Mixed message: Minnesota teens smoke and drink less, but are fatter and more likely to be hurt by guns

Although today's teens are healthier than the teen generation of the 1980s, they may also be the first to have a lower life expectancy than their parents.

The concept of health goes a lot deeper than how many fruits and vegetables a person eats each day.

“[It’s] the absence of disease, of course, but also a level of physical, mental, social, and spiritual wellness that allows a person to participate fully in his or her world,” said Dr. Marla Eisenberg, assistant professor in the University of Minnesota’s Department of Adolescent Health and Medicine.

When it comes to the health of teenagers, the subject becomes extremely complex. Sexuality, drug use, violence and other loaded words swirl around the topic of “adolescent health.” Although today’s teens are healthier than the teen generation of the 1980s, they may also be the first to have a lower life expectancy than their parents. Progress has been made in some key areas, but some alarming issues are surfacing.

This is a costly reality. “One concern about teen health behaviors is that they continue into adulthood. The long-term social and economic costs can be huge,” said Eisenberg. For instance, early pregnancy alone drains $9 billion from the American economy each year, according to Renee Sieving, associate professor at the U of M’s School of Nursing.

There is good news. Compared to the rest of the nation, Minnesota’s teens are ahead of the game in most respects.

“In many areas, teens in Minnesota have better health outcomes than the U.S. as a whole,” said Jennifer O’Brien, the adolescent health coordinator for the state health department.

The Minnesota Student Survey, completed by sixth-, ninth- and twelfth-graders in most of the state’s school districts, reveals some notable bright spots. Cigarette use and alcohol consumption by teens are on the decline. And seat belt use has been steadily rising for the past decade.

The Good News

Cigarette Use: The convergence of effective anti-smoking education, policies that make it harder for teens to obtain cigarettes, and policies that make smoking more difficult in general has proven effective over the past few decades. From 1992 to 2007, there was an 8.3 percent drop in teen cigarette use in Minnesota.

Alcohol Consumption: 17.4 percent fewer high school seniors reported drinking in the past year in the 2007 survey than in 1992. Policy has played a crucial role in this decline as well. “There have been a lot of efforts at the state and local levels to limit teen access to alcohol,” said O’Brien.

Seat Belt Use: 16.7 percent more high school seniors in 2007 reported always using a seatbelt when riding in a car than in 1998. Legal consequences – including fines – seem to have proven powerful disincentives to would-be beltless riders.

But with the promising trends come issues that need to be addressed – a startling spike in certain sexually transmitted infections, pregnancy rates that are beginning to increase after dropping for years, surging obesity rates, and the tragic presence of violence.

The Issues

STIs: Chlamydia rates in Minnesota teens are skyrocketing, especially among suburban kids. And HIV rates have recently seen big increases in young men who have sex with other men. Some question of whether or not enough is being done to promote awareness of “rainbow health” (GLBT-specific health). From 2008 to 2009 alone, HIV rates in this subgroup nearly doubled.

Both trends suggest that teens lack important knowledge about STIs and what can be done about them.

“A lot of young people think that if they don’t have symptoms, they don’t have an STI. But the most common symptom of an STI is not having a symptom. Others think they have to have someone’s permission [to seek sexual health resources],” but they don’t, said Brooke Seltzer of the Annex Teen Clinic.

Such misinformation is linked to the quality of sex education teens get in school, but Minnesota has no standardized sex ed curriculum. “It can be very random, what kind of sex education kids get,” said Seltzer.

Pregnancy: That randomness is one factor behind rising teen pregnancy rates over the past two years, according to teen health experts. The issue is further complicated by the fact that teen pregnancy rates vary tremendously among different racial groups. “Our teen birth rate among African American youth is one of the highest in the nation,” said Eisenberg.

Obesity: Rising obesity rates are another big issue and one that has some of the clearest consequences. Many diseases, including heart disease, diabetes and high blood pressure, are directly linked to obesity. Currently, 15 percent of the state’s ninth-grade boys and 12 percent of ninth-grade girls are at risk for being overweight, and physical activity in Minnesota high school seniors is 13.3 percent less than that of freshmen.

Violence: As has been made painfully clear by recent headlines, violence is common among adolescents today. Homicide is the third leading cause of teen deaths in Minnesota. As with early pregnancy, there are shocking racial disparities in homicide rates – African American males are more than five times as likely to die by homicide than members of any other social group.

“While gangs and fighting have been around for a long time, easy access to weapons and a de-sensitization to violence throughout our culture make aggressive behavior much more deadly,” said Eisenberg.

Public health officials are studying these health problems to see how they can be prevented. O’Brien refers to this kind of problem solving as “upstream intervention,” or deterring risk behavior before it occurs.

“I think the solutions are multilevel. There’s a lot we can do to give young people the skills to avoid risky behavior. There’s a lot we can do on the systems level—changing policies, offering better options in their environments,” said Sieving. “For example, things like limiting kids’ access to firearms, limiting the sale of firearms, is really critical. Taking guns out of the environment makes the environment safer.”

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