Georgia student health survey report: 2003, 2005 and 2007 [July 2008]

Georgia Student Health Survey Report
2003, 2005 & 2007

Acknowledgements

Georgia Department of Human Resources B.J. Walker, Commissioner

Division of Public Health Sandra Elizabeth Ford, M.D., M.B.A., Acting Director



Health Information, Policy, Strategy, and Accountability Martha Okafor, Ph.D., Division Deputy Director

Office of Epidemiology, Evaluation, and Health Information Dafna Kanny, Ph.D., Senior Director



Epidemiology Section John Horan, M.D., M.P.H., Director



Operations Morris Govan, M.A., REHS/RS, Division Deputy Director



Office of Healthy Behaviors Kimberly Redding, M.D., M.P.H., Senior Director

Substance Abuse Prevention and Behavioral Development Unit Brenda Rowe, Ph.D., M.S.W., M.P.A., Director



Office of Birth Outcomes Rosalyn Bacon, M.P.H., Senior Director

Division of Mental Health, Developmental Disabilities, and Addictive Diseases Gwendolyn B. Skinner, Director



State Addictive Diseases Program Travis Fretwell, MAC, NCAC II, CCS, Chief

Georgia Department of Education Kathy Cox, State Superintendent of Schools

Safe & Drug-Free Schools Program Garry McGiboney, Ph.D., Program Manager and Associate Superintendent Marilyn O. Watson, Education Program Specialist

Macro International, Inc.

Applied Research Division James G. Ross, M.S., Senior Vice President Katherine H. Flint, M.A., Senior Technical Director Rena A. Agee, M.A. Project Manager Kevin A.F. Lacy, B.A., Survey Coordinator Tonja Kyle, M.S., Data Manager Mirna Moloney, ABD, Data analyst/statistician Courtney N. Mooney, M.A., Technical Writer

The 2007 Georgia Student Health Survey is funded in part by Cooperative Agreement Number 422649 from the Centers for Disease Control and Prevention.

Suggested Citation: Kanny D., Figueroa A., Horan J. Georgia Student Health Survey Report: 2003, 2005, and 2007. Georgia Department of Human Resources, Division of Public Health, July 2008. Publication Number: DPH08/190HW.

Georgia Student Health Survey Report: 2003, 2005 & 2007

i

Table of Contents

Summary

iii

Introduction

iii

Middle School Findings

Seatbelt Use

2

Riding in a Car with a Drunk Driver

3

Weapon Carrying

4

Physical Fighting

5

Suicide Ideation

6

Cigarette Smoking

7

Lifetime Alcohol Use

8

Lifetime Marijuana Use

9

Initiation of Cigarette Smoking

10

Initiation of Alcohol Use

11

Initiation of Marijuana Use

12

Obesity

13

Physical Education

14

Television Viewing

15

High School Findings

Seatbelt Use

17

Drinking and Driving

18

Weapon Carrying

19

Physical Fighting

20

Sadness

21

Suicide Ideation

22

Cigarette Smoking

23

Alcohol Use

24

Binge Drinking

25

Marijuana Use

26

Initiation of Cigarette Smoking

27

Initiation of Alcohol Use

28

Initiation of Marijuana Use

29

Obesity

30

Fruit and Vegetable Consumption

31

Physical Education

32

Television Viewing

33

Appendices

Appendix A: National Health Objectives and Leading Health Indicators from Healthy People 2010

Measured by the Georgia Student Health Survey, 2003, 2005, 2007, High School

35

Appendix B:

Methodology

36

ii

Georgia Student Health Survey Report: 2003, 2005 & 2007

Summary
Some behaviors pose immediate threats to health (e.g., drinking and driving); others are more closely related to long-term threats to health (e.g., inadequate physical activity). The Georgia Student Health Survey provides information about both immediate and long-term threats to health among middle and high school students in Georgia, including unintentional injuries, violence, suicide, tobacco use, alcohol and other drug use, initiation of risk behaviors, obesity, weight loss practices, dietary behaviors, nutritional behaviors, physical activity, physical education, and sedentary behaviors.
With respect to 17 health behaviors that are targeted in the national public health objectives for 2010 (Healthy People 2010, see Appendix A), Georgia high school students are meeting only one objective, riding in the past 30 days with a driver who had been drinking alcohol (23.9% vs. U.S. objective of 30%), and are within 1-2% of the national objective for three objectives: seat belt use (91.3% vs. U.S. objective of 92%), physical fighting in the past 12 months (34.0% vs. U.S. objective of 32%), carrying a weapon on school property (5.3% vs. U.S. objective of 4.9%).
From 2003 to 2007, there has been a significant decrease in the percentage of high school students who rarely or never wear a seat belt when driving a car.
Introduction
Many of the behaviors that put adults at elevated risk for disease and death are initiated in adolescence, including tobacco use, physical inactivity, poor dietary habits, and behaviors that can result in unintentional injuries and violence. In Georgia in 2006, 75 percent of all deaths among youth and young adults aged 1019 years result from only four causes motor vehicle crashes (39%), other unintentional injuries (15%), homicide (13%), and suicide (8%). Among adults 25 years of age and older, 56 percent of all deaths in Georgia result from heart disease (30%) and cancer (26%). Tobacco use, physical inactivity, and unhealthy diet contribute to heart disease, many cancers, and other chronic diseases. These behaviors are all subject to prevention or modification among school-aged children.
To monitor priority health-risk behaviors that put youth at risk for the leading causes of morbidity, mortality, and social problems, the Georgia Department of Human Resources, Division of Public Health, in collaboration with the Georgia Department of Education, conducted the 2007 Georgia Student Health Survey among a sample of students enrolled in public middle and high schools, statewide. This is the third time the survey has been conducted in the state. A total of 2,219 middle school students and 2,465 high school students participated in the 2007 survey. Topics covered by the survey include unintentional injuries and violence, tobacco use, alcohol and other drug use, dietary behaviors, and physical activity. By monitoring these behaviors, Georgia can assess the overall progress of programs and policies to reduce the behaviors that put youth at risk for developing potentially preventable health problems.
This report summarizes results from the 2007 Georgia Student Health Survey and presents trends in the prevalence of unintentional injuries and violence, tobacco, alcohol, and other drug use; dietary behaviors; and physical activity among middle and high school students in Georgia for 2003, 2005, and 2007. A detailed description of the survey population and the survey methods are provided in Appendix B. Detailed data tables are available at: http://oasis.state.ga.us/oasis/yrbs/qryyrbs.aspx and the survey questions are available at: http://health.state.ga.us/epi/cdiee/studenthealth.asp.

Georgia Student Health Survey Report: 2003, 2005 & 2007

iii

Middle School Findings

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

1

Seatbelt Use
In 2007, approximately 25,000 (7%) middle school students in Georgia never or rarely wear a seat belt when riding in a car. Not wearing a seat belt among middle school students has decreased across all three survey years.

Percentage of Students who Never or Rarely Wear a Seatbelt when Riding in a Car, by SEX,
Middle School, Georgia, 2003, 2005, 2007
Males Females 30
20

Percent

10

Male students are more likely than female students to never or rarely wear a seat belt when riding in a car.

0 2003

2005 Year

2007

Never or rarely wearing a seat belt is more common among Black and Hispanic students than among White students. The percentage of Black students who do not wear a seat belt decreased from 12% in 2003 to 7% in 2007.*

Percentage of Students who Never or Rarely Wear a Seatbelt when Riding in a Car, by RACE/ETHNICITY, Middle School, Georgia, 2003, 2005, 2007
White Black Hispanic 30
20

Percent

10

0 2003

2005 Year

2007

The percentage of 8th graders who do not wear a seat belt decreased from 13% in 2003 to 7% in 2007.

Percentage of Students who Never or Rarely Wear a Seatbelt when Riding in a Car, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th 30

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

2

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who Ever Rode in a Car with Someone who had been Drinking Alcohol, by SEX, Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Percentage of Students who Ever Rode in a Car with Someone who had been Drinking Alcohol, by RACE/ETHNICITY, Middle School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year

Riding in a Car with a Drunk Driver
In 2007, approximately 120,000 (32%) middle school students in Georgia rode in a car driven by someone who had been drinking alcohol. Riding in a car with someone who had been drinking alcohol has remained stable across all three survey years.
Male and female middle school students are equally likely to ride in a car driven by someone who had been drinking alcohol.
The percentage of Black students who rode in a car with someone who had been drinking alcohol decreased from 38% in 2003 to 29% in 2005,* but increased to 33% in 2007. The percentage of Hispanic students who rode with someone who had been drinking increased during the survey years.

Percent

Students who Ever Rode in a Car with Someone who had been Drinking Alcohol, by GRADE, Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th

50

40

30

20

10

0 2003

2005

2007

Year

Students in 8th grade are more likely than students in 6thgrade to ride in a car with someone who had been drinking alcohol.

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

3

Weapon Carrying
In 2007, approximately 132,000 (36%) middle school students in Georgia may have ever carried a weapon. Ever carrying a weapon has remained stable across all three survey years.
Male students are three times more likely than female students to ever carry a weapon.* Ever carrying a weapon is more common among White students compared to Black and Hispanic students. The percentage of Hispanic students who ever carry a weapon increased between 2003 and 2007.
Ever carrying a weapon is more common among 8th graders compared to students in 6th grade.

Percentage of Students who Ever Carried a Weapon, by SEX, Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Ever Carried a Weapon, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Ever Carried a Weapon, by GRADE, Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 100

80

60

40

20

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

4

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who have Ever been in a Physical Fight, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who have Ever been in a Physical Fight, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 100

80

60

40

20

0 2003

2005 Year

2007

Physical Fighting
In 2007, approximately 235,000 (64%) middle school students in Georgia have ever been in a physical fight. Ever being in a physical fight has remained stable across all three survey years.
Male students are more likely than female students to have ever been in a physical fight.*
Black students are more likely than White and Hispanic students to have ever been in a physical fight.*

Percentage of Students who have Ever been in a Physical Fight, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 100

80

60

40

20

0 2003

2005

2007

Year

There are no differences in the likelihood of ever being in a physical fight among middle school students by grade level.

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

5

Suicide Ideation
In 2007, approximately 70,000 (19%) middle school students in Georgia ever seriously thought about killing themselves. Suicidal ideation among middle school students has remained stable across all three survey years.
Female students are more likely than male students to seriously think about killing themselves.*

Percentage of Students who Ever Seriously Thought about Killing Themselves, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 40

30

20

10

0 2003

2005 Year

2007

Suicidal ideation among White and Hispanic students increased in 2005 and decreased in 2007; rates among Black students have remained stable across all three survey years.

Percentage of Students who Ever Seriously Thought about Killing Themselves, by RACE/ETHNICITY, Middle School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 40

30

20

10

0 2003

2005 Year

2007

Suicidal ideation is more common among 8th graders compared to students in other grades.

Percentage of Students who Ever Seriously Thought about Killing Themselves, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 40

30

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

6

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who Smoked Cigarettes, by SEX, Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 30

20

10

0 2003

2005 Year

2007

Percentage of Students who Smoked Cigarettes, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

20

10

0 2003

2005 Year

2007

Percent

Percentage of Students who Smoked Cigarettes, by GRADE, Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 30

20

10

0 2003

2005 Year

2007

Cigarette Smoking
In 2007, approximately 23,000 (6%) middle school students in Georgia smoked cigarettes, a decrease from 9% in 2003.
Cigarette smoking is more common among male students compared to female students. Cigarette smoking is more common among White and Hispanic students than among Black students. The percentage of Black students who smoke cigarettes decreased from 7% in 2003 to 4% in 2007. The percentage of Hispanic students who smoke cigarettes also decreased from 11% in 2003 to 6% in 2007.
Cigarette smoking is more common among 8th graders compared to students in other grades.

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

7

Lifetime Alcohol Use
In 2007, approximately 123,000 (35%) middle school students in Georgia ever drank alcohol, other than a few sips. Ever drinking alcohol among middle school students has remained stable across all three survey years.

Percentage of Students who Ever Drank Alcohol, by SEX, Middle School, Georgia, 2003, 2005, 2007
Males Females 60
40

Percent

20

Male and female middle school students are equally likely to have had a drink of alcohol.
Drinking alcohol is more common among Black and Hispanic students than among White students.

0 2003

2005 Year

2007

Percentage of Students who Ever Drank Alcohol, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007
White Black Hispanic 60

Percent

40

20

Students in 8th grade are more likely than students in 6th grade to have had a drink of alcohol.*

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who Ever Drank Alcohol, by GRADE, Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th 60

Percent

40

20

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

8

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who Ever Used Marijuana, by SEX, Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 30

20

10

0 2003

2005 Year

2007

Percentage of Students who Ever Used Marijuana, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

20

10

0 2003

2005 Year

2007

Percent

Percentage of Students who Ever Used Marijuana, by GRADE, Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 30

20

10

0 2003

2005 Year

2007

Lifetime Marijuana Use
In 2007, approximately 40,000 (11%) middle school students in Georgia had ever used marijuana. Marijuana use among middle school students has remained stable across all three survey years.
Male students are more likely than female students to have ever used marijuana.* Lifetime marijuana use is more common among Black and Hispanic students than among White students.
Students in 8th grade are more likely than 6th graders to have ever used marijuana.

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

9

Initiation of Cigarette Smoking
In 2007, approximately 22,000 (6%) middle school students in Georgia smoked a cigarette for the first time before the age of 11. Smoking a cigarette for the first time before age 11 remained stable across all three survey years.
Smoking a cigarette before age 11 is more common among male students than among female students.
In 2003, Hispanic students were less likely than Black or White students to have smoked a cigarette before the age of 11; however, in 2005 and 2007, they were equally likely as Black or White students to do so.
Smoking a cigarette before the age of 11 was more common among students in 8th grade compared to students in other grades.

Percentage of Students who Smoked a Whole Cigarette Before Age 11, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Males Females 30

Percent

20

10

0 2003

2005 Year

2007

Percentage of Students who Smoked a Whole Cigarette Before Age 11, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

Percent

20

10

0 2003

2005 Year

2007

Percentage of Students who Smoked a Whole Cigarette Before Age 11, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th 30

Percent

20

10

0 2003

2005 Year

2007

10

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who Drank Alcohol Before Age 11, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Males Females 30

Percent

20

10

0 2003

2005 Year

2007

Percentage of Students who Drank Alcohol Before Age 11, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

Percent

20

10

0 2003

2005

Year

* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who Drank Alcohol Before Age 11, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th 30

Percent

20

10

0 2003

2005 Year

2007

Initiation of Alcohol Use
In 2007, approximately 56,000 (16%) middle school students in Georgia had their first drink of alcohol before the age of 11. Drinking alcohol before age 11 among middle school students remained stable across all three survey years.
Drinking alcohol before the age of 11 is more common among male students compared to female students. Among both male and female students, early initiation of alcohol use increased in 2005, but then decreased slightly in 2007.
Drinking alcohol before the age of 11 is more common among Black students than among White students.
The percentage of 6th and 8th graders who had their first drink of alcohol before the age of 11 remained stable across survey years. However, the percentage of 7th graders who have tried alcohol before the age of 11 increased during this time.

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

11

Initiation of Marijuana Use
In 2007, approximately 16,000 (5%) middle school students in Georgia tried marijuana for the first time before age 11. Trying marijuana before age 11 more than doubled between 2003 and 2007.*
Trying marijuana before the age of 11 is more common among male students than among female students. The percentage of male students who tried marijuana before age 11 doubled between 2003 and 2007; the percentage of female students tripled during this time.
Among middle school students in all racial/ethnic groups, early initiation of marijuana use increased across all three survey years, most notably among Hispanic students.*

Percentage of Students who Tried Marijuana Before Age 11, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Males Females 30

Percent

20

10

0 2003

2005 Year

2007

Percentage of Students who Tried Marijuana Before Age 11, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

Percent

20

10

0 2003

2005 Year

2007

Among students in each grade level, early initiation of marijuana use increased across all three survey years, most notably among 6th graders.*

Percentage of Students who Tried Marijuana Before Age 11, by GRADE,
Middle School, Georgia, 2003, 2005, 2007
6th 7th 8th 30

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

12

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percent

Percentage of Students who are Obese, by SEX, Middle School, Georgia, 2003, 2005, 2007

Males Females 30

20

10

0 2003

2005 Year

2007

Percent

Percentage of Students who are Obese, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

20

10

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who are Obese, by GRADE, Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 30

20

10

0 2003

2005 Year

2007

Obesity
In 2007, approximately 43,000 (15%) middle school students in Georgia were obese. The percentage of middle school students who are obese has remained stable across all three survey years.
Being obese is more common among male students than among female students Being obese is more common among Black students than among White and Hispanic students. The percentage of White students who are obese has remained stable during the survey years.
Being obese is more common among 6th graders compared to students in other grades.

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

13

Physical Education
In 2007, approximately 143,000 (39%) middle school students in Georgia attended physical education classes daily. Daily attendance at physical education classes among middle school students increased during all three survey years.
Daily attendance at physical education classes has increased more among male students than among female students.
Daily attendance at physical education classes has increase more among White students than among Black and Hispanic students.

Percentage of Students who Attend Physical Education Class Daily, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Males Females 60

Percent

40

20

0 2003

2005 Year

2007

Percentage of Students who Attend Physical Education Class Daily, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

White Black Hispanic 60

Percent

40

20

0 2003

2005 Year

2007

Daily attendance at physical education classes is comparable among students in 6th, 7th, and 8th grades.

Percentage of Students who Attend Physical Education Class Daily, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

6th 7th 8th 60

Percent

40

20

0 2003

2005 Year

2007

14

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

Percentage of Students who Watch 3+ Hours of TV on a School Day, by SEX,
Middle School, Georgia, 2003, 2005, 2007

Percent

Males Females 100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Watch 3+ Hours of TV on a School Day, by RACE/ETHNICITY,
Middle School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 100

80

60

40

20

0 2003

2005

2007

Year

Television Viewing
In 2007, approximately 163,000 (44%) middle school students in Georgia watched three or more hours per day of television on an average school day. Television viewing among middle school students decreased during the survey years.
Male and female students are equally likely to watch three or more hours per day of television on an average school day.
Black students are more likely than White and Hispanic students to watch three or more hours of television on an average school day.*

Percentage of Students who Watch 3+ Hours of TV on a School Day, by GRADE,
Middle School, Georgia, 2003, 2005, 2007

Percent

6th 7th 8th 100

80

60

40

20

0 2003

2005

2007

Year

There are no differences in the percentage of students who watch three or more hours per day of television by grade level.

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | Middle School Findings

15

High School Findings

16

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Never or Rarely Wear a Seatbelt when Driving a Car, by SEX,
High School, Georgia, 2003, 2005, 2007
Males Females 30

Seatbelt Use
In 2007, approximately 32,000 (7%) high school students in Georgia never or rarely wear a seat belt when driving a car, a significant decrease from 12% in 2003.*

Percent

20
10
0 2003

2005 Year

2007

Male students are more likely than female students to never or rarely wear a seat belt when driving. The percentage of female students who do not wear a seat belt decreased from 10% in 2003 to 4% in 2007.*

Percentage of Students who Never or Rarely Wear a Seatbelt when Driving a Car, by RACE/ETHNICITY, High School, Georgia, 2003, 2005, 2007
White Black Hispanic 30
20

Among all racial/ethnic groups, the percentage of students who never or rarely wore a seat belt when driving decreased across all three survey years. The most significant decrease in seat belt non-compliance occurred among Black students (from 12% in 2003 to 6% in 2007).*

Percent

10

0 2003

2005 Year

2007

Percentage of Students who Never or Rarely Wear a Seatbelt when Driving a Car, by GRADE,
High School, Georgia, 2003, 2005, 2007
9th 10th 11th 12th 30
20

Seat belt non-compliance is more common among 12th graders than among students in other grades. The percentage of 9th grade students who do not wear a seat belt while driving decreased from 16% in 2003 to 5% in 2007.*

Percent

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

17

Drinking and Driving
In 2007, approximately 41,000 (9%) high school students in Georgia had driven a car or other vehicle after drinking alcohol. Driving after drinking alcohol among high school students has remained stable across the three survey years.
Driving after drinking alcohol is more common among male students than among female students.
White students are more likely than Black students to drive after drinking alcohol.*

Percentage of Students who Drove after Drinking Alcohol, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 30

20

10

0 2003

2005 Year

2007

Percentage of Students who Drove after Drinking Alcohol, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

White Black Hispanic 30

Percent

20

10

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Driving after drinking alcohol is more common among 12th graders compared to students in other grades.

Percentage of Students who Drove after Drinking Alcohol, by GRADE,
High School, Georgia, 2003, 2005, 2007
9th 10th 11th 12th 30

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

18

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Carried a Weapon, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Weapon Carrying
In 2007, approximately 88,000 (20%) high school students in Georgia carried a weapon. Carrying a weapon among high school students has remained stable across all three survey years.
Male students are three times more likely than female students to carry a weapon.*

Percentage of Students who Carried a Weapon, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

White students are more likely than Black students to carry a weapon.*

Percent

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Percentage of Students who Carried a Weapon, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 50

40

30

20

10

0 2003

2005

2007

Year

Carrying a weapon is more common among 9th and 10th grade students, except in 2005, where it was more common among 12th graders.

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

19

Physical Fighting
In 2007, approximately 154,000 (34%) high school students in Georgia were in a physical fight. Physical fighting among high school students increased slightly between 2003 and 2007.
Male students are more likely than female students to be in a physical fight.* The percentage of female students who are in a physical fight increased from 22% in 2003 to 28% in 2007. Physical fighting is more common among Black and Hispanic students compared to White students.
Physical fighting is more common among students in 9th, 10th, and 11th, grades compared to students in 12th grade.

Percentage of Students who were in a Physical Fight, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females

50

40

30

20

10

0 2003

2005

2007

Year

Percentage of Students who were in a Physical Fight, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Percentage of Students who were in a Physical Fight, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 50

40

30

20

10

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

20

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Felt Sad or Hopeless, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Percentage of Students who Felt Sad or Hopeless, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

White Black Hispanic 50

40

30

20

10

0 2003

2005

2007

Year

Percent

Percentage of Students who Felt Sad or Hopeless, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 50

40

30

20

10

0 2003

2005

2007

Year

Sadness
In 2007, approximately 137,000 (30%) high school students in Georgia felt so sad or hopeless for two weeks or more in a row that they stopped doing some of their usual activities. Feeling sad or hopeless among high school students has remained stable across all three survey years.
Female students are more likely than male students to have feelings of sadness or hopeless.*
Feeling sad or hopeless is more common among Black and Hispanic students than among White students. Feelings of sadness or hopelessness among Hispanic students peaked in 2005 and decreased in 2007.
There are no differences in the percentage of high school students who feel sad or hopeless by grade level. The percentage of 11th graders who felt sad or hopeless increased significantly from 28% in 2003 to 35% in 2007.*

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

21

Suicide Ideation
In 2007, approximately 72,000 (16%) high school students in Georgia seriously considered attempting suicide. Suicidal ideation among high school students has remained stable across all three survey years.
Female students are more likely than male students to seriously consider attempting suicide.*
Similar percentages of White, Black, and Hispanic students reported suicidal ideation.

Percentage of Students who Seriously Considered Attempting Suicide, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females

50

40

30

20

10

0 2003

2005

2007

Year

Percentage of Students who Seriously Considered Attempting Suicide, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 50

40

30

20

10

0 2003

2005

2007

Year

The percentage of 9th graders reporting suicidal ideation remained stable across all three survey years, whereas the percentages among 10th, 11th, and 12th graders fluctuated during this time.

Percentage of Students who Seriously Considered Attempting Suicide, by GRADE,
High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th

50

40

30

20

10

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

22

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Smoked Cigarettes, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Cigarette Smoking
In 2007, approximately 81,000 (19%) high school students smoked cigarettes. Cigarette smoking among high school students has remained stable across all three survey years.
Cigarette smoking is more common among male students compared to female students.

Percent

Percentage of Students who Smoked Cigarettes, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

White Black Hispanic 50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003 or 2005, n < 100

White students are over two times more likely than Black students to smoke cigarettes.* The percentage of White students who smoke cigarettes decreased from 29% in 2003 to 25% in 2007. In 2007, Hispanic and White students were more likely than Black students to smoke cigarettes.*

Percentage of Students who Smoked Cigarettes, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 50

40

30

20

10

0 2003

2005

2007

Year

Cigarette smoking is more common among 12th graders compared to students in other grades. In 2007, 12th graders were more likely than 9th graders to smoke cigarettes.*

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

23

Alcohol Use
In 2007, approximately 155,000 (38%) high school students in Georgia drank alcohol. Drinking alcohol among high students remained stable across all three survey years.
Male and female students are equally likely to drink alcohol. White students are more likely than Black students to drink alcohol.*

Percentage of Students who Drank Alcohol, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Drank Alcohol, by RACE/ETHNICITY, High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 100

80

60

40

20

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Students in 12th grade are more likely than students in 9th grade to drink alcohol.*

Percentage of Students who Drank Alcohol, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 100

80

60

40

20

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

24

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who had Five or More Drinks in a Row, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Binge Drinking
In 2007, approximately 90,000 (19%) high school students in Georgia engaged in binge drinking. Binge drinking among high school students has remained stable across all three survey years.
Binge drinking is more common among male students than among female students.

Percentage of Students who had Five or More Drinks in a Row, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 50

40

30

20

10

0 2003

2005

2007

Year

White students are approximately three times more likely more likely than Black students to binge drink.*

Percentage of Students who had Five or More Drinks in a Row, by GRADE,
High School, Georgia, 2003, 2005, 2007

Binge drinking is more common among 12th graders compared with students in other grades.

Percent

9th 10th 11th 12th

50

40

30

20

10

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

25

Marijuana Use
In 2007, approximately 87,000 (20%) high school students in Georgia used marijuana. Marijuana use among high school students has remained stable across all three survey years.
Marijuana use is more common among males than among females. There are no differences in the percentage of students who use marijuana by race/ethnicity.
Marijuana use is more common among 12th graders than among 9th , 10th and 11th graders. Between 2003 and 2007, the percentage of 9th graders who use marijuana decreased, while the percentage of 10th graders who use marijuana increased.

Percentage of Students who Used Marijuana, by SEX, High School, Georgia, 2003, 2005, 2007

Percent

Males Females 50

40

30

20

10

0 2003

2005

2007

Year

Percent

Percentage of Students who Used Marijuana, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Percentage of Students who Used Marijuana, by GRADE, High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th 50

40

30

20

10

0 2003

2005

2007

Year

26

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Smoked a Whole Cigarette Before Age 13, by SEX,
High School, Georgia, 2003, 2005, 2007

Males Females 30

Percent

20

10

0 2003

2005 Year

2007

Initiation of Cigarette Smoking
In 2007, approximately 63,000 (15%) high school students in Georgia smoked a cigarette for the first time before the age of 13. The percentage of high school students who smoked a cigarette for the first time before age 13 decreased from 19% in 2003 to 15% in 2007.
In 2003 and 2007, male students were more likely than female students to have smoked a cigarette for the first time before the age of 13.* Early smoking initiation among female students decreased across all three survey years.

Percent

Percentage of Students who Smoked a Whole Cigarette Before Age 13, by RACE/ETHNICITY, High School, Georgia, 2003, 2005, 2007
White Black Hispanic 30
20
10

Early cigarette smoking initiation is more common among White students compared with Black students. In 2003 and 2007, White students were more likely than Black students to have smoked a cigarette for the first time before age 13.* Early smoking initiation decreased among Black students across all three survey years.

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who Smoked a Whole Cigarette Before Age 13, by GRADE,
High School, Georgia, 2003, 2005, 2007
9th 10th 11th 12th 30

In 2005 and 2007, early cigarette smoking initiation was more common among 9th graders compared to students in other grades.

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

27

Initiation of Alcohol Use
In 2007, approximately 109,000 (24%) high school students in Georgia had their first drink of alcohol before the age of 13. Drinking alcohol before age 13 among high school students decreased across all three survey years.
In 2003 and 2007, male students were more likely than female students to have had their first drink of alcohol before the age of 13.*

Percentage of Students who Drank Alcohol Before Age 13, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females

50

40

30

20

10

0 2003

2005

2007

Year

Drinking alcohol before the age of 13 is more common among Black students than among White students.

Percentage of Students who Drank Alcohol Before Age 13, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Drinking alcohol use before the age of 13 is more common among 9th graders compared to students in other grades. The percentage of 9th graders who drank alcohol before age 13 decreased between 2003 and 2007.*

Percentage of Students who Drank Alcohol Before Age 13, by GRADE,
High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th

50

40

30

20

10

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

28

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Used Marijuana Before Age 13, by SEX
High School, Georgia, 2003, 2005, 2007
Males Females 30
20

Initiation of Marijuana Use
In 2007, approximately 36,000 (8%) high school students in Georgia tried marijuana before the age of 13. Trying marijuana before age 13 among high school students remained stable across all three survey years.

Percent

10

0 2003

2005 Year

2007

Male students are more likely than female students to try marijuana before the age of 13.*

Percentage of Students who Used Marijuana Before Age 13, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007
White Black Hispanic 30

Trying marijuana before age 13 is more common among Black students than among White students.

Percent

20

10

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who Used Marijuana Before Age 13, by GRADE,
High School, Georgia, 2003, 2005, 2007

The percentage of 9th graders who tried marijuana before age 13 decreased between 2003 and 2007.

9th 10th 11th 12th 30

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

29

Obesity
In 2007, approximately 62,000 (14%) high school students in Georgia were obese. The percentage of high school students who are obese decreased throughout all three survey years.

Percentage of Students who are Obese, by SEX, High School, Georgia, 2003, 2005, 2007
Males Females 30

Percent

20

Being obese is more common among male students than among female students. The percentage of female students who are obese increased between 2003 and 2007.*

10
0 2003

2005 Year

2007

Being obese is more common among Black and Hispanic students compared to White students.

Percentage of Students who are Obese, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007
White Black Hispanic 30

Percent

20

10

The percentage of 9th and 10th graders who are obese increased between 2003 and 2007, while the percentage of 11th and 12th graders who are obese remained stable during this time.

0 2003

2005

Year
* Data not presented for Hispanics in 2003, n < 100

2007

Percentage of Students who are Obese, by GRADE, High School, Georgia, 2003, 2005, 2007
9th 10th 11th 12th 30

Percent

20

10

0 2003

2005 Year

2007

* Statistically significant at the 95% level of confidence

30

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Ate 5+ Servings of Fruits and Vegetables per Day, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females

50

40

30

20

10

0 2003

2005

2007

Year

Fruit and Vegetable Consumption
In 2007, approximately 85,000 (19%) high school students in Georgia ate five or more servings of fruits and vegetables per day. The percentage of high school students who eat five or more servings of fruits and vegetables per day increased across all three survey years.
In 2003, male students were more likely than female students to eat five or more servings of fruits and vegetables per day.* Although the percentage of females who consume fruits and vegetables daily increased in 2005 and 2007, daily fruit and vegetable consumption remained more common among male students.

Percentage of Students who Ate 5+ Servings of Fruits and Vegetables per Day, by RACE/ETHNICITY, High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic

50

40

30

20

10

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003, n < 100

Percentage of Students who Ate 5+ Servings of Fruits and Vegetables per Day, by GRADE,
High School, Georgia, 2003, 2005, 2007

In 2007, Black and Hispanic students were more likely than White students to eat fruits and vegetables daily.* Hispanic students were also more likely than Black students to eat five or more servings of fruits and vegetables daily* in 2007. In 2003 and 2005, fruit and vegetable consumption was more common among Black students compared to White students.
There are no differences in the percentage of students who eat fruits and vegetables daily by grade level.

Percent

9th 10th 11th 12th

50

40

30

20

10

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

31

Physical Education
In 2007, approximately 156,000 (34%) high school students in Georgia attended physical education class daily. The percentage of high school students who take a physical education class daily increased throughout all three survey years.
Male students are more likely than female students to attend physical education class daily.*
Taking a physical education class daily is more common among White students than among Black students.

Percentage of Students who Attended Physical Education Class Daily, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females

100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Attended Physical Education Class Daily, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic 100

80

60

40

20

0 2003

2005

2007

Year
* Data not presented for Hispanics in 2003 or 2005, n < 100

Students in 9th grade are more likely than students in other grades to attend physical education class daily.* Daily physical education class attendance among 10th graders increased during this time.

Percentage of Students who Attended Physical Education Class Daily, by GRADE,
High School, Georgia, 2003, 2005, 2007

Percent

9th 10th 11th 12th

100

80

60

40

20

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

32

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

Percentage of Students who Watch 3+ Hours of TV on an Average School Day, by SEX,
High School, Georgia, 2003, 2005, 2007

Percent

Males Females

100

80

60

40

20

0 2003

2005

2007

Year

Percentage of Students who Watch 3+ Hours of TV on an Average School Day, by RACE/ETHNICITY,
High School, Georgia, 2003, 2005, 2007

Percent

White Black Hispanic

100

80

60

40

20

0 2003

2005

2007

Year

Television Viewing
In 2007, approximately 195,000 (43%) high school students in Georgia watched three or more hours of television per day on an average school day. The percentage of high school students who watch three or more hours of television on a school day has remained stable across all three survey years.
Male and female students are equally likely to watch three or more hours of television on a school day.
Black students are more likely than White students to watch three or more hours of television on a school day.* In 2003 and 2007 Black students were more likely than Hispanic students to watch three or more hours of television on a school day.* This difference was also present in 2005 but was not statistically significant.

Percentage of Students who Watch 3+ Hours of TV on an Average School Day, by GRADE, High School, Georgia, 2003, 2005, 2007

Daily excessive television viewing is comparable across grade levels.

Percent

9th 10th 11th 12th

100

80

60

40

20

0 2003

2005

2007

Year

* Statistically significant at the 95% level of confidence

Georgia Student Health Survey Report: 2003, 2005 & 2007 | High School Findings

33

Appendices
Appendices

34

Georgia Student Health Survey Report: 2003, 2005 & 2007

Georgia Student Health Survey Report: 2003, 2005 & 2007

National Health Objectives and Leading Health Indicators from Healthy People 20101 Measured by the Georgia Student Health Survey, 2003, 2005, 2007, High School

Obj. Number
15 - 19

Increase use of safety belts.

Objective

2010 Target
(%)
92

Data from 2003
GA Student Health Survey (%) 90.6 -

Data from 2005
GA Student Health Survey (%) 90.4 -

Data from 2007
GA Student Health Survey (%) 91.3 -

15 - 21 Increase the proportion of motorcyclists using helmets.

79







15 - 38 Reduce physical fighting among adolescents.

32

31.4 -

33.8 -

34.0 -

15 - 39 18 - 2

Reduce weapon carrying by adolescents on school property. Reduce the rate of suicide attempts by adolescents.

4.9

5.0 -

7.5

1.0

8.5

7.8

5.3 -
7.9

22 - 6

Increase the proportion of adolescents who engage in moderate physical activity for at least 30 minutes on > 5

35

25.4

23.7



of the previous 7 days.

22 - 7

Increase the proportion of adolescents who engage in vigorous physical activity that promotes cardiorespiratory

85

59.0

61.3



fitness > 3 days per week for > 20 minutes per occasion.

22 - 9

Increase the proportion of adolescents who participate in daily school physical education.

50

29.1

35.9

34.3

22 - 10 Increase the proportion of adolescents who spend at least 50% of school physical education class time being

50

31.0

32.7



physically active.

22 - 11 Increase the proportion of adolescents who view television < 2 hours on a school day.

75

57.6

57.6

56.9

25 - 11 Increase the proportion of adolescents who abstain from sexual intercourse or use condoms, if currently

95







sexually active.

26 6 Reduce the proportion of adolescents who report that they rode, during the previous 30 days, with a driver who

30

had been drinking alcohol.

24.0 -

26.7 -

23.9 -

27 - 2

Reduce tobacco use by adolescents.

27 2a

Reduce tobacco product use (past month).

21

26.1

24.1

26.2

27 2b 27 2c

Reduce cigarette use (past month). Reduce spit tobacco use (past month).

16

20.9

1

7.6

17.2 -

18.6

7.4

8.4

27 2d

Reduce cigar use (past month).

8

13.9

15.1

16.1

27 7 Increase tobacco use cessation attempts by adolescent smokers.

84

59.4

57.3

58.0

Appendix A

1 U.S. Department of Health and Human Services. Healthy People 2010: Understanding and improving health (Conference ed, in 2 vols.). Washington, D.C. NOTE: The presence of a happy face indicates that Georgia high school students met or were within 1-2% of the Healthy People 2010 objective for that health behavior. Georgia Student Health Survey data not collected for this behavior.

35

Appendix B
Methodology
The purpose of the Georgia Student Health Survey was to gather data on behaviors among youth related to the leading causes of mortality and morbidity.
Questionnaire Development
Two self-administered, anonymous questionnaires were developed by the Georgia Division of Public Health for the survey. One questionnaire was developed for middle school students and contained 52 items. The other questionnaire was developed for high school students, and contained 92 items. Both questionnaires were modeled after the core Youth Risk Behavior Survey (YRBS), developed by the Centers for Disease Control and Prevention (CDC). Both questionnaires covered five topics from the YRBS: 1) behaviors that result in unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) dietary behaviors; and 5) physical activity. Additional questions about asthma were added to both questionnaires. Additionally, the high school questionnaires asked about gambling. No questions about sexual behavior were included in either of the questionnaires.
Sampling
Sample Design
Separate middle school and high school samples were selected, with an objective of having 95% confidence limits of approximately +5% around prevalence estimate of key variables. The sampling frame consisted of all regular public schools containing students enrolled in grades 6-8 for the middle schools and 9-12 for the high schools. A two-stage cluster sample design was used to produce a representative sample of middle school students in grades 6-8 and high school students in grade 9-12. The sampling program PC-Sample was used to draw both the middle school and high school samples.
Sampling Procedures
School level The first-stage sampling frame consisted of all public schools containing any of grades 6-8 for the middle schools and 9-12 for the high schools. Schools were selected systematically with probability proportional to school enrollment size (PPS) using a random start. The sample included 50 public middle schools and 50 public high schools.
Class level The second sampling stage consisted of systematic equal probability sampling (with a random start) of classes from each middle school and high school that participated in the survey. All classes in a required subject or all classes meeting during a particular period of the day, depending on the school, were included in the sampling frame.
Student level All students in the selected classes were eligible to participate in the survey. Student makeups were also conducted.

36

Georgia Student Health Survey Report: 2003, 2005 & 2007

Appendix B

Data Collection

Recruitment of Sampled Districts and Schools

School district and school recruitment began in mid January 2007. Tailored letters of invitation were sent to the school districts. These letters were followed by phone calls directly to the superintendent to answer questions and obtain permission to contact the school. School packets were included with the district invitation packet and the superintendents were asked to forward these on to the principal after their approval was received. The recruitment process sometimes included the completion of special research proposals, attendance at board meetings and principal meetings, and other clearance procedures.

As soon as notification was received that a school packet had been sent to the principal, the principal was called, a contact person was assigned, classes selected, and a date for data collection was scheduled.

Classroom-level Data Collection

The Georgia Student Health Survey was administered between March 7 and May 24, 2007 by six specially trained field staff. The data collectors were recruited from a variety of sources, including local and state retired teachers' associations, local universities, and job fairs. They completed an intensive training that included lectures, simulations, and group role plays and discussions. Detailed arrangements and survey schedules were set prior to each school visit.

Weighting

For both the middle school and high school data, a weight variable was calculated for each student record to reflect the likelihood of sampling each student and to reduce bias by compensating for differing patterns of non-response. The weight used for estimation is given by:



W = W1 * W2 * f1 * f2 * f3

W1 = the inverse of the probability of selecting the school

W2 = the inverse of the probability of selecting the classroom within the school

f1 = a school-level non-response adjustment factor calculated by school size category (small, medium, large)

f2 = a student-level non-response adjustment factor calculated by class

f3 = a post stratification adjustment factor calculated by sex, grade, and race

Georgia Student Health Survey Report: 2003, 2005 & 2007

37

Appendix B

Georgia Student Health Survey Response Rates

School Selected Participated

Middle

50

47

High

50

46

Response
Rate (%) 94 92

Selected
2,540 2,785

Student Participated
2,222 2,468

Response Rate
(%) 87 89

Overall1 Response Rate
(%) 82 81

Georgia Student Health Survey Demographic Distribution of Sample

Sex Male Female
Grade 6th 7th 8th 9th 10th 11th 12th
Race/ethnicity White Black Hispanic

Middle School

n

%

1,019

51.6

1,192

48.4

767

32.7

599

33.1

836

33.9

961

46.1

650

39.7

309

8.7

High School

n

%

1,244

50.1

1,212

49.9

973

31.5

508

26.2

567

22.6

404

19.5

1,040

49.2

984

39.3

202

6.5

Statistical Significance
SUDAAN was used to compute 95% confidence intervals, which were used to determine the differences among subgroups at the p <0.05 level. Differences between prevalence estimates were considered statistically significant if the 95% confidence intervals did not overlap.

1Overall Response Rate = School Response Rate * Student Response Rate

38

Georgia Student Health Survey Report: 2003, 2005 & 2007

Georgia Student Health Survey Report 2003, 2005 & 2007