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Health and Colorado's Kids

March 14, 2017

This project is a series of interactive dash boards, accompanied by in-depth analyses, focusing on the rich new dataset provided by the 2015 Healthy Kids Colorado Survey. The survey collects health information every other year from Colorado public school students. About 16,000 high school students took the 2015 survey. Results are tabulated on a statewide basis as well as by demographic characteristics. The data are also broken out regionally.

Sara Schmitt, CHI’s Director of Community Health Policy, is leading this project. Chrissy Esposito, who is working at CHI as a data visualization and storytelling intern, is creating the interactive data dashboards using Tableau software.

The survey is supported by the Colorado Department of Public Health and Environment, the Colorado Department of Education and the Colorado Department of Human Services. The University of Colorado Anschutz Medical Campus administers the survey. HKCS is funded primarily by state dollars and supplemented with federal resources. 

CHI is committed to helping stakeholders across Colorado look at data in new ways, and interact with it to focus on local information. An intimate understanding of the problem helps lead to targeted solutions — and a healthier Colorado.

Data Dashboard: Eighth in a Series on Heath and Colorado's Kids

 

Tracking Substance Use Among Colorado's High School Students: A Decline in Street Drugs but Little Change in Alcohol, Prescription Drugs

By: Chrissy Esposito, Data Visualization and Policy Analyst 

chrissy

Use of street drugs such as cocaine, heroin, methamphetamines and ecstasy declined among Colorado teens between 2013 and 2015. Rates of drinking and prescription drug use, though, remained little changed.

Those findings are based on an analysis of data from the Healthy Kids Colorado Survey, which is administered every two years. Nearly 16,000 high school students took the survey in 2015.

Roughly six of 10 students said they have tried alcohol, and 30 percent are regular drinkers.

Rates of one-time prescription drug use among students are much lower, at 13.7 percent. And regular use of both prescription is lower still at 6.7 percent, the 2015 results show.

The survey also reveals that substance use varies by geography. For example, drinking is highest in Western Slope counties and lower among those who live in the Denver metro area. One-time Prescription drug use is also the highest in Western Slope counties and lowest in Denver County.

This report is part of the Colorado Health Institute’s series of interactive dashboards and in-depth analyses of data from the 2015 HKCS. 

Alcohol

Alcohol is the substance of choice for many Colorado high schoolers. Nearly one of three (30.2 percent) said they had at least one drink in the past 30 days. And in some cases, students are experiment at an early age: a full 18 percent of high schoolers said they had at least one drink before turning 13.

There are geographic and demographic aspects to drinking. Not surprisingly, places where students said it’s easy to get alcohol also had the highest rates of one-time and regular use.

Most students (63 percent) in Chaffee, Fremont, Custer and Lake counties (Health Statistics Region 13) said it was easy to get alcohol. This area also reported some of the highest rates of one-time alcohol use (69 percent), binge drinking (21 percent), and drinking in the past 30 days (36 percent) — an indicator of regular use.

In the Eastern Plains counties of Elbert, Lincoln, Kit Carson and Cheyenne (Health Statistics Region 5), roughly 69 percent of students have tried alcohol, but only 25 percent said they are regular drinkers.  Notably, the survey found a large gap in Arapahoe County (Health Statistics Region 15) between students who said they had tried alcohol (53.4 percent) and those who said they are regular drinkers (15.7 percent).

There is a demographic component to drinking. For instance, one of three white students said they were regular drinkers, as did 40 percent of Native Hawaiian/Pacific Islanders. The rates were much lower for black students (16 percent), Asian students (19 percent) and Native American students (18 percent).

Data suggest that lesbian, gay, or bisexual (LGB) teens are more likely to have tried alcohol and regularly use it than heterosexual students.  Almost 75 percent of LGB students said they have tried alcohol compared with 58 percent of straight students.  Forty percent of LGB respondents said they drank alcohol in the previous month compared with 29 percent of heterosexual students.

Prescription Drugs

The Colorado Consortium for Prescription Drug Abuse Prevention reports that misuse of prescription drugs has become an epidemic. In Colorado, more than 16 percent of students reported they were given, sold or distributed prescription or illicit drugs on school property.

Statewide, 14 percent of students say they have used prescription drugs without a doctor’s note at least once in their life. The highest rates of one-time use were in places where students said drugs were easily obtained — Chaffee, Fremont, Custer and Lake counties (Health Statistics Region 13) at 19 percent and Clear Creek, Gilpin, Park and Teller counties (Health Statistics Region 17) at 18 percent. Denver County (Health Statistics Region 20) reported the lowest rate of use with 10 percent of students saying they have tried prescription drugs without a doctor’s orders.

Multiracial students were most likely to use prescription drugs at least once (18 percent) while black and Asian students were least likely, nine percent.  

As for use in the previous 30 days, about one of 10 students in Pueblo County (Health Statistics Region 7) and Health Statistics Region 13 reported using prescription drugs — the highest regular use in the state. Larimer County (Health Statistics Region 2) reported the lowest rate of just four percent.

Street Drugs

Some good news coming out of the 2015 survey was the overall decrease in use of street drugs by Colorado’s high schoolers.

Less than 6 percent of students said they ever used cocaine, heroin, methamphetamines or ecstasy. Overall, use declined among all racial and ethnic groups except Asian or Native Hawaiian/ Pacific Islander. Their rates of use, however, are very low.

About the Survey
Healthy Kids Colorado Survey, conducted every two years, is supported by the Colorado Department of Public Health and Environment, the Colorado Department of Education and the Colorado Department of Human Services. The University of Colorado Anschutz Medical Campus administers the survey. HKCS is funded primarily by state dollars and supplemented with federal resources. 

Data Dashboard: Seventh in a Series on Heath and Colorado's Kids

Physical Activity Among Colorado's High Schoolers 

By: Maggie Bailey, Research Analyst

maggie

 In this era of tablet computers and smartphones, it can be hard to put down the touch screen and get active.

So difficult, in fact, that 34.1 percent of Colorado high school students spend three or more hours on an average school day playing a video or computer game, according to the 2015 Healthy Kids Colorado Survey (HKCS). The rate has climbed from 2013, when it stood at  32.6 percent.

As for exercise, only 27.8 percent of Colorado high schoolers engage in 60 minutes of physical activity daily for all seven days of the week, the amount recommended by the Centers for Disease Control and Prevention (CDC). But about half (51.9 percent) do exercise at least 60 minutes five days a week, up from 49.1 percent in 2013 — perhaps a more representative standard.

The lure of technology isn’t the only reason some kids don’t regularly break a sweat. The lack of safe streets and sidewalks in a community also can discourage a student from walking or biking to school.

The availability of team sports and robust P.E. classes also play a role in whether a high schooler is an active teen or a sideline spectator. Health Statistics Regions (HSRs) with the highest percentage of students who reported being active also had the highest rates of students regularly showing up for P.E. classes. 

This analysis is part of the Colorado Health Institute’s series of interactive dashboards and in-depth analyses of data from the 2015 HKCS. About 16,000 high schoolers took the survey in 2015.

Physical Activity

The most physically active students live in rural areas. Just over 75 percent of students in the central Eastern Plains (HSR 5), 63.3 percent in northeastern Colorado (HSR 1) and 61.9 percent in northwest Colorado (HSR 11) reported being active at least an hour in five of the previous seven days. These regions also had the highest rates of students meeting the CDC’s recommended 60 minutes of daily physical activity.

The HSRs with the lowest rates of students meeting the one-hour/five-day activity level are urban — Boulder (HSR 16 at 48.3 percent), Denver (HSR 20 at 46.4 percent) and Arapahoe (HSR 15 at 43.1 percent) counties.

There’s a demographic component to exercise as well. Over half (54.2 percent) of heterosexual students reported meeting the five-day standard compared with 39.4 percent of gay, lesbian or bisexual (LGB) students, the survey said.

Asian students are least likely to be active, with 38.1 percent saying they met the five-day standard compared with 44.8 percent of Hispanic students and 48.9 percent of black students. White students and multiracial students are more likely to be active, 55.5 percent and 53.9 percent, respectively.

That said, one of 10 high schoolers (12.5 percent) said they were not active for at least an hour on any day of the previous week. Counties with the lowest rates are urban. Fewer than one of five of students in Pueblo, Denver, and Arapahoe counties said they didn’t participate in at least 60 minutes of physical activity in the previous seven days.

Active Transportation

Walking, biking or skateboarding to a destination fall under the category of “active transportation.”

The highest rates of active transportation one or more days a week are among high schoolers in Boulder (21.6 percent), Denver (27.3 percent) and Arapahoe (23.4) counties

On the other hand, only 13.1 percent of students in Mesa County (HSR 19) said they got to school using their feet. That is the lowest rate in the state, followed by Pueblo County (HSR 7) at 13.4 percent and counties in central Eastern Plains (HSR 5) at 14.2 percent.

Across Colorado, 45.3 percent of respondents said they could get to school walking, biking or skateboarding but only 18.6 percent said they did, a 26.7 percentage point difference. In 2013, the percentage point difference stood at  28.0,  when 47.8 percent of high schoolers said they could walk, bike or ride to school while only 19.9 percent did.

The biggest gap is in the central Eastern Plains. Almost half of students (49.9 percent) said they could get to school by walking, biking or riding a skateboard but only 14.2 percent did so — a 35.7 percentage point difference. Western slope counties (HSR 10) closely followed, with 49.1 percent of students reporting they could get to school via active transportation but only 19.1 percent who did so.

Physical Activity at School and in the Community

Nearly two of three high schoolers (60.1 percent) played on a sports team in the previous 12 months, a small drop from 61.4 percent in 2013. However, there are big differences in terms of race, ethnicity and sexual orientation.  

The rates of sports participation are basically the same for white students (62.3 percent), black students (62.9 percent) and multiracial students (61.4 percent). Nearly eight of 10 (79.7 percent) students who identified t as Native Hawaiian or Pacific Islander said they played on a sports team in the previous 12 months. For Hispanics, the rate is 56 percent and it’s 46.6 percent for students who identified themselves as Asian.

Heterosexual students are more likely to play sports (63 percent) than LGB students (41.3 percent) and those who are unsure of their orientation (45.4 percent).

Students in urban areas are less likely to play on a sports team compared with their rural counterparts. The five lowest rates of students belonging to a team are in Arapahoe, Denver, Pueblo, Mesa and Adams counties. The lowest rate in the state is Adams County at 54.7 percent.

On the other hand, the three highest rates are in rural areas. Nearly 83 percent of students in counties along the Eastern Plains played on a sports team in the previous year, followed by southeast Colorado (HSR 6 at 74.8 percent) and northwest counties (HSR 11 at 68.3 percent).

For students who aren’t interested in high school sports, P.E. classes can be an alternative to get active during school. Two of the three HSRs, 1 and 5, with the highest rates of high schoolers attending P.E. classes are also high in physical activity. Overall, about four of 10 high schoolers (40.7 percent) reported attending a P.E. class one more days on an average school week, down from 46.2 percent in 2013.

About the Survey
Healthy Kids Colorado Survey, conducted every two years, is supported by the Colorado Department of Public Health and Environment, the Colorado Department of Education and the Colorado Department of Human Services. The University of Colorado Anschutz Medical Campus administers the survey. HKCS is funded primarily by state dollars and supplemented with federal resources. 

Data Dashboard: Sixth in a Series on Heath and Colorado's Kids

Marijuana and Colorado's High Schoolers

By: Sara Schmitt, Director of Community Health Policy

sara healthy kids

In 2013, one of five Colorado high schoolers said they recently had used marijuana. Two years later, not much had changed, even though retail marijuana sales to adults became legal in 2014.

Colorado high school usage climbed just one percentage point to 21 percent by 2015, according to the 2015 Healthy Kids Colorado Survey. Not only was that little changed from 2013, it was lower than the national average of 22 percent.

Some students in Colorado — those who are lesbian, gay or bisexual (LGB), older or multiracial — are more likely to use marijuana than others, the survey shows. High schoolers in western Colorado are more likely to use marijuana than those on the Eastern Plains.

- The highest rate of use was among LGB students. One of three (35 percent) said they had used marijuana compared with one of five (20 percent) heterosexual students.

- Nearly 28 percent of 12th graders said they had used marijuana at least once during the past 30 days compared with 12 percent of ninth graders, according to the survey.

- About 28 percent of multiracial students had used marijuana in the past month compared with about 24 percent of Hispanic students and 20 percent of white students.

- High school students in eastern Colorado had lower rates of marijuana use than those on the Western Slope and southwest Colorado. About 10 percent of high school students in Elbert, Lincoln, Kit Carson and Cheyenne counties — Health Statistics Region (HSR) 5 on the Eastern Plains — used marijuana compared with about one of four students (24.5 percent) in Garfield, Eagle, Pitkin, Grand and Summit counties (HSR 12).

Other regions in Colorado with above average percentages of high school students using marijuana are Denver County (HSR 20); Dolores, Montezuma, La Plata, Archuleta and San Juan counties (HSR 9); and Garfield, Pitkin, Eagle, Grand and Summit counties (HSR 12).  

While overall rates of marijuana use did not increase significantly, the northwestern Colorado counties of Jackson, Moffat, Rio Blanco and Routt (HSR 11) recorded the biggest jump in the state, climbing five percentage points.

The biggest drop came in the southwestern counties of Delta, Gunnison, Montrose, San Miguel, Ouray and Hinsdale (HSR 10), where usage fell by nine percentage points.

Fewer Colorado students view regular marijuana use as a concern. Just under half (48 percent) said it was risky in 2015, down from 54 percent in 2013. 

About the Survey
Healthy Kids Colorado Survey, conducted every two years, is supported by the Colorado Department of Public Health and Environment, the Colorado Department of Education and the Colorado Department of Human Services. The University of Colorado Anschutz Medical Campus administers the survey. HKCS is funded primarily by state dollars and supplemented with federal resources. 

 Data Dashboard: Fifth in a Series on Heath and Colorado's Kids

Sexual Health and Colorado's High Schoolers

By: Emily Johnson, Senior Policy and Statistical Analyst

ian

It can be awkward to talk about, but sex is a part of every high schooler’s life.

In Colorado, about one of four high school students is currently having sex, and one of three have had sex at some point. Even for students who aren’t sexually active, high school is a time when they’re learning about sex, relationships and safety. Information and guidance come from a variety of (sometimes conflicting) sources — doctors, parents, teachers, friends, movies, the internet and more.

To figure out how this all translates to actual behavior, the Colorado Health Institute (CHI) turned to recently-released data from the 2015 Healthy Kids Colorado Survey (HKCS). We looked at sexual health across a range of topics including sexual activity, contraceptive use, sexually-transmitted infection (STI) prevention and sexual or relationship violence.

Some of what we found is concerning.

  1. More than seven percent of high schoolers say they have been physically forced to have sex against their will. In a classroom of 30, that’s at least two students — a nine percent increase from the proportion that reported forced sex in 2013.
  2. More students are initiating sex at younger ages. The percentage of high school students who reported having sex before age 13 increased to four percent in 2015 from three percent in 2013.
  3. Despite recent legislation meant to increase sexual education standards and funding, 76 percent of students say they have been taught about HIV/AIDS in school — the lowest percentage since the survey began in 1999, and part of a consistent downward trend over those 17 years (with the exception of 2001).
  4. More high school students are having unprotected sex. Sixty-one percent of students used a condom that last time they had sex, down from 64 percent two years ago. The number of students who don’t use any contraception at all increased from 10 percent to 12 percent.

There are a few bright spots. The number of students using the highly-effective LARC method of birth control grew considerably, from five percent to eight percent, and fewer students say they are having sex under the influence of drugs or alcohol.

And high schoolers in some parts of the state are engaging in healthier sexual behaviors. Condom use in Mesa County increased considerably, jumping to 73 percent in 2015 from 60 percent in 2013. In the mountainous counties of health statistics region 12, the proportion of students having sex without using birth control dropped by more than a third, from 11 percent in 2013 to seven percent in 2015.

But overall, Colorado struggles to move the needle on many measures of sexual health — and in some places, things are getting worse.

This report about sexual health in Colorado’s high schools is the fourth in a series by CHI delving into findings from the HKCS, which collects health information every other year from Colorado public school students. About 16,000 high school students took the 2015 survey.

Sexual Practice: Ever Had Sex

In 2015, 35 percent of high school students say they’ve had sex at least once in their life — up slightly from 33 percent in 2013. This looks similar across most regions of the state, but in some southeastern counties (HSRs 6 and 7), rates are nearly 50 percent. Boulder and Broomfield counties (HSR 16) has the lowest rate of sex among high schoolers at 29 percent, followed by Larimer County (HSR 2) at 31 percent.

Half of lesbian, gay, and bisexual (LGB) students say they have had sex, compared with 34 percent of their heterosexual peers. Students who are unsure of their sexual orientation are the least likely to have ever had sex (33 percent).

By the time students enter senior year, 55 percent have engaged in sex at some point.

Sexual Practice: Currently Sexually Active

In addition to more students having a history of sexual activity, more students are currently sexually active than they were two years ago. A student is considered currently sexually active if he or she has had sex in the past three months.

In 2015, 25 percent of Colorado high schoolers say they are currently sexually active, up from 23 percent in 2013. Unsurprisingly, those areas with the highest and lowest rates of students who have ever had sex also had the highest and lowest rates of currently sexually-active students.

Sexual Practice: Age at Sexual Debut

The percentage of students who had sex for the first time before age 13 also appears to be on a slow rise, going from three percent in 2013 to four percent in 2015.

Interestingly, while students who are unsure of their sexual orientation are the least likely to report ever having had sex, those among them who have had sex are the most likely to report starting at age 12 or younger (12 percent). Nine percent of sexually-active LGB students and three percent of heterosexual students report initiating sex at this age.

There is great variability by race and ethnicity as well. Eight percent of black students and nine percent of American Indian/ laska Native students had their sexual debut before age 13, compared with two percent of white students.

Students in Denver County (HSR 30) are the most likely to report pre-teen sexual debut (six percent). The rate is three times lower in Boulder and Broomfield (HSR 16) and Larimer County (HSR 2).

Safer Sex: Contraception

First the bad news: the number of high school students who say they did not use any birth control during their last sexual encounter grew from 10 percent in 2013 to 12 percent in 2015.

The good news: among younger students, contraceptive use is increasing. Nine percent of sexually-active ninth graders say they did not use birth control in 2015, down from 14 percent in 2013.

And nearly twice as many students are using a long-acting reversible contraceptive (LARC) method. These methods (intrauterine devices and implants) are the most reliable forms of reversible contraception available — as effective at preventing pregnancy as sterilization.

Eight percent of students are now using a LARC method, compared with less than five percent two years ago. Colorado’s rate of LARC use is higher than the U.S. overall --- nationally, just three percent of sexually-active students use an IUD or implant.[i]

This consistently high use has been linked to the success of the Colorado Family Planning Initiative, which sought to improve LARC access for teens at Title X clinics. (Title X clinics are publicly-funded sites that provide comprehensive family planning services and more to low-income and underserved individuals.)

Use of LARC varies greatly across Colorado, from 16 percent in Denver County (HSR 20) to three percent in the northeast corner of the state (HSR 1). More remote counties, which have few or no Title X clinics, tend to have the lowest rates of LARC use.

Safer Sex: Condoms

The percentage of students who report using a condom during their last sexual encounter is also in decline. In 2015, 61 percent of sexually-active students used a condom, down from 64 percent in 2013 and 71 percent in 2011.

This is the reverse of a national trend of increased condom use since 1991.Why? It’s hard to say, but the trend does coincide with another pattern — despite 2013 legislation that intended to make sexual education more comprehensive in Colorado, every year, fewer and fewer students are reporting that they were taught about HIV/AIDS in school.

Without comprehensive education around HIV/AIDS, more students may see condoms as a tool for pregnancy prevention rather than protection from HIV or other STIs — in which case, using it in addition to another form of birth control could seem duplicative.

Safer Sex: Drugs and Alcohol

Alcohol, drugs and sex can be a dangerous combination. One of five high school students (21 percent) say they drank or used drugs before their last sexual intercourse, a slight improvement from 23 percent two years ago.

But this isn’t the same across all demographic groups. While in 2013, 28 percent of male students report the use of drugs or alcohol before sex compared with 17 percent of female students, this gender gap has narrowed. In 2015, 21 percent of male students and 19 percent of female students combined sex with drugs or alcohol.

Sex and Violence: Relationship Violence

Nine percent of students who dated someone in 2015 reported they were intentionally physically hurt by their partner at one point in the past year. This is a very slight improvement from the 10 percent that experienced dating violence in 2013.

Rates of relationship violence among high school students range from as high as 15 percent in Pueblo County (HSR 7) to a low of seven percent in the San Luis Valley (HSR 8).

More than one of 10 female students (12 percent) report having had a violent partner compared with seven percent of male students. Rates of dating violence were also much higher among students of Asian descent (18 percent) than white, black or Hispanic students (eight to nine percent).

But when it comes to relationship violence, the starkest contrast is between students of different sexual orientations. LGB students are nearly three times as likely to report they have been physically hurt on purpose by someone they were dating (20 percent) compared with seven percent of heterosexual students. Dating violence is even more common among students who are unsure of their sexual orientation (25 percent).

Sex and Violence: Forced Sex

More than seven percent of Colorado students report that they have been physically forced to have sex when they didn’t want to, up slightly from 2013.

That’s far too many students. And these rates are even higher in some parts of the state. In Pueblo County (HSR 7), which also has the highest rate of relationship violence, one of 10 of students have been raped.

Similar to dating violence, rape is a much larger problem for female students than male students. Girls are three times more likely to be forced to have sex against their will than their male peers (11 to four percent).

Lesbian, gay, and bisexual students are four times more likely to be physically forced to have sex (20 percent) than their heterosexual peers (five percent).

About the Survey
Healthy Kids Colorado Survey, conducted every two years, is supported by the Colorado Department of Public Health and Environment, the Colorado Department of Education and the Colorado Department of Human Services. The University of Colorado Anschutz Medical Campus administers the survey. HKCS is funded primarily by state dollars and supplemented with federal resources. 


[i] Centers for Disease Control and Prevention (June 10, 2016). Youth Risk Behavior Surveillance – United States, 2015. Surveillance Summaries, 65(6); 1-174. Available at: http://www.cdc.gov/mmwr/volumes/65/ss/ss6506a1.htm

Data Dashboard: Fourth in a Series on Heath and Colorado's Kids

Tobacco and Colorado's High Schoolers

By: Ian Pelto, Public Interest Fellow

ian

Holy smokes! Fewer Colorado high school students are smoking cigarettes, but many appear to be switching to electronic vapor smoking devices for their nicotine fix.

Those are among the findings of the 2015 Healthy Kids Colorado Survey, which collects health information from Colorado public school students.

The 2015 results found that 8.6 percent of students smoked cigarettes in the previous month, down from 10.7 percent in the 2013 Healthy Kids Colorado Survey. High school smoking in Colorado is just slightly lower than the national average of 9.3 percent[i].

Rates of teen smoking vary considerably by geography, sexual orientation, race and ethnicity.

Rural students are much more likely to try smoking cigarettes than urbanites. In Arapahoe County (Health Statistics Region 15), 14.6 percent of students said that they had tried smoking an entire cigarette. But right next door in more rural Lincoln, Elbert, Kit Carson, and Cheyenne counties (Health Statistics Region 5), 38.6 percent of students report that they have tried smoking a cigarette.

About one of five lesbian, gay and bisexual (LGB) students (20.6 percent) reported smoking one or more cigarettes in the past 30 days, a rate three times higher than their heterosexual classmates (6.8 percent).

There are racial and ethnic differences as well. Just over 13 percent of multiracial students smoke, while only 4.7 percent of black students smoke. White and Hispanic students both fall in the middle at 8.3 percent.

More than half (57 percent) of high school students believe it would be easy for them to get cigarettes if they wanted to, and only one of three underage students (31.8 percent) said that they were refused when they tried to buy them.

Easier access is found in regions with above average cigarette use. Lake, Chaffee, Fremont, and Custer counties (Health Statistics Region 13), have the highest rate of cigarette smoking by high schoolers at 19.5 percent and the highest rate who said it’s easy to get a cigarette at 71.3 percent. Denver County (Health Statistics Region 20), which reported the lowest smoking rate in the state at 5.9 percent, also has the second lowest proportion of students reporting easy access at 51.9 percent.

Meanwhile, though cigarette smoking is declining, more than one of four students (26.1 percent) reported they have used an electronic vapor device to smoke at least once in the past 30 days. This percentage is highest among LGB students, with 37.4 percent having recently used vaporizers.

The 2015 Healthy Kids Colorado Survey is the first to ask questions about these devices, which use a small cartridge of nicotine-containing product and an atomizer to turn the liquid into a smoke-like vapor that can be inhaled.

Nearly half (46.2 percent) of high school students say they have tried using an E-vapor device. That’s more than twice the 20.0 percent who said they had ever smoked a cigarette. The FDA began regulating vaporizers in August 2016. While their short- or long-term health effects are still largely unknown, the case against cigarettes is clear: Cigarette smoking is the leading preventable cause of death in the United States 

Data Dashboard: Third in a Series on Heath and Colorado's Kids

Bullying and Colorado's High Schoolers

By: Deborah Goeken, Vice President

deb

Heartbreaking.

That’s how a national public health official described new data that show gay, lesbian or bisexual high school students across the United States are at far greater risk for bullying than their straight peers.

The heartbreak is happening in Colorado as well.

New findings from the Healthy Kids Colorado Survey reveal that more than 36 percent of gay, lesbian or bisexual students report having been bullied at school, roughly twice the 18.2 percent of heterosexual students who said they were bullied on school property.

The difference extends to cyberbullying, with 29 percent of gay, lesbian or bisexual students saying they have been electronically bullied, more than double the 13.1 percent rate of cyberbullying for straight students.

Multiracial students have the highest rate of being bullying because someone thought they were gay, lesbian or bisexual at 13.8 percent, followed by white students at 9.6 percent and Hispanic students at 6.6 percent.

The survey also found that teen girls are more likely to be bullied than teen boys. Nearly one of four girls (23.9 percent) said they were bullied at high school compared with 16.4 percent of boys. The same pattern holds true for cyberbullying, with 20.7 percent of girls saying they have been electronically bullied compared with 9.5 percent of boys.

When it comes being bullied because of race/ethnicity, Asian students reported the highest level of bullying at 33.7 percent, more than triple the rate of white students who said they were bullied (10.5 percent.)

And there are variations across Colorado when it comes to bullying. High school students in the health statistics region (HSR) of Lake, Chaffee, Fremont and Custer counties (HSR 13) in central Colorado reported the highest rate of bullying at 28.1 percent and cyberbullying at 23.2 percent.

This is also the area where teens are most likely to report being bullied by someone who thought they were gay, lesbian or bisexual, with 14.1 percent saying this had happened to them. In the northeastern Colorado counties of Sedgwick, Phillips, Yuma, Washington, Logan and Morgan counties (HSR 1), 12.4 percent reported being bullied for this reason, the second highest rate.

The problem of bullying is pervasive, with 11 HSRs, of the 17 with data about cyberbullying, above the state average of 15.1 percent. Denver County, the state’s biggest metro school district, is in the lowest tier for bullying rates. 

Data Dashboard: Second in a Series on Heath and Colorado's Kids

Mental Health and Colorado's High Schoolers

By: Zoe Wohlgenant, Intern

zoe

Nearly one of three Colorado high school students (29.5 percent) feel so sad or hopeless for two weeks in a row that they stop doing their usual activities, a common symptom of depression. That’s up from less than 25 percent in 2013, according to newly released data from the 2015 Healthy Kids Colorado Survey.

CHI analyzed the results of the survey to better understand how Colorado’s high school students are faring when it comes to mental health. The findings described in this analysis demonstrate that mental health weighs heavily on Colorado’s youth.

Overall, poor mental health is on the increase, with some students in some groups struggling more than others.

Methodology

The results are tabulated on a statewide basis as well as by demographic characteristics. The data are also broken out regionally based on the 21 health statistics regions (HSRs) created by the Colorado Department of Public Health and the Environment. Larger counties make up their own HSRs while smaller counties are grouped together. CHI’s analysis of the mental health data focuses on demographic breakdowns, rather than on geographic variations, because many HSR sample sizes were too small to determine whether differences were statistically significant. The 2015 survey lacks data from four large counties – Weld, Douglas, Jefferson and El Paso. Douglas County did not participate in the survey.  Participation was so low in Weld, Jefferson and El Paso counties that the data could not be broken out individually, but it is included in the statewide findings. 

Feeling Sad and Hopeless

The percentage of students who reported symptoms of depression increased by about five percentage points to 29.5 percent in 2015 from 24.3 percent in 2013.  This increase stands out compared with the national rate, which stayed the same between 2013 and 2015 at 29.9 percent.

The statewide average hides troubling differences among certain students. A majority of LGB students (61.3 percent) report feeling depressed, compared with 25.3 percent of heterosexual students. And high school girls report much higher rates of depression (40 percent) than boys (20 percent).

There are significant differences between racial/ethnic demographics, too. Nearly half (46.5 percent) of Native Hawaiian/Pacific Islander students report feeling depressed. This compares with 28 percent of white students, 30.8 percent of black students and 36.6 percent of multiracial students. 

Suicide

The proportion of Colorado students seriously considering suicide is similar to the national average —17.4 percent in Colorado compared with17.7 percent nationally. However, Colorado’s rate increased from 14.5 percent in 2013 while the national average only increased slightly from 17.0 percent.

The same types of students who are likely to experience symptoms of depression report having serious thoughts about suicide. At 46.3 percent, Colorado’s LGB high school students are more than three times as likely as their heterosexual peers (13.8 percent) to have seriously considered committing suicide in the past year.

Females struggle more with suicidal thoughts than males. Almost one of four female students (22.9 percent) have seriously considered suicide in the past year, compared with 12 percent of male students.

Black students are least likely to consider suicide (11.2 percent), while multiracial students (22.4 percent) and Native Hawaiian students (23 percent) are most likely to consider suicide.

Nearly eight percent of all Colorado high schoolers – 1,095 students – attempted suicide at least once in the past 12 months. That’s lower than the national average of 8.6 percent, but still an increase from the state average of 6.6 percent in 2013.

Not surprisingly, students more likely to seriously consider suicide also have higher rates of suicide attempts. One in four (25.4 percent) of LGB students attempted suicide, compared with 5.6 percent of heterosexual students. And at 11 percent, female students were almost three times as likely as their male classmates to have attempted to commit suicide (4.4 percent).

Following this same pattern, about 15 percent of multiracial students attempted suicide. That’s more than twice the rate of white students (6.9 percent) and black students (5.6 percent). Data are not available on suicide attempts among Native Hawaiian/Pacific Islander students due to sample size.

Trusted Adults

Nearly three of four (71.3) percent of Colorado high schoolers have an adult to go to for help with a serious problem. The types of students who felt they could turn to an adult for help were the same types who were least likely to report depression or suicidal thoughts.  

Only 60.3 percent of LGB students and 48.8 percent of students who were unsure of their sexual orientation report having a trusted adult while 73.9 percent of heterosexual students have an adult to go to with a serious problem. Slightly more male students (73.5 percent) report having a trusted adult than females (69.1 percent). And three of four white students (74.4 percent) feel they can count on an adult, compared with 65.6 percent of Hispanic students and 68.2 percent of multiracial students.

Data from the Healthy Kids Survey shows that having a trusted adult makes a big difference in the mental health and wellbeing of students—those who do are 3.5 times less likely to attempt suicide.

Health Care Providers

Health care providers are increasingly discussing strategies to cope with anxiety and sadness among teens — a positive development.

More than one of five students (22.9 percent) said they talked with their doctor or nurse about how to deal with feeling sad or hopeless during their last checkup. That’s up from 19 percent in 2013 and likely a result of a statewide focus on increased mental health screening in primary care settings. 

Data Dashboard: First in a Series on Health and Colorado's Kids

Colorado High School Students: Who is Most Likely to Confront Violence at School?

By: Maggie Bailey, Research Analyst

maggie


School is a frightening place for some of Colorado’s high school students.

Newly released data from the 2015 Healthy Kids Colorado Survey show that 5.5 percent of students say they skipped school because they felt unsafe while they were there or while they were getting there. That’s up just a bit from 2013, when 5.2 percent of students reported feeling so unsafe that they skipped school.

But school is far scarier — and, in some cases, even dangerous — for certain students, according to the survey.

The results are tabulated on a statewide basis as well as by demographic characteristics. The data are also broken out regionally based on the 21 health statistics regions (HSRs) created by the Colorado Department of Public Health and the Environment. Larger counties make up their own HSRs while smaller counties are grouped together. The 2015 survey lacks data from four counties – Weld, Douglas, Jefferson and El Paso. Douglas County did not participate in the survey.

Unsafe at School: Weapon Threats and Injuries

Among Colorado’s high school students, 5.6 percent say they were threatened or actually injured by someone wielding a gun, knife, club or other weapon in the 12 months before the survey.

The three highest rates for threats or injuries are in Pueblo County (8.6 percent), the region (HSR 13) of Lake, Chaffee, Fremont and Custer counties (7.8 percent) and the region (HSR 17) of Gilpin, Clear Creek, Park and Teller counties (7.6 percent). Large urban school districts tend to have higher rates of violence. Still, some of Colorado’s larger districts are managing to turn in relatively lower rates of threats and injuries. The rate in Denver County, for instance, is 5.6 percent. In Mesa County, home of Grand Junction, it’s 5.9 percent. Boulder County was among the three lowest rates in the state, at 4.1 percent.

Unsafe at School: Gang Threats and Injuries

Statewide, 6.8 percent of students say they have been the victim of gang threats or injuries in the past year.

American Indian/Alaska Native students were the most likely to say they have been threatened or injured by gangs at 11.8 percent. Multiracial students were second at 11.2 percent, followed by Asian students at 9.4 percent, black students at 8.4 percent and Hispanic students at 8.3 percent. The rate for white students, by comparison, is 4.9 percent. And sexual orientation makes a difference, with 11.4 percent of LGB students saying they have been victims of gang threats or injuries, twice the rate of heterosexual students (5.8 percent).

Eleven percent of Denver County students report that they have received gang threats or injuries, the highest level in Colorado. Pueblo County is second at 10.5 percent.

Skipping School Because it Feels Unsafe

While 5.5 percent of Colorado’s high school students say they skipped school in the month before the survey because they were frightened either at school or on the way to school, certain students report more worries about safety. More than 12 percent of LGB students say they skipped school because they felt unsafe compared with 4.1 percent of heterosexual students. And among multiracial students, 8.9 percent say they skipped school out of fear. The rate for Hispanics is 5.4 percent. By comparison, 4.6 percent of white students report not going to school because they feel unsafe.

Eight percent of Pueblo County’s high school students say they skipped school out of fear, the state’s highest rate. The region (HSR 17) of Clear Creek, Park and Teller counties was second at 7.9 percent.

Unsafe at School: Rural versus Urban

The four areas where students are most likely to skip school because they feel unsafe are in counties that are classified as urban in Colorado: Pueblo County (8 percent); the region (HSR 17) of Clear Creek, Park and Teller counties (7.9 percent); Adams County (6.2 percent); and Mesa County (5.9 percent).

Some of the lowest percentages of students skipping school out of fear are in rural areas: the southwestern region (HSR 10) of Delta, Gunnison, Montrose, Ouray, Hinsdale and San Miguel counties (3.4 percent) and the San Luis Valley region (HSR 8) of Saguache, Rio Grande, Conejos, Mineral, Alamosa and Costilla counties (4.0 percent.) Larimer County, the urban county that is home to Fort Collins, has the second lowest rate of 3.9 percent.

Students impacted by gang violence tend to be in urban areas rather than rural. But there are exceptions here as well: the rural area (HSR 13) of Lake, Chaffee, Fremont and Custer counties has the third highest rate of gang-related threats or injuries.

And that trend continues, with some notable exceptions, when it comes to students being threatened or injured with a weapon at school. For example, the urban areas of Pueblo County (HSR 7), Clear Creek, Park, Gilpin and Teller counties (HSR 17) and Adams County (HSR 14) make up three of the top six. But the other three are in rural areas: Lake, Chaffee, Fremont and Custer counties (HSR 13), the northeast corner region (HSR 1) of Sedgwick, Phillips, Logan, Morgan, Washington and Yuma counties and the northwest corner region (HSR 11) of Moffat, Rio Blanco, Routt and Jackson counties.

Weapons: At School and Away

Nearly 16 percent of Colorado high school students say they carried a gun, knife or other weapon in the month before the survey. But only  4.1 percent report carrying a  weapon to school.

There are broad geographic differences, with rural students more likely to carry a weapon. In the Eastern Plains region (HSR 5) of Elbert, Lincoln, Kit Carson and Cheyenne counties, nearly 40 percent of students carry weapons. In the northwest corner area (HSR 11) of Moffat, Rio Blanco, Routt and Jackson counties, about one of three students (32.5 percent) reports having a weapon.

When it comes to bringing weapons to school, the rates are lower but rural students are still most likely to have a gun or knife on school grounds, led by the northwest corner (HSR 11) students at 14.2 percent and followed by the Eastern Plains (HSR 5) students at 11.0 percent. Denver County was lowest at 2.3 percent.

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