The major markers for preventable death such as obesity, smoking, and alcohol or other substance abuse are present by early adulthood in a large proportion of people, suggesting that intervention in psychological or psychiatric disorders contributing to these behaviors should begin as early in life as possible, according to an article in the January issue of the Archives of Pediatrics and Adolescent Medicine.

The findings come from an analysis of the most comprehensive US survey of adolescent health behavior undertaken to date, a project funded by the National Institutes of Health. The analysis also found that significant health disparities exist between racial groups, and that Americans are less likely to have access to health care when they reach adulthood than they did during the teenage years.

“When they were young teenagers, most of the participants had fairly healthy behaviors,” said Christine Bachrach, PhD, Chief of the Demographic and Behavioral Sciences Branch and project officer for the National Longitudinal Study of Adolescent Health Study. “What’s really alarming is how rapidly healthy practices declined by the time the participants reached young adulthood.”

For the current analysis, principal investigator Kathleen Mullan Harris, PhD, and colleagues analyzed the responses of a nationally representative sample of more than 14,000 young adults who have been followed since early adolescence. The survey respondents, recruited from high schools and middle schools around the country, were first interviewed from 1994 to 1995, when they ranged from 12 to 19 years of age, and again in 2001 and 2002, when they were 19 to 26 years old.

The survey participants responded to questions on diet, inactivity, obesity, tobacco use, substance use, binge drinking, violence, reproductive health, mental health, and access to health care.

For nearly all groups surveyed, diet, activity level, obesity, health care access, tobacco, alcohol and illicit drug use, and likelihood of acquiring a sexually transmitted disease worsened as the youth reached adulthood, Harris said.

“These trends are quite stunning,” she added. “Whether or not the trends will continue as they age, we don’t know. But it doesn’t bode well for their future health, especially if these habits become established.”

On the positive side, participants were less likely to experience feelings of depression at adulthood than when they were adolescents, less likely to have suicidal thoughts, and less likely to be victims or perpetrators of violence.