SUMMIT COUNTY, Ohio — The Youth Risk Behavior Survey (YRBS) is a cross-sectional surveillance tool developed by the Centers for Disease Control and Prevention (CDC) to track adolescent risk behaviors over time. Summit County Public Health (SCPH) and the Summit County Alcohol, Drug Addiction and Mental Health Board (ADM) contracted with Case Western University Prevention Research Center for Healthy Neighborhoods (PRCHN) to administer the YRBS in Summit County. In the 2023 school year, the YRBS was given to over 12,000 students in Summit County in grades 7th through 12th. “Currently, the YRBS survey is one of the most effective tools we have to measure the overall health of Summit County’s youth,” commented Chris Barker, SCPH’s Health Commissioner.

The survey informs initiatives funded by the ADM Board, SCPH, and other community partners to address identified areas of concern and has been completed every five years since 2013. “The insights the YRBS provides will not only allow us to target behavioral health funding and programming in high impact areas, but it will also provide a wealth of data that can be used throughout the community to collaborate and incorporate effective strategies. Increased focus on our children is critical, and it will take our collective work to enhance their well-being and opportunities to thrive,” added Aimee Wade, Executive Director of the ADM Board.     

Significant Improvements/Strengths 

Alcohol, Drugs, and Mental Health

• Prevalence rates for all illicit substances among high school students have decreased from 2018 to 2023.
• The prevalence for all students attempting suicide has significantly decreased from 2018 to 2023.
• The rate of seeking counseling for mental health has significantly increased for all students.
• Since 2018, there has been a significant decrease in e-cigarette use among all students.

Unintentional Injuries and Violence

• There was a decrease in high school students that reported they carried a weapon on school property.

Sexual Behaviors and Gambling

• There was a significant increase in sexually active middle school students who reported using condoms compared to 2018.
• The number of high school students who are currently sexually active has significantly decreased since 2013.
• Gambling in the past 12 months has significantly decreased for all students.

Positive Childhood Experiences (PCEs) 

The YRBS data was also used to analyze protective factors. Protective factors contribute to the physical, social, and mental well-being of a child. Protective factors in the questionnaire include having a sense of belonging, having parents talk to their children about school and support them at home, having at least one trusted teacher or adult at school, and having at least one trusted friend. 

Results showed that youth reporting higher numbers of protective factors were less likely to engage in health risk behaviors and more likely to engage in health-promoting behaviors compared to their peers with fewer protective factors.        

• Nearly 1 in 5 high school students indicated that they have experienced no PCEs. 
• 30% of high school students reported that they have three PCEs.  
• Results showed that youth reporting higher numbers of protective factors were less likely to engage in health risk behaviors and more likely to engage in health-promoting behaviors compared to their peers with fewer protective factors.

Significant Declines/Issues

Obesity, Diet and Physical Activity

Obesity rates for middle and high school students varied from 2018 to 2023.

• Obesity rates have increased among all students.
• The number of students who described themselves as overweight significantly decreased among all students.
• There was a significant increase in the number of students who had a concussion from playing sports or physical activity. 

The LGBTQ Experience

One troubling set of findings from the 2023 YRBS was the self-reported experiences of LGBTQ high school students (sexual orientation was not asked of middle school youth). In the 2023 YRBS, LGBTQ youth were more likely than heterosexual youth to say they:

• Have used alcohol, tobacco or other substances 
• Have purposefully hurt themselves, considered or attempted suicide
• Felt unsafe at, going to or coming home from school 
• Were physically hurt (on purpose) by someone they were dating 
• Were bullied in school, away from school and/or electronically
• Have experienced 4 or more childhood adverse experiences

Adverse Childhood Experiences (ACEs)

The high school questionnaire includes 13 questions covering 11 categories on adverse childhood experiences (ACEs). Understanding ACEs is critical for creating interventions that promote healthy youth development. 

• Half of all high school students stated that they have experienced emotional abuse from their parents or other adults in the home. 
• One in five high school students live with a parent or guardian with substance use issues. 
• One in four high school students live with a parent or guardian with mental health issues.

SCPH and the ADM Board are committed to protecting and improving the health and quality of life of our youth. Summit County’s schools and educational agencies played an important role in collecting this information. Our schools serve as the front line to not only protect the health of adolescents, but schools also help educate them on how to live a healthy life.

The full report and data brief summary on the results of the most recent YRBS can be found on the ADM Board’s website at https://admboard.org/about/data-and-reports/ or SCPH’s website at https://www.scph.org/assessments-reports.

The YRBS is a joint initiative by the County of Summit ADM Board and Summit County Public Health.