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Youth Risk Behavior Surveillance --- Selected Steps Communities, United States, 2007

Shari Shanklin, MPH1
Nancy D. Brener, PhD1
Laura Kann, PhD1
Shannon Griffin-Blake, PhD2
Ann Ussery-Hall, MPH3,4
Alyssa Easton, PhD2
Erica Barrett, MBA3,4
Joseph Hawkins, MA5
William A. Harris, MM1
Tim McManus, MS1
1Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
2Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
3Northrop Grumman, Atlanta, Georgia
4The Ginn Group, Atlanta, Georgia
5Westat, Rockville, Maryland

Corresponding author: Shari Shanklin, MPH, Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, MS K-33, 4770 Buford Hwy., NE, Atlanta, GA 30341. Telephone: 770-488-6104; Fax: 770-488-6156; E-mail: bsa7@cdc.gov.

Abstract

Problem: Priority health-risk behaviors, including tobacco use, unhealthy dietary behaviors, and physical inactivity often are established during childhood and adolescence, extend into adulthood, are interrelated, and are preventable. These behaviors contribute to chronic disease and other health conditions, including asthma.

Reporting Period Covered: January--May 2007.

Description of System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors and the prevalence of obesity and asthma among youth and young adults. YRBSS includes a national school-based survey conducted by CDC and state and local school-based surveys conducted by state and local education and health agencies.

In 2007, as a component of YRBSS, communities participating in the Steps Cooperative Agreement Program (Steps Program) also conducted school-based surveys of students in grades 9--12 in their program intervention areas. These communities used a standard questionnaire that measured tobacco use, dietary behaviors, and physical activity and monitored the prevalence of obesity and asthma. This report summarizes results from surveys of students in 26 Steps communities that conducted surveys in 2007.

Results: Results from the 26 Steps communities indicated that a substantial proportion of adolescents engaged in health-risk behaviors that increased their likelihood of becoming obese. During 2007, across surveys, the percentage of high school students who had ever smoked at least one cigarette every day for 30 days ranged from 3.7% to 20.1% (median: 9.0%), the percentage who had eaten fruits and vegetables five or more times per day during the 7 days before the survey ranged from 13.9% to 23.9% (median: 17.9%), and the percentage who met recommended levels of physical activity ranged from 27.7% to 55.5% (median: 40.1%). Across surveys, the percentage of students who were obese ranged from 4.6% to 20.2% (median: 13.6%), and the percentage of students who had ever been told by a doctor or nurse that they had asthma ranged from 16.8% to 28.5% (median: 21.6%).

Interpretation: Although the prevalence of many health-risk behaviors and health conditions related to obesity and asthma varies across Steps communities, a substantial proportion of high school students engage in behaviors that place them at risk for chronic disease.

Public Health Action: Steps Program staff at the national, tribal, state, and local levels will use YRBSS data for decision making, program planning, and enhancing technical assistance to reduce tobacco use and exposure and to increase healthy eating and physical activity. These data will be used to help focus existing programs on activities that have shown the greatest promise of results, as well as identify populations of greatest need and opportunities for strategic collaboration to identify and disseminate lessons learned.

Introduction

The Steps Cooperative Agreement Program (Steps Program) is a national, multilevel chronic disease prevention effort coordinated by CDC. Through this program, Steps communities (i.e., small cities or rural areas whose activities are coordinated by a state health department, large cities or urban areas, and tribes or tribal entities) receive funds to implement chronic disease prevention and health promotion activities focused on reducing the burden of obesity, diabetes, and asthma and addressing three related risk behaviors: tobacco use, unhealthy dietary behaviors, and physical inactivity.

To measure program outcomes and assess progress toward program goals, Steps communities participate in existing surveillance systems, including the Youth Risk Behavior Surveillance System (YRBSS). CDC developed YRBSS to monitor six categories of priority health-risk behaviors among youth and young adults, including behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infections; unhealthy dietary behaviors; and physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based survey conducted by CDC and state, territorial, tribal, and local school-based surveys conducted by state, territorial, tribal, and local education and health agencies; surveys have been conducted biennially since 1991. Steps communities participating in YRBSS use a modified standard questionnaire that measures tobacco use, dietary behaviors, and physical activity and monitors the prevalence of obesity and asthma. Participation in YRBSS provides community-level data on risk behaviors; high-quality data that are comparable across Steps communities, states, and the nation; and a consistent, stable source of data that will enable programs to monitor progress.

In 2003, the Steps Program funded 12 programs representing 24 communities. In 2004, the Steps Program funded 10 additional programs representing 16 communities. This report summarizes results from the 26 Steps communities funded in 2003 and 2004 that obtained weighted data for the 2007 YRBSS cycle and granted CDC permission to publish their data. Results from community surveys that did not obtain weighted data are not included in this report. All surveys were conducted during spring 2007.

Methods

Sampling

Each community school-based survey employed a two-stage cluster sample design to produce a representative sample of public school students in grades 9--12 in its program intervention area.* In the first sampling stage, all schools with any students in grades 9--12 were selected in 24 communities; in two communities (Cleveland, OH, and Cherokee Nation), schools with any students in grades 9--12 were selected with probability proportional to school enrollment size. In the second sampling stage, intact classes from either a required subject (e.g., English or social studies) or a required period (e.g., homeroom or second period) were selected randomly, and all students in selected classes were eligible to participate. Community surveys that had a scientifically selected sample of students, appropriate documentation, and an overall response rate of 60% or higher were weighted. A weight was applied to each record to adjust for student nonresponse and the distribution of students by grade, sex, and race/ethnicity in each jurisdiction. Therefore, weighted estimates are representative of all students in grades 9--12 attending public schools in each Steps community.

In 2007, a total of 26 communities had weighted data and granted permission to include their data in this report. Student sample sizes ranged from 644 to 2,197 (Table 1). School response rates ranged from 83% to 100%; student response rates ranged from 64% to 88%; and overall response rates, calculated by multiplying the school response rate by the student response rate, ranged from 64% to 88%.

Sixteen of the 26 communities for which results are provided in this report are small cities or rural communities, nine are large cities or urban communities, and one is a tribe. Race/ethnic distributions of students varied across communities (Table 1). In six communities, more than 50% of students are Hispanic; in five communities, more than 50% of students are non-Hispanic black; and in eight communities, more than 80% of students are non-Hispanic white. The Cherokee Nation Steps community comprises a 14-county service delivery area that is nonreservation based. It includes all racial/ethnic groups residing in the service delivery area. Therefore, Cherokee Nation students might belong to an ethnicity other than Cherokee.

For comparison purposes, this report also includes previously published data from the 2007 national school-based Youth Risk Behavior Survey (YRBS) (1). The sampling frame for the 2007 national YRBS consisted of all public and private schools with students in at least one of grades 9--12 in the 50 states and the District of Columbia. A three-stage cluster sample design produced a nationally representative sample of students in grades 9--12 who attended public and private schools. For the 2007 national YRBS, 14,103 questionnaires were completed in 157 schools. The school response rate was 81%, the student response rate was 84%, and the overall response rate was 68%.† Additional information about the national YRBS sample has been published previously (1).

Data Collection Procedures and Questionnaire

Procedures for both the national and the Steps YRBS were designed to protect students' privacy by allowing for anonymous and voluntary participation. Before survey administration, local parental permission procedures were followed. Students completed the self-administered questionnaire during one class period and recorded their responses directly on a computer-scannable booklet or answer sheet. A detailed explanation of the YRBSS methodology and questionnaire development has been published previously (2).

The national YRBS questionnaire contained 98 questions, and the standard Steps questionnaire contained 36 of these questions and one question to monitor the prevalence of emergency room or urgent care center visits among those students who currently have asthma. Communities could add questions to the standard questionnaire. Skip patterns were not included in any questionnaire to protect student privacy by ensuring all students completed the questionnaire in approximately the same amount of time. Only data from standard Steps questions are provided in this report. Information about the reliability of the standard questions has been published previously (3).

Data Processing and Coding

Each community data set and the national data set were cleaned and edited for inconsistencies. Missing data were not imputed statistically. Among Steps community data sets, the number of completed questionnaires that failed quality-control checks§ and were excluded from analysis ranged from 0 to 19 (median: 6.5). Of the 14,103 completed questionnaires from the national YRBS, 62 failed quality control and were excluded from analysis, leaving 14,041 usable questionnaires (Table 1).

Race/ethnicity was computed from two questions: 1) "Are you Hispanic or Latino?" (response options were "yes" or "no"), and 2) "What is your race?" (response options were "American Indian or Alaska Native," "Asian," "Black or African American," "Native Hawaiian or Other Pacific Islander," or "White"). For the second question, students could select more than one response option. For this report, students were classified as "Hispanic/Latino" if they answered "yes" to the first question, regardless of how they answered the second question. Students were classified as "black" if they answered "no" to the first question and selected only "Black or African American" to the second question. Students were classified as "white" if they answered "no" to the first question and selected only "White" to the second question. Students were classified as "other" if they answered "no" to the first question and selected "American Indian or Alaska Native," "Asian," or "Native Hawaiian or Other Pacific Islander" or selected more than one response to the second question. Race/ethnicity was set to missing for students who did not answer the first question or for students who answered "no" to the first question and did not answer the second question. Throughout this report, students who self-identified as "Hispanic/Latino" are referred to as "Hispanic" and students who self-identified as "Black or African American" are referred to as "black."

Students were classified as obese or overweight based on their body mass index (kg/m2) (BMI), which was calculated from self-reported height and weight. The BMI values were compared to sex- and age-specific reference data from the 2000 CDC Growth Charts (4). Obese was defined as a BMI of >95th percentile for age and sex. Overweight was defined as a BMI of >85th percentile and <95th percentile for age and sex. Previous YRBS reports used the terms "overweight" to describe those youth with a BMI >95th percentile for age and sex and "at risk for overweight" for those with a BMI >85th percentile and <95th percentile. However, this report uses the terms "obese" and "overweight," respectively, in accordance with the 2007 recommendations from the Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity convened by the American Medical Association (AMA) and co-funded by AMA in collaboration with the Health Resources and Services Administration and CDC (5). These classifications are not intended to diagnose individual students as obese or overweight, but rather to provide estimates of obesity and overweight for the population of students surveyed. The reliability and validity of self-reported height and weight among high school students has been described previously (6).

Analytic Methods

Statistical analyses were conducted on weighted data using SAS (7) and SUDAAN (8) software to account for the complex sampling designs. Prevalence estimates and 95% confidence intervals (CIs) were computed for all variables and all data sets. The median prevalence across Steps communities was compared with the prevalence and 95% CI from the national YRBS for each behavior. If the median prevalence was not within the 95% CI for the national estimate, the difference was considered statistically significant.

Results

Tobacco Use

Lifetime Cigarette Use

Across Steps surveys, the overall percentage of students who had ever tried cigarette smoking (even one or two puffs) (i.e., lifetime cigarette use) ranged from 34.9% to 64.2% (median: 48.7%). Prevalence among female students ranged from 31.7% to 63.4% (median: 47.9%), and prevalence among male students ranged from 33.5% to 67.1% (median: 49.1%) (Table 2).

Lifetime Daily Cigarette Use

Across Steps surveys, the overall percentage of students who had ever smoked at least one cigarette every day for 30 days (i.e., lifetime daily cigarette use) ranged from 3.7% to 20.1% (median: 9.0%). Prevalence among female students ranged from 2.5% to 22.4% (median: 7.7%), and prevalence among male students ranged from 4.0% to 22.1% (median: 8.5%) (Table 2).

Current Cigarette Use

Across Steps surveys, the overall percentage of students who had smoked cigarettes on at least 1 day during the 30 days before the survey (i.e., current cigarette use) ranged from 7.2% to 28.6% (median: 13.2%). Prevalence among female students ranged from 5.7% to 28.6% (median: 14.1%), and prevalence among male students ranged from 8.1% to 28.9% (median: 13.8%) (Table 3).

Current Frequent Cigarette Use

Across Steps surveys, the overall percentage of students who had smoked cigarettes on 20 or more days during the 30 days before the survey (i.e., current frequent cigarette use) ranged from 2.2% to 13.7% (median: 5.1%). Prevalence among female students ranged from 0.7% to 13.0% (median: 3.7%), and prevalence among male students ranged from 2.7% to 15.8% (median: 5.6%) (Table 3).

Smoked More than 10 Cigarettes per Day

Across Steps surveys, among students who currently smoked cigarettes, the overall percentage of students who had smoked more than 10 cigarettes per day on the days they smoked during the 30 days before the survey ranged from 2.2% to 15.8% (median: 8.0%). Prevalence among female students ranged from 0.0% to 11.4% (median: 5.3%), and prevalence among male students ranged from 2.4% to 19.8% (median: 13.7%) (Table 4).

Tried to Quit Smoking Cigarettes

Across Steps surveys, among students who currently smoked cigarettes, the overall percentage of students who had tried to quit smoking cigarettes during the 12 months before the survey ranged from 43.2% to 61.9% (median: 51.7%). Prevalence among female students ranged from 49.9% to 58.5% (median: 51.8%), and prevalence among male students ranged from 46.5% to 55.7% (median: 48.5%) (Table 4).

Smoked a Whole Cigarette Before Age 13 Years

Across Steps surveys, the overall percentage of students who had smoked a whole cigarette for the first time before age 13 years ranged from 5.5% to 20.5% (median: 12.1%). Prevalence among female students ranged from 4.4% to 20.6% (median: 10.7%). Prevalence among male students ranged from 6.6% to 20.6% (median: 13.5%) (Table 5).

Smoked Cigarettes on School Property

Across Steps surveys, the overall percentage of students who had smoked cigarettes on school property on at least 1 day during the 30 days before the survey ranged from 1.7% to 8.9% (median: 4.0%). Prevalence among female students ranged from 0.9% to 10.8% (median: 2.6%), and prevalence among male students ranged from 2.6% to 10.2% (median: 4.8%) (Table 5).

Bought Cigarettes in a Store or Gas Station

Across Steps surveys, among students who currently smoked cigarettes and were aged <18 years, the overall percentage of students who usually obtained their own cigarettes by buying them in a store (i.e., a convenience store, supermarket, or discount store) or gas station during the 30 days before the survey ranged from 5.8% to 25.1% (median: 11.4%). Prevalence among male students ranged from 11.0% to 26.8% (median: 20.9%). The prevalence among female students was not available (Table 6).

Dietary Behaviors

Ate Fruits and Vegetables Five or More Times per Day

Across Steps surveys, the overall percentage of students who had eaten fruits and vegetables five or more times per day during the 7 days before the survey ranged from 13.9% to 23.9% (median: 17.9%). Prevalence among female students ranged from 10.8% to 21.2% (median: 17.0%), and prevalence among male students ranged from 14.6% to 26.4% (median: 19.4%) (Table 7).

Drank Soda or Pop at Least One Time per Day

Across Steps surveys, the overall percentage of students who had drunk a can, bottle, or glass of soda or pop (not including diet soda or diet pop) at least one time per day during the 7 days before the survey ranged from 16.7% to 45.3% (median: 26.6%). Prevalence among female students ranged from 11.5% to 37.4% (median: 21.7%), and prevalence among male students ranged from 20.0% to 52.9% (median: 30.4%) (Table 7).

Physical Activity

Met Recommended Levels of Physical Activity

Across Steps surveys, the overall percentage of students who had been physically active doing any kind of physical activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more days during the 7 days before the survey (i.e., met recommended levels of physical activity) (9) ranged from 27.7% to 55.5% (median: 40.1%). Prevalence among female students ranged from 18.4% to 50.1% (median: 32.2%), and prevalence among male students ranged from 32.6% to 61.4% (median: 49.9%) (Table 8).

Did Not Participate in 60 or More Minutes of Physical Activity on Any Day

Across Steps surveys, the overall percentage of students who did not participate in 60 or more minutes of any kind of physical activity that increased their heart rate and made them breathe hard some of the time on at least 1 day during the 7 days before the survey (i.e., did not participate in 60 or more minutes of physical activity on any day) ranged from 7.6% to 30.9% (median: 17.9%). Prevalence among female students ranged from 7.8% to 41.1% (median: 22.3%), and prevalence among male students ranged from 5.1% to 21.2% (median: 12.0%) (Table 8).

Used Computers 3 or More Hours per Day

Across Steps surveys, the overall percentage of students who played video or computer games or used a computer for something that was not school work for 3 or more hours per day on an average school day (i.e., used computers 3 or more hours per day) ranged from 15.8% to 31.5% (median: 23.1%). Prevalence among female students ranged from 9.8% to 28.2% (median: 19.6%), and prevalence among male students ranged from 19.0% to 36.2% (median: 26.0%) (Table 9).

Watched Television 3 or More Hours per Day

Across Steps surveys, the overall percentage of students who watched television 3 or more hours per day on an average school day ranged from 18.0% to 57.2% (median: 33.0%). Prevalence among female students ranged from 14.7% to 59.8% (median: 30.8%), and prevalence among male students ranged from 20.4% to 54.2% (median: 32.1%) (Table 9).

Attended Physical Education Classes

Across Steps surveys, the overall percentage of students who went to physical education (PE) classes on 1 or more days in an average week when they were in school (i.e., attended PE classes) ranged from 25.5% to 96.1% (median: 49.6%). Prevalence among female students ranged from 21.6% to 98.4% (median: 42.2%), and prevalence among male students ranged from 29.6% to 96.1% (median: 55.6%) (Table 10).

Attended Physical Education Classes Daily

Across Steps surveys, the overall percentage of students who went to PE classes 5 days in an average week when they were in school (i.e., attended PE classes daily) ranged from 2.4% to 46.4% (median: 26.4%). Prevalence among female students ranged from 2.4% to 46.4% (median: 26.1%), and prevalence among male students ranged from 2.4% to 48.5% (median: 26.5%) (Table 10).

Played on at Least One Sports Teams

Across Steps surveys, the overall percentage of students who had played on at least one sports team (run by their school or community groups) during the 12 months before the survey ranged from 43.9% to 71.0% (median: 54.7%). Prevalence among female students ranged from 35.0% to 67.5% (median: 49.1%), and prevalence among male students ranged from 52.9% to 74.4% (median: 61.1%) (Table 11).

Obesity, Overweight, and Weight Control

Obese

Across Steps surveys, the overall percentage of students who were obese ranged from 4.6% to 20.2% (median: 13.6%). Prevalence among female students ranged from 2.4% to 16.4% (median: 9.7%), and prevalence among male students ranged from 6.8% to 24.7% (median: 16.7%) (Table 12).

Overweight

Across Steps surveys, the overall percentage of students who were overweight ranged from 8.3% to 19.9% (median: 15.5%). Prevalence among female students ranged from 6.3% to 25.3% (median: 15.9%), and prevalence among male students ranged from 10.1% to 18.9% (median: 15.0%) (Table 12).

Described Themselves as Overweight

Across Steps surveys, the overall percentage of students who described themselves as slightly or very overweight ranged from 21.1% to 36.3% (median: 28.8%). Prevalence among female students ranged from 24.8% to 44.2% (median: 33.1%), and prevalence among male students ranged from 16.1% to 31.7% (median: 23.2%) (Table 13).

Were Trying to Lose Weight

Across Steps surveys, the overall percentage of students who were trying to lose weight ranged from 36.2% to 53.4% (median: 43.8%). Prevalence among female students ranged from 45.5% to 69.9% (median: 59.1%), and prevalence among male students ranged from 23.0% to 46.0% (median: 30.4%) (Table 13).

Ate Less Food, Fewer Calories, or Low-Fat Foods to Lose Weight or to Keep from Gaining Weight

Across Steps surveys, the overall percentage of students who had eaten less food, fewer calories, or low-fat foods to lose weight or to keep from gaining weight during the 30 days before the survey ranged from 30.0% to 44.7% (median: 37.9%). Prevalence among female students ranged from 32.4% to 62.2% (median: 50.8%), and prevalence among male students ranged from 20.1% to 33.4% (median: 25.6%) (Table 14).

Exercised to Lose Weight or to Keep From Gaining Weight

Across Steps surveys, the overall percentage of students who had exercised to lose weight or to keep from gaining weight during the 30 days before the survey ranged from 48.3% to 67.3% (median: 63.1%). Prevalence among female students ranged from 46.8% to 78.4% (median: 68.9%), and prevalence among male students ranged from 44.8% to 68.3% (median: 54.7%) (Table 14).

Did Not Eat for 24 or More Hours to Lose Weight or to Keep From Gaining Weight

Across Steps surveys, the overall percentage of students who did not eat for 24 or more hours to lose weight or to keep from gaining weight during the 30 days before the survey ranged from 6.5% to 15.3% (median: 11.0%). Prevalence among female students ranged from 8.8% to 22.9% (median: 14.2%), and prevalence among male students ranged from 3.9% to 12.7% (median: 7.8%) (Table 15).

Took Diet Pills, Powders, or Liquids to Lose Weight or to Keep from Gaining Weight

Across Steps surveys, the overall percentage of students who had taken diet pills, powders, or liquids without a doctor's advice to lose weight or to keep from gaining weight during the 30 days before the survey ranged from 3.4% to 10.5% (median: 5.9%). Prevalence among female students ranged from 2.7% to 14.7% (median: 6.2%), and prevalence among male students ranged from 2.3% to 9.2% (median: 6.3%) (Table 15).

Vomited or Took Laxatives to Lose Weight or to Keep from Gaining Weight

Across Steps surveys, the overall percentage of students who had vomited or taken laxatives to lose weight or to keep from gaining weight during the 30 days before the survey ranged from 2.8% to 8.4% (median: 4.8%). Prevalence among female students ranged from 3.6% to 11.8% (median: 6.2%), and prevalence among male students ranged from 1.2% to 9.1% (median: 4.1%) (Table 16).

Asthma

Lifetime Asthma

Across Steps surveys, the overall percentage of students who had ever been told by a doctor or nurse that they had asthma (i.e., lifetime asthma) ranged from 16.8% to 28.5% (median: 21.6%). Prevalence among female students ranged from 16.1% to 27.8% (median: 21.8%), and prevalence among male students ranged from 15.3% to 31.6% (median: 22.3%) (Table 17).

Current Asthma

Across Steps surveys, the overall percentage of students who had lifetime asthma and still had asthma (i.e., current asthma) ranged from 7.2% to 16.7% (median: 11.3%). Prevalence among female students ranged from 7.8% to 18.1% (median: 11.6%), and prevalence among male students ranged from 5.9% to 15.9% (median: 10.0%) (Table 17).

Went to an Emergency Room or Urgent Care Center Because of Asthma

Across Steps surveys, among students who currently have asthma, the overall percentage of students who went to an emergency room or urgent care center because of their asthma one or more times during the 12 months before the survey ranged from 12.6% to 37.7% (median: 25.2%). Prevalence among female and male students separately was unavailable for all communities except one (Table 18).

Discussion

For 14 of the 29 behaviors measured in both the 2007 Steps YRBS and the 2007 national YRBS, the median prevalence across Steps communities did not differ significantly from the national prevalence. For the remaining 15 behaviors, significant differences were detected.

Compared with students nationally, students in the Steps communities were less likely to participate in seven behaviors related to tobacco use. These behaviors include lifetime daily cigarette use (median: 9.0%; national estimate: 12.4%, CI: 10.4%--14.7%), current cigarette use (median: 13.2%; national estimate: 20.0%, CI: 17.6%--22.6%), current frequent cigarette use (median: 5.1%; national estimate: 8.1%, CI: 6.7%--9.8%), smoked more than 10 cigarettes per day (median: 8.0%; national estimate: 10.7%, CI: 9.0%--12.6%), smoked a whole cigarette for the first time before age 13 years (median: 12.1%; national estimate: 14.2%, CI: 12.2%--16.5%), smoked cigarettes on school property (median: 4.0%; national estimate: 5.7%, CI: 4.7%--6.8%), and bought cigarettes in a store or gas station (median: 11.4%; national estimate: 16.0%, CI: 12.8%--19.9%).

For nutrition-related behaviors, whereas students in Steps communities were less likely to drink soda or pop at least one time per day compared with students nationally (median: 26.6%; national estimate: 33.8%, CI: 31.0%--36.8%), they also were less likely to eat fruits and vegetables 5 or more times per day (median: 17.9%; national estimate: 21.4%, CI: 19.8%--23.1%).

Compared with students nationally, students in the Steps communities were more likely to meet recommended levels of physical activity (median: 40.1%; national estimate: 34.7%, CI: 32.5%--37.0%). Similarly, the median prevalence of students in the Steps communities who did not participate in 60 or more minutes of physical activity on any day (17.9%) and the median prevalence of students in the Steps communities who watched television 3 or more hours per day on an average school day (33.0%) were lower than the national prevalence (24.9%, CI: 23.2%--26.6% and 35.4%, CI: 33.1%--37.7%, respectively).

The median percentage of students in the Steps communities who had eaten less food, fewer calories, or low-fat foods to lose weight or to keep from gaining weight during the 30 days before the survey was 37.9%. This was lower than the national prevalence of 40.6% (CI: 39.4%--41.9%). However, the students in the Steps communities were more likely to have exercised to lose weight or to keep from gaining weight during the 30 days before the survey (median: 63.1%; national estimate: 60.9%, CI: 59.8%--62.1%).

The median percentage of students in the Steps communities who had ever been told by a doctor or nurse that they had asthma was 21.6%. This was higher than the national prevalence of 20.3% (CI: 19.2%--21.4%).

Across Steps communities, prevalence did not vary substantially for more than one half of the risk behaviors. However, a range of 25 or more percentage points or a fivefold variation or greater was identified for the following risk behaviors:

  • lifetime cigarette use (minimum: 34.9%; maximum: 64.2%);
  • lifetime daily cigarette use (minimum: 3.7%; maximum: 20.1%);
  • current frequent cigarette use (minimum: 2.2%; maximum: 13.7%);
  • smoked more than 10 cigarettes per day (minimum: 2.2%; maximum: 15.8%);
  • smoked cigarettes on school property (minimum: 1.7%; maximum: 8.9%);
  • drank soda or pop at least one time per day (minimum: 16.7%; maximum: 45.3%);
  • met recommended levels of physical activity (minimum: 27.7%; maximum: 55.5%);
  • watched television 3 or more hours per day (minimum: 18.0%; maximum: 57.2%);
  • attended PE classes (minimum: 25.5%; maximum: 96.1%);
  • attended PE classes daily (minimum: 2.4%; maximum: 46.4%);
  • played on one or more sports teams (minimum: 43.9%; maximum: 71.0%); and
  • went to an emergency room or urgent care center because of asthma (minimum: 12.6%; maximum: 37.7%).

In part, these variations might reflect differences in state and local laws and policies, enforcement practices, availability of effective school and community interventions, prevailing behavioral and social norms, demographic characteristics of the population, and adult practices. In addition, these variations might indicate which communities would benefit from additional targeted technical assistance related to effective school and community interventions and policies. Significant differences between communities also can alert program managers to the opportunity to learn from each other by taking advantage of the national network they have established within the Steps Program. Communities can use these data to identify, prioritize, and develop community-specific activities to further reduce risk factors associated with obesity, diabetes, and asthma over time.

Limitations

The findings in this report are subject to at least four limitations. First, these data apply only to youth who attended school during 2007 and, therefore, are not representative of all persons in this age group in each community. Nationwide, in 2005, of persons aged 16--17 years, approximately 3% were not enrolled in a high school program and had not completed high school (10). Second, although the national YRBS includes private schools, Steps surveys do not, limiting the comparability. Third, the extent of underreporting or overreporting of behaviors cannot be determined, although the survey questions demonstrate good test-retest reliability (3). Finally, because BMI was calculated on the basis of self-reported height and weight, the prevalence of obesity and overweight might be underestimated (6).

Conclusion

Steps Program staff at the national, tribal, state, and local levels will use YRBSS data for decision making, program planning, and enhancing technical assistance to increase physical activity and healthy eating and to reduce tobacco use and exposure. These data will be used to help focus existing programs on activities that have shown the greatest promise of results, such as smoke-free policies for public places, healthier vending machine policies, asthma action plans, and increased frequency of physical education in schools, as well as identify populations of greatest need and opportunities for strategic collaboration to identify and disseminate lessons learned.

References

  1. Eaton DK, Kann L, Kinchen S, et al. Youth risk behavior surveillance---United States, 2007. In: Surveillance Summaries, June 6, 2008. MMWR 2008;57(No. SS-4).
  2. CDC. Methodology of the Youth Risk Behavior Surveillance System. MMWR 2004;53(No. RR-12).
  3. Brener ND, Kann L, McManus T, Kinchen SA, Sundberg EC, Ross JG. Reliability of the Youth Risk Behavior Survey Questionnaire. J Adolesc Health 2002;31:336--42.
  4. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, et al. CDC growth charts: United States. Advance data from vital and health statistics, no. 314. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2000. Available at http://www.cdc.gov/nchs/data/ad/ad314.pdf.
  5. Barlow SE and the Expert Committee. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120:S164-S192.
  6. Brener ND, McManus T, Galuska DA, Lowry R, Wechsler H. Reliability and validity of self-reported height and weight among high school students. J Adolesc Health 2003;32:281--7.
  7. SAS Institute, Inc. SAS,® version 9.1 [Software and documentation]. Cary, NC: SAS Institute; 2003.
  8. Research Triangle Institute. SUDAAN,® software for the statistical analysis of correlated data, release 9.0.0 [Software and documentation]. Research Triangle Park, NC: Research Triangle Institute; 2004.
  9. US Department of Health and Human Services and US Department of Agriculture. Dietary guidelines for Americans 2005. Washington, DC; 2005. Available at http://www.healthierus.gov/dietaryguidelines.
  10. Laird J, Kienzl G, DeBell M, Chapman C. Dropout rates in the United States: 2005. Washington, DC: US Department of Education, National Center for Education Statistics; 2007. Publication no. NCES 2007-059.

* Data from three large cities/urban communities included in this report (Boston, Philadelphia, and DeKalb County, GA) also are included in a previously published report (1). The data for the Boston and Philadelphia Steps communities are subsets of the Boston Public Schools data and the Philadelphia School District data, respectively, whereas the DeKalb County, GA, data are identical to those published previously.

† Overall response rate = (number of participating schools / number of eligible sampled schools) x (number of useable questionnaires / number of eligible students sampled).

§ For questionnaires containing 50 or more questions, those that failed quality control had less than 20 remaining responses after editing or had the same answer to 15 or more questions in a row. For questionnaires containing less than 50 questions, those that failed quality control had less than 15 remaining responses after editing or had the same answer to 12 or more questions in a row.

100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables.

Steps Program Youth Risk Behavior Survey Coordinators

State-Coordinated Small Cities/Rural Communities: Arizona, Lynn Ladd, Arizona Department of Education; Colorado, Mina Liebert, MS, Colorado Department of Public Health and Environment; Minnesota, Cara McNulty, MS, Minnesota Department of Health; New York, Cynthia A. Jaconski, MPH, New York State Department of Health; Pennsylvania, William Barbour, Pennsylvania Department of Health.

Large Cities/Urban Communities: Boston, Massachusetts, Barbara Huscher Cohen, MA, Boston Public Schools; Cleveland, Ohio, Jean L. Frank, MPH, Case Western Reserve University; DeKalb County, Georgia, Rachel Yelk Woodruff, MPH, DeKalb County Board of Health; Hillsborough County, Florida, Ercilia R. Calcano, MPH, Hillsborough County Health Department; New Orleans, Louisiana, Romericus Stewart, MPH, City of New Orleans Health Department; Philadelphia, Pennsylvania, Kenneth D. Smith, PhD, Philadelphia Department of Public Health; Salinas, California, Sarah Bartelmann, MPH, Monterey County Health Department; San Antonio, Texas, Richard Jackson, MPA, San Antonio Metropolitan Health District; Santa Clara County, California, Dorothy Su, MPH, Santa Clara County Public Health Department.

Tribe: Cherokee Nation, Oklahoma, Julie Deerinwater-Anderson, MPH, Cherokee Nation Health Services.

Table 1

TABLE 1. Sample sizes, response rates, and demographic characteristics* — selected Steps communities, Youth Risk Behavior Surveys, 2007 Steps community Student sample size Response rate (%) Sex (%) Grade (%) Race/Ethnicity (%) School Student Overall Female Male 9 10 11 12 White† Black† Hispanic Other§ State-coordinated small cities/ rural communities Santa Cruz County, Arizona 1,004 100 83 83 50.3 49.7 30.0 26.6 21.9 21.3 5.0 0.2 94.1 0.7 Yuma County, Arizona 1,365 100 81 81 49.2 50.8 28.6 26.4 24.7 19.9 19.0 1.4 77.1 2.4 Mesa County, Colorado 913 100 68 68 48.8 51.2 26.8 25.8 24.6 22.4 81.2 0.1 15.1 3.5 Pueblo County, Colorado 895 100 67 67 48.7 51.3 29.9 25.3 21.4 22.7 42.4 1.9 52.1 3.5 Teller County, Colorado 743 100 79 79 48.5 51.5 24.8 26.4 23.7 24.5 86.3 1.6 7.2 4.9 Weld County, Colorado 1,152 100 76 76 49.5 50.5 28.1 27.4 22.4 21.5 52.8 0.5 44.2 2.5 Minneapolis, Minnesota 1,064 100 79 79 49.3 50.7 25.7 25.7 22.5 25.9 28.3 44.0 15.1 12.5 Rochester, Minnesota 928 100 82 82 49.4 50.6 28.6 25.4 22.8 23.1 79.5 9.0 2.4 9.1 St. Paul, Minnesota 905 100 77 77 49.2 50.8 26.3 27.1 25.2 21.2 26.5 28.2 9.9 35.5 Broome County, New York 1,019 100 75 75 48.3 51.7 26.3 25.7 24.9 22.8 88.6 6.2 2.8 2.4 Chautauqua County, New York 779 83 77 64 49.0 51.0 26.1 25.6 23.4 23.1 89.6 0.9 5.3 4.2 Jefferson County, New York 759 91 78 71 48.5 51.5 26.1 25.4 22.1 23.2 87.1 5.6 2.6 4.7 Rockland County, New York 839 100 78 78 48.7 51.3 25.6 25.4 25.2 23.4 56.8 19.4 15.0 8.9 Fayette County, Pennsylvania 979 88 78 69 47.3 52.7 28.9 25.1 23.8 21.9 91.7 6.7 0.7 0.9 Luzerne County, Pennsylvania 1,236 100 82 82 48.3 51.7 26.4 25.2 24.5 23.6 90.2 1.6 5.6 2.6 Tioga County, Pennsylvania 1,044 100 84 84 48.9 51.1 26.7 25.8 24.8 22.4 86.0 1.6 6.1 6.2 Large cities/urban communities Boston, Massachusetts 1,161 100 66 66 48.3 51.7 29.4 23.2 24.4 22.9 11.2 51.9 27.6 9.3 Cleveland, Ohio 940 100 73 73 51.0 49.0 36.3 25.3 19.0 19.4 15.5 72.5 10.0 2.0 DeKalb County, Georgia 2,197 100 83 83 49.9 50.1 31.3 24.1 23.0 21.3 9.5 80.1 5.2 5.2 Hillsborough County, Florida 644 100 71 71 51.9 48.1 28.6 27.0 23.2 21.2 21.6 45.4 27.0 6.0 New Orleans, Louisiana 2,034 100 88 88 50.8 49.2 29.0 24.4 23.2 23.1 5.3 88.9 2.2 3.6 Philadelphia, Pennsylvania 1,295 100 73 73 50.3 49.7 29.7 25.3 30.3 14.4 7.7 67.9 10.2 14.2 Salinas, California 1,270 100 83 83 49.4 50.6 26.1 26.4 24.8 22.5 15.1 0.9 74.6 9.3 San Antonio, Texas 1,317 100 64 64 49.4 50.6 33.5 26.1 20.6 19.7 2.2 8.0 88.0 1.8 Santa Clara County, California 1,429 88 85 75 49.3 50.7 26.0 25.4 25.7 22.6 7.9 0.9 57.6 33.6 Tribe Cherokee Nation, Oklahoma¶ 650 100 78 78 47.9 52.1 28.2 26.5 23.5 21.8 43.3 0.5 1.9 54.4 United States 14,041 81 84 68 49.5 50.5 29.0 26.2 23.4 21.3 60.3 15.1 16.9 7.7 * Weighted population estimates for the United States and each site. † Non-Hispanic. § American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and multiple race (non-Hispanic). ¶ The Cherokee Nation Steps community comprises a 14-county service delivery area that is nonreservation based. It includes all racial/ethnic groups residing in the service delivery area. Therefore, Cherokee Nation students might belong to an ethnicity other than Cherokee.
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Table 2

TABLE 2. Percentage of high school students who ever smoked cigarettes, by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Lifetime cigarette use* Lifetime daily cigarette use† Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 57.8 51.3–64.1 66.4 60.8–71.6 62.0 57.1–66.7 9.3 7.0–12.3 11.1 8.6–14.2 10.2 8.3–12.4 Yuma County, Arizona 52.2 46.0–58.3 60.5 54.9–65.7 56.2 51.3–61.1 7.6 5.6–10.4 13.0 9.5–17.4 10.3 8.0–13.0 Mesa County, Colorado 49.6 42.6–56.7 51.6 46.3–56.8 50.7 45.9–55.4 10.6 7.2–15.5 13.2 9.9–17.3 11.9 9.4–15.0 Pueblo County, Colorado 63.4 56.5–69.9 61.5 55.5–67.3 62.4 56.7–67.8 12.5 9.4–16.4 14.2 10.6–18.6 13.3 10.5–16.7 Teller County, Colorado 52.5 44.4–60.4 45.3 38.6–52.1 48.8 43.5–54.0 17.6 12.2–24.8 14.3 10.8–18.7 16.0 12.6–20.2 Weld County, Colorado 50.4 44.0–56.7 51.6 46.5–56.6 50.9 46.7–55.2 9.5 7.3–12.3 9.8 7.3–13.0 9.6 7.8–11.8 Minneapolis, Minnesota 41.2 35.2–47.3 44.0 38.0–50.1 42.7 37.8–47.7 3.7 2.3–5.8 6.6 4.3–10.2 5.1 3.6–7.2 Rochester, Minnesota 31.7 25.6–38.4 37.9 30.2–46.4 34.9 28.6–41.8 6.6 4.2–10.2 8.5 5.4–13.2 7.7 5.4–10.7 St. Paul, Minnesota 48.3 40.6–56.2 48.8 42.4–55.2 48.6 42.5–54.9 7.9 4.6–13.2 9.0 6.0–13.1 8.4 5.9–11.8 Broome County, New York 41.7 36.5–47.2 33.5 28.8–38.6 37.7 33.6–41.9 13.6 9.9–18.4 6.0 4.3–8.2 9.7 7.4–12.6 Chautauqua County, New York 37.4 31.1–44.2 38.6 31.1–46.7 38.1 32.0–44.6 11.1 8.2–14.9 8.6 5.2–14.1 10.0 7.3–13.5 Jefferson County, New York 47.5 38.4–56.7 51.9 44.7–59.1 49.9 42.9–56.9 12.5 8.9–17.4 13.0 8.9–18.5 12.9 9.9–16.5 Rockland County, New York 36.0 30.7–41.8 36.8 30.5–43.6 36.4 31.7–41.4 6.7 4.6–9.9 8.0 5.6–11.4 7.4 5.7–9.6 Fayette County, Pennsylvania 57.3 50.9–63.4 55.7 50.5–60.7 56.5 52.5–60.4 15.6 12.4–19.5 15.5 12.1–19.6 15.6 13.3–18.1 Luzerne County, Pennsylvania 52.1 47.8–56.4 52.3 46.5–58.0 52.3 48.2–56.3 16.7 13.6–20.2 20.5 16.1–25.7 18.7 15.7–22.0 Tioga County, Pennsylvania 55.1 49.6–60.4 52.8 48.2–57.4 54.0 49.9–58.0 17.2 13.8–21.2 22.1 17.6–27.3 19.8 16.7–23.2 Large cities/urban communities Boston, Massachusetts 43.3 38.1–48.6 41.7 36.9–46.6 42.6 38.6–46.8 5.4 3.5–8.1 6.2 4.3–9.0 5.8 4.2–8.0 Cleveland, Ohio 51.6 47.2–56.0 56.1 51.0–61.1 53.8 50.5–57.2 6.5 4.5–9.4 8.4 5.3–13.2 7.4 5.6–9.8 DeKalb County, Georgia 42.3 38.8–45.9 49.0 45.8–52.2 45.6 43.1–48.2 3.1 2.1–4.6 6.7 5.3–8.3 4.9 4.0–5.9 Hillsborough County, Florida 40.0 34.5–45.8 38.9 30.8–47.8 39.5 34.1–45.3 2.5 1.2–5.0 6.3 3.7–10.7 4.5 2.8–7.0 New Orleans, Louisiana 45.8 42.4–49.2 49.2 45.1–53.4 47.4 44.5–50.3 5.8 4.6–7.3 8.2 6.3–10.7 6.9 5.7–8.4 Philadelphia, Pennsylvania 42.1 35.8–48.6 46.0 40.0–52.1 44.1 38.8–49.5 4.9 3.2–7.5 5.4 3.7–7.9 5.1 4.0–6.6 Salinas, California 38.9 33.7–44.4 49.1 43.0–55.2 44.0 39.9–48.2 3.4 2.1–5.5 4.0 2.5–6.4 3.7 2.6–5.2 San Antonio, Texas 58.6 54.4–62.6 62.9 58.5–67.1 60.7 57.6–63.7 7.2 5.3–9.7 7.6 5.3–10.6 7.5 6.0–9.3 Santa Clara County, California 36.9 32.3–41.7 39.9 34.8–45.1 38.6 34.8–42.6 3.4 2.0–5.6 7.2 4.5–11.4 5.5 3.8–7.8 Tribe Cherokee Nation, Oklahoma 60.9 50.5–70.5 67.1 60.6–73.0 64.2 56.3–71.4 22.4 17.0–29.0 17.7 13.6–22.6 20.1 16.4–24.2 Median 47.9 49.1 48.7 7.7 8.5 9.0 Range 31.7–63.4 33.5–67.1 34.9–64.2 2.5–22.4 4.0–22.1 3.7–20.1 United States 48.8 45.6–52.1 51.8 48.4–55.3 50.3 47.2–53.5 11.8 9.8–14.1 13.0 10.9–15.4 12.4 10.4–14.7 * Ever tried cigarette smoking, even one or two puffs. † Ever smoked at least one cigarette every day for 30 days. § 95% confidence interval.
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Table 3

TABLE 3. Percentage of high school students who currently smoked cigarettes, by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Current cigarette use* Current frequent cigarette use† Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 22.8 18.0–28.6 28.9 24.1–34.3 25.8 22.4–29.6 3.7 2.0–6.7 6.0 4.0–8.8 4.8 3.4–6.7 Yuma County, Arizona 15.0 11.9–18.8 23.2 18.4–28.8 19.0 15.6–23.0 2.5 1.4–4.5 8.0 5.4–11.5 5.2 3.7–7.3 Mesa County, Colorado 14.7 10.6–20.2 18.5 14.4–23.4 16.6 13.4–20.4 5.7 3.6–9.0 6.6 4.5–9.4 6.1 4.6–8.1 Pueblo County, Colorado 18.7 15.3–22.7 21.7 17.4–26.9 20.3 17.1–23.9 5.1 3.3–7.9 9.7 6.8–13.5 7.4 5.5–9.9 Teller County, Colorado 22.2 16.1–29.7 16.4 12.3–21.5 19.2 15.4–23.7 11.9 7.2–19.0 7.5 4.8–11.5 9.7 6.8–13.6 Weld County, Colorado 15.7 12.6–19.5 16.2 12.6–20.7 15.9 13.3–18.9 5.8 4.1–8.2 4.3 2.7–6.9 5.1 3.7–6.9 Minneapolis, Minnesota 8.5 5.5–12.8 10.6 7.5–14.7 9.6 7.2–12.8 2.0 0.8–4.9 3.5 1.9–6.6 2.7 1.6–4.7 Rochester, Minnesota 13.5 9.8–18.4 13.5 9.0–19.9 13.6 10.1–18.2 5.2 3.1–8.5 5.8 3.5–9.4 5.5 3.9–7.7 St. Paul, Minnesota 11.7 8.0–16.8 14.0 10.8–17.9 12.8 10.2–16.0 3.7 1.8–7.4 7.0 4.7–10.3 5.4 3.7–7.7 Broome County, New York 15.0 10.8–20.5 10.0 8.0–12.3 12.6 9.9–15.9 7.4 4.9–10.9 4.7 3.2–6.8 6.0 4.4–8.1 Chautauqua County, New York 12.4 8.8–17.2 11.4 7.9–16.3 11.9 8.9–15.7 6.6 3.8–11.1 6.2 3.5–10.7 6.4 4.3–9.4 Jefferson County, New York 16.8 12.2–22.8 17.3 13.3–22.1 17.1 13.6–21.4 8.9 6.0–13.0 10.0 6.6–14.8 9.5 7.2–12.6 Rockland County, New York 11.7 8.4–16.1 10.5 7.4–14.7 11.1 8.5–14.4 3.0 1.6–5.7 4.8 3.1–7.5 3.9 2.7–5.7 Fayette County, Pennsylvania 21.9 17.6–26.9 23.6 19.0–28.9 22.9 19.7–26.5 11.5 8.5–15.3 12.4 9.3–16.3 12.0 9.8–14.6 Luzerne County, Pennsylvania 19.9 16.1–24.4 23.0 18.6–28.2 21.7 18.3–25.5 11.3 8.7–14.6 15.8 12.1–20.2 13.7 11.2–16.7 Tioga County, Pennsylvania 21.3 17.6–25.5 20.9 16.5–26.2 21.1 17.7–25.0 10.7 8.2–13.9 13.0 9.7–17.2 11.9 9.6–14.6 Large cities/urban communities Boston, Massachusetts 8.3 5.8–11.7 9.2 6.8–12.2 8.7 6.8–11.1 1.9 0.9–3.8 3.8 2.2–6.5 2.9 1.7–4.7 Cleveland, Ohio 8.1 5.8–11.2 13.4 9.6–18.3 10.8 8.5–13.6 3.2 1.9–5.3 5.4 3.6–8.1 4.4 3.3–5.9 DeKalb County, Georgia 7.0 5.5–9.0 10.0 8.1–12.2 8.5 7.2–10.0 1.4 0.7–2.5 4.2 3.0–5.9 2.8 2.1–3.8 Hillsborough County, Florida 5.7 3.2–10.2 8.8 4.9–15.4 7.2 4.5–11.4 0.7 0.2–2.3 4.2 2.3–7.8 2.4 1.4–4.0 New Orleans, Louisiana 7.9 6.4–9.8 11.9 9.4–14.9 9.9 8.3–11.7 1.9 1.2–3.0 5.5 3.8–7.7 3.6 2.7–4.7 Philadelphia, Pennsylvania 7.0 5.1–9.5 8.1 5.4–12.0 7.7 6.0–9.8 2.2 1.0–4.6 3.5 1.9–6.3 2.8 1.7–4.5 Salinas, California 6.0 4.0–8.9 10.4 7.6–14.0 8.2 6.4–10.4 1.7 0.8–3.7 2.7 1.6–4.6 2.2 1.5–3.3 San Antonio, Texas 16.7 13.9–19.9 17.9 14.4–21.9 17.4 15.1–20.0 2.2 1.3–3.8 3.0 1.7–5.2 2.8 1.8–4.1 Santa Clara County, California 7.1 5.1–9.8 11.4 8.5–15.2 9.3 7.3–11.6 0.9 0.4–1.9 3.7 2.1–6.6 2.3 1.4–3.9 Tribe Cherokee Nation, Oklahoma 28.6 22.7–35.3 28.4 22.6–34.9 28.6 23.4–34.4 13.0 10.6–15.8 10.6 6.8–16.3 11.7 9.3–14.7 Median 14.1 13.8 13.2 3.7 5.6 5.1 Range 5.7–28.6 8.1–28.9 7.2–28.6 0.7–13.0 2.7–15.8 2.2–13.7 United States 18.7 16.5–21.1 21.3 18.3–24.6 20.0 17.6–22.6 7.4 5.9–9.2 8.7 7.2–10.5 8.1 6.7–9.8 * Smoked cigarettes on at least 1 day during the 30 days before the survey. † Smoked cigarettes on 20 or more days during the 30 days before the survey. § 95% confidence interval.
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Table 4

TABLE 4. Percentage of high school students who currently smoked more than 10 cigarettes per day* and who tried to quit smoking cigarettes,† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Smoked more than 10 cigarettes per day Tried to quit smoking cigarettes Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona —¶ — 7.2 3.7–13.7 4.7 2.3–9.4 — — 46.5 36.9–56.4 49.4 41.1–57.7 Yuma County, Arizona 0.1 0.0–1.0 13.7 7.3–24.3 8.2 4.2–15.1 49.9 37.4–62.5 48.5 36.7–60.5 49.0 39.1–58.9 Mesa County, Colorado — — — — 8.9 4.1–18.1 — — — — 52.2 41.6–62.5 Pueblo County, Colorado — — — — 6.3 3.0–12.8 — — — — 51.1 43.5–58.7 Teller County, Colorado — — — — 15.8 9.8–24.4 — — — — 55.1 46.6–63.4 Weld County, Colorado — — — — 7.7 4.5–12.9 — — — — 51.3 43.4–59.1 Minneapolis, Minnesota — — — — — — — — — — — — Rochester, Minnesota — — — — 6.4 3.5–11.4 — — — — 46.4 36.6–56.5 St. Paul, Minnesota — — — — 2.4 0.7–7.9 — — — — — — Broome County, New York — — — — 14.6 8.6–23.7 — — — — 43.2 32.6–54.4 Chautauqua County, New York — — — — — — — — — — — — Jefferson County, New York — — — — 13.7 7.3–24.3 — — — — 51.7 43.3–60.1 Rockland County, New York — — — — — — — — — — — — Fayette County, Pennsylvania — — 14.0 7.7–24.0 12.8 7.8–20.5 — — 55.7 45.7–65.3 61.9 54.9–68.5 Luzerne County, Pennsylvania 10.5 5.8–18.1 19.8 13.4–28.3 15.5 11.2–21.0 58.5 48.8–67.5 48.1 38.2–58.2 52.8 45.8–59.6 Tioga County, Pennsylvania 11.4 6.9–18.1 — — 13.8 9.8–19.1 53.4 43.2–63.2 — — 55.1 48.1–61.8 Large cities/urban communities Boston, Massachusetts — — — — — — — — — — — — Cleveland, Ohio — — — — — — — — — — — — DeKalb County, Georgia — — — — 7.8 4.7–12.6 — — — — 53.4 45.6–61.0 Hillsborough County, Florida — — — — — — — — — — — — New Orleans, Louisiana — — — — 7.1 3.9–12.6 — — — — 54.8 45.5–63.7 Philadelphia, Pennsylvania — — — — — — — — — — — — Salinas, California — — — — — — — — — — — — San Antonio, Texas 0.0 — 2.4 0.8–7.2 2.2 0.9–5.2 50.3 41.1–59.6 50.0 40.6–59.4 50.2 43.9–56.6 Santa Clara County, California — — — — 4.2 1.6–10.6 — — — — 45.5 34.0–57.4 Tribe Cherokee Nation, Oklahoma — — — — 9.9 5.6–16.9 — — — — 57.0 49.6–64.2 Median 5.3 13.7 8.0 51.8 48.5 51.7 Range 0.0–11.4 2.4–19.8 2.2–15.8 49.9–58.5 46.5–55.7 43.2–61.9 United States 7.1 5.4–9.3 13.8 11.4–16.7 10.7 9.0–12.6 55.1 50.9–59.3 45.1 42.1–48.1 49.7 47.2–52.2 * On the days they smoked during the 30 days before the survey, among students who currently smoked cigarettes. † During the 12 months before the survey, among students who currently smoked cigarettes. § 95% confidence interval. ¶ Not available.
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Table 5

TABLE 5. Percentage of high school students who smoked a whole cigarette for the first time before age 13 years and who smoked cigarettes on school property,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Smoked a whole cigarette before age 13 years Smoked cigarettes on school property Female Male Total Female Male Total Steps community % CI† % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 10.4 7.4–14.3 17.5 13.8–21.9 13.9 11.5–16.6 2.5 1.4–4.5 6.3 4.1–9.7 4.4 3.0–6.3 Yuma County, Arizona 10.4 8.0–13.4 16.1 13.2–19.6 13.2 11.3–15.4 1.5 0.8–3.0 5.9 3.5–9.5 3.7 2.4–5.6 Mesa County, Colorado 10.9 7.7–15.3 15.6 12.3–19.5 13.3 10.9–16.3 6.6 4.3–9.9 5.5 3.7–8.2 6.0 4.5–8.1 Pueblo County, Colorado 13.5 10.4–17.4 19.5 15.2–24.7 16.7 14.0–19.9 7.6 5.4–10.6 10.2 7.4–13.9 8.9 7.0–11.2 Teller County, Colorado 13.8 9.8–19.2 13.6 10.2–17.9 13.9 11.1–17.2 10.8 7.3–15.8 5.0 3.1–7.9 7.9 5.8–10.8 Weld County, Colorado 12.0 9.0–15.9 15.1 11.6–19.4 13.5 11.0–16.5 7.0 5.0–9.8 6.6 4.7–9.2 6.8 5.2–8.8 Minneapolis, Minnesota 7.9 5.3–11.4 8.9 5.7–13.5 8.3 6.0–11.5 0.9 0.4–2.1 2.6 1.3–4.9 1.8 1.1–3.0 Rochester, Minnesota 6.3 4.1–9.8 8.1 5.3–12.1 7.5 5.5–10.2 2.4 1.3–4.6 4.3 2.7–6.9 3.5 2.3–5.1 St. Paul, Minnesota 7.9 5.4–11.4 11.8 8.8–15.8 9.9 7.6–12.9 3.1 1.8–5.4 5.0 2.9–8.4 4.0 2.6–6.3 Broome County, New York 10.9 7.7–15.2 7.7 5.5–10.7 9.5 7.4–12.1 5.5 3.1–9.8 4.0 2.6–6.1 4.8 3.1–7.3 Chautauqua County, New York 8.7 6.0–12.5 11.5 8.1–16.0 10.1 7.4–13.6 2.1 0.9–4.9 3.1 1.5–6.4 2.6 1.4–4.9 Jefferson County, New York 10.6 7.5–14.7 13.4 9.3–19.1 12.2 9.5–15.6 2.3 1.1–4.7 5.6 3.2–9.7 4.1 2.6–6.5 Rockland County, New York 4.4 2.6–7.1 6.6 4.3–9.8 5.5 4.0–7.5 3.1 1.8–5.4 4.1 2.4–7.1 3.6 2.3–5.6 Fayette County, Pennsylvania 15.8 12.5–19.7 17.9 14.2–22.4 16.9 14.3–19.9 2.3 1.3–4.2 8.2 5.6–11.7 5.4 3.9–7.3 Luzerne County, Pennsylvania 11.5 9.2–14.4 12.4 9.5–15.9 12.1 10.3–14.3 4.6 3.1–6.9 9.6 6.7–13.7 7.4 5.6–9.7 Tioga County, Pennsylvania 16.2 12.8–20.4 20.6 16.8–24.9 18.5 15.6–21.8 2.9 1.8–4.7 6.5 4.2–9.8 4.7 3.3–6.7 Large cities/urban communities Boston, Massachusetts 6.4 4.6–8.8 8.8 6.3–12.2 7.9 6.2–10.0 2.7 1.5–4.6 4.1 2.5–6.7 3.4 2.3–5.1 Cleveland, Ohio 12.9 9.6–17.0 15.4 11.3–20.7 14.1 11.1–17.7 3.2 1.8–5.4 6.8 4.3–10.5 5.0 3.7–6.9 DeKalb County, Georgia 7.4 5.8–9.4 15.0 12.7–17.6 11.2 9.7–12.8 1.7 1.1–2.5 4.2 3.1–5.6 2.9 2.3–3.7 Hillsborough County, Florida 12.5 8.7–17.7 9.3 5.5–15.3 11.3 9.0–14.1 0.9 0.2–3.3 2.7 1.2–6.0 1.7 0.9–3.5 New Orleans, Louisiana 11.2 9.0–13.8 15.4 12.5–18.8 13.3 11.4–15.5 1.6 1.0–2.5 4.4 3.1–6.2 3.0 2.2–4.0 Philadelphia, Pennsylvania 8.5 6.5–11.0 11.5 8.5–15.5 9.9 8.0–12.2 1.8 0.7–4.5 3.0 1.6–5.4 2.6 1.5–4.5 Salinas, California 6.4 4.4–9.2 12.1 9.0–16.0 9.2 7.2–11.9 1.0 0.4–2.7 2.8 1.6–4.9 1.9 1.2–3.1 San Antonio, Texas 16.1 12.9–19.8 18.1 14.7–22.1 17.2 14.8–19.9 3.7 2.4–5.6 5.2 3.6–7.4 4.6 3.5–6.0 Santa Clara County, California 7.3 5.5–9.6 11.3 7.6–16.4 9.6 7.1–13.0 1.3 0.6–2.6 4.6 3.0–6.9 3.0 2.0–4.4 Tribe Cherokee Nation, Oklahoma 20.6 14.3–28.8 20.4 13.2–30.2 20.5 14.8–27.8 4.5 2.1–9.3 4.3 2.2–8.2 4.4 2.6–7.3 Median 10.7 13.5 12.1 2.6 4.8 4.0 Range 4.4–20.6 6.6–20.6 5.5–20.5 0.9–10.8 2.6–10.2 1.7–8.9 United States 11.9 10.3–13.6 16.4 13.5–19.7 14.2 12.2–16.5 4.8 3.8–6.1 6.5 5.5–7.7 5.7 4.7–6.8 * On at least 1 day during the 30 days before the survey. † 95% confidence interval.
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Table 6

TABLE 6. Percentage of high school students who usually obtained their own cigarettes by buying them in a store or gas station,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Female Male Total Steps community % CI† % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona —§ — 20.9 15.5–27.4 19.3 14.5–25.3 Yuma County, Arizona — — 11.0 6.1–19.1 11.4 7.8–16.4 Mesa County, Colorado — — — — 8.4 4.1–16.5 Pueblo County, Colorado — — — — 6.9 3.6–12.6 Teller County, Colorado — — — — — — Weld County, Colorado — — — — 8.6 4.5–16.0 Minneapolis, Minnesota — — — — — — Rochester, Minnesota — — — — 5.8 2.2–14.3 St. Paul, Minnesota — — — — — — Broome County, New York — — — — — — Chautauqua County, New York — — — — — — Jefferson County, New York — — — — 8.5 3.4–19.6 Rockland County, New York — — — — — — Fayette County, Pennsylvania — — — — 15.4 9.0–25.0 Luzerne County, Pennsylvania — — 26.8 19.5–35.7 20.5 15.2–27.2 Tioga County, Pennsylvania — — — — 10.1 5.7–17.3 Large cities/urban communities Boston, Massachusetts — — — — — — Cleveland, Ohio — — — — — — DeKalb County, Georgia — — — — 25.1 18.4–33.3 Hillsborough County, Florida — — — — — — New Orleans, Louisiana — — — — 24.4 17.8–32.5 Philadelphia, Pennsylvania — — — — — — Salinas, California — — — — — — San Antonio, Texas — — — — 11.2 7.3–16.9 Santa Clara County, California — — — — 23.2 13.8–36.3 Tribe Cherokee Nation, Oklahoma — — — — 11.5 5.4–22.7 Median — 20.9 11.4 Range — 11.0–26.8 5.8–25.1 United States 11.3 8.0–15.6 20.0 16.0–24.8 16.0 12.8–19.9 * During the 30 days before the survey, among students who were aged <18 years and who currently smoked cigarettes. † 95% confidence interval. § Not available.
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Table 7

TABLE 7. Percentage of high school students who ate fruits and vegetables* five or more times per day† and who drank a can, bottle, or glass of soda or pop§ at least one time per day,† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Ate fruits and vegetables five or more times per day Drank soda or pop at least one time per day Female Male Total Female Male Total Steps community % CI¶ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 16.2 12.6–20.6 18.4 14.3–23.3 17.4 15.0–20.2 14.5 11.2–18.5 22.5 19.0–26.4 18.6 15.9–21.7 Yuma County, Arizona 16.9 13.9–20.5 20.6 17.2–24.5 18.8 16.2–21.6 23.0 18.7–27.9 34.7 31.0–38.5 28.8 26.0–31.8 Mesa County, Colorado 10.8 8.1–14.4 17.7 14.2–21.9 14.3 12.0–16.9 21.2 17.1–25.9 30.8 26.9–34.9 26.1 23.4–28.9 Pueblo County, Colorado 16.1 12.6–20.5 18.7 14.7–23.5 17.4 14.4–20.8 23.8 18.8–29.6 29.8 25.0–35.1 26.9 23.1–31.1 Teller County, Colorado 17.9 14.7–21.7 18.4 13.4–24.9 18.2 15.2–21.7 12.1 8.7–16.7 29.9 25.4–34.8 21.4 17.7–25.6 Weld County, Colorado 16.1 12.7–20.2 20.1 17.1–23.5 18.0 15.4–21.0 19.6 16.2–23.5 32.8 28.6–37.2 26.2 23.4–29.2 Minneapolis, Minnesota 19.8 14.4–26.6 20.7 17.1–24.9 20.2 16.9–23.9 20.2 15.7–25.7 23.2 19.0–28.0 21.6 18.2–25.4 Rochester, Minnesota 16.3 13.1–20.1 15.7 12.0–20.1 16.1 13.4–19.2 11.5 8.3–15.7 23.3 18.8–28.6 17.9 14.2–22.3 St. Paul, Minnesota 21.2 16.6–26.6 26.4 21.7–31.8 23.9 20.2–28.0 21.3 16.8–26.5 26.4 21.5–31.9 23.9 20.3–27.8 Broome County, New York 20.5 16.4–25.4 19.8 15.9–24.4 20.5 17.9–23.3 19.0 15.0–23.7 29.6 25.2–34.3 24.6 21.4–28.2 Chautauqua County, New York 21.2 17.0–26.1 22.4 18.3–27.1 21.8 18.9–25.0 18.6 14.1–24.0 33.1 28.7–37.9 26.1 22.4–30.0 Jefferson County, New York 17.0 12.8–22.2 17.9 13.7–23.1 17.6 14.9–20.7 20.5 16.6–25.0 36.5 30.5–43.0 28.7 24.9–32.7 Rockland County, New York 13.1 9.8–17.3 14.6 11.3–18.6 13.9 11.2–16.9 14.5 11.2–18.7 20.0 15.8–24.9 17.3 14.3–20.8 Fayette County, Pennsylvania 16.3 12.7–20.6 15.5 12.2–19.5 15.9 13.6–18.6 27.0 22.2–32.3 43.1 38.2–48.1 35.4 31.7–39.3 Luzerne County, Pennsylvania 19.1 15.5–23.2 15.5 13.2–18.0 17.3 15.4–19.4 22.1 18.9–25.6 40.1 35.6–44.7 31.4 29.0–34.0 Tioga County, Pennsylvania 20.7 17.5–24.3 22.2 18.2–26.7 21.4 18.7–24.4 27.2 23.7–31.0 37.1 32.8–41.6 32.3 29.2–35.7 Large cities/urban communities Boston, Massachusetts —†† — — — — — 25.1 21.2–29.5 30.1 25.8–34.7 27.7 24.7–31.0 Cleveland, Ohio 17.4 14.7–20.4 20.0 16.9–23.5 18.7 16.6–21.1 37.3 32.7–42.2 35.6 30.4–41.1 36.4 32.5–40.5 DeKalb County, Georgia 19.4 17.0–21.9 22.7 20.5–25.1 21.0 19.5–22.6 23.9 21.1–27.1 29.4 26.6–32.3 26.7 24.6–28.9 Hillsborough County, Florida 14.6 10.5–19.8 19.4 14.5–25.6 17.0 13.6–21.0 28.5 22.2–35.7 24.6 19.5–30.5 26.6 22.7–31.0 New Orleans, Louisiana 20.4 17.9–23.2 23.5 20.8–26.5 22.0 19.9–24.3 34.4 31.4–37.6 31.9 28.8–35.2 33.2 30.6–35.8 Philadelphia, Pennsylvania 16.7 13.8–20.1 16.2 12.4–20.9 16.6 13.9–19.7 27.9 23.2–33.1 30.8 25.7–36.4 29.1 25.0–33.6 Salinas, California 17.7 14.5–21.4 16.5 13.3–20.3 17.0 14.7–19.7 12.1 9.7–15.0 21.3 17.0–26.4 16.7 14.0–19.9 San Antonio, Texas 14.4 11.6–17.8 19.7 16.5–23.4 17.0 14.7–19.5 28.0 24.4–31.9 36.5 32.1–41.1 32.4 29.2–35.6 Santa Clara County, California 17.0 14.4–20.0 20.6 16.8–24.9 19.0 16.7–21.5 17.7 13.9–22.3 23.7 20.2–27.7 20.8 18.3–23.5 Tribe Cherokee Nation, Oklahoma 16.6 11.9–22.6 19.2 13.9–25.9 17.9 15.0–21.2 37.4 30.4–45.0 52.9 44.7–61.1 45.3 40.0–50.7 Median 17.0 19.4 17.9 21.7 30.4 26.6 Range 10.8–21.2 14.6–26.4 13.9–23.9 11.5—37.4 20.0–52.9 16.7–45.3 United States 19.9 18.0–22.0 22.9 21.1–24.8 21.4 19.8–23.1 29.0 25.9–32.2 38.6 35.6–41.6 33.8 31.0–36.8 * 100% fruit juice, fruit, green salad, potatoes (excluding French fries, fried potatoes, or potato chips), carrots, or other vegetables. † During the 7 days before the survey. § Not including diet soda or diet pop. ¶ 95% confidence interval. †† Not available.
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Table 8

TABLE 8. Percentage of high school students who met recommended levels of physical activity* and who did not participate in 60 or more minutes of physical activity on any day,† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Met recommended levels of physical activity Did not participate in 60 or more minutes of physical activity on any day Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 18.4 14.9–22.5 37.4 31.7–43.5 27.7 23.8–32.0 40.6 36.3–45.2 20.2 16.3–24.8 30.5 27.3–33.8 Yuma County, Arizona 23.4 19.3–28.0 36.8 30.8–43.2 30.0 26.6–33.7 41.1 36.3–46.1 20.7 16.9–25.1 30.9 27.6–34.3 Mesa County, Colorado 29.2 24.8–34.1 49.6 44.7–54.4 39.5 35.9–43.2 28.1 23.2–33.6 14.0 10.8–17.9 21.0 18.1–24.2 Pueblo County, Colorado 31.3 26.7–36.3 44.4 38.0–51.0 38.0 34.1–42.1 26.0 20.9–31.8 15.3 11.2–20.5 20.5 17.0–24.5 Teller County, Colorado 35.2 29.8–41.1 38.2 31.5–45.4 36.7 32.6–41.0 24.0 19.2–29.6 12.5 9.5–16.4 18.2 14.9–22.0 Weld County, Colorado 25.2 21.3–29.5 41.5 36.7–46.6 33.3 29.6–37.2 26.6 22.3–31.5 16.8 13.0–21.5 21.8 18.2–25.8 Minneapolis, Minnesota 30.8 26.2–35.7 45.7 39.0–52.5 38.3 34.5–42.2 20.7 16.1–26.0 17.0 13.7–20.9 19.0 15.9–22.6 Rochester, Minnesota 36.4 30.3–43.0 53.9 49.5–58.2 45.0 41.3–48.8 10.5 8.2–13.4 11.5 8.7–15.1 10.9 9.2–13.0 St. Paul, Minnesota 35.9 30.8–41.4 53.7 47.9–59.4 45.0 40.4–49.7 16.8 13.3–21.0 11.3 8.3–15.3 13.9 11.6–16.6 Broome County, New York 41.4 35.1–48.1 52.1 46.3–57.9 46.9 41.9–51.9 14.0 10.1–19.2 10.9 8.4–14.0 12.5 9.9–15.7 Chautauqua County, New York 50.1 43.9–56.3 60.6 54.2–66.7 55.5 50.8–60.2 7.8 4.9–12.1 7.5 5.2–10.7 7.6 5.7–10.1 Jefferson County, New York 47.8 41.8–53.9 57.2 50.8–63.5 52.5 48.1–56.9 13.9 10.1–18.9 8.8 5.9–12.9 11.4 9.1–14.2 Rockland County, New York 37.5 32.5–42.9 54.7 48.9–60.4 46.4 41.9–50.9 20.5 16.6–25.1 8.6 5.3–13.6 14.4 11.6–17.8 Fayette County, Pennsylvania 38.6 33.7–43.7 57.6 52.5–62.6 48.6 44.8–52.5 12.0 8.7–16.3 5.1 3.5–7.4 8.3 6.4–10.8 Luzerne County, Pennsylvania 40.7 35.6–46.0 59.1 54.5–63.6 50.2 46.3–54.1 13.2 10.6–16.3 7.8 5.5–11.0 10.4 8.6–12.7 Tioga County, Pennsylvania 44.9 39.6–50.3 57.3 52.6–61.8 51.1 47.6–54.7 11.7 9.1–14.9 6.8 5.0–9.2 9.3 7.7–11.2 Large cities/urban communities Boston, Massachusetts 25.4 21.5–29.7 32.6 27.9–37.8 29.0 25.8–32.6 34.8 30.5–39.3 21.2 16.9–26.2 27.8 24.8–31.1 Cleveland, Ohio 26.0 21.1–31.5 43.6 38.7–48.6 34.6 30.4–39.1 28.6 25.1–32.4 15.9 12.4–20.1 22.4 20.2–24.7 DeKalb County, Georgia 26.8 24.0–29.7 44.8 41.8–47.8 35.7 33.6–37.9 27.3 24.6–30.2 16.8 14.6–19.3 22.1 20.2–24.1 Hillsborough County, Florida 22.6 16.8–29.5 44.8 37.3–52.7 33.3 29.0–37.8 31.4 24.4–39.4 14.4 10.3–19.7 23.1 18.6–28.3 New Orleans, Louisiana 30.7 27.5–34.1 42.4 38.7–46.1 36.4 33.6–39.2 28.5 25.7–31.6 18.6 16.5–21.0 23.6 21.6–25.7 Philadelphia, Pennsylvania 24.3 19.8–29.4 40.1 33.9–46.6 32.0 28.0–36.3 31.9 27.2–36.9 18.7 14.6–23.7 25.6 22.1–29.4 Salinas, California 34.2 29.7–39.0 50.3 45.3–55.2 42.3 38.9–45.9 17.8 14.5–21.5 9.7 7.7–12.2 13.7 11.8–15.8 San Antonio, Texas 29.1 25.2–33.2 52.2 48.2–56.1 40.8 37.7–44.0 24.5 21.1–28.3 10.9 8.5–14.0 17.7 15.4–20.4 Santa Clara County, California 40.1 34.7–45.7 50.8 45.7–55.9 45.5 41.1–50.0 15.1 12.5–18.2 9.1 6.5–12.5 12.0 9.9–14.5 Tribe Cherokee Nation, Oklahoma 33.2 28.5–38.2 61.4 53.9–68.4 47.7 43.7–51.6 17.7 14.4–21.5 9.3 4.8–17.2 13.5 10.1–17.7 Median 32.2 49.9 40.1 22.3 12.0 17.9 Range 18.4–50.1 32.6–61.4 27.7–55.5 7.8–41.1 5.1–21.2 7.6–30.9 United States 25.6 22.8–28.6 43.7 41.1–46.4 34.7 32.5–37.0 31.8 29.2–34.5 18.0 16.4–19.8 24.9 23.2–26.6 * Were physically active doing any kind of physical activity that increased their heart rate and made them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more days during the 7 days before the survey. † Did not participate in 60 or more minutes of any kind of physical activity that increased their heart rate and made them breathe hard some of the time on at least 1 day during the 7 days before the survey. § 95% confidence interval.
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Table 9

TABLE 9. Percentage of high school students who played video or computer games or used a computer* for 3 or more hours per day† and who watched 3 or more hours per day of television,† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Used computers 3 or more hours per day Watched television 3 or more hours per day Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 27.1 21.9–33.2 21.0 17.9–24.4 24.2 20.9–27.9 42.8 37.2–48.6 32.2 28.0–36.7 37.5 33.9–41.2 Yuma County, Arizona 18.2 14.8–22.1 22.0 18.4–26.0 20.1 17.6–22.8 36.4 32.1–41.0 29.0 24.8–33.6 32.8 29.5–36.3 Mesa County, Colorado 11.2 8.8–14.3 25.2 21.5–29.1 18.3 15.8–21.2 17.9 14.1–22.5 23.4 19.1–28.3 20.7 18.2–23.4 Pueblo County, Colorado 15.7 11.3–21.4 26.9 22.5–31.8 21.2 17.5–25.5 30.5 25.3–36.2 28.9 23.9–34.3 29.6 25.7–33.9 Teller County, Colorado 16.4 11.6–22.7 23.5 19.6–27.9 20.2 16.3–24.7 16.4 12.6–21.1 20.4 16.0–25.7 18.8 15.8–22.3 Weld County, Colorado 12.6 10.0–15.8 19.0 15.3–23.2 15.8 13.2–18.8 26.0 22.1–30.3 23.9 19.6–28.8 25.0 21.6–28.7 Minneapolis, Minnesota 13.1 10.5–16.3 20.9 17.5–24.7 17.1 14.9–19.6 34.0 29.1–39.2 28.0 23.3–33.2 30.7 27.2–34.5 Rochester, Minnesota 13.3 9.9–17.6 22.4 18.8–26.6 18.1 15.4–21.1 14.7 11.1–19.4 20.9 17.5–24.7 18.0 15.3–21.0 St. Paul, Minnesota 16.0 12.6–20.0 25.2 19.9–31.3 20.5 17.4–24.1 34.9 29.4–40.8 32.0 26.1–38.5 33.4 28.7–38.3 Broome County, New York 20.9 17.2–25.1 25.2 21.4–29.5 23.3 20.2–26.7 24.7 19.9–30.2 25.3 21.7–29.3 25.1 21.6–29.0 Chautauqua County, New York 18.8 15.5–22.7 24.8 19.8–30.6 22.0 19.2–25.1 24.4 20.2–29.2 26.5 21.2–32.6 25.4 22.5–28.6 Jefferson County, New York 15.5 12.0–19.8 30.0 25.2–35.3 23.0 19.7–26.7 26.0 20.5–32.4 31.1 24.5–38.5 28.5 23.7–33.9 Rockland County, New York 28.2 23.3–33.7 29.4 23.9–35.4 28.8 24.4–33.5 28.9 22.9–35.7 38.2 31.2–45.8 33.6 28.4–39.3 Fayette County, Pennsylvania 21.4 17.7–25.6 33.0 27.5–38.9 27.5 23.8–31.5 30.6 25.7–36.0 36.5 31.7–41.7 33.7 30.4–37.2 Luzerne County, Pennsylvania 26.3 22.0–31.1 36.2 32.7–39.9 31.5 28.5–34.7 25.0 20.9–29.6 30.3 26.7–34.2 27.8 24.9–31.0 Tioga County, Pennsylvania 19.7 16.5–23.2 24.1 19.7–29.1 21.9 18.9–25.3 25.1 21.4–29.2 28.1 24.0–32.6 26.7 23.7–30.0 Large cities/urban communities Boston, Massachusetts 21.3 17.7–25.5 29.8 25.6–34.3 25.7 22.8–28.8 41.2 36.1–46.5 43.2 38.4–48.1 42.1 38.6–45.7 Cleveland, Ohio 22.8 18.7–27.4 32.9 28.0–38.2 27.8 24.5–31.4 59.8 52.7–66.5 54.2 49.9–58.5 57.2 52.5–61.7 DeKalb County, Georgia 21.7 19.6–24.0 26.0 23.2–29.0 23.8 22.1–25.6 53.1 49.2–57.0 51.7 48.0–55.4 52.3 49.3–55.3 Hillsborough County, Florida 24.1 19.5–29.3 26.1 21.0–32.0 25.1 21.8–28.7 44.1 36.9–51.5 42.6 36.8–48.7 43.3 37.7–49.1 New Orleans, Louisiana 27.4 24.5–30.5 28.8 25.8–32.0 28.0 25.9–30.3 55.2 51.1–59.3 46.2 42.2–50.2 50.5 47.4–53.7 Philadelphia, Pennsylvania 26.0 22.4–29.9 33.7 28.1–39.7 29.6 26.2–33.2 53.3 43.8–62.5 51.4 44.3–58.4 52.2 44.9–59.5 Salinas, California 17.5 15.0–20.4 27.8 24.0–32.0 22.7 20.4–25.1 30.8 26.5–35.5 34.2 30.4–38.1 32.5 29.4–35.8 San Antonio, Texas 19.5 16.5–23.0 28.9 24.6–33.7 24.3 21.7–27.1 43.7 39.8–47.7 47.9 43.6–52.1 45.7 42.6–48.8 Santa Clara County, California 23.1 20.0–26.6 32.0 26.5–38.0 27.8 24.7–31.2 39.0 34.7–43.4 40.5 35.8–45.4 39.8 36.2–43.6 Tribe Cherokee Nation, Oklahoma 9.8 6.8–14.0 24.2 19.8–29.2 17.3 14.8–20.1 30.8 23.2–39.6 35.2 31.2–39.5 33.2 29.0–37.8 Median 19.6 26.0 23.1 30.8 32.1 33.0 Range 9.8–28.2 19.0–36.2 15.8–31.5 14.7–59.8 20.4–54.2 18.0–57.2 United States 20.6 18.6–22.7 29.1 26.6–31.8 24.9 22.9–27.0 33.2 30.7–35.9 37.5 35.0–40.0 35.4 33.1–37.7 * For something that was not school work. † On an average school day. § 95% confidence interval.
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Table 10

TABLE 10. Percentage of high school students who attended physical education (PE) classes, by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Attended PE classes* Attended PE classes daily† Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 35.2 29.0–42.0 57.1 49.2–64.7 46.3 39.7–52.9 28.3 21.9–35.9 42.3 33.8–51.3 35.3 28.5–42.7 Yuma County, Arizona 38.8 29.2–49.2 53.3 45.6–60.8 46.0 39.1–53.1 28.6 20.3–38.6 37.4 29.9–45.5 32.9 26.5–39.9 Mesa County, Colorado 36.2 31.0–41.7 51.2 44.8–57.5 43.9 39.5–48.5 32.5 27.7–37.6 44.0 37.6–50.5 38.4 34.0–43.0 Pueblo County, Colorado 45.2 37.5–53.1 62.4 56.3–68.1 54.1 47.9–60.2 34.5 27.8–41.8 48.5 41.0–56.0 41.4 35.7–47.4 Teller County, Colorado 50.9 40.7–61.1 69.2 61.3–76.1 60.4 52.8–67.6 2.6 1.2–5.5 7.4 3.9–13.7 5.1 2.9–8.9 Weld County, Colorado 40.1 34.5–46.0 58.5 51.6–65.0 49.3 43.8–55.0 4.8 2.8–7.9 7.5 4.9–11.3 6.2 4.5–8.4 Minneapolis, Minnesota 35.0 30.5–39.8 42.5 35.8–49.4 38.7 33.9–43.8 23.5 19.2–28.4 26.2 20.1–33.4 24.9 20.4–29.9 Rochester, Minnesota 38.4 29.8–47.7 50.3 42.4–58.3 44.5 36.8–52.4 32.0 24.5–40.6 39.5 33.1–46.1 35.5 29.2–42.3 St. Paul, Minnesota 33.3 24.9–42.8 41.6 33.3–50.4 37.5 30.4–45.2 25.5 17.1–36.2 26.9 20.5–34.4 26.3 19.7–34.2 Broome County, New York 98.4 97.0–99.2 92.0 88.0–94.7 95.0 92.6–96.7 4.4 2.3–8.3 6.1 3.8–9.7 5.4 3.5–8.2 Chautauqua County, New York 96.6 93.7–98.2 92.7 89.3–95.1 94.7 92.2–96.4 2.9 1.3–6.5 7.0 4.5–10.9 5.0 3.1–8.0 Jefferson County, New York 95.6 92.9–97.3 95.5 90.9–97.8 95.5 92.7–97.3 2.4 0.9–5.8 2.4 1.1–5.3 2.4 1.3–4.4 Rockland County, New York 96.1 92.9–97.9 96.1 92.8–97.9 96.1 93.9–97.5 3.3 1.8–6.1 4.9 2.9–8.1 4.2 2.6–6.6 Fayette County, Pennsylvania 64.6 57.1–71.4 67.5 61.7–72.7 66.1 60.8–71.0 32.5 25.9–39.8 32.4 27.6–37.6 32.4 28.0–37.2 Luzerne County, Pennsylvania 72.9 65.4–79.2 75.3 68.9–80.7 74.2 68.2–79.4 9.4 6.0–14.4 11.9 9.2–15.2 10.8 8.2–14.0 Tioga County, Pennsylvania 69.3 62.1–75.6 69.3 61.2–76.4 69.3 62.8–75.1 42.2 35.5–49.2 40.9 33.7–48.6 41.5 35.9–47.3 Large cities/urban communities Boston, Massachusetts 27.9 21.6–35.3 31.9 25.4–39.2 29.9 24.1–36.4 6.0 3.4–10.6 6.2 3.6–10.3 6.1 3.7–9.9 Cleveland, Ohio 21.6 16.4–27.9 29.6 24.5–35.3 25.5 21.0–30.6 13.6 8.9–20.4 17.2 12.2–23.8 15.3 11.0–21.0 DeKalb County, Georgia 35.6 29.3–42.5 45.3 40.1–50.6 40.4 35.4–45.6 27.0 21.2–33.7 29.5 25.2–34.2 28.2 23.8–33.0 Hillsborough County, Florida 22.2 16.4–29.3 39.5 31.4–48.2 30.8 25.0–37.1 13.8 10.2–18.5 23.8 17.2–31.8 18.7 15.0–23.0 New Orleans, Louisiana 52.6 46.1–59.1 55.9 50.9–60.9 54.4 49.4–59.2 29.3 23.8–35.6 29.3 25.0–34.0 29.2 24.9–34.0 Philadelphia, Pennsylvania 40.2 26.9–55.1 47.9 37.8–58.2 43.9 33.0–55.3 17.9 12.2–25.5 23.1 14.9–34.1 20.3 14.2–28.1 Salinas, California 46.8 38.3–55.5 54.0 45.7–62.1 50.4 42.6–58.2 26.8 19.7–35.3 26.1 20.7–32.3 26.5 21.0–32.8 San Antonio, Texas 44.2 39.2–49.3 55.3 49.9–60.6 50.0 45.6–54.3 35.9 31.4–40.7 45.2 39.6–51.0 40.8 36.6–45.2 Santa Clara County, California 69.0 59.6–77.0 76.2 68.0–82.9 72.8 64.7–79.6 46.4 35.2–58.0 47.0 34.0–60.4 46.4 34.7–58.6 Tribe Cherokee Nation, Oklahoma 33.0 25.0–42.3 49.2 40.3–58.0 41.5 34.5–48.8 29.3 21.6–38.4 44.4 37.4–51.5 37.2 31.7–43.1 Median 42.2 55.6 49.6 26.1 26.5 26.4 Range 21.6–98.4 29.6–96.1 25.5–96.1 2.4–46.4 2.4–48.5 2.4–46.4 United States 49.4 41.8–56.9 57.7 51.7–63.5 53.6 47.0–60.1 27.3 22.1–33.2 33.2 28.4–38.5 30.3 25.4–35.8 * On 1 or more days in an average week when they were in school. † 5 days in an average week when they were in school. § 95% confidence interval.
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Table 11

TABLE 11. Percentage of high school students who played on at least one sports team,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Female Male Total Steps community % CI† % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 43.0 38.1–48.0 58.9 53.3–64.2 50.8 46.5–55.1 Yuma County, Arizona 35.1 30.1–40.5 52.9 46.6–59.1 43.9 39.4–48.6 Mesa County, Colorado 50.3 44.1–56.5 59.8 53.9–65.3 55.1 50.4–59.7 Pueblo County, Colorado 54.4 47.8–60.9 63.9 57.6–69.8 59.5 54.7–64.1 Teller County, Colorado 57.7 51.6–63.6 62.2 56.2–67.8 60.0 55.1–64.7 Weld County, Colorado 52.4 47.1–57.6 61.2 56.5–65.8 57.0 53.0–60.9 Minneapolis, Minnesota 45.6 39.1–52.2 63.1 56.4–69.3 54.3 49.0–59.6 Rochester, Minnesota 62.0 54.9–68.6 69.7 64.9–74.0 66.0 61.5–70.2 St. Paul, Minnesota 49.3 42.4–56.2 56.7 51.9–61.4 52.9 48.0–57.9 Broome County, New York 59.7 52.9–66.1 64.9 60.1–69.4 62.2 57.9–66.4 Chautauqua County, New York 67.5 61.4–73.1 74.4 68.6–79.4 71.0 66.4–75.3 Jefferson County, New York 66.4 59.1–73.0 63.1 57.8–68.2 64.7 60.4–68.8 Rockland County, New York 56.5 50.9–61.9 67.3 61.1–72.9 62.1 57.7–66.3 Fayette County, Pennsylvania 47.2 40.9–53.6 58.0 51.5–64.2 52.9 47.8–57.9 Luzerne County, Pennsylvania 55.0 49.6–60.3 62.3 57.5–66.8 58.7 54.8–62.4 Tioga County, Pennsylvania 61.0 55.3–66.4 60.5 55.5–65.2 60.8 56.9–64.5 Large cities/urban communities Boston, Massachusetts 43.7 38.9–48.6 61.0 56.3–65.5 52.6 49.0–56.1 Cleveland, Ohio 39.9 34.4–45.6 53.1 45.4–60.7 46.4 41.8–51.0 DeKalb County, Georgia 46.9 43.2–50.6 58.6 55.3–62.0 52.8 50.1–55.5 Hillsborough County, Florida 48.2 42.8–53.7 57.2 50.2–63.9 52.5 48.0–57.0 New Orleans, Louisiana 41.9 38.8–45.1 63.2 59.9–66.5 52.4 49.9–54.9 Philadelphia, Pennsylvania 35.0 27.5–43.4 56.6 51.3–61.7 45.4 40.3–50.7 Salinas, California 43.9 38.5–49.4 53.4 48.9–57.9 48.7 45.2–52.2 San Antonio, Texas 42.0 37.7–46.4 59.4 55.3–63.5 50.7 47.8–53.6 Santa Clara County, California 49.4 42.2–56.7 61.9 57.4–66.3 55.8 51.5–60.1 Tribe Cherokee Nation, Oklahoma 48.9 42.0–55.7 70.8 65.3–75.7 60.1 55.7–64.3 Median 49.1 61.1 54.7 Range 35.0–67.5 52.9–74.4 43.9–71.0 United States 50.4 47.1–53.7 62.1 59.5–64.7 56.3 53.7–58.9 * Run by their school or community groups during the 12 months before the survey. † 95% confidence interval.
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Table 12

TABLE 12. Percentage of high school students who were obese*† and who were overweight,†§ by sex — selected Steps communities, Youth Risk Behavior Survey (YRBS), 2007 Obese Overweight Female Male Total Female Male Total Steps community % CI¶ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 7.3 4.4–11.9 16.7 13.7–20.2 12.2 10.2–14.5 16.8 13.7–20.4 17.1 13.0–22.1 17.0 14.4–19.8 Yuma County, Arizona 10.6 8.0–13.9 22.5 19.4–26.0 16.9 14.5–19.5 18.5 14.7–23.1 17.5 14.7–20.8 18.0 16.0–20.3 Mesa County, Colorado 6.4 4.0–10.0 9.2 6.9–12.1 7.8 6.1–10.1 9.3 6.5–12.9 12.0 9.3–15.4 10.7 8.7–13.0 Pueblo County, Colorado 8.4 5.9–11.8 15.7 12.2–19.9 12.2 9.8–15.0 14.2 10.8–18.5 13.2 10.4–16.5 13.7 11.4–16.3 Teller County, Colorado 2.4 1.2–4.8 6.8 4.4–10.4 4.6 3.1–6.8 6.3 4.4–9.0 10.1 6.8–14.8 8.3 6.2–10.9 Weld County, Colorado 7.1 5.1–9.7 16.5 13.5–20.1 11.9 10.1–14.0 13.2 10.6–16.5 11.5 9.0–14.6 12.3 10.4–14.5 Minneapolis, Minnesota 11.2 6.4–19.1 15.8 11.8–20.8 13.6 10.4–17.5 16.1 12.0–21.1 13.1 10.3–16.6 14.5 12.2–17.3 Rochester, Minnesota 3.4 1.9–6.0 12.0 9.2–15.5 7.8 6.3–9.6 13.1 10.1–16.9 12.8 10.0–16.2 12.9 11.0–15.2 St. Paul, Minnesota 12.3 9.1–16.4 17.3 13.2–22.2 14.9 12.3–17.9 14.2 10.7–18.5 13.5 10.3–17.5 13.8 11.4–16.6 Broome County, New York 7.3 5.1–10.2 12.9 9.8–16.9 10.2 8.3–12.5 13.1 10.2–16.9 15.7 12.5–19.6 14.5 12.3–17.0 Chautauqua County, New York 9.5 6.6–13.6 16.1 12.9–19.9 12.9 10.5–15.8 15.4 10.5–21.9 16.8 13.2–21.1 16.1 12.7–20.2 Jefferson County, New York 7.3 5.0–10.6 22.0 13.9–32.9 15.0 9.7–22.4 15.7 12.1–20.2 14.2 10.3–19.2 14.9 12.6–17.5 Rockland County, New York 8.6 5.8–12.6 16.6 12.5–21.7 12.8 10.0–16.1 12.2 8.7–17.0 15.5 12.6–19.0 13.9 11.6–16.7 Fayette County, Pennsylvania 10.7 8.3–13.8 19.8 16.2–24.0 15.6 13.4–18.1 14.4 11.4–18.2 15.5 12.1–19.7 15.0 12.4–18.1 Luzerne County, Pennsylvania 6.8 4.6–9.9 14.1 11.1–17.7 10.6 8.6–13.0 14.3 11.8–17.4 15.0 12.1–18.3 14.7 12.7–16.8 Tioga County, Pennsylvania 9.9 8.0–12.3 17.2 13.6–21.5 13.7 11.4–16.3 21.1 18.0–24.5 17.0 13.7–20.8 19.0 16.8–21.3 Large cities/urban communities Boston, Massachusetts 11.3 8.8–14.4 17.8 14.3–21.9 14.7 12.5–17.3 22.1 18.6–26.0 15.5 12.6–19.1 18.6 16.4–21.1 Cleveland, Ohio 14.4 11.6–17.8 18.1 14.3–22.7 16.3 14.2–18.6 25.3 20.2–31.2 14.6 11.4–18.5 19.9 16.9–23.2 DeKalb County, Georgia 13.4 11.5–15.5 12.8 10.7–15.3 13.1 11.7–14.7 16.9 14.8–19.2 15.8 13.4–18.6 16.3 14.9–17.9 Hillsborough County, Florida 11.1 7.3–16.7 16.7 12.9–21.4 13.9 11.1–17.2 15.0 10.9–20.4 14.9 10.9–20.0 14.9 12.3–18.0 New Orleans, Louisiana 12.7 10.7–15.0 20.6 17.5–24.1 16.7 14.6–18.9 20.2 17.7–23.0 14.6 12.5–17.0 17.4 15.8–19.2 Philadelphia, Pennsylvania 12.4 9.7–15.6 15.1 12.6–18.0 13.7 11.5–16.4 20.0 15.2–25.8 15.0 12.3–18.2 17.5 14.7–20.6 Salinas, California 8.9 6.1–12.9 22.3 18.8–26.2 15.8 13.6–18.4 18.3 15.4–21.6 18.9 15.6–22.7 18.6 16.7–20.7 San Antonio, Texas 16.4 13.5–19.7 23.8 20.5–27.5 20.2 18.0–22.6 21.3 18.4–24.4 17.1 13.9–20.9 19.1 16.9–21.6 Santa Clara County, California 8.0 5.7–11.2 16.9 13.5–20.8 12.6 10.5–15.1 21.9 18.1–26.3 17.8 14.5–21.6 19.8 17.1–22.7 Tribe Cherokee Nation, Oklahoma 12.1 9.1–15.8 24.7 19.4–31.0 18.6 15.1–22.8 19.3 13.5–26.7 15.1 11.3–19.8 17.1 13.2–21.9 Median 9.7 16.7 13.6 15.9 15.0 15.5 Range 2.4–16.4 6.8–24.7 4.6–20.2 6.3–25.3 10.1–18.9 8.3–19.9 United States 9.6 8.3–11.0 16.3 15.1–17.5 13.0 11.9–14.1 15.1 13.8–16.5 16.4 15.4–17.5 15.8 14.8–16.8 * Students who were >95th percentile for body mass index (BMI), by age and sex, based on reference data. † Previous YRBS reports used the terms “overweight” to describe those youth with a BMI >95th percentile for age and sex and “at risk for overweight” for those with a BMI >85th percentile and <95th percentile. However, this report uses the terms “obese” and “overweight” in accordance with the 2007 recommendations from the Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity convened by the American Medical Association (AMA) and cofunded by AMA in collaboration with the Health Resources and Services Administration and CDC. § Students who were >85th percentile but <95th percentile for BMI, by age and sex, based on reference data. ¶ 95% confidence interval.
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Table 13

TABLE 13. Percentage of high school students who described themselves as slightly or very overweight and who were trying to lose weight, by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Described themselves as overweight Were trying to lose weight Female Male Total Female Male Total Steps community % CI* % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 39.0 33.6–44.8 24.6 20.9–28.8 31.7 28.0–35.7 66.9 61.2–72.2 39.4 35.4–43.6 53.1 49.3–56.9 Yuma County, Arizona 37.2 32.5–42.3 31.7 28.2–35.4 34.4 31.5–37.4 62.5 57.2–67.5 40.3 35.8–45.0 51.3 47.1–55.5 Mesa County, Colorado 34.2 28.6–40.3 18.1 14.6–22.2 25.9 22.6–29.5 55.4 49.6–61.0 25.1 21.2–29.5 39.8 36.8–42.9 Pueblo County, Colorado 37.3 32.1–42.9 22.3 18.9–26.1 29.7 26.3–33.3 60.9 55.9–65.6 28.6 24.5–33.0 44.5 40.6–48.6 Teller County, Colorado 29.5 24.3–35.3 18.4 14.4–23.1 23.8 20.2–27.9 58.6 53.6–63.4 23.0 19.1–27.5 40.2 36.4–44.0 Weld County, Colorado 32.7 29.1–36.4 23.1 19.6–27.1 27.8 25.3–30.5 59.0 54.2–63.5 32.8 28.1–37.9 45.7 42.2–49.3 Minneapolis, Minnesota 31.0 25.5–37.1 17.2 12.9–22.5 24.0 20.6–27.7 46.9 41.0–52.9 25.4 20.5–30.9 36.2 32.8–39.7 Rochester, Minnesota 29.4 24.4–35.1 22.4 19.0–26.1 25.8 22.6–29.3 55.3 49.4–61.1 23.6 19.9–27.6 39.1 35.4–43.0 St. Paul, Minnesota 34.3 29.2–39.7 23.2 19.4–27.5 28.6 25.4–32.2 55.4 49.8–60.8 30.5 24.9–36.7 42.8 38.9–46.8 Broome County, New York 31.4 26.3–37.0 23.5 20.0–27.4 27.3 23.9–30.9 58.2 52.0–64.2 29.2 24.3–34.7 43.1 38.8–47.5 Chautauqua County, New York 33.5 26.8–40.9 25.0 21.2–29.2 29.2 25.6–33.0 61.6 55.4–67.5 32.0 27.3–37.1 46.4 42.7–50.2 Jefferson County, New York 31.3 25.8–37.4 27.4 19.7–36.7 29.2 23.6–35.6 59.8 54.1–65.3 33.5 26.7–41.0 46.2 41.5–51.1 Rockland County, New York 29.8 25.0–35.1 29.3 24.7–34.3 29.5 26.2–33.1 60.7 56.2–64.9 33.2 28.9–37.8 46.6 43.3–49.9 Fayette County, Pennsylvania 35.9 30.7–41.4 26.5 21.8–31.9 31.0 27.7–34.5 69.9 65.6–73.8 31.8 27.1–37.0 49.9 46.5–53.2 Luzerne County, Pennsylvania 32.8 28.4–37.5 23.2 19.2–27.7 27.8 24.7–31.1 60.6 56.4–64.6 25.9 22.2–29.9 42.6 39.4–45.9 Tioga County, Pennsylvania 38.0 34.1–42.1 26.2 21.9–30.9 32.0 28.9–35.3 59.2 54.7–63.6 30.4 26.3–34.9 44.6 41.2–48.1 Large cities/urban communities Boston, Massachusetts 35.4 31.4–39.6 23.3 19.6–27.3 29.1 26.1–32.2 54.7 50.8–58.6 30.5 26.7–34.6 42.1 38.9–45.4 Cleveland, Ohio 31.5 27.1–36.2 19.9 16.3–24.1 25.9 22.5–29.5 46.0 40.3–51.8 27.6 23.7–31.8 37.0 33.1–41.1 DeKalb County, Georgia 30.1 27.4–32.9 16.1 13.8–18.6 23.1 21.3–25.0 51.3 48.4–54.1 26.1 23.4–28.9 38.6 36.3–41.0 Hillsborough County, Florida 32.5 26.7–38.9 21.1 16.4–26.7 27.1 23.2–31.3 56.6 48.7–64.1 27.9 22.7–33.9 42.7 38.1–47.4 New Orleans, Louisiana 24.8 21.8–28.0 17.3 14.5–20.7 21.1 19.0–23.5 46.5 42.8–50.2 30.4 26.6–34.5 38.5 35.5–41.6 Philadelphia, Pennsylvania 27.4 23.6–31.6 18.9 15.6–22.7 23.1 20.5–26.0 45.5 40.6–50.5 27.0 22.6–31.9 36.4 32.8–40.2 Salinas, California 41.7 36.9–46.6 31.1 26.3–36.3 36.3 32.8–40.0 65.2 60.6–69.5 37.2 32.6–42.0 51.0 47.3–54.7 San Antonio, Texas 36.0 31.8–40.3 29.9 26.6–33.5 32.8 30.1–35.6 61.1 57.1–64.9 46.0 41.3–50.8 53.4 50.4–56.5 Santa Clara County, California 44.2 39.3–49.2 28.6 24.4–33.2 36.3 32.7–40.0 60.7 56.5–64.7 35.5 30.5–40.8 47.9 44.2–51.7 Tribe Cherokee Nation, Oklahoma 37.1 30.8–44.0 25.3 18.7–33.1 30.8 26.7–35.3 64.6 57.4–71.1 33.0 28.3–38.1 48.2 43.6–52.9 Median 33.1 23.2 28.8 59.1 30.4 43.8 Range 24.8–44.2 16.1–31.7 21.1–36.3 45.5–69.9 23.0–46.0 36.2–53.4 United States 34.5 32.9–36.1 24.2 23.0–25.3 29.3 28.2–30.4 60.3 58.4–62.1 30.4 28.8–32.1 45.2 43.8–46.7 * 95% confidence interval.
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Table 14

TABLE 14. Percentage of high school students who ate less food, fewer calories, or low-fat foods* and who exercised,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Ate less food, fewer calories, or low-fat foods to lose weight or to keep from gaining weight Exercised to lose weight or to keep from gaining weight Female Male Total Female Male Total Steps community % CI† % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 52.9 47.7–58.1 32.0 27.5–36.8 42.7 39.1–46.4 70.6 64.7–75.9 61.7 56.7–66.5 65.9 61.6–69.9 Yuma County, Arizona 49.2 44.5–53.9 32.0 28.3–36.0 40.6 37.4–43.9 67.5 62.1–72.5 59.2 55.4–63.0 63.4 59.8–66.9 Mesa County, Colorado 50.1 45.8–54.5 20.4 17.1–24.1 34.9 31.9–38.1 68.4 63.2–73.2 48.5 43.2–53.9 58.3 54.4–62.1 Pueblo County, Colorado 51.7 45.9–57.4 22.7 19.1–26.6 36.9 33.4–40.4 73.2 67.8–78.0 55.1 49.3–60.7 64.1 59.9–68.1 Teller County, Colorado 54.4 48.7–60.0 20.1 16.9–23.8 36.8 33.2–40.7 74.2 69.1–78.7 50.1 44.2–56.0 61.8 58.2–65.4 Weld County, Colorado 52.3 48.4–56.1 28.6 24.2–33.5 40.4 37.6–43.4 72.3 68.0–76.1 58.8 53.8–63.7 65.5 62.3–68.6 Minneapolis, Minnesota 39.1 34.3–44.1 21.7 17.5–26.6 30.7 27.1–34.6 55.6 49.9–61.2 50.8 45.8–55.8 53.2 49.1–57.2 Rochester, Minnesota 51.5 46.9–56.0 20.7 17.1–24.9 36.0 32.8–39.4 73.9 69.1–78.1 44.8 40.7–49.0 59.2 55.7–62.6 St. Paul, Minnesota 43.8 38.4–49.5 24.1 19.1–30.0 33.8 30.3–37.6 59.3 54.7–63.7 53.5 46.9–60.0 56.4 51.9–60.8 Broome County, New York 50.8 45.4–56.2 26.3 22.3–30.7 38.2 34.4–42.2 72.5 68.0–76.6 51.6 47.9–55.3 61.7 58.6–64.7 Chautauqua County, New York 53.9 47.9–59.9 29.4 23.9–35.6 41.5 37.0–46.1 75.9 70.8–80.3 55.7 48.6–62.6 65.7 61.8–69.4 Jefferson County, New York 54.5 47.5–61.3 25.4 20.6–30.8 39.6 35.5–43.7 77.8 72.7–82.1 57.7 52.0–63.3 67.3 63.7–70.7 Rockland County, New York 55.1 49.4–60.7 29.8 25.5–34.6 42.2 38.8–45.7 70.3 64.7–75.3 59.0 53.5–64.2 64.5 60.9–67.9 Fayette County, Pennsylvania 62.2 57.1–67.0 29.0 24.3–34.2 44.7 41.2–48.2 78.4 74.5–81.9 53.8 48.4–59.1 65.5 62.0–68.8 Luzerne County, Pennsylvania 59.6 55.6–63.4 27.8 24.2–31.8 43.3 40.2–46.4 73.7 69.5–77.5 54.9 50.7–59.0 63.9 60.7–67.0 Tioga County, Pennsylvania 52.2 47.2–57.2 23.8 20.7–27.2 37.9 35.0–40.8 71.6 66.9–75.8 54.8 49.7–59.7 63.1 59.3–66.7 Large cities/urban communities Boston, Massachusetts —§ — — — — — — — — — — — Cleveland, Ohio 32.4 28.1–37.0 28.6 23.2–34.8 30.6 27.6–33.8 46.8 40.9–52.8 54.3 49.2–59.3 50.4 47.0–53.8 DeKalb County, Georgia 39.2 36.3–42.2 25.6 22.8–28.7 32.5 30.3–34.8 56.8 53.9–59.6 54.2 50.6–57.8 55.6 53.2–57.9 Hillsborough County, Florida 44.8 38.5–51.3 23.7 17.5–31.3 34.7 29.8–40.0 57.8 52.1–63.4 49.7 42.7–56.6 53.8 49.6–57.9 New Orleans, Louisiana 35.2 32.1–38.5 25.4 22.4–28.6 30.5 28.1–32.9 53.1 50.0–56.2 54.7 50.8–58.6 53.8 51.2–56.3 Philadelphia, Pennsylvania 34.9 28.9–41.4 24.0 20.6–27.8 30.0 26.3–33.9 47.3 41.8–52.9 49.2 44.8–53.6 48.3 44.5–52.0 Salinas, California 49.0 44.4–53.6 29.0 25.2–33.2 38.9 35.5–42.5 67.2 62.8–71.2 62.1 57.5–66.5 64.6 61.1–67.9 San Antonio, Texas 45.5 41.6–49.4 33.4 29.5–37.7 39.2 36.5–42.0 63.9 60.3–67.3 68.3 64.1–72.4 66.2 63.5–68.8 Santa Clara County, California 48.4 44.4–52.3 26.9 23.2–30.9 37.6 34.8–40.4 68.9 63.9–73.5 63.6 59.4–67.7 66.1 62.7–69.3 Tribe Cherokee Nation, Oklahoma 57.6 53.0–62.2 24.7 20.8–29.1 40.6 36.9–44.5 65.2 60.4–69.7 48.2 40.6–55.8 56.5 50.8–62.0 Median 50.8 25.6 37.9 68.9 54.7 63.1 Range 32.4–62.2 20.1–33.4 30.0–44.7 46.8–78.4 44.8–68.3 48.3–67.3 United States 53.2 51.2–55.1 28.3 27.2–29.5 40.6 39.4–41.9 67.0 65.2–68.7 55.0 53.6–56.4 60.9 59.8–62.1 * To lose weight or to keep from gaining weight during the 30 days before the survey. † 95% confidence interval. § Not available.
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Table 15

TABLE 15. Percentage of high school students who did not eat for 24 or more hours* and who took diet pills, powders, or liquids,*† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Did not eat for 24 or more hours to lose weight or to keep from gaining weight Took diet pills, powders, or liquids to lose weight or to keep from gaining weight† Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 18.1 14.4–22.6 8.5 6.0–12.0 13.5 11.1–16.4 9.6 6.8–13.4 7.2 5.3–9.8 8.4 6.6–10.7 Yuma County, Arizona 16.3 13.5–19.5 10.3 7.2–14.4 13.3 11.1–15.9 7.2 4.8–10.6 8.1 6.1–10.9 7.7 5.9–9.9 Mesa County, Colorado 15.2 11.8–19.3 7.7 5.4–10.9 11.4 9.5–13.6 6.4 4.3–9.6 6.8 4.6–10.0 6.6 5.0–8.7 Pueblo County, Colorado 14.2 10.9–18.4 9.6 6.9–13.2 11.9 9.9–14.4 10.0 7.3–13.4 8.7 6.0–12.4 9.4 7.6–11.6 Teller County, Colorado 15.2 11.1–20.5 7.0 4.6–10.5 11.0 9.0–13.4 9.2 6.7–12.5 7.2 4.7–11.1 8.2 6.5–10.2 Weld County, Colorado 16.8 13.2–21.3 7.5 5.2–10.8 12.1 9.9–14.7 9.4 7.1–12.4 6.9 4.8–9.8 8.1 6.5–10.1 Minneapolis, Minnesota 14.7 10.7–19.8 6.8 4.7–9.8 10.9 8.5–14.0 3.9 2.5–6.0 5.6 3.4–8.9 4.9 3.4–6.9 Rochester, Minnesota 12.7 9.3–17.0 3.9 2.4–6.6 8.6 6.8–10.7 4.1 2.3–7.2 3.2 1.6–6.1 3.6 2.4–5.5 St. Paul, Minnesota 8.8 6.0–12.9 4.4 2.7–6.9 6.5 5.0–8.5 4.4 2.4–7.6 2.3 1.1–4.5 3.4 2.2–5.2 Broome County, New York 12.2 9.9–14.8 8.7 5.8–12.9 10.7 8.7–13.1 4.6 3.1–6.9 7.6 5.0–11.4 6.4 4.6–8.7 Chautauqua County, New York 11.3 8.6–14.7 6.8 4.3–10.6 9.2 7.3–11.4 5.5 3.4–8.7 4.1 2.5–6.5 4.9 3.4–6.9 Jefferson County, New York 13.3 9.8–17.7 7.2 4.8–10.6 10.1 8.1–12.7 6.0 3.8–9.6 4.8 2.9–8.1 5.6 3.7–8.5 Rockland County, New York 11.1 7.7–15.7 6.2 3.9–9.7 8.6 6.5–11.3 4.6 2.8–7.3 6.8 3.9–11.4 5.7 3.9–8.1 Fayette County, Pennsylvania 15.0 11.6–19.2 7.3 5.0–10.7 11.0 9.0–13.3 8.0 5.7–11.0 6.7 4.8–9.3 7.3 5.8–9.1 Luzerne County, Pennsylvania 14.9 11.7–18.8 7.2 5.0–10.1 11.0 8.9–13.5 4.2 2.9–6.2 5.2 3.5–7.7 4.8 3.7–6.2 Tioga County, Pennsylvania 18.5 14.6–23.0 8.4 6.3–11.2 13.5 11.2–16.1 7.0 5.0–9.6 4.5 2.9–6.8 5.7 4.5–7.2 Large cities/urban communities Boston, Massachusetts 14.3 11.4–17.8 11.1 8.8–13.9 12.8 10.7–15.1 5.9 4.0–8.5 6.2 3.9–9.8 6.2 4.6–8.3 Cleveland, Ohio 14.3 11.6–17.6 9.3 6.4–13.4 11.9 9.8–14.4 2.7 1.7–4.3 6.3 4.1–9.7 4.6 3.3–6.3 DeKalb County, Georgia 11.4 9.6–13.3 7.9 6.3–9.8 9.6 8.4–11.0 4.3 3.2–5.7 4.4 3.1–6.0 4.5 3.5–5.6 Hillsborough County, Florida 13.0 9.2–18.0 9.2 5.8–14.3 11.2 8.4–14.8 7.3 4.4–11.7 7.0 4.3–11.3 7.3 5.1–10.4 New Orleans, Louisiana 17.7 15.3–20.4 12.7 10.5–15.4 15.3 13.5–17.3 7.0 5.5–8.8 9.2 7.5–11.3 8.0 6.8–9.5 Philadelphia, Pennsylvania 11.0 8.1–14.8 9.0 6.3–12.6 10.0 7.8–12.7 3.6 2.2–5.8 6.4 4.1–9.8 5.2 3.8–7.1 Salinas, California 13.3 10.5–16.6 4.3 2.7–6.6 8.7 7.1–10.7 5.9 4.0–8.8 3.2 2.1–4.8 4.5 3.5–5.9 San Antonio, Texas 13.7 10.9–17.0 8.4 6.3–11.1 11.0 9.4–12.8 6.8 4.9–9.4 4.1 2.9–5.8 5.4 4.3–6.9 Santa Clara County, California 14.1 11.4–17.3 6.9 4.5–10.5 10.6 8.7–12.9 8.4 6.3–11.3 4.3 2.5–7.2 6.3 4.8–8.4 Tribe Cherokee Nation, Oklahoma 22.9 16.9–30.3 7.9 4.9–12.5 15.1 11.3–19.8 14.7 10.5–20.1 6.7 3.7–12.1 10.5 7.6–14.4 Median 14.2 7.8 11.0 6.2 6.3 5.9 Range 8.8–22.9 3.9–12.7 6.5–15.3 2.7–14.7 2.3–9.2 3.4–10.5 United States 16.3 15.2–17.3 7.3 6.1–8.6 11.8 11.0–12.6 7.5 6.6–8.4 4.2 3.5–5.1 5.9 5.2–6.5 * To lose weight or to keep from gaining weight during the 30 days before the survey. † Without a doctor’s advice. § 95% confidence interval.
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Table 16

TABLE 16. Percentage of high school students who vomited or took laxatives,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Female Male Total Steps community % CI† % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 11.8 8.7–15.9 4.6 2.7–7.8 8.3 6.2–10.9 Yuma County, Arizona 8.7 6.6–11.5 8.0 5.0–12.5 8.4 6.5–10.7 Mesa County, Colorado 4.6 3.0–7.0 1.2 0.6–2.5 2.9 1.9–4.3 Pueblo County, Colorado 7.8 5.5–10.9 5.4 2.8–10.2 6.7 4.8–9.3 Teller County, Colorado 7.3 4.8–10.9 7.1 4.9–10.2 7.2 5.4–9.4 Weld County, Colorado 7.6 5.8–9.9 6.2 3.9–9.6 6.9 5.3–8.9 Minneapolis, Minnesota 5.1 3.4–7.7 3.7 1.9–7.1 4.6 3.0–6.8 Rochester, Minnesota 5.2 3.3–8.0 2.4 1.3–4.4 3.9 2.7–5.6 St. Paul, Minnesota 3.6 2.1–6.2 2.0 0.9–4.2 2.8 1.8–4.4 Broome County, New York 7.4 4.8–11.3 4.5 2.7–7.4 6.2 4.3–8.9 Chautauqua County, New York 3.7 2.3–6.0 3.7 1.9–7.1 3.7 2.4–5.6 Jefferson County, New York 6.6 4.2–10.1 1.4 0.6–3.4 4.1 2.9–5.9 Rockland County, New York 5.1 2.9–8.7 4.8 2.3–9.7 4.9 2.9–8.2 Fayette County, Pennsylvania 4.4 2.8–6.8 2.4 1.3–4.4 3.3 2.2–5.0 Luzerne County, Pennsylvania 4.6 3.0–7.0 3.4 2.2–5.2 4.0 3.0–5.4 Tioga County, Pennsylvania 4.1 2.4–6.9 4.1 2.6–6.3 4.1 3.0–5.7 Large cities/urban communities Boston, Massachusetts 6.3 4.1–9.6 6.0 4.1–8.9 6.2 4.5–8.6 Cleveland, Ohio 6.2 4.4–8.6 6.9 4.6–10.1 6.5 4.8–8.8 DeKalb County, Georgia 6.0 4.8–7.5 4.1 2.9–5.7 5.1 4.2–6.2 Hillsborough County, Florida 6.8 4.7–9.8 4.3 2.3–7.9 5.5 3.9–7.8 New Orleans, Louisiana 6.7 5.3–8.4 9.1 7.2–11.4 7.9 6.6–9.3 Philadelphia, Pennsylvania 3.9 2.6–5.9 5.9 3.9–8.8 4.8 3.5–6.7 Salinas, California 7.0 5.3–9.2 3.6 2.1–5.9 5.3 4.2–6.6 San Antonio, Texas 6.6 4.6–9.3 3.1 1.9–5.1 4.8 3.6–6.4 Santa Clara County, California 5.1 3.7–7.0 2.0 1.1–3.7 3.9 2.7–5.6 Tribe Cherokee Nation, Oklahoma 7.9 4.0–15.2 1.2 0.4–3.6 4.4 2.7–7.0 Median 6.2 4.1 4.8 Range 3.6–11.8 1.2–9.1 2.8–8.4 United States 6.4 5.5–7.4 2.2 1.7–2.8 4.3 3.7–5.0 * To lose weight or to keep from gaining weight during the 30 days before the survey. † 95% confidence interval.
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Table 17

TABLE 17. Percentage of high school students who had lifetime asthma* and who had current asthma,† by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Lifetime asthma Current asthma Female Male Total Female Male Total Steps community % CI§ % CI % CI % CI % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona 16.6 12.9–21.1 18.3 14.6–22.8 17.6 14.7–21.0 7.9 5.6–11.1 6.7 4.4–9.9 7.2 5.5–9.4 Yuma County, Arizona 16.1 13.1–19.6 18.8 15.6–22.5 17.4 15.2–19.9 7.8 5.7–10.4 8.5 6.6–10.9 8.1 6.7–9.7 Mesa County, Colorado 16.5 13.2–20.5 19.8 16.2–24.1 18.2 15.6–21.1 9.6 6.9–13.0 10.4 7.5–14.1 10.0 7.8–12.6 Pueblo County, Colorado 26.4 22.5–30.6 26.7 22.3–31.7 26.8 23.4–30.5 13.5 10.1–17.7 12.3 9.9–15.1 13.1 10.9–15.7 Teller County, Colorado 24.3 19.8–29.4 18.2 15.1–21.8 21.3 18.4–24.5 13.4 10.3–17.2 7.8 5.6–10.8 10.6 8.4–13.2 Weld County, Colorado 22.0 18.0–26.6 24.9 21.1–29.0 23.4 20.7–26.3 11.4 9.1–14.2 11.7 9.0–15.1 11.5 9.7–13.6 Minneapolis, Minnesota 21.5 17.6–25.8 18.8 14.6–23.8 20.2 17.2–23.5 14.5 11.4–18.2 7.9 5.5–11.3 11.2 9.1–13.6 Rochester, Minnesota 25.2 20.7–30.3 21.3 17.3–25.9 23.1 19.9–26.8 16.0 11.7–21.5 9.7 7.0–13.3 12.9 10.0–16.4 St. Paul, Minnesota 18.5 14.6–23.2 15.3 11.3–20.4 16.8 14.0–20.2 10.6 7.8–14.3 5.9 3.6–9.7 8.2 6.1–11.0 Broome County, New York 26.5 22.5–30.9 24.7 19.9–30.2 25.7 22.3–29.5 14.5 11.3–18.4 12.8 9.1–17.7 13.7 11.3–16.6 Chautauqua County, New York 25.6 20.5–31.3 27.4 22.7–32.5 26.5 23.5–29.7 18.1 14.5–22.3 15.4 11.7–20.2 16.7 14.1–19.8 Jefferson County, New York 24.8 18.2–32.8 23.6 18.5–29.6 24.1 19.2–30.0 16.2 10.9–23.4 13.2 9.2–18.6 14.7 10.5–20.1 Rockland County, New York 24.8 21.1–28.9 25.7 21.6–30.2 25.2 22.2–28.5 11.8 8.9–15.5 11.0 8.1–14.8 11.4 9.2–14.0 Fayette County, Pennsylvania 19.0 15.5–23.0 19.7 16.5–23.4 19.3 16.9–22.0 10.5 7.7–14.1 9.0 6.5–12.3 9.7 7.7–12.2 Luzerne County, Pennsylvania 19.1 15.1–24.0 18.6 14.7–23.3 18.9 15.6–22.7 10.8 7.9–14.6 7.6 5.9–9.8 9.2 7.3–11.5 Tioga County, Pennsylvania 19.4 16.5–22.5 18.1 14.0–22.9 18.7 16.3–21.3 8.6 6.4–11.3 7.4 5.1–10.6 8.0 6.4–9.9 Large cities/urban communities Boston, Massachusetts 27.8 23.5–32.6 25.9 21.8–30.5 26.8 23.7–30.1 16.4 13.5–19.9 11.9 9.0–15.4 14.1 12.0–16.5 Cleveland, Ohio 18.0 14.9–21.7 26.0 21.4–31.2 21.9 19.2–24.8 11.2 8.8–14.3 12.9 9.8–16.7 12.0 10.1–14.3 DeKalb County, Georgia 23.5 21.4–25.8 26.9 24.2–29.8 25.3 23.6–27.1 13.1 11.1–15.4 11.7 9.9–13.8 12.5 11.1–13.9 Hillsborough County, Florida 25.0 20.4–30.2 28.8 22.4–36.1 26.9 23.0–31.2 13.7 9.7–19.1 15.9 11.0–22.3 14.7 11.3–18.9 New Orleans, Louisiana 25.6 23.2–28.1 31.6 28.5–34.9 28.5 26.5–30.5 12.8 10.5–15.5 12.3 10.3–14.8 12.5 10.9–14.4 Philadelphia, Pennsylvania 24.8 21.1–29.0 24.5 20.0–29.6 24.7 21.9–27.8 14.2 10.8–18.5 11.2 8.9–14.0 12.7 10.5–15.4 Salinas, California 20.0 16.5–24.1 17.3 14.7–20.3 18.6 16.5–21.0 10.1 7.5–13.5 6.8 5.1–8.9 8.4 6.7–10.5 San Antonio, Texas 17.3 14.6–20.4 16.9 13.6–20.8 17.4 15.2–19.8 9.5 7.5–12.0 7.3 5.3–10.0 8.5 7.0–10.3 Santa Clara County, California 18.8 14.8–23.6 23.3 18.6–28.7 21.3 18.8–24.0 8.5 6.1–11.7 7.8 6.0–10.0 8.4 7.1–9.8 Tribe Cherokee Nation, Oklahoma 18.7 13.6–25.2 20.3 15.1–26.7 19.5 15.2–24.6 9.3 6.3–13.6 6.6 4.3–10.1 7.9 5.6–10.9 Median 21.8 22.3 21.6 11.6 10.0 11.3 Range 16.1–27.8 15.3–31.6 16.8–28.5 7.8–18.1 5.9–15.9 7.2–16.7 United States 20.7 19.2–22.2 19.9 18.6–21.3 20.3 19.2–21.4 12.5 11.3–13.8 9.3 8.4–10.3 10.9 10.1–11.9 * Ever told by a doctor or nurse that they had asthma. † Ever told by a doctor or nurse that they had asthma and still have asthma. § 95% confidence interval.
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Table 18

TABLE 18. Percentage of high school students who went to an emergency room or urgent care center because of their asthma,* by sex — selected Steps communities, Youth Risk Behavior Survey, 2007 Female Male Total Steps community % CI† % CI % CI State-coordinated small cities/ rural communities Santa Cruz County, Arizona —§ — — — — — Yuma County, Arizona — — — — — — Mesa County, Colorado — — — — — — Pueblo County, Colorado — — — — 32.1 23.7–41.8 Teller County, Colorado — — — — — — Weld County, Colorado — — — — 12.6 7.1–21.5 Minneapolis, Minnesota — — — — 17.6 9.5–30.3 Rochester, Minnesota — — — — 15.6 9.7–24.2 St. Paul, Minnesota — — — — — — Broome County, New York — — — — 16.3 10.8–23.7 Chautauqua County, New York — — — — 17.6 10.5–28.0 Jefferson County, New York — — — — — — Rockland County, New York — — — — — — Fayette County, Pennsylvania — — — — — — Luzerne County, Pennsylvania — — — — 23.6 16.1–33.3 Tioga County, Pennsylvania — — — — — — Large cities/urban communities Boston, Massachusetts — — — — 29.8 20.8–40.8 Cleveland, Ohio — — — — 37.0 28.3–46.7 DeKalb County, Georgia 44.1 35.9–52.7 29.6 21.0–39.9 37.7 31.4–44.4 Hillsborough County, Florida — — — — — — New Orleans, Louisiana — — — — — — Philadelphia, Pennsylvania — — — — 30.3 22.8–39.1 Salinas, California — — — — — — San Antonio, Texas — — — — — — Santa Clara County, California — — — — 26.8 16.4–40.7 Tribe Cherokee Nation, Oklahoma — — — — — — Median 44.1 29.6 25.2 Range 44.1–44.1 29.6–29.6 12.6–37.7 United States — — — — — — * One or more times during the 12 months before the survey, among students who currently have asthma. † 95% confidence interval. § Not available.
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