It depends on what you define as progress, or on what you define as an acceptable risk.
Every two years, the Centers for Disease Control and Prevention puts out results from its latest Youth Risk Behavior Survey, or YRBS. Teens are surveyed about all kinds of risky and healthy behaviors, from how likely they are to wear a bike helmet to whether or not they've eaten fruits or vegetables in the past week, as well as the usual suspects like smoking and unprotected sex.
The latest numbers are out now, this time for 2013. And the great things about this survey are that you can zero in on a single state, compare results from different years, and compare state and national numbers. Here's a look at the survey results for Rhode Island, comparing 2013 with 2003. You may have seen some headlines lately like, "Rhode Island Youth Making Healthier Choices," based on this survey. But that's only part of the story. I've broken out some selected results for you below, comparing what Rhode Island teens said about themselves in 2003 and 10 years later, and then comparing RI results to the nation's. Some show a positive trend, others a troubling one. I invite your comments.
- In 2003, 15% of RI teens said they never or rarely wore a seat belt. In 2013, that number dropped to 6%. That's slightly better than the national rate of about 7% for 2013.
- In 2013, about 36% of RI teens said they had texted or emailed while driving at least once during the past month. (No data was available for 2003 - think how smartphones have proliferated since then!) That's better than the national average of about 41%. But should we be proud of the fact that more than one in three teens texts while driving?
- It's pretty close, statistically, but consider this: in 2013, 5.6% of RI teens carried a gun, compared to 5.5% nationwide.
- In 2003, about 8% of RI teens attempted suicide at least once during the past year. In 2013, that number went up to about 14%. Why? Nationwide, the rate is about 8% for 2013.
- 9% of RI teens were frequent smokers in 2003. That number has dropped to 3% for 2013, better than the national average of about 6%. But among RI teens who do smoke regularly, about half are not currently trying to quit.
- In 2013, about 30% of RI teens admitted drinking alcohol at least once during the previous month, down from about 44% in 2003. The numbers are comparable to national rates.
- But in 2013 (no data available for 2003), nearly 14% admitted taking a prescription drug (like OxyContin) without a doctor's prescription. Nearly 18% are taking Rx meds illicitly nationwide. What this statistic doesn't tell you, however, is how many teens are prescribed powerful, addictive opioid painkillers by their doctors. They may have a legitimate need for these painkillers, but some may get hooked or divert pills to others.
- RI teens are mostly like their peers in terms of the amount of fruits and vegetables they eat (most have some) and how often they have breakfast (most do). RI teens drink less sugary pop than their counterparts nationwide.
- But yikes: in 2013, 7% of RI teens said they had vomited or taken laxatives over the past month to keep from gaining weight. That's compared to about 4% nationwide.
- Of RI teens who are sexually active (about 27% in 2013), about a third don't use condoms. About 10% use no form of birth control (compared to 13% nationwide). In Rhode Island, those numbers have not changed substantially in the past 10 years. Why?
Regardless of which way the trend line seems to be going, or how we stack up to our peers, I think it's fair to say that changing behavior doesn't happen overnight. Public health messages take time to spread. And teens aren't making lifestyle decisions in a vacuum. They're watching us, watching peers, and watching their screens.