Changes in health risk behaviors for males and females from early adolescence through early adulthood.

OBJECTIVE We sought to identify (a) the course of changes in smoking, alcohol and marijuana use, violence, and sexual behavior from early adolescence through young adulthood for males and females, (b) points of divergence and convergence for 5 health risk behaviors between males and females, and (c) whether the trajectories of change in health risk behaviors differed for males and females. METHOD Data from four waves of the nationally representative National Longitudinal Study of Adolescent Health (Add Health) followed 18,911 youth from early adolescence through the transition to adulthood (ages 13 through 31 years) and were analyzed using zero-inflated negative binomial growth models and logistic growth models. RESULTS Generally, health risk behaviors steadily increased through adolescence into the early 20s, subsequently leveling off or decreasing. Results indicated early adolescent females were more likely to smoke and have more sexual partners, and 14- and 18-year-old females had higher rates of increase for getting drunk. The majority of findings, however, indicated that adolescent and young adult males engaged in more risk behaviors and were increasingly likely to engage over time. Among youth engaged in health risk behaviors, males reported greater frequency and increases in rates over time for most risk behaviors. CONCLUSIONS We identify several critical groups for health professionals to address: early adolescent females not previously identified as more engaged in health risks; adolescent females "catching up" to male health risks; early and mid-adolescent males shifting into adult patterns of heightened health risk behaviors; and the group of risk-taking males across age groups.