Improving Young Adult Health: Strategy 1 – Collect Data & Adopt a Measure

Strategy 1: Collect Data & Adopt a Measure

Why Measurement Counts

As a starting point to better understand the needs of young adults in one’s state, some national datasets, such as the Behavioral Risk Factor Surveillance System (BRFSS) and the National College Health Assessment (NCHA), provide state-level health data on young adults. Additionally, by fielding one’s own surveys or adapting existing survey tools, such as the Child/Adult Needs and Strengths Assessment, Transition to Adulthood Version (ANSA-T), 

Title V agencies can gather the information that is most useful to them and build relationships with local stakeholders.

After identifying the young adult health issue that is most important in one’s context, Title V programs can commit to action by adopting a young adult health state measure. Doing so benefits states by facilitating the identification of strategies and tracking of progress over time. Through this data-driven approach, agencies can maximize their positive impact over the life course. 

Use YA Health Measures from Public Use Datasets

Online Resources from the Center for Disease Control and Prevention: WONDER, WISQARS, STD Annual Reports

The Center for Disease Control and Prevention (CDC) offers a number of online, state-level health data sources that can be broken down for the young adult age group. One resource is the Wide-ranging OnLine Data for Epidemiologic Research (WONDER), which has statistics on mortality from all causes (e.g. suicide, transport accidents, childbirth), and STD morbidity ( Additionally, the Web-based Injury Statistics Query and Reporting System (WISQARS) provides user-friendly data visualizations of fatal and non-fatal injury statistics by age group ( State STD rates for 15-24 year olds are reported annually by the CDC Division of Sexually Transmitted Disease Prevention.

Behavioral Risk Factor Surveillance System (BRFSS)

The CDC also administers the BRFSS, a national survey that collects state-level data about U.S. adult residents’ risk behaviors, chronic health conditions and use of preventive services. Data can be analyzed by age group, and some information is collected on conditions that are particularly relevant to young adults. These measures include healthcare, mental/behavioral health and sexual health. 

Listed below are metrics, publicly available and based on the 2018 BRFSS survey, that were determined to be highly relevant for assessing young adult health in one’s state. Data on the following measures can be downloaded from the CDC website. Some rates can also be analyzed online at

  1. C03.01: Healthcare Coverage
  2. C03.02: One Person as Healthcare Provider
  3. C03.03: Foregone Care due to Cost
  4. C06.10: Depressive Disorder
  5. C09: Tobacco Use
  6. C10: Alcohol Consumption
  7. C13: Seat Belt Use & Drinking and Driving
  8. C17.03: HIV/AIDS risk

BRFSS offers Optional Data Modules for states to have additional questions fielded by the CDC for a fee. States interested in collecting more detailed young adult health information may consider choosing modules on Health Care Access, E-Cigarettes, Marijuana Use, Depression and Anxiety and/or Sexual Orientation and Gender Identity among others.

National College Health Assessment (NCHA)

Besides the BRFSS, state-level YA data are also available to members of the American College Health Association (ACHA) through the National College Health Assessment. The ACHA partners with colleges nationally to field this survey. The NCHA provides varied information on college students, many of whom are young adults. In addition to information on more common topics such as Substance Use (including Marijuana and E-Cigarettes), Sexual Behavior and Mental Health, the NCHA also collects data on Relationships and Violence, Sleep and the Academic Impacts of negative physical and mental health events. 

Results from the NCHA’s national sample are published online as both an Executive Summary and Data Report. This information can offer a helpful comparison for states to see where their rates fall relative to the country.

Additionally, the ACHA provides individual results to member colleges. Title V programs may wish to partner with colleges in their state to utilize these data for needs assessment. Some NCHA results are also available for public use through a proposal submission process if organizations wish to access state-level data through other means.

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✔ Field a Young Adult Health Survey

Multiple state Title V agencies have partnered with external organizations to develop and publish the results of state-level surveys on young adult health. These external partners include local universities and private research firms. By adapting publicly available surveys to collect data in one’s state, programs can close gaps in knowledge that would not otherwise be addressed. Ideas for collaborations are explored further in the next chapter, Strategy 2: Build Collaborative Networks

Child/Adult Needs and Strengths Assessment, Transition to Adulthood (ANSA-T)

The Adult Needs and Strengths Assessment is a free survey tool that organizations can use to gain an in-depth understanding of young adult health in their state. The Transition to Adulthood version (ANSA-T) is modified with significant contributions from young adult stakeholders. This survey uses a 4-point scale to assess the needs and strengths of transitioning individuals and family. Questions are grouped as follows:

  • Functioning
  • Mental Health
  • Acculturation
  • Educational/Vocational
  • Risk Behaviors
  • Substance Abuse
  • Strengths (of the transitioning young adult)
  • Caregiver Needs and Strengths

The ANSA-T is available for use with permission from the Praed Foundation (847-501-5113 / General information can be viewed on the Praed Foundation website.

Understanding Young Adult Substance Use & Suicide in North Dakota
In 2018, North Dakota’s Department of Human Services partnered with the University of Wyoming to conduct a survey of young adults’ attitudes towards and use of substances. These organizations also collected data on suicide and gambling, and demographic factors such as race, living situation and sexual orientation. Thanks to the previous iteration of this survey conducted in 2016, North Dakota was able to analyze changes in rates over time. Learn more

✔ Select a YA State Performance/Outcome Measure

As data provide a clearer picture of where states should focus their efforts, Title V programs can translate findings into actionable goals through a state performance or outcome measure. Selecting and tracking a young adult measure over time enables states to: 

1) establish concrete objectives and strategies, 

2) quantify improvements, and 

3) adapt strategies based on rate changes

As of 2018, 5 Title V agencies have selected state measures with a young adult health focus. These measures are:

  • Illinois: Rate of chlamydia infections in women ages 15-24
  • Iowa: % of adults 18-24 years old who report being physically active
  • Maine: % of new mothers ages 18-24 years whose most recent pregnancy was unintended
  • Rhode Island: Youth suicide rate ages 10-24
  • Texas: % of young adults ages 18-24 who visited a doctor for a routine checkup in the past year

Evident from the diverse topic areas chosen by each state, young adult health spans a wide range of issues. Title V agencies are encouraged to align their YA measure with the most pressing issues and/or existing efforts in their state, in order to maximize resources and impact.

next: Strategy 2 – Build Collaborative Networks

previous: Strategies Overview

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