Adolescent connectedness and adult health outcomes

Riley J. Steiner, Ganna Sheremenko, Catherine Lesesne, Patricia J. DIttus, Renee E. Sieving, Kathleen A. Ethier

Research output: Contribution to journalArticlepeer-review

103 Scopus citations


BACKGROUND: Because little is known about long-term effects of adolescent protective factors across multiple health domains, we examined associations between adolescent connectedness and multiple health-related outcomes in adulthood. METHODS: We used weighted data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 14 800). Linear and logistic models were used to examine associations between family and school connectedness in adolescence and self-reported health risk behaviors and experiences in adulthood, including emotional distress, suicidal thoughts and attempts, physical violence victimization and perpetration, intimate partner physical and sexual violence victimization, multiple sex partners, condom use, sexually transmitted infection (STI) diagnosis, prescription drug misuse, and other illicit drug use. RESULTS: In multivariable analyses, school connectedness in adolescence had independent protective associations in adulthood, reducing emotional distress and odds of suicidal ideation, physical violence victimization and perpetration, multiple sex partners, STI diagnosis, prescription drug misuse, and other illicit drug use. Similarly, family connectedness had protective effects for emotional distress, all violence indicators, including intimate partner violence, multiple sex partners, STI diagnosis, and both substance use indicators. Compared to individuals with low scores for each type of connectedness, having high levels of both school and family connectedness was associated with 48% to 66% lower odds of health risk behaviors and experiences in adulthood, depending on the outcome. CONCLUSIONS: Family and school connectedness may have long-lasting protective effects across multiple health outcomes related to mental health, violence, sexual behavior, and substance use. Increasing both family and school connectedness during adolescence has the potential to promote overall health in adulthood.

Original languageEnglish (US)
Article numbere20183766
Issue number1
StatePublished - Jul 2019

Bibliographical note

Funding Information:
FUNDING: Supported by funding from the Division of Adolescent and School Health in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (contract HHSS2002013M53944B task order 200-2014-F-59670). This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Persons interested in obtaining data files from Add Health should contact Add Health, The University of North Carolina at Chapel Hill, Carolina Population Center, Carolina Square, Suite 210, 123 W. Franklin Street, Chapel Hill, NC 27516 ( No direct support was received from grant P01-HD31921 for this analysis.

Publisher Copyright:
© 2019 by the American Academy of Pediatrics.


  • Adolescent
  • Adolescent Health
  • Adult
  • Dangerous Behavior
  • Family Relations/psychology
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Linear Models
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Mental Health
  • Protective Factors
  • Psychology, Adolescent
  • Schools
  • Self Report
  • Social Distance
  • Social Identification
  • Social Isolation/psychology
  • Social Marginalization/psychology

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.


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