Declining Health Risk Exposure among Chicago Public High School Students: Trends from the Youth Risk Behavior Survey 1997-2017

Abstract

There have been improvements nationally in teenagers' self-reported health risk since the 1990s. This study provides an overview of trends in substance use, sexual health, violence and victimization, and mental health status among Chicago Public High School (CPS) students over a 20-year period. We compared responses to 29 identically worded items from the 1997, 2007, and 2017 Chicago Youth Risk Behavior Survey (YRBS) in the four domains. We show changes in responses across individual items, mean changes across the four domains, and change in the proportion of students with highest risk exposure (10 affirmative responses). Analyses control for CPS students grade, sex, and race/ethnicity. Reductions in substance use, sexual health risk, and violence and victimization (30, 40% and 40% in the mean number of affirmative responses, respectively) were observed. Mental health showed an initial improvement from 1997 to 2007, only to worsen by 2017 and show little difference from 1997. There was an approximate 70% decrease in the likelihood of being in the high multiple risk category (10 affirmative responses) in 2017 compared to 1997 (OR 0.33; CI 0.22-0.49). In alignment with national trends, our study documents significant improvement in Chicago public high school students long-term health risk exposure over the 20-year study period, with the notable exception of mental health status. These improvements occurred simultaneously with improvements in academic achievement coinciding with changes in the study population of CPS students and demographic changes in many Chicago neighborhoods.

Acknowledgements

We are grateful to the Centers for Disease Control and Prevention for making their data publicly available and to Dr. Arthur Elster for his review and comments.

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