Alabama

Please be sure to read the data notes & limitations page. This explains many aspects of these comments, including how only changes over time can be discussed as statistically significant, and why the comparisons with national rates only discuss data for selected subgroups.

Overview of Findings

Findings for Alabama were mostly encouraging. Several objectives showed improvement, including safety belt use, riding with a driver who had been drinking alcohol, binge drinking, marijuana use and tobacco use. Rates of motor vehicle crash mortality, homicide, physical fighting, weapon carrying, and suicide attempts requiring medical attention were flat. Final rates for most Alabama objectives compared unfavorably with national rates. Final rates of physical fighting and condom use roughly matched national rates for those objectives.

Highlights of Findings by Objective

Jump To: Mortality; Unintentional Injury; Violence; Substance Use and Mental Health; Reproductive Health; Chronic Disease Prevention

Mortality

Findings for adolescent mortality in Alabama were mixed, with declines in some groups and increases for others. Overall rates for younger adolescents decreased considerably; rates for older adolescents were fairly flat; and rates for young adults increased considerably, especially among males. Overall rates for males and females generally followed this pattern, as did rates for Whites. By contrast, rates for Blacks decreased overall, including a decrease for young adult males. In 2007, the mortality rate for males was two to three times the rate for females. Whites had slightly higher rates than Blacks for most age and gender groups. Hispanic young adults had rates nearly twice that of Whites and Blacks, driven by high rates for males.

Comparison with national data. National changes in mortality differed from changes Alabama by age group. For younger adolescents, the rate was fairly flat, in contrast to a decrease in Alabama; for older adolescents, the rate decreased in contrast to flat rates in Alabama. Young adults increased slightly, compared to a large increase in Alabama. As in Alabama, a national decrease in mortality among Black young adults stood in contrast to increases for Whites and Hispanics. Alabama rates in 2007 were higher than national rates for nearly all groups, with a few exceptions, mostly among younger adolescents. The national gender disparity matched the pattern noted in Alabama.  The slightly higher rate of mortality for Whites than Blacks in Alabama was in contrast to much higher rates for Blacks than Whites nationally. Nationally Hispanic young adults had slightly higher rates than Whites and lower rates than Blacks, in contrast to Alabama, where they had by far the highest rates.

Unintentional Injury

(motor vehicle crashes, safety belt use, & riding with a driver who has been drinking alcohol)  Please note the data for safety belt use are presented as “not wearing safety belt,” the inverse of the objective.

Adolescent mortality in Alabama due to motor vehicle crashes (MVC) was flat from baseline, with considerable variation among subgroups. An increase among young adult rates was offset by a decrease among older adolescents. Similarly, rates for males increased, while female rates decreased. The rate for Whites increased slightly; the rate for Blacks decreased somewhat. In 2007, the rate of MVC mortality for males was nearly three times the rate for females. Whites had more than twice the rate of Blacks.

Comparison with national data. National adolescent MVC mortality was also flat overall.  This pattern was consistent across all subgroups, in contrast to the wide variation in Alabama. In 2007, Alabama rates of MVC mortality were substantially higher than national rates, especially among young adults who had a rate more than twice the rate for young adults nationally. In 2007, the national patterns of disparities by gender and racial/ethnic groups were similar to the patterns noted for Alabama, with somewhat smaller differences.

Rates of safety belt use in Alabama increased from baseline due primarily to increases in rates for males, especially Black males. Increases for all other groups were not statistically significant. In 2009, females had higher rates than males; Blacks and Whites had similar rates.

Comparison with national data. National changes in safety belt use largely mirrored changes in Alabama, with significant increases for all adolescents, all males, including Black males. In 2009, the rate of safety belt use in Alabama was slightly lower than the national rate for all adolescents and for males. Whites had higher rates than Blacks, in contrast to fairly similar rates in Alabama.

Rates of adolescents in Alabama who reported riding with a driver who had been drinking alcohol declined significantly for males, especially White males. In 2009, Blacks reported higher rates than Whites; male and female rates were very similar.

Comparison with national data. National rates of adolescents riding with a driver who had been drinking alcohol also declined significantly from 1999 for all males and White males. In 2009, the overall rate of Alabama adolescents riding with a driver was higher than the national rate. Similar to Alabama, male and female rates were very similar. Nationally, Whites had higher rates than Blacks, the reverse of the pattern noted for Alabama.

Violence

(homicide, physical fighting, weapon carrying)

Rates of adolescent homicide mortality in Alabama were flat from baseline among older adolescents. There was a steep rise among older adolescent Black, with a large increase for males.

Comparison with national data. National rates of homicide mortality among older adolescents were also flat. National rates also increased for older adolescent Black males nationally, but with a smaller increase than seen in Alabama. In 2007 the Alabama rate for older adolescents was slightly higher than the national rate for that group.  Rates for older adolescent Blacks and Black males matched the Alabama rates.

The overall rate of physical fighting among adolescents in Alabama was flat from baseline. There were no significant changes for any subgroups. In 2009, males reported substantially higher rates of physical fighting than females; this gender disparity was much larger for Whites than for Blacks. Blacks reported higher rates than Whites.

Comparison with national data. The national rate of physical fighting decreased moderately overall and for a few subgroups, in contrast to no change in Alabama. In 2009, Alabama rates of physical fighting matched the national rates. The national gender and racial/ethnic patterns were similar to those noted for Alabama.

The overall rate of weapon carrying among adolescents in Alabama was flat from baseline. The rate for females overall increased significantly; however, there were no other significant changes among subgroups. In 2009, males in Alabama were more than three times as likely as females to report weapon carrying; this difference was even larger among Whites. Whites and Blacks reported similar rates of this behavior.

Comparison with national data. National rates of weapon carrying were also flat from baseline, with no significant increase among females. In 2009, rates of weapon carrying among adolescents in Alabama were higher than national rates. The racial/ethnic and gender patterns noted for Alabama were mostly similar to patterns seen nationally. One exception is slightly higher rates among Whites compared to Blacks, in contrast to more similar rates in Alabama.

Substance Abuse and Mental Health

(binge drinking, marijuana use, suicide, suicide attempts requiring medical attention)

Rates of binge drinking in Alabama decreased significantly from baseline overall and for all males, Black males and all Whites. In 2009, males were more likely to report binge drinking than females. The rate for Whites was substantially higher than the rate for Blacks; this difference was more pronounced among males: White males were more than twice as likely to report binge drinking.

Comparison with national data. The gender disparity in Alabama rates was larger than the slight gender disparity in national rates.  National racial/ethnic disparities matched patterns in Alabama.

Overall rates of marijuana use in Alabama decreased significantly from baseline. Significant decreases were also seen for males and females overall, and all Whites and White females. In 2009, males reported higher rates than females. Blacks and Whites reported similar rates.

Comparison with national data. Consistent with the trend in Alabama, national rates of marijuana use declined from baseline. Nationally, males reported slightly higher rates of marijuana than females, in contrast to the nearly two-fold difference noted in Alabama. Nationally, Whites reported rates somewhat higher than Blacks.

Rates of adolescent suicide mortality in Alabama were based on too few deaths to be considered stable. This suggests improvement from baseline, when more deaths resulted in stable rates, notably among older adolescent White males.

Comparison with national data. National rates of adolescent suicide mortality for older adolescents decreased slightly overall and for White males, suggesting smaller improvement than seen in Alabama.

The overall rate of adolescent suicide attempts requiring medical attention in Alabama in 2009 remained flat from baseline.  In 2009, the rate for males was higher than the rate for females, and higher for Blacks than for Whites.

Comparison with national data. The national rate of adolescent suicide attempts requiring medical attention decreased nationally in contrast to remaining flat in Alabama. At final, the Alabama rate overall was nearly twice the national rate.  The Alabama rate was higher than the national rate for both Blacks and Whites.  Nationally, females reported higher rates than males, the reverse of the pattern noted in Alabama.

Reproductive Health

(sexual inexperience, no current sexual activity, condom use)

Please note that for the first two objectives, the text and tables present findings about adolescents who are sexually experienced and currently sexually active, the inverse of the actual objective.  For the third objective, the table presents findings for lack of condom use, the inverse of the objective. (See Data Notes & Limitations).

In 2009, adolescent males were more likely to report having engaged in sexual intercourse than adolescent females. Blacks reported higher rates than Whites.

Comparison with national data. Alabama rates of sexually experienced adolescents were higher in 2009 than national rates. As in Alabama, Blacks reported higher rates than Whites. However, nationally, males and females reported very similar rates, compared to the gender disparity noted for Alabama.

In 2009, sexually experienced Blacks were more likely to report current sexual activity than their White peers. Males and females reported similar rates, both overall and among Black and White adolescents.

Comparison with national data. Adolescents in Alabama reported higher rates of current sexual activity than adolescents nationally. As in Alabama, Blacks reported higher rates than Whites. Females reported slightly higher rates than males nationally, especially among Whites, in contrast to very similar rates noted for Alabama.

Rates of adolescent condom use in Alabama in 2009 were higher among females than males and slightly higher among Whites than Blacks.

Comparison with national data. In 2009, the overall rate of condom use in Alabama roughly matched the national rate. National rates were higher for males than for females, as in Alabama; the gender disparity was slightly smaller in Alabama than nationally.

Chronic Disease Prevention

(tobacco use)

Large and significant decreases in tobacco use from baseline were seen among Alabama’s adolescents overall and for most subgroups. In 2009, males reported higher rates than females and Whites reported higher rates than Blacks.

Comparison with national data. National rates of tobacco use among adolescents also decreased considerably from baseline. In 2009, the rate for Alabama roughly matched the national rate. The national gender and racial/ethnic patterns matched the patterns noted for Alabama.

Additional data may be available at: http://www.adph.org/schoolhealth/Default.asp?id=1205