Youth risk behavior surveillance - National Alternative High School Youth Risk Behavior Survey, United States, 1998

Alternative high schools serve approximately 280,000 students nationwide wh o are at high risk for failing or dropping out of regular high school or wh o have been expelled from regular high school because of illegal activity o r behavioral problems. Such settings provide important opportunities for de livering health promotion education and services to these youth and young a dults. However; before this survey, the prevalence of health-risk behaviors among students attending alternative high schools nationwide was unknown. The Youth Risk Behavior Surveillance System (YRBSS) monitors the following six categories of priority health-risk behaviors among youth and young adul ts: behaviors that contribute to unintentional and intentional injuries; to bacco use; alcohol and other drug use: sexual behaviors that contribute to unintended pregnancy and sexually-transmitted diseases (STDs) (including hu man immunodeficiency virus [HIV] infection); unhealthy dietary behaviors; a nd physical inactivity. The national Alternative High School Youth Risk Beh avior, Survey (ALT-YRBS) is one component of the YRBSS; it was conducted in 1998 to measure priority health-risk behaviors among students at alternati ve high schools. The 1998 ALT-YRBS used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 i n the United States who attend alternative high schools. The school respons e rate Ir as 81.0%, and the student response rate was 81.9%, resulting in a n overall response rate of 66.3%. Tills report summarizes results from the 1998 ALT-YRBS. The reporting period is February - May 1998. In the United States, 73.6% of all deaths among youth and young adults aged 10-24 years results from only four causes - motor vehicle crashes, other u nintentional injuries, homicide, and suicide. Results from the 1998 ALT-YRB S demonstrates that many students at alternative high schools engage in beh aviors that increase their likelihood of death from these four causes. Duri ng the 30 days preceding the survey 51.9% had ridden with a driver who had been drinking alcohol, 25.1% had driven a vehicle after drinking alcohol. 3 2.9% had carried a weapon, 64.5% had drunk alcohol, and 53.0% had used mari juana. During the 12 months preceding the survey, 15.7% had attempted suici de, and 29.0% had rarely or never worn a seat belt. Substantial morbidity a mong school-aged youth and young adults also results from unintended pregna ncies and STDs, including HIV infection. ALT-YRBS results indicate that in 1998, a total of 87.8% of students students at alternative high schools had had sexual intercourse, 54.1% of sexually active students had not used a c ondom at last sexual intercourse, and 5.7% had ever injected an illegal dru g. Among adults aged greater than or equal to 25 years, 66.5% of all deaths result from two causes - cardiovascular disease and cancer Most risk behav iors associated with these causes of death are initiated during adolescence . In 1998, a total of 64.1% of students at alternative high schools had smo ked cigarettes during the 30 days preceding the survey, 38.3% had smoked a cigar during the 30 days preceding the survey, 71.2% had not eaten greater than or equal to 5 servings of fruits and vegetables during the day precedi ng the survey, and 81.0% had nor attended physical education (PE) class dai ly. Comparing ALT-YRBS, results with 1997 national YRBS results demonstrate s that the prevalence of most most, risk behaviors is higher among students attending alternative high schools compared with students at regular high schools. Some risk behaviors are more common among certain sex and racial/e thnic subgroups of students. ALT-YRBS data can be used nationwide by health and education officials to i mprove policies and programs designed to reduce risk behaviors associated w ith the leading causes of,morbidity and mortality among students attending alternative high schools.