The effect of socioeconomic status on chronic disease risk behaviors among US adolescents.

OBJECTIVE To examine the relationship between socioeconomic status and risk behaviors for chronic disease among a nationally representative sample of adolescents in the United States. DESIGN Household survey, the Youth Risk Behavior Survey supplement to the 1992 National Health Interview Survey. SETTING United States. PARTICIPANTS Nationally representative sample of 6321 adolescents aged 12 to 17 years. MAIN OUTCOME MEASURES Standardized prevalence rates and logistic and multiple regression models were used to examine the effect of educational level of the responsible adult and family income on 5 risk behaviors for chronic disease among adolescents--cigarette smoking, sedentary lifestyle, insufficient consumption of fruits and vegetables, excessive consumption of foods high in fat, and episodic heavy drinking of alcohol. RESULTS Most adolescents (63%) reported 2 or more of the 5 risk behaviors. Controlling for age, sex, race/ethnicity, and school enrollment status of adolescents, as the educational level of the responsible adult increased, cigarette smoking, sedentary lifestyle, and insufficient consumption of fruits and vegetables were less likely among adolescents. Among girls, but not boys, consumption of foods high in fat decreased as education of the responsible adult increased. As family income increased, adolescents were less likely to smoke cigarettes, less likely to be sedentary, and less likely to engage in episodic heavy drinking. CONCLUSION Among adolescents, risk behaviors for chronic disease are common and inversely related to socioeconomic status. Improved community- and school-based programs to prevent such behaviors among adolescents are needed, especially among socially and economically disadvantaged youth.