behaviors such as drinking, smoking tobacco, and using illicit drugs (2); and perform poorly in school (3).However, insufficient sleep is common among high school students, with less than one third of U.S. high school students sleeping at least 8 hours on school nights (4).In a policy statement published in 2014, the American Academy of Pediatrics (AAP) urged middle and high schools to modify start times as a means to enable students to get adequate sleep and improve their health, safety, academic performance, and quality of life (5).AAP recommended that "middle and high schools should aim for a starting time of no earlier than 8:30 a.m." (5).To assess state-specific distributions of public middle and high school start times and establish a pre-recommendation baseline, CDC and the U.S. Department of Education analyzed data from the 2011-12 Schools and Staffing Survey (SASS).Among an estimated 39,700 public middle, high, and combined schools* in the United States, the average start time was 8:03 a.m.Overall, only 17.7% of these public schools started school at 8:30 a.m. or later.The percentage of schools with 8:30 a.m. or later start times varied greatly by state, ranging from 0% in Hawaii, Mississippi, and Wyoming to more than three quarters of schools in Alaska (76.8%) and North Dakota (78.5%).A school system start time policy of 8:30 a.m. or later provides teenage students the opportunity to achieve the 8.5-9.5 hours of sleep recommended by AAP (5) and the 8-10 hours recommended by the National Sleep Foundation (6).Every few years, the U.S. Department of Education conducts SASS, which provides data on the condition of elementary and secondary education in the United States.SASS consists of several questionnaires, including those tailored to schools, teachers, principals, school districts, and library media centers.SASS is a mail-based survey, with telephone and field followup, and uses a stratified probability sample design.† For the 2011-12 school year, the sample included about 10,250 traditional public schools and 750 public charter schools, with a unit response rate for public schools of 72.5%.As part of the school questionnaire in the 2011-12 school year, respondents were asked, "At what time do most of the students in