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The State of Health in New Mexico 2018

3. Healthy Youth

Healthy Behaviors Foster Resilient Youth

The future success and health of New Mexico youth may be determined by the behaviors they engage in as young people. From 2014-2016, the five leading causes of death among New Mexicans aged 15-24 years were unintentional injury (predominantly motor vehicle crashes and drug overdoses), suicide, homicide, cancer, and congenital abnormalities. These causes of death are associated with alcohol and drug use, suicidal behaviors, and physical violence. The three leading causes of death, unintentional injury, suicide, and homicide, are highly associated with behaviors that can be modified, such as alcohol and drug use, seat belt use and other driving behaviors, suicidal behaviors, and engaging in physical violence. For two of the leading causes of death, New Mexico has experienced decreases in death rates over the last decade. Unintentional injury deaths decreased from 55 per 100,000 youth aged 15-24 years from 2004-2006 to 45 per 100,000 from 2014-2016, and homicides decreased from 14 per 100,000 to 11 per 100,000 over the same time period.

The chronic diseases that are among the leading causes of death for New Mexicans of all ages (cancer, heart disease, respiratory diseases, stroke, and diabetes) are associated with risk behaviors often initiated during adolescence, such as tobacco use, alcohol use, poor nutrition, and inadequate physical activity. Unsafe sexual behaviors put young people at risk of unplanned pregnancy and sexually transmitted infections. Strong relationships between youth and their families, schools, peers, and communities can encourage resiliency in young people and help them to avoid the many risks facing them. The 2015 New Mexico Youth Risk and Resiliency Survey (YRRS) examined these risk behaviors and resiliency factors among high school and middle school students.

Alcohol, Tobacco, and Other Drug Use

Alcohol use at an early age is associated with adverse outcomes later in life, such as alcohol dependence and abuse, and is also associated with traffic-related fatalities and other injuries. Most alcohol related behaviors have decreased in prevalence in recent years among New Mexico high school students. Current drinking (at least one drink in the past 30 days) decreased from 50.7% in 2003 to 26.1% in 2015, and binge drinking decreased from 35.4% to 14.6% (Figure 1). Among middle school students, 8.5% were current drinkers and 5.0% were binge drinkers.

Alcohol use varied with parent education, an indicator of socioeconomic status. High school students whose parents didn't finish high school had a higher rate of binge drinking than those parents with a college or professional school education (18.9% vs. 10.3%). There were no differences for most alcohol indicators by race/ethnicity.

Illicit drug use among adolescents is associated with heavy alcohol and tobacco use, violence, and suicide. In descending order, drugs with the highest current use rates among high school students were marijuana (25.3%), painkillers to get high (7.9%), ecstasy (4.6%), cocaine (4.5%), methamphetamines (3.2%), inhalants (4.2%), and heroin (2.8%). Among middle school students, lifetime use rates were 14.0% for marijuana, 6.7% for inhalants, 5.2% for prescription drug use without a prescription, 2.7% for cocaine, and 2.5% for pain killers to get high. While American Indian high school students had a higher rate of current marijuana use (33.9%) than other students, other differences in drug use by race/ethnicity were not statistically significant. In the case of every drug, the prevalence of use increased with decreasing levels of parent education.

Tobacco use increases the risk of several chronic diseases, such as heart disease, chronic obstructive pulmonary disease, acute respiratory illness, stroke, and various cancers. The rate of current cigarette smoking among high school students decreased substantially from 2003 (30.2%) to 2015 (11.4%). The high school current spit tobacco use rate was 8.7%, with no trend in recent years. E-cigarette use was the most common current tobacco use behavior (24.0%), and one-third (33.4%) of all high school students were current users of at least one form of tobacco (cigarettes, cigars, hookah, spit-tobacco, or e-cigarettes). Among middle school students, 4.3% were current cigarette smokers, 12.0% were current e-cigarette users, and 14.1% used at least one form of tobacco. Among middle school students there was no difference between boys and girls for current use of at least one form of tobacco, while among high school students, boys were more likely than girls to use at least one form of tobacco (37.6% vs. 28.9%). High school students whose parents had more education were less likely to use at least one form of tobacco than those whose parents had less education.

Suicidal Behaviors

Past suicide attempts are a leading risk factor for future suicides. Past year suicide attempts among high school students have decreased over the past several years from a high rate of 14.5% in 2003 to 9.4% in 2015. In 2015, 8.8% of middle school students made at least one lifetime suicide attempt.

Suicide attempts were far more common among girls than boys. This is true in both middle school (12.0% vs. 4.4%) and high school (12.4% vs. 6.4%). Among high school students, American Indian students (13.9%) had higher rates than Hispanic (8.6%) or White (8.6%) students. Disparities by race/ethnicity were not apparent among middle school students.

Physical Activity

Regular physical activity can reduce body fat, maintain body weight, and reduce the risk of chronic diseases. Obesity among adolescents is associated with a lack of physical activity and is a contributing factor for various chronic diseases. At least 60 minutes of daily physical activity is considered to be the adequate minimum for children aged 6-17 years. In 2015, 69.1% of high school students and 59.9% of middle school students failed to achieve this level of physical activity. In both middle and high school, boys were much more likely than girls to get adequate physical activity. Race/ethnicity was not associated with physical activity among high school students, but among middle school students, Hispanic and White students were more likely to exercise daily than were American Indian students.

Sexual Behaviors

Adolescents who initiate sexual intercourse at an early age are less likely to use contraception, are at higher risk for unplanned pregnancy, and are likely to have a greater number of lifetime sexual partners than those who wait until later to engage in sex. In 2015, 39.0% of high school students and 6.5% of middle school students ever had sexual intercourse. Among the 25.1% of sexually active high school students (had sexual intercourse within the last 3 months), condom use decreased with grade level (as students got older), while the use of reliable birth control methods (birth control pills, IUDs, injectable birth control, or birth control ring) increased.

Contributing Factors

Risk and Resiliency Factors

Young people who have strong relationships with caring adults and friends are resilient and resistant to the risks facing them. The 2015 YRRS clearly demonstrated that students who had strong relationships across the domains of family, school, community, and peers were less likely than other students to engage in alcohol use, drug use, tobacco use, suicidal behaviors, unsafe sexual practices, and lack of physical activity (Figure 2).

Health Disparities

In addition to the disparities by sex, race/ethnicity, and parent education already mentioned, the YRRS identified specific groups of young people who are at extreme risk for almost all areas of risk behaviors in the survey. The three groups who consistently face the highest levels of risk are lesbian, gay, and bisexual (LGB) youth, youth in unstable housing (homeless), and youth with physical disabilities. The magnitude of the disparities faced by these young people are generally far greater than those associated with other demographic factors or characteristics (Figure 3).

LGB students made up 11.0% of public high school students in 2015, and those who were unsure of their sexual orientation made up 4.1%. Compared to straight students, LGB students had far higher rates of binge drinking (23.6% vs. 12.4%), current cigarette smoking (22.8% vs. 9.3%), current heroin use (10.9% vs. 1.2%), past year suicide attempts (29.2% vs. 6.7%), and forced sexual intercourse (19.3% vs. 5.6%).

Six percent (6.0%) of students were living in unstable housing. Compared to students in stable housing, these students had had far higher rates of binge drinking (42.5% vs. 12.2%), current cigarette smoking (43.1% vs. 9.1%), current heroin use (29.1% vs. 1.0%), past year suicide attempts (30.4% vs. 8.5%), and forced sexual intercourse (21.6% vs. 6.6%).

Students with physical disabilities made up 11.3% of students. Compared to students without physical disabilities, these students had higher rates of binge drinking (17.7% vs. 13.4%), current cigarette smoking (15.3% vs. 10.3%), current heroin use (5.6% vs. 2.3%), past year suicide attempts (18.7% vs. 8.5%), and forced sexual intercourse (15.0% vs. 6.6%).

Assets and Resources

New Mexico has more than 70 school based health centers that provide quality, integrated, youth-friendly, and culturally responsive health care services to keep children and adolescents healthy, in school, and ready to learn. These centers offer services on or near school property, where students have easy access to them. They offer primary and behavioral health services such as immunizations; asthma and diabetes management; nutrition advice; and behavioral health services, such as grief therapy, help with peer pressure and bullying, and suicide prevention.

The Office of Substance Abuse Prevention (OSAP) of the New Mexico Human Services Department (HSD), provides funding and technical assistance to community groups throughout the state to offer local level evidence-based substance-use prevention interventions directed toward youth.

For each of New Mexico's 33 counties and in five American Indian tribal communities, there is a community health council. Each of these councils provide youth-based prevention programming.

Summary

New Mexico has seen encouraging trends among youth in recent years, including declines in health risk behaviors such as suicidal behaviors and alcohol use, and declines in deaths due to unintentional injury and homicide. However, serious concerns remain. While the rate of cigarette use has decreased substantially, new products such as e-cigarettes have meant that overall tobacco use rates have not decreased. Drug use rates, though not increasing, are extremely high relative to the rest of the U.S. Disparities in risk persist by gender, race/ethnicity, and parent education, but are most pronounced by sexual orientation, housing status, and physical disability status. References
  1. Leading Causes of Death, Ages 15-24. NMDOH Bureau of Vital Records and Health Statistics. Retrieved on 11/7/2017, New Mexico Department of Health, Indicator-Based Information System for Public Health website: http://ibis.health.state.nm.us/.
  2. Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD; 2016.
  3. US Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. US Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office on Smoking and Health; 2004.
  4. Daniels SR, Arnett DK, Eckel RH, et. al. Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999-2012.
  5. Santelli JS, Kaiser J, Hirsch L, Radosh A, Simkin L, Middlestadt S. Initiation of sexual intercourse among middle school adolescents: the influence of psychosocial factors. Journal of Adolescent Health 2004; 34(3): 200-208.


Figure 1. Binge drinking by Year, Grades 9-12, New Mexico and the United States, 2003-2015 Binge drinking by Year, Grades 9-12, New Mexico and the United States, 2003-2015 Source: NM YRRS Figure 2. Selected Risk Behaviors by Resiliency Factor: Parents Interested in Homework, Grades 9-12, New Mexico, 2015 Selected Risk Behaviors by Resiliency Factor: Parents Interested in Homework, Grades 9-12, NM, 2015 Source: NM YRRS Figure 3. Suicide Attempts by Housing, Sexual Orientation, and Physical Disability, Grades 9-12, New Mexico, 2015 Suicide Attempts: Disparities by Housing, Sexual Orientation, and Physical Disability, Grades 9-12, NM, 2015 Source: NM YRRS

What is Being Done?

  • Trends in youth health statistics are being monitored with the New Mexico Youth Risk and Resiliency Survey, and targeted evidence-based interventions are being implemented statewide.
  • Substance abuse prevention programs at the state and local levels emphasize opioid use/misuse prevention.
  • Fifty-one NMDOH-sponsored school based health centers provide integrated health care services and information throughout the state.
  • Comprehensive suicide prevention programs addressing depression/anxiety, substance abuse, bullying, violence, and means restriction.
  • Peer-to-peer mentoring stressing positive youth development and engagement, and building healthy relationships.

What Needs to be Done?

  • Increase positive youth development and leadership programs, with meaningful engagement of youth to develop, implement, and evaluate them.
  • Increase the number of school based health centers throughout the state, as these meet the healthcare needs of students where they spend a majority of their time.
  • Increase healthy nutrition and physical activity interventions targeting middle school aged youth.
The information provided above is from the New Mexico Department of Health's NM-IBIS web site (http://ibis.health.state.nm.us). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Sun, 16 June 2019 from New Mexico Department of Health, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.nm.us".

Content updated: Tue, 20 Mar 2018 15:16:58 MDT