Adolescent Risk Behavior Disparities

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Preliminary review of RAAPS risk assessment data shows disparities in risk behaviors between privately insured teens and those with state funded insurance or no insurance

Preliminary review of RAAPS risk assessment data shows disparities in risk behaviors between privately insured teens and those with state funded insurance or no insurance

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  • What are they: preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.
  • The majority of health problems among adolescents are due to risky behaviors rather than biological dysfunction. Almost 3/4 of adolescent mortality is a result of motor vehicle crashes, homicide, suicide and unintentional injuries.
  • CDC has identified 6 areas of health risk behavior that are most likely to cause adverse health outcomes in life. These causes are rarely screened or directly counseled during heath care visits .
  • Reviewed responses based on insurance status to give us an idea as related to SES. No other published risk data is able to provide this information.


  • 1.
    • Contributing to the Health and Success of Youth…
    • Through Tools and Training to Positively Change Lives
  • 2. Health Disparities
    • Contributing Factors:
    • Poverty
    • Environmental threats
    • Access to health care
    • Individual and behavioral risk factors
    • Educational inequalities
  • 3. CDC Reported Leading Causes of Death Among Persons Aged 10-24 Years in the U.S., 2005
  • 4.
    • Unintentional injuries and violence
    • Tobacco use
    • Alcohol and other drug use
    • Sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection
    • Poor dietary behaviors
    • Physical inactivity
    CDC Identified Six Categories of Adolescent Behavior that Contribute to Leading Causes of Morbidity, Mortality, Academic and Social Problems
  • 5. Snapshot of RAAPS Adolescent Risk Data
  • 6.
    • RAAPS was born at the University of Michigan out of research and practical need
    • RAAPS was built by software professionals and uses a structured, secured database meeting regulatory compliance requirements
    • All questions have been scientifically validated
    • Youth were involved in the development of the assessment
  • 7.
    • (**Actual questions can be viewed at:
    • Total Surveys Completed by Youth
    • 11-20 years: 6425:
    • Privately Insured: 2178 (34%)
    • State Funded Insurance (Medicaid): 3218 (50%)
    • No Insurance: 735 (11%)
    • Other: 294 (5%)
    Snapshot of RAAPS Data: 2010-2011
  • 8. RAAPS Q1. In the past 12 months, have you tried to lose weight by (described)…..? Average cost per patient can extend >$100,000
  • 9. RAAPS Q2. Do you eat some fruits and vegetables everyday? Direct & Indirect Costs U.S. $33.4 Billion
  • 10. RAAPS Q6. During the past month, have you been threatened, teased, or hurt by someone (bullying behaviors described)….? Bullying is associated with poor physical health 3 years after experienced
  • 11. RAAPS Q7. Has anyone ever abused you (physical, emotional, sexual described)…? Medical Costs U.S. $5.4 Billion
  • 12. RAAPS Q8. Have you ever carried a weapon (described) to protect yourself? Medical Costs U.S. $3 Billion
  • 13. RAAPS Q9. In the past 3 months, have you smoked cigarettes or any other form of tobacco (described)…? Direct Medicaid Costs U.S. $30.9 Billion
  • 14. RAAPS Q11. In the past 3 months, have you drunk any alcohol (described)….? Medical Costs U.S. $18 Billion
  • 15. RAAPS Q12. In the past 12 months, have you smoked marijuana, used other street drugs, (described….)? Direct & Indirect Costs U.S. $86.1 Billion
  • 16. RAAPS Q14. Have you ever had any kind of sex (described)?
  • 17. RAAPS Q17. Do you have questions about (sexual health topics described)….? Associated Costs U.S. STI: $14.7 Billion, HIV: $3 Billion
  • 18. RAAPS Q18. During the past month, did you often feel very sad (described)….? Direct & Indirect Costs U.S. $26.1 Billion
  • 19. RAAPS Q20. In the past 12 months, have you (self harm/suicide behaviors described)….? Self Inflicted Injuries U.S. $1 Billion
  • 20. RAAPS Q21. Do you have at least one adult in your life that you can talk to….?
  • 21.
    • Higher risk behaviors in all categories (21 RAAPS questions) than privately insured adolescents
    • 40% + higher in:
      • Unsafe diet practices
      • Not eating fruits and vegetables
      • Reports of being bullied
      • Carrying weapons for protection
      • Using cigarettes, marijuana or other illegal drugs, and use of prescription/non-prescription drugs to get high
      • Questions about sexual behaviors
      • Depressive feelings
    Adolescents with Medicaid
  • 22.
    • Implications for Medicaid adolescent population health
    • Where do we go from here?