Number of Teens is going up, but their health status is going down   SAN FRANCISCO, CA - The number of teenagers in the United States is steadily increasing, but their overall health status appears to be deteriorating, according to a newreport by adolescent medicine specialists at the University of California San Francisco. Most adolescent health problems have their origins in environmental and behavioral factors, with injury and violence replacing illness as the leading cause of death for young people, says Elizabeth Ozer, PhD, lead author of the report and UCSF assistant professor of pediatrics. The current U.S. adolescent population -- ages 10 to 19 -- is about 36 million, and this is expected to reach 40 million by the year 2000. A major theme that emerges from the report is that the majority of adolescent disease and death can be attributed to preventable risk factors, including unhealthy behaviors such as a sedentary life style, poor nutritional habits, substance use and abuse, unsafe sexual practices, and risky vehicle use. "It is well known that many of these same behaviors that begin during the adolescent years are also associated with adult orbidity and mortality, so intervening during the teen years does provide an opportunity to prevent health-damaging behaviors in the adult," Ozer emphasizes. Titled "America's Adolescents: Are They Healthy?," the report is published by the National Adolescent Health Information Center based at UCSF. It is a compilation of data from several recent national studies. The report is being distributed this week at the annual meeting of the Society for Adolescent Medicine which is taking place in San Francisco. Demographic trends indicate an increase in the number of teens and single parent families living in poverty and of the proportion of minority adolescents during the 1990s, according to the data. "These factors portend a decrease in the health status of adolescents and an increase in prevention, medical, and mental health needs," the report co-authors write. One of the most alarming statistics cited in the report is the large number of adolescents who say they carry a gun or some other type of weapon. Nationwide, one third of all male students reported carrying a weapon, and among black male students, as many as one in five carry a gun. The report does reveal some positive trends. Overall death rates of adolescents and young adults have shown a downward trend from the mid-1980s to mid-1990s, and there has been a significant decline in the use of drugs, alcohol, and cigarettes over the past 15 years. This is tempered, however, by recent data that now shows a shift toward increased substance abuse. "This finding suggests that societal messages about substance abuse had made an impact in the past and that it is now time to rekindle this effort," Ozer says. Other major findings of the report include: Health Care Utilization Adolescents have the lowest utilization of health care services of any age group. Adolescents and young adults are less likely to have health insurance than other age groups. Mortality During Adolescence Accidents and unintentional injuries, homicide, and suicide account for the greatest number of adolescent deaths. Males are dying at a higher rate than females across all race and age groups. Death rates for white adolescents in 1993 were at or below the 1985 levels. In contrast, black older adolescent males and females were more likely to die in 1993 than they were in 1987. Black males aged 15-19 are more than 9 times as likely to die from homicide as their white peers. Risky Behaviors During Adolescence Adolescents are increasingly initiating risky health behaviors at earlier ages. Cigarette smoking among teenagers is now on the rise. Sixty percent of adolescents who attend high school report having ever tried a cigarette, one third are currently smoking, and as many as a quarter of these adolescents smoke every day. More than three quarters of high school age adolescents have consumed alcohol in their lifetime, about half report current alcohol use, and about one quarter report heavy, episodic drinking. Almost one third of adolescents who use alcohol and are of driving age report driving after drinking in the previous month. After a decline in illicit drug use among teenagers, drug use has once again begun to increase. More than one-third of high school seniors have used marijuana at some point in their lives. More than two-thirds of students have had sexual intercourse by their senior year of high school. Between 1991-94, there was a consistent decrease in pregnancy and birth rates among teens aged 15 to 19.