1. Emerging Risks for Adolescent Health
Kathleen A. Ethier, PhD
Director, Division of Adolescent and School Health
Healthy Schools, Promising Futures Learning Collaborative
June 13, 2018

2. Emerging (and Converging) Trends
Opioids & Other High-Risk Substances
Interrelated Risk Factors (clustering)
Sexual Minority Youth
Sexual Minority Youth (2015 YRBS)
Lesbian, gay, and bisexual students are significantly more likely to report experiencing physical and sexual dating violence, as well as being bullied at school or online compared to heterosexual students
Experiencing physical and sexual dating violence
18% LGB vs. 8% heterosexual; 23% LGB vs. 9% heterosexual
Being bullied at school or online
at school: 34% LGB vs. 19% heterosexual
online: 28% LGB vs. 14% heterosexual
Opioids & Other High-Risk Substances (2015 YRBS)
Nationwide, 16.8% of students had taken prescription drugs without a doctor’s prescription one or more times during their life.
During 2009–2015, a significant linear decrease occurred in the prevalence of having ever taken prescription drugs without a doctor’s prescription (20.2%–16.8%).
Across 32 states, the prevalence of having ever taken prescription drugs without a doctor’s prescription ranged from 10.8% to 19.2% (median: 14.4%) . Across 17 large urban school districts, the prevalence ranged from 7.9% to 16.1% (median: 13.3%).
Inter-related risk factors – discuss clustering (2015 YRBS)
Almost 14% of high school students engage in three or more risk behaviors (i.e., sexually active but no condom use, having 4+ partners, substance use/misuse, dating violence, and/or suicide attempt).
One-tenth of students are at particularly high risk for morbidity and mortality during adolescence and into adulthood, given they have three or more risks that can contribute to serious adverse health outcomes
Students with higher numbers of risks are more likely to be engaging in behaviors directly linked to mortality, such as injecting drugs or attempting suicide.
How do we identify cluster kids?
What should we be doing to address clustering?

3. Decline in Systems Level Policies & Practices
In % of school districts specify time requirements for health education in middle schools, down from more than 65% in 2006.
Only 34% of school districts require full time nurses in their schools.
Fewer than 2% of districts had policies requiring schools to provide health services such as testing for HIV and STDs.
Fewer than 50% of districts require that health teachers get professional development on substance use, HIV, human sexuality, STDs, or suicide.
(2016 SHPPS data)
CDC. School Health Policies and Practices Study (SHPPS)

4. On the Horizon Promoting Adolescent Health through
School-Based HIV Prevention
CDC will begin a five year cooperative agreement to reduce HIV and STD and related risk behaviors among middle and high school students. This multi-component approach includes:
School-based surveillance
School-based HIV/STD prevention
Technical assistance and capacity building
Promoting Adolescent Health through School-Based HIV Prevention
CDC will makes awards as part of a five years cooperative agreement to reduce HIV, STD, and related risk behaviors among middle and high school students. This multi-component approach includes:
School-Based Surveillance - This component establishes and strengthens systematic procedures to collect Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles) data, and report results to help support development of policies and practices to reduce priority health-risk behaviors among youth.
School-Based HIV/STD Prevention - This component includes activities to strengthen health education, including HIV/STD prevention, increase access to/use of key health services, and establish and maintain safe and supportive environments.
 Technical Assistance and Capacity Building - This component will enable organizations to: (1) build the capacity of strategy 2 awardees to implement school-based prevention and to deliver sustainable initiatives in districts and schools, (2) provide training and technical assistance for school-based substance use approaches, and (3)strengthen capacity for evidence based policy and practice in states.
Approximately $17 million in available funds
Five (5) year project period, with an anticipated award date of August 1, 2018

5. Up Next 2017 YRBS Data Release June 14th CDC will release
MMWR Surveillance Summary
Public data set
YRBS Data Summary and Trends Report
Covers the set of behaviors & experiences that place youth at highest risk for HIV and STD, including sexual behavior, violence victimization, mental health and suicide, and high risk substance use.
Includes 10 year trends and an additional focus on sexual minority youth
YRBS data release
On June 14th, 2018 CDC will release a public data set, an MMWR Surveillance Summary (Youth Risk Behavior Surveillance – United States, 2017) and the YRBS Data Summary and Trends Report, which will address trends in Youth Health Risk Behaviors such as:
Sexual Behaviors
High Risk Substance Use
Violence Behaviors
Mental Health
As well as a n additional focus on sexual minority youth including national estimates of the health risk behaviors.

6. YRBSS Web site and Youth Online www.cdc.gov/yrbs

7. For More Information
Web: