This section contains national-level data for the 21 Critical Health Objectives for Adolescents and Young Adults for subgroups based on gender and race/ethnicity. The text below summarizes gender differences and then describes racial/ethnic disparities by objective. The tables (click on the links to the right) present national data by gender and race/ethnicity.
In this 2011 update, with data for the final year, the overall patterns changed little from midcourse. With a few exceptions, including a decrease in condom usage among Black and Hispanic adolescents and a slight decrease in suicide rates among males 15-19, all objectives continued to move in the same direction from midcourse.
Most gender differences persist across all areas. Males continue to have substantially higher mortality rates than females for overall mortality, motor vehicle crashes, homicide and suicide. Males also remain much more likely to be in a physical fight, carry weapons on school property, and smoke cigarettes, although both males and females have experienced sizable declines in smoking. Measures for two additional objectives improved greatly for both males and females: fewer report riding with a driver who had been drinking and more report never having had sexual intercourse. Males experienced the greatest change for both measures and now have roughly equal rates as females for both objectives. Females continue to be more likely to attempt suicide, including attempts that require medical attention
As with gender, most race/ethnicity differences persist across all areas. Disparities have narrowed for some indicators, as the most at-risk groups saw the greatest improvement. In a few cases, subgroups changed in a way that was contrary to the overall change. In some instances, racial/ethnic differences are particularly marked among males or females.
Overall mortality disparities persist: Black and Native American adolescents and young adults have the highest rates; Whites and Hispanics have similar, lower rates; and Asians/Pacific Islanders have the lowest rate. The disparity for Blacks narrowed, driven largely by the substantial decline in homicide among Black males. Black young adults (ages 20-24) experienced a considerable decline in overall mortality, while the rate for all young adults increased for males and females. Mortality rates decreased for younger (ages 10-14) and older (ages 15-19) adolescents.
Disparities in motor vehicle crash mortality continue. Native American youths continue to have by far the highest rate. Whites have the next highest rate, followed by Hispanics, Blacks, and Asians/Pacific Islanders. Changes in these rates were fairly small, with Native American males having the largest decrease and Hispanic males having the largest increase.
Differences in seat belt use are fairly small. While Black youths continue to report the lowest seatbelt use, they experienced a steeper increase than Whites, Hispanics, or Asians narrowing this gap considerably. Riding with a driver who has been drinking alcohol decreased for all adolescents, with similar declines across racial/ethnic groups. Hispanics continue to report the highest rates of this behavior.
Black youths continue to have the highest homicide rates by far, and the rates have held steady or increased from baseline for all groups. Homicide rates for black youths had been improving at Midcourse, but increased by the final year. The overall homicide rates changed little, with disparities persisting: Hispanics have the second highest homicide rate, just under half that of Blacks and higher than the Native American rate; Asians/Pacific Islanders and Whites have similar, relatively low rates.
Race/ethnicity disparities in weapon carrying changed little. White youths are now the most likely to report carrying a weapon, followed closely by Hispanics and Blacks. Asians have by far the lowest rate. Among males, Whites report the highest rate, slightly higher than the rate for Hispanics. Physical Fighting is highest among Blacks, followed by Hispanics, and is somewhat lower among Whites and much lower among Asians. Among males, Hispanics experienced a steep decrease and Blacks now have the highest rate, followed by Hispanics and Whites.
Substance Use and Mental Health
Rates and disparities changed very little for binge drinking and marijuana use. Binge drinking rates are similar and high among Native American, White and Hispanic adolescents and lower among Blacks and Asians/Pacific Islanders. For marijuana use, rates are highest for Native Americans, fairly similarly for Whites, Blacks and Hispanics. Asians saw a large increase from baseline and now report usage similar to Whites, Blacks and Hispanics.
Overall, suicide rates and disparities decreased slightly. Native American adolescents continue to have by far the highest suicide rates – more than twice that of Whites, who have the second highest rate. Blacks, Hispanics, and Asian/Pacific Islanders continue to have similar, relatively low rates. Black, White and Native American males ages 15-19 experienced the greatest decline and account for the overall decrease in suicide rates. There was no significant change in the overall rate of suicide attempts requiring medical attention, although there was a significant reduction among Asian females. Rates are highest for Blacks, followed by Whites and Asians.
Rates of pregnancy decreased considerably for all racial/ethnic groups, and exceeded the Healthy People 2010 target. Black female adolescents experienced the largest absolute decline in pregnancy rates, resulting in a lower rate than Hispanics, contrary to baseline. Whites continue to have the lowest rates, nearly half that of Blacks and Hispanics.
Reported rates of having engaged in sexual intercourse did not change significantly from baseline. Whites are still the least likely to report being sexually experienced, followed by Hispanics and Blacks. Asians have by far the lowest rate] There was a particularly large decrease among Hispanics males. Among sexually experienced adolescents, there was no significant change in the overall percentage that were currently sexually active. Blacks reported by far the highest rate of this behavior, followed by Whites and Hispanics. Asians had by far the lowest rate. Disparities in condom use at last intercourse changed slightly. Blacks, especially females, had a large decrease in condom use, while Whites (males and females) reported large increases. While Blacks had by far the highest rate at baseline, Blacks and Whites had near equal rates at final. Hispanics and Asians continued to have similar, lower rates.
Chronic Disease Prevention
Tobacco use has decreased substantially for all racial/ethnic groups. White adolescents continue to be the most likely to report past-month use, followed by Hispanics, Blacks and Asians. Absolute decreases were largest for White and Hispanic adolescents and smallest, but still considerable, for Black adolescents.
Overweight is increasing among all adolescents, and disparities persist. Rates are highest for Blacks, especially females, followed by Mexicans, especially males. Rates remain lower for Whites.