title: Health status and behavioral outcomes for youth who anticipate a high likelihood of early death.
abstract: OBJECTIVE
  The relationship between adolescents' perceived risk for dying and their involvement in risk behaviors is unknown. We sought to determine the proportion of US youth who anticipate a high likelihood of early mortality and relationships with health status and risk behaviors over time.
  
  
  METHODS
  We analyzed data from times 1 (1995), 2 (1996), and 3 (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of youth in grades 7 through 12. The relationship between perceived risk for premature mortality and health behaviors/outcomes was assessed by using bivariate and multivariate analyses.
  
  
  RESULTS
  At time 1, 14.7% of the 20594 respondents reported at least a 50/50 chance that they would not live to age 35. In adjusted models, illicit drug use, suicide attempt, fight-related injury, police arrest, unsafe sexual activity, and a diagnosis of HIV/AIDS predicted early death perception at time 2, time 3, or both (adjusted odds ratios: 1.26-5.12). Conversely, perceived early mortality at time 1 predicted each of these behaviors and outcomes, except illicit drug use, at time 2 or time 3, most strongly a diagnosis of HIV/AIDS (adjusted odds ratios: 7.13 [95% confidence interval: 2.50-20.36]).
  
  
  CONCLUSIONS
  Adolescent involvement in risk behaviors predicted a belief in premature mortality 1 and 7 years later. Reciprocally, adolescents' perceived risk for early death predicted serious health outcomes, notably a diagnosis of HIV/AIDS in young adulthood. Given its frequency and influence on behavior and health, adolescents' perceived risk for early death should be incorporated into psychosocial assessments and interviews.
authors: Department of Pediatrics, Division of General Academic Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA. borow004@umn.edu
authors: Iris Wagman
authors: IW
authors: Borowsky
authors: Marjorie
authors: M
authors: Ireland
authors: Michael D
authors: MD
authors: Resnick
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D012309:Risk-Taking; D014481:United States / Q000453:epidemiology