Being, Belonging, Becoming: Minnesota's Adolescent Health Action Plan
Health Status of Minnesota Youth
Developing effective strategies starts by assessing the current health status of youth. This assessment includes examination of the key factors that affect youth health.
Population of Adolescents
The number of adolescents in Minnesota is projected to increase slightly from 2000 to 2030, but their percentage of the total population is expected to decline. At the same time, the population of adolescents will be more racially and ethnically diverse - a trend that mirrors changes in the Minnesota population as a whole. In 2000, youth of color (age 10-19) represented 16 percent of all adolescents in Minnesota, and they are expected to comprise 27 percent in the year 2030 .
Challenges to Health
In conversations with Minnesota youth age 12 to 21, they identified the following as the most significant challenges to their health:
1. TRADITIONAL PROBLEMS
Alcohol and other drug use; Sexual activity, pregnancy and issues of sexuality; Depression and suicide
2. STRESS AND DISTRESS
3. INADEQUATE RESOURCES FOR YOUTH:
Inadequate fit between schools and youth; Inadequate recreational opportunities for youth
4. YOUTH DISCONNECTION FROM ADULTS:
Adult stereotypes about youth and lack of respect for youth; Problems with parents and families; Problems with adults
5. SOCIETAL PROBLEMS
Violence, racism, poverty, homelessness, unhealthy neighborhoods, people who are disconnected
Factors that Affect the Health of Minnesota Adolescents:
Too few adolescents have access to appropriately designed and delivered health care services. Challenges include:
1) lack of health care providers who understand adolescent health and enjoy working with teens;
2) lack of coordination of health care services;
3) lack of access to services at convenient times and locations;
4) lack of confidentiality for sensitive services; and
5) difficulties in financing of health care services when youth seek services outside of the traditional health service system.
A large proportion of teens believe that their family cares about them and are able to talk with their parents about problems .
Youth in grades 6, 9 and 12 generally have positive feelings about themselves .
Peers can have a strong impact on the health of teens. In Minnesota, friends are the number one source of happiness for adolescents in public schools . Nationally, teens who spend significant amounts of time hanging out with friends, especially those who are involved in specific risk behaviors, are more likely to be involved in these behaviors themselves .
School has a powerful influence on the health and well-being of adolescents. Yet an alarming percentage of students report cutting or skipping school and there are significant disparities in school completion by race and ethnicity [2,4].
In a 1999 national public opinion poll of Americans, a strong majority of adults describe teens negatively, using words such as rude, irresponsible and wild. Only 38% believe that todays youth, once grown, will make the United States a better place. Despite their pessimism about teens, adults believe that helping youth get a good start in life is one of the most important issues facing the country, even more important than creating jobs or reducing crime .
Minnesota Adolescent Health Behaviors and Outcomes
Injury and Violence
Youth age 10-19 represented 14% of all motor vehicle crash deaths and 19% of all motor vehicle crash injuries in 2005 . An alarming percentage of high school students report driving after use of alcohol or other drugs and riding with others who have used these chemicals .
For 15-19 year old youth, homicide and suicide combined accounted for more than one quarter (29%) of deaths in this age group in the years 2003-2005 .
On average, a classroom of 30 high school students will have two youths who have been sexually abused .
Nationally, adolescents and young adults experienced the highest rates of violent crime in 2005 .
Causes of Death
Unintentional and intentional injuries are the leading causes of death among Minnesota adolescents age 10-19, especially older teens. Deaths due to motor vehicle injuries represent more than 80 percent of all unintentional injury deaths among this age group .
Tobacco, Alcohol and Other Drugs
Nearly 3 out of 10 high school students and 1 out of 10 middle school students are current tobacco users. The percentage of students who are current tobacco users fell by 25 percent between 2000 and 2005. Most young smokers say they would like to quit and many have tried to quit unsuccessfully .
Alcohol is the most widely used chemical among Minnesota adolescents. Between 1998-2004, alcohol use and marijuana use decreased moderately among 9th and 12th graders .
Sexual Behavior, Pregnancy, STDs & HIV
The percent of students in 9th and 12th grades who have ever had sexual intercourse has decreased steadily from 1992 to 2004 .
The statewide teen pregnancy and birth rates have decreased gradually from 1990 to 2005. Teen birth rates have fallen for all racial/ethnic groups except Hispanics. Depending on the racial/ethnic group, Minnesota youth of color face teen birth rates that are 2 to 6 times higher than white teens . Nationally, teen pregnancy rates have declined because:
1) fewer teens are having sex; and
2) more sexually active teens are using contraceptives effectively .
Adolescents and young adults (ages 15-24) account for the majority of cases of chlamydia and gonorrhea reported in Minnesota . Youth of color, particularly African Americans (including African-born immigrants) and Hispanics, are disproportionately represented among youth diagnosed with STD and HIV infection [12,13].
Factors that contribute to this disparity require careful attention and focus.
Nutrition and Physical Activity
There are limited data about nutrition and physical activity among Minnesota adolescents. Only about half of 6th and 9th grade students and just over one-third of 12th grade students take part in physical activity on a regular basis. Most young people do not eat adequate amounts of fruits and vegetables every day. Nearly one of every four high school students feel they are overweight .
Mental Health & Suicide
An alarming percentage of Minnesota teens report feeling pervasive sadness, high levels of stress, feelings of hopelessness/discouragement, and having thought about or having tried to kill themselves . Between 2003 and 2005, 119 young people age 15-19 took their own lives, making suicide the second leading cause of death for this age group .
3. MN Departments of Education, Health, Human Services, and Public Safety, Minnesota Student Survey 2004 . Major reports are: 2004 Minnesota Student Survey Statewide Tables , and Minnesota Student Survey 1992-2004 Trends.
8. MN Department of Health, Center for Health Statistics, 2003 Minnesota Health Statistics; 2004 Minnesota Health Statistics; 2005 Minnesota Health Statistics . Also available through Minnesota Vital Statistics Interactive Queries, https://www2.health.state.mn.us/iq/frontPage.jsp
9. US Department of Justice, Bureau of Justice Statistics, Results from the National Crime Victimization Survey available at http://www.ojp.usdoj.gov/bjs/cvict.htm#ncvs
11. National Campaign to Prevent Teen Pregnancy, Science Says: Teen Contraceptive Use , September 2006, Washington, DC, http://www.teenpregnancy.org/works/sciencesays.asp
12. MN Department of Health, STD and HIV Section, 2005 Minnesota Sexually Transmitted Disease Statistics, http://www.health.state.mn.us/divs/idepc/dtopics/stds/stats/stdsurvrpts.html