Add Health Study: Most Behaviors Preceding Major Causes of Preventable Death Have Begun By Young Adulthood (NICHD Press Release)
Jan 25, 2006
NIH News
National Institutes of Health
National
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Most Behaviors Preceding Major Causes of
Preventable Death Have Begun By Young Adulthood
The analysis also found that
significant health disparities exist between racial groups, and that Americans
are less likely to have access to health care when they reach adulthood than
they did during the teenage years.
"Smoking, obesity, and alcohol
abuse are leading contributors to preventable death in the
Principal investigator Kathleen
Mullan Harris, Ph.D., and her colleagues of the
The National Longitudinal Study
of Adolescent Health was designed to measure the effects of home, family, and
school environment on behaviors that promote health. The study was undertaken in response to a
mandate by Congress. Funding for the
survey was provided by a grant from the NICHD with contributions from 17 other
federal agencies.
"When they were young
teenagers, most of the participants had fairly healthy behaviors," said
Christine Bachrach, Ph.D., Chief of NICHD's Demographic and Behavioral Sciences
Branch and project officer for the study.
"What's really alarming is how rapidly healthy practices declined by the
time the participants reached young adulthood."
For the current analysis, the
researchers analyzed the responses of a nationally representative sample of
more than 14,000 young adults who have been followed since early
adolescence. The survey respondents,
recruited from high schools and middle schools around the country, were first
interviewed from 1994 to 1995, when they ranged from
The survey participants
responded to questions on diet, inactivity, obesity, tobacco use, substance
use, binge drinking, violence, reproductive health, mental health, and access
to health care.
For nearly all groups surveyed,
diet, activity level, obesity, health care access, tobacco, alcohol and illicit
drug use, and likelihood of acquiring a sexually transmitted disease worsened
as the youth reached adulthood, Dr. Harris said.
"These trends are quite
stunning," Dr. Harris added. "Whether or
not the trends will continue as they age, we don't know. But it doesn't bode well for their future
health, especially if these habits become established."
By the time they had reached
adulthood, Dr. Harris explained, the participants were more likely to be obese,
to frequently eat fast food, and to be sedentary. They were also less likely to have health
insurance, to receive health care when they needed it, or to receive regular
dental and physical health examinations.
The authors reported "dramatic"
increases in behaviors related to 3 leading contributors to preventable
deaths. "These findings underscore the
importance of ongoing preventive efforts related to smoking, poor diet and
physical inactivity, and alcohol consumption, early in the life course."
For example, among young white
women, the proportion reporting no weekly physical exercise was 5 percent
during the adolescent years, but was 46 percent in early adulthood. Similarly, among white males, the proportion
that was obese grew from 14 percent in the teen years to 19 percent when they
became adults.
The researchers added that the
decline in health care coverage resulted from young adults leaving their
parents' health insurance or Medicaid coverage as they reached legal age.
On the positive side,
participants were less likely to experience feelings of depression at adulthood
than when they were adolescents, less likely to have suicidal thoughts, and
less likely to be victims or perpetrators of violence.
For most of the indicators,
Asians and whites were at lowest risk, while blacks and Native Americans were
at highest risk. Racial and ethnic
disparities in health as well as in access to health care also increased as the
participants reached adulthood. No
single racial or ethnic group, however, had a greater overall risk profile than
any other group.
Whites, for example, were
healthier during earlier adolescence than most other groups, but experienced
the greatest declines upon reaching adulthood.
By the time they reached adulthood, whites had the highest rates of
smoking (31 percent for males, 28 percent for females) and white males had the
highest rate of binge drinking (67 percent).
At adulthood, blacks were the
least likely to smoke cigarettes (13 percent for males, 8 percent for females)
to binge drink (33 percent for males, 15 percent for females) or to use hard
drugs (5 percent for males, 2 percent for females). When they were adults, blacks (18 percent)
and Native Americans (16 percent) were more likely to develop asthma than were
other groups.
Among female adults, blacks (55
percent) and Asians (53 percent) were the least likely to exercise, and among
males, white and blacks were the least likely to exercise.
"The variability in health
disparities among groups also implies that no one overall solution will work to
reduce disparities, but approaches specific to each health outcome are needed,"
Dr. Harris said
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The NICHD is part of the National Institutes of Health (NIH), the
biomedical research arm of the federal government. NIH is an agency of the U.S. Department of
Health and Human Services. The NICHD
sponsors research on development, before and after birth; maternal, child, and
family health; reproductive biology and population issues; and medical
rehabilitation.
