Behaviors in young adulthood affect risk of preventable death

A survey by the US Department of Health and Human Services's National Institutes of Health (NIH) found that, by the time youth in the US reach early adulthood, a large percentage have begun the poor practices that will contribute to three leading causes of preventable death: smoking, overweight and obesity, and alcohol abuse. Furthermore, the analysis 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 teenage years. These findings appear in the January 2006 issue of Archives of Pediatrics and Adolescent Medicine.

"Smoking, obesity, and alcohol abuse are the leading contributors to preventable death in the United States. By early adulthood, a large proportion of Americans smoke, are overweight, and drink alcohol to excess," said Duane Alexander, MD, director of the National Institute of Child Health and Human Development—the NIH Institute that funded the analysis.

Researchers at the Carolina Population Center and the University of North Carolina at Chapel Hill conducted their analysis using data from the National Longitudinal Study of Adolescent Health. They analyzed the responses of a nationally representative sample of more than 14,000 young adults who have been followed since early adolescence. Respondents, recruited from high schools and middle schools across the country, were interviewed from 1994 to 1995—when they ranged from 12 to 19 years of age—and again in 2001 and 2002, when they were between 19 and 26 years old. They responded to questions about diet, inactivity, obesity, tobacco use, substance abuse, binge drinking, violence, reproductive health, mental health, and access to health care.

Across nearly all age 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 youth reached adulthood, said lead investigator Kathleen Mullan Harris, PhD. By the time participants reached adulthood, they were more likely to be obese, eat fast food often, and be sedentary. They were less likely to have health insurance, receive health care when they need it, and receive regular dental and physical examinations.On the positive side, participants were less likely to experience feelings of depression in adulthood than they did when they were an adolescent, less likely to have suicidal thoughts, and less likely to be the victim or perpetrator of violence.

"These trends are stunning," said Dr. Harris. "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."