As they transition from childhood to adulthood, adolescents make choices that affect their current and future health. These choices are often influenced by family members and friends as well as community school, and work environments.

Six critical types of adolescent health behavior contribute to the leading causes of death and disability among adults and youth (CDC) :

• Alcohol and drug use
• Injury and violence (including suicide)
• Tobacco use
• Nutrition
• Physical activity
• Sexual behaviors

Excessive alcohol consumption is the third leading cause of preventable death in the United States and is a risk factor for many health and societal problems. In 2006, the estimated economic cost of excessive drinking in the U. S. was $223.5 billion (Bouchery et al 2011). Approximately 5% of the total population drinks heavily and 15% of the population engages in binge drinking (CDC) .

Among adults, excessive consumption can take the form of heavy drinking, binge drinking, or both.

• Heavy drinking is defined as more than two drinks per day on average for men or more than one drink per day on average for women.
• Binge drinking is defined as five or more drinks during a single occasion for men or four or more drinks during a single occasion for women.

Underage drinking can also be considered a form of excessive drinking because it is both illegal and often involves consumption in quantities and settings that can lead to serious immediate and long-term consequences.

• People aged 12 to 20 years drink 11% of all alcohol consumed in the United States. More than 90% of this alcohol is consumed in the form of binge drinks (OJJDP) [PDF - 1.08MB] .

Find out more about the Community Guide’s alcohol consumption recommendations.

Asthma is a chronic lung disease with recurring symptoms. Symptoms include wheezing, breathlessness, chest tightness, and cough.

• Almost 9% of children and 7% of adults in the United States have asthma (CDC) .
• Asthma is more common among the poor and certain minority groups (CDC) .
• Medical  treatment for asthma consists of daily controller medications to prevent asthma exacerbations and rescue medications as needed to relieve acute symptoms.

Find out more about the Community Guide’s asthma recommendations.

• Birth defects affect about one in every 33 babies born in the United States and account for more than 20% of all infant deaths (CDC) .
• Babies born with birth defects have a greater chance of illness and long term disability than babies without birth defects (CDC) .
• If a woman has enough folic acid in her body before she is pregnant, it can help prevent major birth defects of her baby’s brain and spine (CDC) .

Find out more about the Community Guide’s birth defect recommendations.

• Cancer is the second leading cause of death in the United States, killing more than 553,000 Americans each year(CDC) .
• In 2006, the cost of medical care for cancer was an estimated $104.1 billion in the United States (National Cancer Institute) .
• More systematic efforts to expand use of established screening tests, reduce tobacco use and obesity, and improve diet and physical activity could prevent much of the suffering and death from cancer (ACS) .
• From 2004 – 2006, approximately half of colorectal and cervical cancer cases and one third of breast cancer cases were diagnosed at a late stage of disease; this could be partially explained by screening use differences (CDC) .

Find out more about the Community Guide’s cancer recommendations.

• Diabetes is the seventh leading cause of death in the United States and accounted for $116 billion in total U.S. healthcare system costs in 2007 (CDC) .
• Almost 24 million Americans have diabetes, including 5.7 million who don’t know they have the disease (CDC) .
• About 186,300 people younger than 20 years have diabetes—Type 1 or Type 2 (CDC) .

Find out more about the Community Guide’s diabetes recommendations.

Health communication is defined as the study and use of communication strategies to inform and influence individual and community decisions that enhance health (NCI 2001) .

• The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care as well as enhancement of the quality of life and health of individuals within the community.
• Health communication considers a variety of channels to deliver its targeted or tailored messages to specific segments among varied audiences, including individuals, communities, health professionals, special groups, and policy makers.

Social marketing is the use of strategic marketing practices “…to influence social behaviors not to benefit the marketer, but to benefit the target audience.” (Kotler & Andreasen, 2003)

• Social marketing is customer centered and focuses on three major decisions: segmentation, targeting and positioning. Guided by these decisions, the “marketing mix” (or 4 Ps of marketing: place, price, product & promotion) is developed to produce the desired responses in the target markets.
• Eight established benchmark criteria have been widely accepted as essential components of social marketing efforts: consumer orientation, insight, behavioral objectives, segmentation, exchange, competition, marketing mix, and theory.

Find out more about the Community Guide’s health communication recommendations.

• More than one million people in the United States are living with HIV/AIDS (CDC) .
• Each year, there are approximately 19 million new STD infections, and almost half of them are among youth aged 15 to 24 (CDC) .
• About half of US high school students have ever had sexual intercourse, and 15% of high school students had had four or more sex partners during their life (CDC) .

Find out more about the Community Guide’s HIV/AIDS, STIs & pregnancy recommendations.

Mental disorders are common in the United States.

• In the U.S., about one in four adults and one in five children have diagnosable mental disorders (National Institute of Mental Health) .
• Mental disorders are the leading cause of disability among ages 15-44 in the United States and Canada combined (National Institute of Mental Health) .
• The cost of lost earnings alone due to major mental disorders in the United States is around $193 billion each year (Kessler 2003).

Find out more about the Community Guide’s mental health recommendations.

• Motor vehicle-related injuries kill more children and young adults than any other single cause in the United States and are the leading cause of death from injury for people of all ages (CDC).
• Each year, motor vehicle crashes take the lives of more than 40,000 people in the United States and result in 2.7 million emergency department visits (CDC) .
• Use of child safety seats and safety belts and deterrence of alcohol-impaired driving are among the most important preventive measures to reduce motor vehicle-related injuries and deaths.

Find out more about the Community Guide’s motor vehicle safety recommendations.

Healthy eating is associated with lower risk for:

• Chronic diseases, such as Type 2 diabetes, hypertension, heart disease and certain cancers
• Overweight and obesity
• Micronutrient deficiencies

Nutrition among the U.S. population needs improvement.

• 63% of the adult population is overweight or obese (CDC) .
• Fewer than 25% of Americans eat fruits and vegetables 5 or more times per day (CDC) .

Find out more about the Community Guide’s nutrition recommendations.

• Overweight and obesity have been shown to increase the likelihood of certain diseases and other health problems, and are important concerns for adults, children, and adolescents in the United States.
• An estimated 26.7 percent of adults in the United States reported being obese in 2009, up 1.1 percentage points since 2007 (Behavioral Risk Factor Surveillance System) .
• Approximately 300,000 deaths per year may be attributable to obesity (Office of the Surgeon General) .
• In 2008, the annual healthcare cost of obesity in the US was estimated to be as high as 147 billion dollars a year (Finkelstein 2009).

Find out more about the Community Guide’s obesity recommendations.

• Mouth and throat diseases, which range from cavities to cancer, cause pain and disability for millions of Americans each year, yet almost all oral diseases are largely preventable.
• Tooth decay affects more than one-fourth of U.S. children aged 2–5 and half of those aged 12–15 (CDC) .
• Each year, an estimated 35,000 people learn that they have mouth (oral) or throat (pharyngeal) cancer (CDC) .
• As many as one third of all dental injuries and up to 19% of head and face injuries are sports related (Burt 2001).

Find out more about the Community Guide’s oral health recommendations.

Studies show that regular physical activity reduces the risk for depression, diabetes, heart disease, high blood pressure, obesity, stroke, and certain kinds of cancer. Yet, the 2008 Physical Activity Guidelines Advisory Committee  notes that data from various national surveillance programs consistently show most adults and youth in the U.S. do not meet current physical activity recommendations, e.g., 45% to 50% of adults and 35.8% of high school students say they get the recommended amounts of moderate to vigorous physical activity.

How much physical activity is enough to impact health?  The 2008 Physical Activity Guidelines for Americans  provides science-based recommendations for population subgroups, including:

• Children and adolescents (age 6-17)
• Adults (age 18-64)
• Older adults (age 65 and older)
• People with disabilities

Find out more about the Community Guide’s physical activity recommendations.

Social determinants of health are societal conditions that affect health and can potentially be changed by social and health policies and programs.

Three broad categories of social determinants are:

• Social institutions – including cultural and religious institutions, economic systems, and political structures
• Surroundings – including neighborhoods, workplaces, towns, cities, and built environments
• Social relationships – including position in social hierarchy, differential treatment of social groups, and social networks

Find out more about the Community Guide’s social environment recommendations.

Tobacco use is responsible for more than 430,000 deaths each year and is the largest cause of preventable morbidity and mortality in the United States (CDC) .

It is recognized as a cause of:

• Multiple cancers
• Heart disease
• Stroke
• Complications of pregnancy
• Chronic obstructive pulmonary disease

Find out more about the Community Guide’s tobacco use recommendations.

Diseases that can be prevented by vaccines remain major causes of illness and death for people of all ages in the United States.

• Flu seasons are unpredictable and can be severe. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths range from a low of about 3,000 to a high of about 49,000 people (CDC) .
• In the U.S., an estimated 800,000 to 1.4 million persons have chronic Hepatitis B virus infection (CDC) .
• Since implementation of the varicella (chicken pox) vaccine program in 1995, the number of cases has declined 85%, the number of hospitalizations has declined 85%, and the number of deaths has declined 82% (CDC) .

Find out more about the Community Guide’s vaccination recommendations.

• Violence-related injuries and deaths can result from both interpersonal violence and suicidal behavior.
• In 2006, 5,958 young people aged 10 to 24 years died as a result of homicide–an average of 16 each day (CDC) .
• Suicide is the third leading cause of death for young people aged 15 to 24 years CDC) .
• In 2006, more than 1,500 children aged 0 to 17 years died from abuse and neglect (rate of 2.04 per 100,000 children) and approximately 905,000 children were confirmed by Protective Services as being maltreated (Administration for Children & Families) .

Find out more about the Community Guide’s violence prevention recommendations.

• Worksite policies and programs may help employees reduce health risks and improve their quality of life.
• Worksite interventions can be delivered:
  • At the worksite (e.g., signs to encourage stair use, health education classes)
  • At other locations (e.g., gym membership discounts, weight management counseling)
  • Through the employee health benefits plan (e.g., flu shots, cancer screenings)

Find out more about the Community Guide’s workplace health recommendations.