Healthy Adolescents COMMUNITY HEALTH ASSESSMENT
Prepared by: HealtheConnectionsHealthPlanning November 2013 CHA Adolescents Ages 12-19 |
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Overarching Goal Statement Healthy People in Every Stage of Life: All people, and especially those at greater risk of health disparities, can achieve their optimal lifespan if they have the best possible quality of health in every stage of life.
Strategic Goal Statement Achieving Healthy Independence: Increase the number of adolescents who are prepared to be healthy, safe, independent, and productive members of society (Adolescents ages 12–19 years).
Healthy Adolescents TABLE OF CONTENTS Introduction ........................................................................................................................1 Key Findings .......................................................................................................................2 Demographics and Social Determinants .......................................................................4 Education........................................................................................................................... 5 Economic Stability ............................................................................................................ 6 Family Stability ................................................................................................................... 7 Public Safety ...................................................................................................................... 8 Healthy Care ....................................................................................................................10 Chronic Disease Management ................................................................................... 10 Healthy Behaviors ...........................................................................................................11 Active Living .................................................................................................................... 11 Healthy Eating/Healthy Weight ................................................................................... 14 Pregnancy and Births..................................................................................................... 15 Sexual Health .................................................................................................................. 17 Mental & Emotional Well-Being ................................................................................... 20 Preventing Substance Abuse & Excessive Alcohol Use .......................................... 24 Injury-Free Living ............................................................................................................. 26 Data Tables ......................................................................................................................29 References .......................................................................................................................33
CHA Adolescents Ages 12-19 |
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Adolescence—a time of newfound freedom and exploration— is a period when behaviors are established that have both an immediate and a long-lasting health impact.
INTRODUCTION Adolescence (ages 12-19) is a time of new-found freedom, exploration, and transition. During this period of development, young people are transforming from children to young adults. In the midst of managing their changing bodies, they are tasked with navigating complex social lives and being held increasingly responsible for their actions. It is during this phase of life that behaviors are established that have both immediate and long-lasting health impacts.
Many of the leading causes of death among adults are related to behaviors that take shape and solidify during adolescence. Although adolescents are generally perceived as healthy, they tend to engage in risky and negative activities that may result in harmful or fatal outcomes, which is reflected by the leading causes of death for this age group: motor vehicle accidents, homicide, suicide and other unintentional injuries.
This chapter highlights issues impacting the health of adolescents in Madison County. It is an overview of health outcomes and behaviors, as well as social determinants of health pertaining to young people on the brink of adulthood.
CHA Adolescents Ages 12-19 |
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KEY FINDINGS Healthy Behaviors Over one third of Madison County and New York State 7-12th grade youth are overweight or obese (37.9% and 34.9% respectively). Of all the 7th-12th grade adolescents in Madison County classified as overweight/obese, two-thirds are obese. The county birth rate for girls ages 10-14 decreased from 0.3 per 1,000 in 2004-2006 to 0.0 per 1,000 in 2008-2010. The county birth rate for girls ages 15-17 decreased from 14.2 per 1,000 in 2004-2006 to 6.4 per 1,000 in 2008-2010. Madison County births to girls ages 15-19 decreased from 26.1 per 1,000 to 13.3 per 1,000. Madison adolescent mothers are more likely to deliver healthy weight newborns than the New York State teen mothers. Madison teen mothers are also more likely to carry their pregnancies to full term compared to New York State. Madison pregnant adolescents receive no or late pre-natal care more often than state teen expectant moms. The ratio of pregnancy rate to birth rate of adolescent girls in DeRuyter and Erieville (2:1) is two times the ratio of Georgetown and Bouckville (1:1). The adolescent suicide mortality rate of Madison is 2.9 per 100,000, exceeding the New York State rate of 2.4 per 100,000. Madison County teens considering suicide are more likely to confide in a teen friend, than a trusted parent or adult friend. According to TAP, although 60% of sexually active teens report always using some form of birth control, 46% admit to never or rarely using condoms. The rate of self- inflicted injuries in the 10-14 year olds is 30.1 per 100,000; exceeding the New York State rate of 18 per 100,000. In 2010, 56.9 % of Madison County students in grades 7-12 said it would be easy or very easy to get alcohol. In 2007, the county and state DWI arrests rates for people ages 16-21 were 66.7 and 43.7 per 10,000, respectively ; where in data year 2010 the Madison County rate decreased to 44.5 per 10,000, while New York State’s rate decreased to 32.2 per 10,000.
CHA Adolescents Ages 12-19 |
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Social Determinants of Health Between 2007 and 2010 the drop-out percentage in Madison County decreased from 2.2 to 1.2. Between 2007 and 2011 the rate of youth ages 16-21 in Madison County arrested for drug use, possession and/or sale increased from 27.6 per 10,000 to 33.6 per 10,000. Since 2007, 8th grade proficiency in science and social studies has remained high or increased substantially. Science performance rose slightly from 83.5% to 83.9% performing at or above level, social studies proficiency increased from 65.4% to 78.3%. In 2011, less 8th graders performed at or above level in English Language Arts (ELA) and mathematics compared to 2007. ELA proficiency decreased from 67.3% to 51.0%; Compared to New York State fewer Madison County teens are arrested for committing violent crimes (82.6 per 10,000 vs. 4.3 per 10,000); damaging property (168.5 vs. 83.6); and for the possession, sale, or use of drugs (202.8 vs. 33.6).
Key Indicates a favorable status compared to New York State and/or when compared to Madison County’s previous data. Indicates an unfavorable but similar status compared to New York State and/or when compared to Madison County’s previous data (difference within 10%). Indicates an unfavorable and worse status compared to New York State and/or when compared to Madison County’s previous data (difference greater than 10%).
CHA Adolescents Ages 12-19 |
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DEMOGRAPHICS AND SOCIAL DETERMINANTS OF HEALTH According to the 2010 Census, adolescents constitute 13.3% (9,764) of the population of Madison County. The gender distribution in this demographic is fairly even. Males amount to 49.9% (4,869) of this age group, while females are 50.1% (4,895) of the adolescent cohort in the county .1
Figure 1
Source: U.S. Census Bureau, 2010
Adolescents living in poverty face additional challenges to maintaining or attaining good health. Limited resources can impact access to primary care providers (including lack of transport to reach appointments, or lack of insurance needed to be seen by a provider). Single-parent familes are particularly vulnerable to poverty. Studies show that young people growing up in poverty are disproportionally exposed to violence and have lower educational attainment.2
Figure 2
Source: 2009-2011 American Community Survey (ACS) 3-year Estimates
CHA Adolescents Ages 12-19 |
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Education Proficiency in English Language Arts (ELA), a strong indicator of literacy, has declined significantly from 67.3% to 51.0% between 2006 and 2011 among Madison County eight graders . Despite these declines, Madison County routinely outperforms the New York State average performance in every subject except math . 18 The relationship between literacy and health is complex. Literacy impacts health knowledge, health status, and access to health services. Health status is influenced by several related socioeconomic factors. Literacy impacts income level, occupation, education, housing, and access to medical care. Low literacy is associated with a variety of adverse health outcomes, including increased mortality, hospitalization, and in some cases poorer control of chronic health conditions.
Figure 4
Source: New York State Kids’ Well-being Indicators Clearinghouse (NYS KWIC), 2013
CHA Adolescents Ages 12-19 |
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Economic Stability Poverty affects many aspects of an adolescents’ life, including living conditions, nutrition, and access to health care. Adolescents living in poverty are at an increased risk of being exposed to violence, engaging in riskier behavior, and performing poorly in school. Additionally, low-income neighborhoods are targeted more for liquor, cigarette, and soda advertisements. Childhood poverty is also associated with teenage pregnancy. For pregnant adolescents, low-income can lead to malnutrition and decreased access to prenatal care, which further complicates innately high-risk teenage pregnancies.27 The number of children and youth ages 0 to 17 living below the poverty level in Madison County increased from 2,081 in the year 2005 to 2,669 in the year 2011. 18 The Supplemental Nutrition Assistance Program (SNAP) serves as an indicator of poverty. In Madison County more children received SNAP benefits in 2011 compared to 2005 (1,965 vs. 3,327).18 The Alliance for Excellent Education states that nationally, adolescents growing up in the lower 25th percentile of income are seven times more likely to drop out of high school compared to their counterparts in the top 25% of income.28 Fortunately, between 2007 and 2010 the high school drop-out percentage in Madison County decreased from 2.2 to 1.2.18
Figure 5
Source: NYS KWIC, 2013
CHA Adolescents Ages 12-19 |
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Family Stability In 2012 the U.S. Department of Health and Human Services’ Youth and Families, Children's Bureau reported that over 400,000 children in the United States were living in foster care. These young people are often seeking refuge from abusive and neglectful homes. However, in some cases, entering the foster care system continues to put children in high-risk circumstances that can influence health for years to come. The Casey Foundation’s Northwest Foster Care Alumni Study found that young adults who grow up in the foster care system suffer from mental illness at disproportionally higher rates than their peers.29 The transient nature of foster care prohibits many adolescents from keeping in contact with primary care providers. During some point in their lives, young people in the child welfare system are often exposed to living environments below the poverty level, or endure bouts of homelessness. According the New York State Kid’s Well-being Indicators Clearinghouse (NYS KWIC), Madison has been successfully adopting children from the foster care system at rates far exceeding the New York State average (75% vs. 43% in 2007).18
CHA Adolescents Ages 12-19 |
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Public Safety When comparable data is available, Madison County youth between ages 16 and 21 tend to be involved in less criminal activity than NYS as a whole. The state rate for violent crimes; property crimes; and drug use, possession, or sale exceeds Madison County’s rates. However, Madison youth have a higher rate of driving while intoxicated compared to New York State.18
Figure 6
Source: NYSKWIC, 2013.Note: Data not available for New York State arrest categories for those under age 16.
According to the Pride Survey, the majority of Madison youth have not been involved in activities that may involve or lead to violence. Less than 10% of youth surveyed participated in gangs. However over one-fifth of those surveyed threatened a classmate.20
Figure 7
Source: Pride Survey, 2012
CHA Adolescents Ages 12-19 |
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On school premises, Madison adolescents feel the most safe in the classroom and gymnasium, and the least safe outside on school property.
Figure 8
Source: Pride Survey, 2012
CHA Adolescents Ages 12-19 |
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HEALTHY CARE Chronic Disease Management Managing chronic diseases such as asthma or diabetes during the adolescent years proves challenging for young people, parents and medical professionals. Increased independence, a body in metamorphosis, and peer pressure greatly impact an adolescent’s decisions regarding healthy or unhealthy behavior.3 Some youth struggle with feeling different from their peers because of their disease; some asthmatic youth may even experience a delayed onset of puberty.4 Although Madison County asthmatic adolescents visit the emergency room and are hospitalized at a lower rate than New York State, attention to this age group remains important. According to a 2008 study, adherence to prescribed treatments for asthma may decrease dramatically during adolescents and young adulthood (Figure 4).5 Failing to adhere to prescribed medication can result in increased asthma severity and lead to more hospitalizations and absences from school. The increased experimentation with cigarettes further complicates asthma. Additionally, adolescents may opt out of participating in physical activity due to asthma, which may contribute to weight gain in this demographic.3
Figure 9
Source: New York State Department of Health (NYSDOH), Community Health Indicators Report, 2013; data collected 2009-2011. Data from 2009 SPARCS dataset denoted by (*).
Figure 10
Source: McGann, Sexton & Chyun cited in DiMatteo.
CHA Adolescents Ages 12-19 |
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HEALTHY BEHAVIORS Active Living Regular participation in physical activity has benefits throughout the life of an individual. Engaging in activities such as dance, martial arts, and sports is associated with lower rates of obesity and depression, improved sleep patterns among other positive outcomes. Youth who establish active lifestyles are more likely to continue those healthy habits throughout adulthood. The US Department of Health and Human Services recommends that adolescents participate in five hours of exercise or physical activity weekly.6 For data year 2010, the Madison County Youth Bureau Teen Assessment Project (TAP) survey found that roughly half of the teens surveyed in the county were engaging in only one hour or less of unstructured physical activity per week, falling far below national guidelines (Figure 5).7 However, students involved in organized sports tend to exercise a minimum of 2 hours per week, with over 20% engaging in at least eleven hours of exercise per week (Figure 6). The proportion of youth participating in organized sports has been increasing. As is expected, youth participating in formal fitness programs engage in the recommended five hours or more of weekly exercise more frequently than adolescents not enrolled in structured fitness activities.
CHA Adolescents Ages 12-19 |
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Over half of teens that participated in TAP 2010 reported texting, using the internet, or watching TV for a minimum of two hours a week. The benefits of technological advances cannot be under estimated. However, when young people neglect to engage in physical activity in order to use the internet, watch television, or send text messages, the health consequences of the digital age must be considered. Unfortunately, while adolescents are interfacing with media they are not physically active, and they are being exposed to messages that promote poor eating habits. According to Yale University’s Sugary Drink Food Advertising to Children and Teens Score (FACTS) study, young people are disproportionally targeted by soda and energy drink companies via multimedia advertising campaigns: Nationally from 2008-2010, adolescent exposure to TV commercials promoting fullcalorie soda doubled. Twenty-one sugary drink brands had YouTube channels in 2010. These brands received over 229 million views by June 2011. Between 2008 and 2010 teens viewed 20% more TV ads for energy drinks and listened to 46% more energy drink radio commercials than adults.8
Figure 11
Source: TAP, 2010
CHA Adolescents Ages 12-19 |
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Figure 12
Figure 13
Source Figures 11 & 12: Teen Assessment Project Report, Madison County (2010)
CHA Adolescents Ages 12-19 |
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Healthy Eating & Healthy Weight
Figure 14
Maintaining a healthy weight is essential to preventing chronic diseases such as cardiovascular disease, diabetes, and cancer. Unfortunately, childhood and adolescent obesity have skyrocketed nationwide, as well as within Madison County. According to Ogden and Carroll obesity has tripled in adolescents during the last three decades. Neither New York State nor Madison County has not escaped this epidemic.6 Over one third of Madison County and New York State 7-12th grade youth are overweight or obese (37.9% and 34.9% respectively). In Madison County twothirds of all the 7th-12th grade adolescents are classified as obese or overweight are obese.9
Figure 15
Source Figures 14 & 15: New York State Department of Health (NYSDOH) “Obesity and Related Indicators - MadisonCounty� http://www.health.ny.gov/statistics/chac/indicators/obs.htm.
CHA Adolescents Ages 12-19 |
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Pregnancy and Births Teenage pregnancy can affect the lives of the young parents and newborn children in various ways. Adolescents may sacrifice pursuing higher education and be forced to settle for low-paying and lowskill employment in order to meet the immediate needs of supporting a young family, thus stunting earning potential and the many health benefits that accompany higher paying jobs (health insurance, increased access to care, safer neighborhoods, etc.). Adolescent pregnancies are at higher risk for complications for the pregnant woman and baby compared to young adult pregnancies.10 Fortunately, adolescent pregnancies in Madison County and New York State are on the decline. Madison County has lower rates of adolescent pregnancies in all three age brackets than NYS. Single Year Birth Rates The county birth rate for girls ages 10-14 decreased from 0.5 per 1,000 in 2006 to 0.0 per 1,000 in 2011.11 The county birth rate for girls ages 15-17 decreased from 10.9 per 1,000 in 2006 to 9.1 per 1,000 in 2011.12 Madison County births to girls ages 15-19 decreased from 34.1 per 1,000 in 2006 to 21.9 per 1,000 in 2011.13
Figure 16
Source: NYSDOH, Vital Statistics 2011
Figure 17
Source: NYSDOH, Vital Statistics 2011
CHA Adolescents Ages 12-19 |
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Prenatal care is essential for all pregnant women. Regular appointments help improve the health of the expectant mother and baby. Adolescent pregnancies are at high-risk for complications due to: 1) complex social scenarios surrounding teen pregnancy, 2) adolescent girls are at an increased risk of high blood pressure and preeclampsia compared to expectant mothers in their 20’s and 30’s.10 On average, Madison County adolescent women deliver fewer underweight babies and carry to full term more frequently than their state counter-parts. County adolescents are also slightly more likely to receive early prenatal care compared to New York State adolescents. However, Madison pregnant adolescents are less likely to receive prenatal care at the middle and late stages of pregnancy than state expectant moms.
TABLE 1 Adolescent Pregnancy and Birth Rates per 1,000 Females by ZIP Code, 2008-2010 Teen Pregnancy Rate
Teen Birth Rate
Rate Ratio
Bridgeport (13030)
36.2
20.7
1.7
Canastota (13032)
35.7
24.3
1.5
Cazenovia (13035)
8.9
4.8
1.9
Chittenango (13037)
28.2
14.6
1.9
DeRuyter (13052)
10.4
5.2
2.0
Erieville (13061)
14.5
7.2
2.0
Georgetown (13072)
9.0
9.0
1.0
Kirkville (13082)
30.3
21.0
1.4
New Woodstock (13122)
41.7
33.3
1.3
Bouckville (13310)
29.4
29.4
1.0
Brookfield (13314)
*
*
*
Earlville (13332)
20.6
17.2
1.2
Eaton (13334)
38.7
32.7
1.2
Hamilton (13346)
3.2
2.3
1.4
*
*
*
Madison (13402)
96.3
74.1
1.3
Morrisville (13408)
15.4
10.6
1.5
Munnsville (13409)
33.8
29.5
1.1
*
*
*
Oneida (13421)
55.4
39.9
1.4
Lebanon (13485)
41.0
25.6
1.6
Location
Hubbardsville (13355)
North Brookfield (13418)
Source: NYSDOH, Perinatal Data Profile 2012 *Data not available
Madison teen birth rates and teen pregnancies by township. The towns of Georgetown and Bouckville have 1:1 ratios of pregnancy rates to birth rates. Cazenovia, Chittenango, DeRuyter and Erieville have rate ratios equal to or greater than 1.9; in these regions it appears that nearly half of the reported teen pregnancies did not result in births. The data provided did not indicate whether these pregnancies were terminated or which 2010 pregnancies resulted in 2011 births. Nonetheless, high rate ratios may serve as an indication of areas that may require additional focus on adolescent enrollment in prenatal care education. CHA Adolescents Ages 12-19 |
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Sexual Health For many adolescents, becoming sexually active occurs during the teenage years. Having access to accurate information about the ramifications of engaging in sexual intercourse at this age is crucial to preserve individual health, prevent pregnancy, and prevent the spread of disease. According to the 2010 Teen Assessment Project (TAP) Report, the majority of adolescents in Madison County have never had sex. However, the proportion of young people never engaging in sex decreased significantly between 2007 and 2010 (79% and 69% respectively).7 Roughly 30% of Madison County teens surveyed were sexually active. Of these reported sexually active teens, 59% always use some form of birth control. However, nearly 50% reported rarely/never using condoms and 40% reported using alcohol or drugs before engaging in sexual activity.7 People under the influence of substances are at a higher risk of not using condoms and/or not using condoms effectively.
Figure 18
Figure 19
Source Figures 18 & 19: Tap, 2010
CHA Adolescents Ages 12-19 |
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In recent survey years the percentage of teens consistently using birth control has been between 60% and 65%. However, there is greater variation with condom use specifically. Between 2003 and 2010 the percentage of teens that reported always using condoms has fluctuated between 52% and 66%. It must be noted that the TAP Survey collects self-reported data. The information provided may be over- or under-estimations concerning certain behaviors.
Figure 20
Figure 21
Source for Figures 20 & 21: TAP, 2010.
CHA Adolescents Ages 12-19 |
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Although Madison County adolescent STD rates remain far lower than NYS average, both have risen significantly within the last decade (See Healthy Behaviors Table).
Figure 22
Source: HIV/AIDS and Other Sexually Transmitted Infection Indicators - Madison County http://www.health.ny.gov/statistics/chac/chai/docs/sti_25.htm
CHA Adolescents Ages 12-19 |
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Mental & Emotional Well-Being Learning the skills needed to rationally cope with the ups and downs of life are important tools for young people to obtain. In most cases managing one’s thoughts, emotions, and actions require average effort and supervision. However, individuals living with mental health disorders may find navigating through society extremely challenging for a number of reasons. Cognitive and emotional development affects every aspect of an adolescent’s life. Mental impairments range from learning disabilities like dyslexia to extreme personality disorders such as schizophrenia. Kessler and Berglund report, as cited by the National Adolescent Health Information Center, that fifty percent of diagnosable mental health disorders are present as early as 14 years old; by age 24, three-fourths of mental health diseases have started.14 This fact is reflected in the service utilization numbers of the Madison County Mental Health Department. The agency reported that 1 out of every 4 clients seen at the clinic the year 2012 were adolescents. The adolescent age range exceeded all other age groups in terms of number of patients seen. Like most diseases, early detection and treatment of psychosocial disorders helps improve the quality of life for not only the individual living with the disease, but also their support system. The Madison County Mental Health Department reports that in 2012, 106 adolescents ages 12-18 were treated by the child psychiatrist at the mental health clinic.15
Figure 23
Source: Madison County Mental Health Department, 2013.
CHA Adolescents Ages 12-19 |
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Suicide is the fifth leading cause of premature death in Madison County.16 The adolescent suicide mortality rate in the county exceeds the state average (2.9 vs. 2.4). Self-inflicted injury rates that result in hospitalizations are almost two times higher for Madison County adolescents than the average New York State 10-14 year olds. Although the hospitalization rates for the 10-14 and 15-19 age group are relatively similar (30.1 per 100,000 and 37.5 per 100,000). Madison County adolescents 15 – 19 years of age are significantly less likely to be hospitalized for self-inflicted injuries compared to the state average 15 – 19 year old.17
Figure 24
Source: NYSDOH, Community Health Indicator Reports - Injury Indicators 2012
Figure 25
Source: TAP, 2010
CHA Adolescents Ages 12-19 |
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Figure 26 TAP survey results indicate that the top three reasons Madison teen’s considered suicide in 2010 were problems with their home life, failed relationships, and feelings of isolation.
Source: TAP, 2010
Figure 27 The survey also found that teens were slightly more inclined to keep their problems to themselves or do nothing when they had thoughts of committing suicide; followed by confiding in friends, and isolating themselves. According to this data, peer support plays a vital role in mental health. Increasing teen awareness of mental health symptoms and county resources may help improve outreach to teens who struggle with depression and other mental health issues.
Source: TAP, 2010
CHA Adolescents Ages 12-19 |
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The percentage of Madison teens attempting suicide has declined from 13.2% in 2003 to 10% in 2010. However, the majority of suicide attempts continue to result in substantial harm to the individual.7
Figure 28
Source: TAP, 2010
Figure 29
Source: TAP, 2010
Note: Original question “If you attempted suicide during the past 12 months, did any attempt result in an injury, poisoning, or overdose that had to be treated by a doctor or nurse?” For the years 2003, 2007and 2010 the vast majority replied “I did not attempt suicide during the past 12 months” (86.9%, 88.6%, and 90.0% respectively).
CHA Adolescents Ages 12-19 |
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Preventing Substance Abuse & Excessive Alcohol Use
As adolescents age they are exposed to alcohol and other drugs (AOD) at an increased rate. With less supervision and more opportunities to earn income, it is easier to gain access to substances. Underage drinking and use of illicit drugs are a public health concern in Madison County. Between 2007 and 2011 the rate of youth ages 16-21 arrested for drug use, possession and/or sale increased from 27.6 per 10,000 to 33.6 per 10,000. However, this arrest rate is below the 2007 and 2010 New York State rates of 215.4 and 202.8 respectively. 18 The number of DWI arrest among young adults aged 16 to 21 has decreased statewide. In 2007 the county and state DWI arrest rates were 66.7 and 43.7 per 10,000 respectively; where in data year 2010 Madison County DWI arrest rates decreased to 44.5 and New York State decreased to 32.2 per 10,000. Although the county has shown a decrease in the DWI arrest rate; the county rate continues to exceed state rate. 18 According to data provided by the New York SPARCS Statewide Planning and Research Cooperative System (SPARCS) in 2009 59 Madison residents between the ages of 5 and 24 were discharged from the ER with and alcohol or drug related diagnosis. The majority (57 out of 59) of these people were in the 15-24 age range and the remaining individuals were in the 5-14 age range. Amongst the older cohort, drug and alcohol discharges constituted 1.2% of all ER discharges; in the younger cohort less than 0.08% of ER discharges were alcohol or drug related .19 Madison percentages are lower than state proportions (Figure 24). The 2012 Pride Survey ,conducted by BRiDGES of the Madison County Council on Alcoholism and Substance Abuse, Inc., found that over 40% percent of the 12th graders surveyed indicated that they consumed alcohol during the previous month.20 Between grades 7 and 12, the use of all drugs increased steadily. According to Pride, the risk perception of cigarettes and prescription drugs consistently exceeds the perception of risk of alcohol and marijuana. The perception of risk associated with marijuana decreased steadily between 7th graders and 12th graders, which coincides with the increase of marijuana use as the grade level increases. Despite the seemingly consistent moderate to high risk perception of alcohol, consumption increased as students aged.
Figure 30
Source: SPARCS,2009.
CHA Adolescents Ages 12-19 |
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Figure 31
Figure 32
Figure 33
Source Figures 31—33 : Pride Survey, 2012
CHA Adolescents Ages 12-19 |
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Injury Free Living In New York State the leading cause of death for adolescents is unintentional injury.21 The NYS DOH encourages parental involvement and safety education ( e.g. wearing bike helmets, completing formal driving lessons) to decrease injury incidents. The Madison percentage of injury related ER visits for adolescents exceeded the NYS proportion in 2009.19 For data years 2009-2011 the adolescent injury hospitalization rates exceeded NYS rates.17
Figure 34
Source: SPARCS,2009.
Figure 35
Source:New York State Department of Health (NYSDOH). “Injury Indicators - Madison County� http://www.health.ny.gov/statistics/chac/chai/docs/inj_25.htm.. Date accessed November 6, 2013.
CHA Adolescents Ages 12-19 |
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Among NYS teens ages 15 to 19 years old motor vehicle crashes are a leading cause of hospitalizations and unintentional deaths and hospitalizations. In 2007 the Bureau of Injury Prevention Crash Outcome Data Evaluation System (CODES) found that young people between ages 10 and 19 were involved in 17.5% of Madison County motor vehicle accidents. CODES did not indicate whether or not people were drivers or passengers. The data covered two age groups: 10-14 which made up 2.7% of accidents, and 15-19 which constituted 14.8% of county accidents.22 It is estimated that seat belts reduce the risks of serious injuries in motor vehicle accidents by 50-83%. Female teens are less likely to be fatally injured in motor vehicle accidents than male teens. Teen driving is the most impaired at night. In an effort to reduce the number of night-time accidents involving adolescent drivers, New York State enacted the Graduated Driver License Law which limits night teen driving.23
Figure 36
Source: 2011 Youth Risk Behavior Surveillance Survey. NYS Data unavailable denoted by (*).
There is little county-level data on adolescent behaviors that may lead to injury. However, the 2011 National Youth Risk Behavior Surveillance Survey does provide national and state statistics for behaviors affecting the adolescent age group. Compared to national results, New York State high school students are far less likely to ride in vehicles driven by individuals who were drinking (24.1% vs 3.9%). However, New York teens were more likely to drive themselves after consuming alcohol, than to allow someone else who had been drinking to drive them. 24
CHA Adolescents Ages 12-19 |
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Between 2003 and 2010 the lowest percentage of adolescents drove or rode in motor vehicles when the driver was intoxicated in 2007 (12%). In 2003, 16% of students participated in this activity. TAP Survey year 2010 had the highest percentage of students driving or riding with intoxicated drivers (16.3%).
Figure 37
Source: TAP Survey, 2010.
For survey years 2003, 2007, and 2010 81-81.3% of Madison teens believed that their friends would try to prevent them from doing something harmful.
Figure 38
Source: TAP Survey, 2010.
CHA Adolescents Ages 12-19 |
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DATA TABLES Data Years
Madison County
New York State
Percent of overweight but not obese children (85th <95th percentile) for 7th to 10th grade
2008-2010
12.5
16.6
Percent of overweight or obese children (85th percentile and higher) for 7th to 10th grade
2008-2010
37.9
34.9
Percent of obese (95th percentile or higher ) for 7th and 10th grades
2008-2010
25.4
18.3
Healthy Behaviors
Data Years
Madison County
New York State
Healthy Eating & Healthy Weight
Active Living Percentage of students grades 9-12 spending two or more hours online
2007
54.0
2012
54.0
Percentage of students grades 9-12 spending two or more hours watching television, playing video or computer games
2007
66.0
2012
59.0
2012
57.0
2012
62.0
2012
51.0
~
2012
30.0
~
Percent staying at home with no parents present two or more hours per week Percent talking or text to friends on the telephone two or more hours per week.
2007
38.0
Percent that spend two or more hours per week in organized sports Sexual health Percentage of teens that are sexually active Sexually active and always use birth control
2007
55.0
2012
60.0
Sexually active and at least sometimes admit to drinking or using drugs before sexual intercourse
2007
36.0
2012
40.0
2008-2010
NA
0.1
Tobacco Free Living Percent of cigarette smoking in adolescents (past 3month) Preventing Substance Abuse & Excessive Alcohol Use Young Adults - Driving While Intoxicated, rate/10,000 arrests for young adults ages 16-21 years
2007
66.7
43.7
2011
44.5
32.2
Young Adults Arrests - Drug Use/Possession/Sale, rate/10,000 arrests for young adults ages 16-21 years
2007
27.6
215.4
2011
33.6
202.8
Percentage of students that have tried marijuana
2007
17.0
Incidence of young adult arrests for drug use possession sale (per 10,000)
2007
27.6
Percentage of 12th graders who have tried marijuana
2007
52.0
Percentage of 7th, 8th graders who have tried marijuana
2007
7.0
Percentage of students in grades 9-12 that said it would be easy or very easy to get alcohol
2007
76.0
Percentage of teens reported drinking alcohol
2007
31.0
Percentage of teens who drove or rode in a car with a driver who had been drinking alcohol
2007
23.0
~ 215.4
2012
21.6
Used Marijuana in the Past 30 days
2012
14.5
Used Prescription Drugs in the Past 30 days
2012
5.3
~
Sources: Teen Assessment Project (TAP), and Pride Survey Madison County Health Assessment Indicators http://www.health.ny.gov/statistics/chac/chai/chai_25.htm (Date accessed- June 16, 2013).
CHA Adolescents Ages 12-19 |
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Healthy Behaviors/ Chronic Disease
Data Years
Madison County
New York State
2008-2010
12.7
28.5
2008-2010
0.0
0.3
2008-2010
0.0
1.3
2008-2010
6.4
11.2
2008-2010
10.3
28.5
2008-2010
13.3
22.6
Adolescent Pregnancies by Age - 15-19 years, rate/1,000 females ages 15-19 years
2008-2010
18.7
50.2
Low Birth weight Births (<2,500 Grams) Mothers 10-19 years, percent live births
2008-2010
6.4
9.7
Premature Births (Less Than 37 Weeks) - Mothers 10-19 years, percent live births
2008-2010
8.5
13.5
Prenatal Care - Births to Women 10-19 Years Receiving Early (1st Trimester) Prenatal Care, percent live births for females ages 10-19 years
2010
55.3
54.4
Prenatal Care - Births to Women 10-19 Years Receiving Late (3rd Trimester) or No Prenatal Care, percent live births for females ages 10-19 years
2010
8.5
11.7
% of Medicaid enrollees (ages 2-20 years) who had at least one dental visit within the last year
2008-2010
36.9
40.8
2011
57.9
61.0
Diabetes short-term complication hospitalization rate (per 10,000) - ages 6-17 years
2008-2010
1.0
3.0
Asthma Emergency Department (ED) Visits Rate per 10,000 Population, Age 15-24
2008-2010
47.8
83.3
Asthma hospitalization rate per 10,000 - Ages 1524 years
2008-2010
2.0
7.5
Data Years
Madison County
New York State
Primary & Preventive Care Pregnancy rate among females aged 15-17 years (per 1,000) Adolescent Births by Age - 10-14 years, rate/1,000 females ages 10-14 years
2004-2006
0.3
1.5
Adolescent Pregnancies by Age - 10-14 years, rate/1,000 females ages 10-14 years Adolescent Births by Age - 15-17 years, rate/1,000 females ages 15-17 years
2004-2006
14.2
36.7
Adolescent Pregnancies by Age - 15-17 years, rate/1,000 females ages 15-17 years Adolescent Births by Age - 15-19 years, rate/1,000 females ages 15-19 years
2004-2006
26.1
61.3
Percentage of children ages 12-21 years who have had the recommended number of well child visits in government sponsored insurance programs. Chronic Disease Management Asthma
Cancer Cancer Incidence (15-19 years)-Number of Cases
2002-2006
1
313
2005-2009
2
324
Child Cancer Incidence (0-19 years)-Number of Cases
2002-2006
17
18
2005-2009
0
183
2005-2009
195.4
182.6
Cancer Incidence per 1,000,000 (ages 0-19)
Source: Madison County Health Assessment Indicators http://www.health.ny.gov/statistics/chac/chai/chai_25.htm . Date accessed- June 16, 2013.
CHA Adolescents Ages 12-19 |
30
Data Years
Madison County
New York State
Data Years
Madison County
New York State
Self-Inflicted Injury Hospitalization (15-19)
2004-2006
7.4
9.7
2008-2010
37.5
97.5
Unintentional injury mortality rate for 0-19 year olds
2004-2006
12.2
7.5
2008-2010
10.4
6.1
Mortality by Age - Adolescents 15-19 years (ThreeYear Average),rate/100,000 youth ages 15-19 years
2008-2010
32.8
37.6
Motor Vehicle Crashes - Hospitalizations (Three-Year Average),rate/100,000 youth/young adults ages 1524 years
2008-2010
97.6
102.6
Motor Vehicle Crashes - Mortality (Three-Year Average),rate/100,000 youth/young adults ages 15-24 years
2008-2010
25.7
9.2
Self-Inflicted Injuries - Hospitalizations 10-14 years (Three-Year Average),rate/100,000 youth ages 10-14 years
2008-2010
30.1
18.0
Self-Inflicted Injuries - Suicide Mortality (Three-Year Average),rate/100,000 youth ages 10-19 years
2008-2010
2.9
2.4
Unintentional Injuries - Hospitalizations 0-19 years, rate/100,000 children/youth ages birth-19 years
2010
187.4
259.3
Hospitalizations Resulting from Assault (Three-Year Average),rate/100,000 youth ages 10-19 years
2008-2010
8.7
66.1
Injury Free Living
Infection Free Living STD - Reported Cases of Chlamydia, Males 15-19 years
2004-2006
354.7
576.2
2008-2010
391.0
1023.1
STD - Reported Cases of Chlamydia, Females 15-19 years
2004-2006
808.4
2601.6
2008-2010
1060.1
3618.5
2008-2010
56.3
328.2
2011
30.1
26.0
2008-2010
0.2
0.2
STD - Reported Cases of Gonorrhea (Three-Year Average),rate/100,000 youth ages 15-19 years (20082010) Percentage of adolescent females with 3-dose HPV immunization - Ages 13-17 years Mental & Emotional Well-being % of Children (0-17)with Medicaid with Severe Emotional Disturbance
~
Source: Madison County Health Assessment Indicators http://www.health.ny.gov/statistics/chac/chai/chai_25.htm. Date accessed- June 16, 2013.
Key Indicates a favorable status compared to New York State and/or when compared to Madison County’s previous data. Indicates an unfavorable but similar status compared to New York State and/or when compared to Madison County’s previous data (difference within 10%). Indicates an unfavorable and worse status compared to New York State and/or when compared to Madison County’s previous data (difference greater than 10%).
~
Neither favorable nor unfavorable; comparison unavailable CHA Adolescents Ages 12-19 |
31
Social Determinants of Health
Data Years
Madison County
New York State
Data Years
Madison County
New York State
20102011
84.2
82.0
Education High School Graduates Intending to Enroll in College Public Schools, percent graduating seniors Annual Dropouts - Public Schools (%)
2006-2007
2.2
3.1
20102011
1.4
2.7
Student Performance in English Language Arts - Public Schools - Grade 8 (%)
2006-2007
67.3
57.2
20102011
51.0
46.9
Student Performance in Mathematics-Public Schools Grade 8 (%)
2006-2007
65.9
59.0
20102011
59.3
59.9
Student Performance in Science - Public Schools Grade 8 (%)
2006-2007
83.5
64.7
20102011
83.9
69.0
Student Performance in Social Studies - Public Schools, Grade 8 (%)
2006-2007
65.4
56.9
20102011
78.3
69.3
Students with limited English Proficiency - Public and Non-Public Schools (%)
2006-2007
0.1
7.9
20102011
0.2
9.6
Data Years
Madison County
New York State
Data Years
Madison County
New York State
Juvenile Arrests - Violent Crimes, rate/10,000 youth under 16 years old
2011
2.7
N/A
Juvenile Delinquent Probation Cases Adjusted, rate JD cases closed youth 7-15 years old
2011
66.0
40.8
Juvenile Delinquent Probation Cases Referred to Petition, rate JD cases closed ages 7-15 years
2011
34.0
8.4
~
Public Well Being
~
Young Adult Arrests - Property Crimes - 16-21 years, rate/10,000 young adults ages 16-21 years
2007
124.2
153.6
2011
83.6
168.5
Young Adult Arrests - Violent Crimes - 16-21 years, rate/10,000 young adults ages 16-21 years
2007
9.2
93.3
2011
4.3
82.6
Children and Youth Receiving Supplemental Security Income (%)
2007
1.2
1.7
2011
1.2
2.1
Foster Care Admissions - Children/Youth Admitted to Foster Care (%)
2007
4.5
2.9
2011
2.1
2.6
Foster Care Adoption Milestone - Children/Youth Discharged to Adoption (%)
2007
22.2
40.2
2011
75.0
43.3
Foster Care Adoption Milestone - Children/Youth Freed for Adoption (%)
2007
3.0
5.3
2011
3.3
5.9
~
Foster Care Adoption Milestone - Children/Youth with Adoption Goal Set (%)
2004
8.1
7.4
2011
8.1
7.4
~
Foster Care Children In Care - Children/Youth 0-21 years (%)
2007
3.7
4.9
2011
2.6
4.0
~
Foster Care Discharges - Children/Youth Discharged from Foster Care (%)
2007
38.4
33.7
2011
43.5
37.1
~
Source: http://www.nyskwic.org/get_data/county_report_detail.cfm?countyID=36053 . Date accessed- June 16, 2013.
CHA Adolescents Ages 12-19 |
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REFERENCES [1] US CENSUS.http://www.census.gov. Date accessed: February 12, 2013. [2] Wight, Vanessa R “Adolescents and Poverty” The Prevention Researcher, Volume 18, Number 4, 2011, Pages 3-6, Item# A184-Wight http://www.tpronline.org/article.cfm/Adolescents_and_Poverty. Date accessed: June 12, 2013. [3] Worthington, Barbara.”Diabetes Management In Young People — Family Matters.”Social Work TodayVol. 8 No. 5 P. 18. Oct. 2008.<http://www.socialworktoday.com/archive/090208p18.shtml.> Date accessed: June 12, 2013. [4] Towns SJ and van Asperen PP. Diagnosis and management of asthma in adolescents. The Clinical Respiratory Journal 2009; 3: 69–76..< http://onlinelibrary.wiley.com/doi/10.1111/j.1752699X.2009.00130.x/pdf.> Date accessed: June 12, 2013. [5] McGann, Sexton & Chyun cited in DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50years of research. Med Care. 2004;42: 200–9; as cited in The Clinical Respiratory Journal. Vol 3. Issue 2. Mar 2009.< http://onlinelibrary.wiley.com/ doi/10.1111/j.1752-699X.2009.00130.x/pdf.> [6] Centers for Disease Control and Prevention “Childhood Obesity Facts.” <http://www.cdc.gov/ healthyyouth/obesity/facts.htm.> Date accessed: June 2, 2013. [7] 2010 Teen Assessment Project (TAP) Report, sponsored by the Madison County Youth Bureau. < http://www.healthymadisoncounty.org/linkeddocs/data/data-2010tap.pdf.> Date accessed: February 15,2013. [8]Harris,JL; Schwartz,MB; and Brownell,KD. “Sugary Drink (FACTS)Food Adverticsing to Children and Teens Score, Evaluating Sugary Drink Nutrition and Marketing to Youth.” Rudd Center for Food Policy and Obesity, Yale University;2011 <http://www.sugarydrinkfacts.org/resources/ SugaryDrinkFACTS_Report.pdf.> Date accessed: May 29, 2013. [9] New York State Department of Health (NYSDOH). “Obesity and Related Indicators - Madison County.“<http://www.health.ny.gov/statistics/chac/indicators/obs.htm.>Date accessed: July 15, 2013. [10] Sharma, Himanshu “Medical Risks for Teenage Pregnancy,” August 2012 http:// www.onlymyhealth.com/medical-risks-teenage-pregnancy-1345154327. Date accessed: June 5, 2013. [11] New York State Department of Health “Madison County Teen fertility rate per 1,000 (births to mothers aged 10-14 years/female population aged 10-14 years).”<https://www.health.ny.gov/ statistics/chac/birth/b6_25.htm.> Date accessed: November 19, 2013. [12] New York State Department of Health “Madison County Teen fertility rate per 1,000 (births to mothers aged 15-17 years/female population aged 15-17 years).” <https:// www.health.ny.gov/statistics/chac/birth/b7_25.htm.> Date accessed: November 19, 2013. [13] New York State Department of Health “Madison County Teen fertility rate per 1,000 (births to mothers aged 15-19 years/female population aged 15-19 years).” <https://www.health.ny.gov/ statistics/chac/birth/b8_25.htm.> Date accessed: November 19, 2013.
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[14] National Adolescent Health Information Center “The Mental Health of Adolescents: A National Profile, 2008.” < http://nahic.ucsf.edu/wp-content/uploads/2008/02/ MentalHealthBrief2008.pdf.> Date accessed: June 15, 2013. [15] Madison County Mental Health Department (personal communication, June.7,2013) [16] New York State Department of Health “Leading Causes of Premature Death (Death before age 75), New York State, 2009-2011.” < http://www.health.ny.gov/statistics/leadingcauses_death/pm_deaths_by_county.htm.> Date accessed: June 10, 2013. [17] New York State Department of Health,” Community Health Indicator Reports - Injury Indicators 2012”< https://www.health.ny.gov/statistics/chac/chai/docs/inj_25.htm.> Date accessed:November 6, 2013. [18] Council on Children & Families.Kids’ Well-being Indicators Clearinghouse (KWIC).”KWIC County Report.” <http://www.nyskwic.org/get_data/county_report_detail.cfm?countyID=36053.>Date accessed:February,6 2013. [19] New York State Statewide Planning and Research Cooperative System (SPARCS) 2009. [20] Administered by BRiDGES ”Pride Surveys Report: 2012-13 Madison County Schools. Pride Surveys Questionnaire for Grades 6 thru 12 Standard Report, 2012-13 Madison County Schools.”Canastota, NY December 12, 2012. Pride Surveys, 160 Vanderbuilt Court. Bowling Green KY, 42103. [21]Centers for Disease Control and Prevention “Youth Violence: State Statistics” <http://www.cdc.gov/violenceprevention/youthviolence/stats_at-a_glance/ny.html.> Date accessed: June 5, 2013. [22] “Motor Vehicle Crashes in Madison County, New York, 2007 Hospitalization Outcomes by Specific Age Groups” based on NYSDOH, Bureau of Injury Prevention Crash Outcome Data Evaluation System (CODES) data. <http://www.health.ny.gov/statistics/prevention/injury_prevention/traffic/county/madison/ madison_age_hosp.pdf.> Date accessed: November 5, 2013. [23]New York State Department of Health ”Teen Drivers and Passengers Safety, Teens Ages 15 to 19 Years”< http://www.health.ny.gov/prevention/injury_prevention/children/fact_sheets/teens_1519_years/teen_drivers_passenger_safety_15-19_years.htm.> Date accessed: November 6, 2013. [24] US Department of Health and Human Services and The Centers for Disease Control and Prevention “2011 Youth Risk Behavior Surveillance Survey”. Morbidity and Mortality Weekly Report, Vol. 61, No.4 June 8 2012<http://www.cdc.gov/mmwr/pdf/ss/ss6104.pdf.> Date Accessed November,6 2013. [25]National Network of Libraries of Medicing “Quick Guide to Health Literacy.” <http:// www.he.alth.gov/communication/literacy/quickguide/factsbasic.htm.> Date accessed: June 3, 2013. [26] Ancker, Jessica S.; Kaufman, David “Rethinking Health Numeracy: A Multidisciplinary Literature Review.”November 2007Journal of the American Medical Informatics Association;Nov/Dec2007, Vol.14 Issue 6, p713.
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[27] Wight, Vanessa R “Adolescents and Poverty” The Prevention Researcher, Volume 18, Number 4, 2011, Pages 3-6, Item# A184-Wight < http://www.tpronline.org/article.cfm/ Adolescents_and_Poverty.> Date accessed: June 12 2013 [28] Alliance for Excellent Education “High School Dropouts in America” September 2010 <https:// www.nationalserviceresources.org/files/sample-forms/hs-dropouts-in-america.pdf.>Date accessed: June 7, 2013. [29]Casey Foundation’s Northwest Foster Care Alumni Study cited in Washington State Department of Social & Health Services “2008 Fact Sheet: Improving health care of children in foster care: an ongoing collaboration.” <http://waysandmeans.house.gov/media/pdf/110/thompson.pdf.>. Date accessed: June 7, 2013.
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For Report Information please contact: Madison County Department of Health www.healthymadisoncounty.org © 2013 Madison County Department of Health PO Box 605 • Wampsville, NY 13163 Tel: 315‐366‐2361 • Fax: 315‐366‐2697 health@madisoncounty.ny.gov
CHA Adolescents Ages 12-19 |
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