The greatest number of deaths among teenagers are attributable to accidents, unintentional injuries, homicides, and suicides. This means that most deaths among teenagers are related to their behavior, rather than to disease or other natural causes. Other examples of national trends in risky behavior among teenagers include the following:
• Across all races, teenage boys die more frequently than teenage girls because of accidents, injuries, homicides, or suicides.
• Adolescents are starting risky behavior at an earlier age.
• Cigarette smoking among teenagers is on the increase, even as smoking is declining for all other age groups.
• After a decline in illicit drug use among teenagers, it is again on the increase.
• More than two thirds of students have had sexual intercourse by their senior year of high school (although the incidence of teenage pregnancy is decreasing).
The greatest danger to male teenagers seems to be that a significant percentage of them multiply their risks by engaging in more than one risky behavior. Teens who become involved in one risky behavior at an early age are more likely to take other risks. For example, boys or young men who use drugs or have school problems or past criminal involvement are more likely to be sexually active.
The higher incidence of problem behaviors among teenage males suggests that the origin of these behaviors rests in genetic differences between boys and girls and in differences in social expectations about behavior. Levels of the male hormone testosterone may influence the development of problem behavior in 13-year-old boys. But the association between hormone levels and problem behavior does not persist as boys get older. During this later period, problem behavior seems to be self-perpetuating, independent of testosterone levels at that time, and more influenced by social and psychological factors. Also, there is evidence that risky behavior is also on the rise among adolescent females in urban areas across the United States, a trend that cannot be explained by testosterone levels.
Boys and young men who strongly endorse a traditional view of masculinity appear to be more likely to engage in risky behaviors, such as getting suspended from school, drinking, using drugs, having multiple sexual partners, forcing someone to have sex, or not using condoms consistently. Mistaken beliefs about being tough and getting respect, which are traditionally part of the popular concept of manhood in the United States, may lead young men to engage in behaviors that endanger their health.
Preventive health programs around the United States have typically focused on single behaviors or problems, but new approaches to prevention are emerging. For example, new prevention efforts are more broadly based and deal more with the interrelationships among various types of risky behaviors within the context of the family, neighborhood, and peer group in which these risky behaviors arise.
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