The Epidemiology of Adolescent Health

  • K. Clements-Nolle
  • C. M. Rivera


Adolescence is a time when many health problems are first identified and many health behaviors, both positive and negative, are established. This chapter reviews mortality and morbidity data as well as a range of behavioral health indicators in five major areas: (1) chronic disease, (2) mental health and suicide, (3) substance use, (4) sexual health, and (5) injury and violence. The most recent national data are summarized to describe trends over time and subpopulation differences in adolescent health indicators. The findings demonstrate that most adolescent health problems are preventable, highlighting the importance of early intervention to promote healthy behaviors and resilience.


High School Student Eating Disorder Sexually Transmitted Infection National Health Interview Survey Smokeless Tobacco 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Adar, L. S., & Gorden-Larson, P. (2001). Maturational timing and overweight prevalence in US adolescent girls. American Journal of Public Health, 91, 642–644.CrossRefGoogle Scholar
  2. Akinbami, L. J., & Schoendorf, K. C. (2002). Trends in childhood asthma: Prevalence, health care utilization, and mortality. Pediatrics, 110(2), 315–322.PubMedCrossRefGoogle Scholar
  3. Akinbami, L. J., Moorman, J. E., Garbe, P. L., & Sondik, E. J. (2009). Status of childhood asthma in the United States, 1980–2007. Pediatrics, 123, s131–s145.PubMedCrossRefGoogle Scholar
  4. Akinbami, L. J., Moorman, J. E., & Liu, X. (2011). Asthma prevalence, health care use and mortality: United States, 2005–2009. National Health Statistics Reports, 32, 1–15.PubMedGoogle Scholar
  5. American Lung Association. (2010). Trends in asthma morbidity and mortality. Retrieved April 28, 2011, from
  6. Angold, A., Messer, S. C., Stangl, D., Farmer, E. M., Costello, E. J., & Burns, B. J. (1988). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88, 75–80.CrossRefGoogle Scholar
  7. Barter, C. (2009). In the name of love: Partner abuse and violence in teenage relationships. British Journal of Social Work, 39, 211–233.CrossRefGoogle Scholar
  8. Bethell, C., Simpson, L., Stumbo, S., Carle, A. C., & Gombojav, N. (2010). National, state, and local disparities in childhood obesity. Health Affairs, 29(3), 347–356.PubMedCrossRefGoogle Scholar
  9. Bloom, B., Dey, A. N., & Freeman, G. (2006). Summary health statistics for U.S. children: National Health Interview Survey, 2005. Vital Health and Statistics, 10(231), 1–84.Google Scholar
  10. Bosch, F. X., & de Sanjosé, S. (2003). Human papillomavirus and cervical cancer—Burden and assessment of causality. Journal of the National Cancer Institute. Monographs, 31, 3–13.PubMedCrossRefGoogle Scholar
  11. Brady, S. S., Tschann, J. M., Pasch, L. A., Flores, E., & Ozer, E. J. (2008). Violence involvement, substance use and sexual activity among Mexican-American and European-American adolescents. Journal of Adolescent Health, 43, 285–295.PubMedCrossRefGoogle Scholar
  12. Brooks, T. L., Harris, S. K., Thrall, J. S., & Woods, E. R. (2002). Association of adolescent risk factors with mental health symptoms in high school students. Journal of Adolescent Health, 31, 240–246.PubMedCrossRefGoogle Scholar
  13. Carlyle, K. E., & Steinman, K. J. (2007). Demographic differences in the prevalence, co-occurrence, and correlates of adolescent bullying at school. Journal of School Health, 77(9), 623–629.PubMedCrossRefGoogle Scholar
  14. Carpenter, C. S., & Stehr, M. (2008). The effects of mandatory seat belt laws on seat belt use, motor vehicle fatalities, and crash-related injuries among youths. Journal of Health Economics, 27, 642–662.PubMedCrossRefGoogle Scholar
  15. Centers for Disease Control and Prevention. (2006a). Physical dating violence among high school students—United States, 2003. Morbidity and Mortality Weekly Report, 55, 532–535.Google Scholar
  16. Centers for Disease Control and Prevention. (2010a). Summary health statistics for U.S. children: National Health Interview Survey, 2009. National Center for Health Statistics (PHS)-2011-1575, Series 10, Number 247.Google Scholar
  17. Centers for Disease Control and Prevention. (2010b). Sexually transmitted disease surveillance 2009. Retrieved April 28, 2011, from
  18. Centers for Disease Control and Prevention. (2010c). Mortality among teenagers aged 1219 years: United States, 19992006. Retrieved April 28, 2011, from
  19. Centers for Disease Control and Prevention. (2011a). How much physical activity do children and adolescents need? Retrieved April 28, 2011, from
  20. Centers for Disease Control and Prevention. (2011b). Diabetes public health resource. Children and diabetes: More information. Retrieved April 28, 2011, from
  21. Centers for Disease Control and Prevention. (2011c). African Americans and sexually transmitted diseases. Retrieved April 28, 2011, from
  22. Centers for Disease Control and Prevention. (2011d). HIV/AIDS surveillance in adolescents and young adults (through 2008). Retrieved April 28, 2011, from
  23. Centers for Disease Control and Prevention. (2011e). Health, United States, 2010: With special feature on death and dying. Hyattsville, MD. 2011. Retrieved April 28, 2011, from
  24. Chen, K. W., Killeya-Jones, L. A., & Vega, W. (2005). Prevalence and co-occurrence of psychiatric symptom clusters in the U.S. adolescent population using DISC predictive scales. Clinical Practice and Epidemiology in Mental Health, 1, 22.PubMedCrossRefGoogle Scholar
  25. Connell, C. M., Gilreath, T. D., & Hansen, N. B. (2009). A multiprocess latent class analysis of the co-occurrence of substance use and sexual risk behavior among adolescents. Journal of Studies on Alcohol and Drugs, 70, 943–951.PubMedGoogle Scholar
  26. Dietz, W. H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3 pt2), 518–525.PubMedGoogle Scholar
  27. Dunlop, S. M., & Romer, D. (2010). Adolescent and young adult crash risk: Sensation seeking, substance use propensity, and substance use behaviors. Journal of Adolescent Health, 46, 90–92.PubMedCrossRefGoogle Scholar
  28. Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., et al. (2010). Youth risk behavior surveillance–United States, 2009. Morbidity and Mortality Weekly Report, 59, 1–142.Google Scholar
  29. Eaton, D. K., Lowry, R., Brener, N. D., Kann, L., Romero, L., & Wechsler, H. (2011). Trends in human immunodeficiency virus- and sexually transmitted disease-related risk behaviors among U.S. High school students, 1991–2009. American Journal of Preventive Medicine, 40(4), 427–433.PubMedCrossRefGoogle Scholar
  30. Ehlers, C. L., & Criado, J. R. (2010). Adolescent ethanol exposure: Does it produce long-lasting electrophysiological effects? Alcohol, 44, 27–37.PubMedCrossRefGoogle Scholar
  31. Ellickson, P., Saner, H., & McGuigan, K. A. (1997). Profiles of violent youth: Substance use and other concurrent problems. American Journal of Public Health, 87, 985–991.PubMedCrossRefGoogle Scholar
  32. Fagot-Campagna, A., Narayan, K. M. V., & Imperatore, G. (2001). Type 2 diabetes in children: exemplifies the growing problem of chronic diseases [Editorial]. British Medical Journal, 322, 377–378.PubMedCrossRefGoogle Scholar
  33. Fagot-Campagna, A., Pettitt, D. J., Engelgau, M. M., Burrows, N. R., Geiss, L. S., Valdez, R., et al. (2000). Type 2 diabetes among North American children and adolescents: An epidemiologic review and a public health perspective. Journal of Pediatrics, 136(5), 664–672.PubMedCrossRefGoogle Scholar
  34. Finer, L. B., & Henshaw, S. K. (2006). Disparities in rates of unintended pregnancies in the US. Perspectives on Sexual and Reproductive Health, 38(2), 90–96.PubMedCrossRefGoogle Scholar
  35. Forhan, S. E., Gottlieb, S. L., Sternberg, M. R., Xu, F., Datta, S. D., McQuillan, G. M., et al. (2009). Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States. Pediatrics, 124(6), 1505–1512.PubMedCrossRefGoogle Scholar
  36. Freedman, D. S., Zuguo, M., Srinivasan, S. R., Berenson, G. S., & Dietz, W. H. (2007). Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart study. Journal of Pediatrics, 150(1), 12–17.PubMedCrossRefGoogle Scholar
  37. Gilbert, W., Jandial, D., Field, N., Bigelow, P., & Danielsen, B. (2004). Birth outcomes in teenage pregnancies. The Journal of Maternal-Fetal & Neonatal Medicine, 16(5), 265–270.CrossRefGoogle Scholar
  38. Glied, S., & Pine, D. S. (2002). Consequences and correlates of adolescent depression. Archives of Pediatrics & Adolescent Medicine, 156, 1009–1014.Google Scholar
  39. Guttmannova, K., Bailey, J. A., Hill, K. G., Lee, J. O., Hawkins, J. D., Woods, M. L., et al. (2011). Sensitive periods for adolescent alcohol use initiation: Predicting the lifetime occurrence and chronicity of alcohol problems in adulthood. Journal of Studies on Alcohol and Drugs, 72, 221–231.PubMedGoogle Scholar
  40. Hanson, R. F. (2002). Adolescent dating violence: prevalence and psychological outcomes. Child Abuse & Neglect, 26, 447–451.CrossRefGoogle Scholar
  41. Harrison, L. (2001). Understanding the differences in youth drug prevalence rates produced by the MTF, NHSDA, and YRBS studies. Journal of Drug Issues, 31(3), 665–694.Google Scholar
  42. Havens, J. R., Young, A. M., & Havens, C. E. (2011). Nonmedical prescription drug use in a nationally representative sample of adolescents: Evidence of greater use among rural adolescents. Archives of Pediatrics & Adolescent Medicine, 165(3), 250–255.CrossRefGoogle Scholar
  43. Hoffman, S. D. (2006). By the numbersThe public costs of teen childbearing. Retrieved April 28, 2011, from
  44. Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2010. Ann Arbor: Institute for Social Research, University of Michigan.Google Scholar
  45. Kandel, D. B., Johnson, J. B., Bird, H. R., Canino, G., Goodman, S. H., Lahey, B. B., et al. (1997). Psychiatric disorders associated with substance use among children and adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study. Journal of Abnormal Child Psychology, 25(2), 121–132.PubMedCrossRefGoogle Scholar
  46. Kost, K., Henshaw, S., & Carlin, L. (2010). U.S. teenage pregnancies, births and abortions: National and State Trends and Trends by Race and Ethnicity. Retrieved April 28, 2011, from
  47. Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1998). Major depressive disorder in older adolescents: Prevalence, risk factors, and clinical implications. Clinical Psychology Review, 18, 765–794.PubMedCrossRefGoogle Scholar
  48. Liu, L. L., Lawrence, J. M., Davis, C., Liese, A. D., Pettitt, D. J., Pihoker, C., et al. (2010). Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH for Diabetes in Youth study. Pediatric Diabetes, 11(1), 4–11.PubMedCrossRefGoogle Scholar
  49. Mallory, G. B., Fiser, D. H., & Jackson, R. (1989). Sleep-associated breathing disorders in morbidly obese children and adolescents. Journal of Pediatrics, 115, 892–897.PubMedCrossRefGoogle Scholar
  50. Manlove, J., Terry-Humen, E., Mincieli, L., & Moore, K. (2008). Outcomes for children of teen mothers from kindergarten through adolescence. In S. Hoffman & R. Maynard (Eds.), Kids having kids: Economic costs and social consequences of teen pregnancy. Washington, DC: The Urban Institute Press.Google Scholar
  51. Mata, I., Perez-Iglesias, R., Roiz-Santianez, R., Tordesillas-Gutierrez, D., Pazos, A., Gutierrez, A., et al. (2010). Gyrification brain abnormalities associated with adolescence and early-adulthood cannabis use. Brain Research, 1317, 297–304.PubMedCrossRefGoogle Scholar
  52. McKay, A., & Barrett, M. (2010). Trends in teen pregnancy rates from 1996–2006: A comparison of Canada, Sweden, USA, and England/Whales. The Canadian Journal of Human Sexuality, 19(1–2), 43–52.Google Scholar
  53. Merikangas, K., Avenevoli, S., Costello, J., Koretz, D., & Kessler, R. C. (2009). National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 367–369.PubMedCrossRefGoogle Scholar
  54. Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989.PubMedCrossRefGoogle Scholar
  55. Miller, T. R., Finkelstein, A. E., Zaloshnja, E., & Hendrie, D. (2006). The cost of child and adolescent injuries and the savings from prevention. In K. D. Liller (Ed.), Injury prevention for children and adolescents: Research, practice, and advocacy. Washington, DC: APHA Press.Google Scholar
  56. Moscicki, E. K. (2001). Epidemiology of completed and attempted suicide: Toward a framework for prevention. Clinical Neuroscience Research, 1(5), 310–323.CrossRefGoogle Scholar
  57. Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. Journal of the American Medical Association, 285(16), 2094–2100.PubMedCrossRefGoogle Scholar
  58. National Center for Injury Prevention and Control. (2011). WISQARS injury mortality reports, 1999–2008. Retrieved April 28, 2011, from
  59. National Research Council and Institute of Medicine. (2009). Adolescent health services: Missing opportunities. Washington, DC: National Academy Press.Google Scholar
  60. Naughton, M. J., Ruggiero, A. M., Lawrence, J. M., Impetore, G., Klingensmith, G. J., Waitzfelder, B., et al. (2008). Health-related quality of life of children and adolescents with type 1 or type 2 diabetes mellitus: SEARCH for Diabetes in Youth Study. Archives of Pediatrics & Adolescent Medicine, 162(7), 649–657.CrossRefGoogle Scholar
  61. Ogden, C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007–2008. Journal of the American Medical Association, 303(3), 242–249.PubMedCrossRefGoogle Scholar
  62. Patton, G. C., Coffey, C., Carlin, J. B., Sawyer, S. M., Williams, J., Olsson, C. A., et al. (2011). Overweight and obesity between adolescence and young adulthood: A 10-year prospective cohort study. Journal of Adolescent Health, 48(3), 275–280.PubMedCrossRefGoogle Scholar
  63. Pazol, K., Warner, L., Gavin, L., Callaghan, W. M., Spitz, A. M., Anderson, J. E., et al. (2011). Vital signs: Teen pregnancy–United States, 1991–2009. Morbidity and Mortality Weekly Report, 60, 1–8.Google Scholar
  64. Perper, K., Peterson, K., & Manlove, J. (2010). Child trends fact sheet: Diploma attainment among teen mothers. Retrieved April 28, 2011, from
  65. Perrin, J. M., Bloom, S. R., & Gortmaker, S. L. (2007). The increase of childhood chronic conditions in the United States. Journal of the American Medical Association, 297(4), 2755–2759.PubMedCrossRefGoogle Scholar
  66. Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review. International Journal of Obesity, 35(7), 891–898.Google Scholar
  67. Santelli, J. S., Lindberg, L. D., Finer, L. B., & Singh, S. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use. American Journal of Public Health, 97(1), 150–156.PubMedCrossRefGoogle Scholar
  68. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of the American Medical Association, 289(14), 1813–1819.PubMedCrossRefGoogle Scholar
  69. SEARCH for Diabetes in Youth Study Group. (2006). The burden of diabetes mellitus among US youth: Prevalence estimates from the SEARCH for diabetes in youth study group. Pediatrics, 118, 1510–1518.CrossRefGoogle Scholar
  70. Sivak, M., & Schoettle, B. (2010). Toward understanding the recent large reductions in U.S. road fatalities. Traffic Injury Prevention, 11(6), 561–566.PubMedCrossRefGoogle Scholar
  71. Soni, A. (2009). The five most costly childrens conditions, 2006: Estimates for the U.S. civilian noninstitutionalized children, ages 017. Agency for Healthcare Research and Quality. Statistical Brief #242.Google Scholar
  72. Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings. Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293.Google Scholar
  73. Substance Abuse and Mental Health Services Administration. (2010). Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National findings. Office of Applied Studies, NSDUH Series H-38A, DHHS Publication No. SMA Findings.Google Scholar
  74. Supinya, I., & Biro, F. M. (2011). Adolescent women and obesity. Journal of Pediatric and Adolescent Gynecology, 24, 58–61.CrossRefGoogle Scholar
  75. Swartz, M. B., & Puhl, R. (2003). Childhood obesity: A societal problem to solve. Obesity Reviews, 4(1), 57–71.CrossRefGoogle Scholar
  76. Teen Research Unlimited. (2009). Teen dating abuse report 2009: Impact of the economy and parent/teen dialogue on dating relationships and abuse. Retrieved April 28, 2011, from;folderId=72612%26;name=DLFE-202.pdf
  77. Turner, C., & McClure, R. (2003). Age and gender differences in risk-taking behaviour as an explanation for high incidence of motor vehicle crashes as a driver in young males. International Journal of Injury Control and Safety Promotion, 10(3), 123–130.CrossRefGoogle Scholar
  78. U.S. Census Bureau. (2011). U.S. interim projections by age, sex, race, and Hispanic origin: 20002050. Retrieved from
  79. U.S. Department of Health and Human Services. (2011). Childhood obesity. Retrieved April 28, 2011, from
  80. U.S. Surgeon General. (2001). Overweight and obesity: Health consequences. Retrieved April 28, 2011, from
  81. Weinstock, H., Berman, S., & Cates, W., Jr. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36(1), 6–10.PubMedCrossRefGoogle Scholar
  82. Whitaker, R. C., Wright, J. A., Pepe, M. S., Seidel, K. D., & Dietz, W. H. (1997). Predicting obesity in young adulthood from childhood and parental obesity. The New England Journal of Medicine, 37(13), 869–873.CrossRefGoogle Scholar
  83. Wolak, J., Mitchell, K., & Finkelhor, D. (2006). Online victimization: 5 years later. Alexandria, VA: National Center for Missing and Exploited Children. Retrieved April 28, 2011, from
  84. Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of childhood and adolescence: Gender and psychopathology. Annual Review of Clinical Psychology, 4, 275–303.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.School of Community Health SciencesUniversity of Nevada, RenoRenoUSA

Personalised recommendations