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Teenagers: Engaging less in high-risk activities since 1991

Nearly a third of high school students drink regularly, a quarter had a physical fight in the last year and more than a third are sexually active, according to a national biennial survey of youth and the risks they take.

Older kids, 15 to 19, face many behavior-related negative health consequences and social problems, including sexually transmitted disease or unintended pregnancy. They may live with or die from consequences related to their tobacco, alcohol and drug use; unhealthy diets; physical inactivity and whether they brawl or carry weapons.

The Centers for Disease Control and Prevention says four causes lead to 70 percent of all deaths for those ages 10 to 24: motor vehicle crashes, other unintended injuries, homicide and suicide.

Every two years the CDC conducts the "Youth Risk Behavior Surveillance" survey in schools to create a statistical portrait of what teens are doing. The 2013 survey asked about 104 health-risk behaviors, as well as questions regarding excess weight and whether those surveyed had asthma. Students were polled in 42 states and 21 large urban school districts to create a nationally representative sample.

The survey found that in the 30 days before the survey:

— 41 percent of those who drove had texted or emailed while driving

— 35 percent had consumed alcohol

— 23 percent used marijuana

In the past year:

— 22 percent were offered, sold or given drugs at school

— 20 percent were bullied on school grounds

— 8 percent attempted suicide.

Experts call teen risk behavior a canary in the cavern, warning adults that something is amiss.

“It’s important to pay attention any time you have somebody acting out, either by being involved sexually or using drugs at an earlier than expected age because it’s an indicator that something else is going on in their lives,” said Karen Khaleghi, co-founder of Creative Care, an addiction treatment facility in Malibu, California.

Over time

Despite findings that may set parents' teeth on edge, there's a hefty chunk of good news in the 2013 survey: Across most categories, the percentage of high school-age teens engaging in high-risk activities has dropped or at least not increased over the past two decades.

"Since the earliest year of data collection, the prevalence of most health-risk behaviors has decreased (e.g. physical fighting, current cigarette use, and current sexual activity)," the report notes, "but the prevalence of other health-related behaviors has not changed (e.g. suicide attempts treated by a doctor or nurse, having ever used marijuana and having drunk alcohol or used drugs before last sexual intercourse) or has increased (e.g. having not gone to school because of safety concern and obesity and overweight)."

Suicide is one of the most complex issues in the survey. The number of high school-age students who seriously considered it fell precipitously from 29 percent in 1991 to 17 percent, but the number who actually attempted it rose from 7.3 percent to 8 percent. Attempts that result in an injury requiring treatment increased from 1.7 percent to 2.7 percent in that time frame.

Tobacco use by teenagers was less likely than in the past. More than 2 out of 3 students had tried cigarettes in 1991, 41.1 percent in 2013. While one-quarter in 1991 had smoked a whole cigarette by age 13, fewer than 1 in 10 had in 2013. And asked about smoking in the past month, 27 percent did in '91 compared to the recent 15.7 percent.

One in 8 smoked frequently in the early 1990s; it's now just over 1 in 20, with 4 percent smoking daily. Use of tobacco overall, including smokeless tobacco, cigarettes or cigars, is 22.4 percent, compared to 1997's 41 percent.

A teen's brain

Thanks to what the National Institute of Mental Health calls powerful new technologies, researchers are learning a lot about the growth of the brain and connections between development, function and behavior.

"The research has turned up some surprises, among them the discovery of striking changes taking place during the teen years," NIH says in "The Teen Brain: Still Under Construction." "These findings have altered long-held assumptions about the timing of brain maturation. In key ways, the brain doesn't look like that of an adult until the early 20s."

It's not fully developed until 25 or 26.

Parts of the brain do not all develop simultaneously. Basic functions come first. Only later will the section of the brain responsible for impulse control and planning grow up.

While teens are at "close to a lifelong peak of physical health, strength and mental capacity," the rates of death by injury jump from ages 15 to 19. Crime rates are highest for young males then, while drug and alcohol use has a growth spurt. Behavior and risk impact brain development and a child's future. Genetics, experience, family, friends, community and culture all combine to determine the brain's actual structure, the institute says.

Behaviors can impair brain development, says Khaleghi. If you take a developing brain and add regular or binge alcohol use, for example, it may lower IQ. But adolescents "don't have the cognitive faculties that allow them to do a cost-benefit risk assessment. They aren't able to accurately judge a high-risk situation; therefore, they're not able to say 'I am in the middle of a party at a friend's house. This is not a surrounding I know well and I traveled an hour-and-a-half to get here, so it's probably better to have my wits about me. I don't really know these people.' They don't do that ... and there's a domino of increasing likelihood that something goes sideways."

Everyone is doing it?

Khaleghi, a therapist and a mom, knows it sometimes seems to kids that everyone else is doing something, whether it's drinking or having sex. Statistically, it's far from true and teens should know that, she said.

For example, numerous reports note a decrease in teen pregnancy and abortion rates. As the risk-behavior survey shows, teen sexual activity rates are down.

Kathryn Kost, a Guttmacher Institute senior research associate who co-wrote a recent report on teen pregnancy, births and abortion told the Deseret News there are "very substantial and continuing declines" that began in the early 1990s when teen pregnancy rates were high. She said change resulted from better education of youths regarding sex.

Bill Albert of the National Campaign to Prevent Teen and Unplanned Pregnancy said teens need the credit for making better choices.

Not all kids drink or use drugs, but adults need to ask themselves what's driving those who do, said Khaleghi.

"My belief is kids drink to deal with emotional upset or emotional upheaval," she said. She believes there are similar drivers for younger-than-expected sexual activity. "Something is going on in life that created a great deal of emotional stress."

Strong ties to family, community, religion and school are deterrents to risky behavior. So are parents who establish clear boundaries and monitor their children, said Khaleghi.

It's important for parents to keep communication open so children know they can discuss issues. She suggests small "side-by-side" talks, like in the car, starting when a child is young.

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