TY - JOUR
T1 - Health status and behavioral outcomes for youth who anticipate a high likelihood of early death
AU - Borowsky, Iris Wagman
AU - Ireland, Marjorie
AU - Resnick, Michael D.
PY - 2009/7
Y1 - 2009/7
N2 - OBJECTIVE: The relationship between adolescents' perceived risk for dying and their involvement in risk behaviors is unknown. We sought to determine the proportion of US youth who anticipate a high likelihood of early mortality and relationships with health status and risk behaviors over time. METHODS: We analyzed data from times 1 (1995), 2 (1996), and 3 (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of youth in grades 7 through 12. The relationship between perceived risk for premature mortality and health behaviors/outcomes was assessed by using bivariate and multivariate analyses. RESULTS: At time 1, 14.7% of the 20 594 respondents reported at least a 50/50 chance that they would not live to age 35. In adjusted models, illicit drug use, suicide attempt, fight-related injury, police arrest, unsafe sexual activity, and a diagnosis of HIV/AIDS predicted early death perception at time 2, time 3, or both (adjusted odds ratios: 1.26-5.12). Conversely, perceived early mortality at time 1 predicted each of these behaviors and outcomes, except illicit drug use, at time 2 or time 3, most strongly a diagnosis of HIV/AIDS (adjusted odds ratios: 7.13 [95% confidence interval: 2.50-20.36]). CONCLUSIONS: Adolescent involvement in risk behaviors predicted a belief in premature mortality 1 and 7 years later. Reciprocally, adolescents' perceived risk for early death predicted serious health outcomes, notably a diagnosis of HIV/AIDS in young adulthood. Given its frequency and influence on behavior and health, adolescents' perceived risk for early death should be incorporated into psychosocial assessments and interviews.
AB - OBJECTIVE: The relationship between adolescents' perceived risk for dying and their involvement in risk behaviors is unknown. We sought to determine the proportion of US youth who anticipate a high likelihood of early mortality and relationships with health status and risk behaviors over time. METHODS: We analyzed data from times 1 (1995), 2 (1996), and 3 (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of youth in grades 7 through 12. The relationship between perceived risk for premature mortality and health behaviors/outcomes was assessed by using bivariate and multivariate analyses. RESULTS: At time 1, 14.7% of the 20 594 respondents reported at least a 50/50 chance that they would not live to age 35. In adjusted models, illicit drug use, suicide attempt, fight-related injury, police arrest, unsafe sexual activity, and a diagnosis of HIV/AIDS predicted early death perception at time 2, time 3, or both (adjusted odds ratios: 1.26-5.12). Conversely, perceived early mortality at time 1 predicted each of these behaviors and outcomes, except illicit drug use, at time 2 or time 3, most strongly a diagnosis of HIV/AIDS (adjusted odds ratios: 7.13 [95% confidence interval: 2.50-20.36]). CONCLUSIONS: Adolescent involvement in risk behaviors predicted a belief in premature mortality 1 and 7 years later. Reciprocally, adolescents' perceived risk for early death predicted serious health outcomes, notably a diagnosis of HIV/AIDS in young adulthood. Given its frequency and influence on behavior and health, adolescents' perceived risk for early death should be incorporated into psychosocial assessments and interviews.
KW - Adolescent health
KW - HIV
KW - Health outcomes
KW - Perceptions of mortality
KW - Risk behaviors
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U2 - 10.1542/peds.2008-3425
DO - 10.1542/peds.2008-3425
M3 - Article
C2 - 19564273
AN - SCOPUS:67649609949
SN - 0031-4005
VL - 124
SP - e81-e88
JO - Pediatrics
JF - Pediatrics
IS - 1
ER -