Health status and behavioral outcomes for youth who anticipate a high likelihood of early death

Citation

Borowsky, I. W.; Ireland, M.; & Resnick, M. D. (2009). Health status and behavioral outcomes for youth who anticipate a high likelihood of early death. Pediatrics. vol. 124 (1) pp. 81-88

Abstract

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 20594 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.

URL

http://dx.doi.org/10.1542%2Fpeds.2008-3425

Reference Type

Journal Article

Journal Title

Pediatrics

Author(s)

Borowsky, I. W.
Ireland, M.
Resnick, M. D.

Year Published

2009

Volume Number

124

Issue Number

1

Pages

81-88

DOI

10.1542/peds.2008-3425

Reference ID

1074