title: Policy implications for local application of the 2009 Youth Risk Behavior Survey, Duval County, Florida.
abstract: BACKGROUND
  Youth Risk Behavior Survey (YRBS) data have rarely been analyzed at the subcounty level. The purpose of this study was to explore the feasibility of such analysis and its potential to inform local policy and resource allocation.
  
  
  METHODS
  We administered the 2009 YRBS to 5,860 students from 46 public middle and high schools in Duval County, Florida. In addition to asking core questions, we asked a set of questions customized for local needs, including questions about zip codes. These data were used to simulate subcounty areas consistent with areas identified by behavioral, morbidity, mortality, and health disparity surveillance. We oversampled Duval County and used weighting procedures that adjusted for subcounty areas.
  
  
  RESULTS
  Many Duval County health risk behavior rates were higher than those for Florida overall but did not vary significantly within the county. Physical activity and violence-related behaviors were exceptions that reflect major health disparities in parts of the county with a high proportion of racial/ethnic minorities.
  
  
  CONCLUSIONS
  This study demonstrated that collecting subcounty data in large metropolitan areas is feasible and that analysis of these data at the local level has implications for policy. Some health risk behaviors were common across the county, indicating the need for health promotion and disease prevention programs at the school district level. Other health risk behaviors were more prevalent in specific areas of the county and may have been exacerbated by state or local policies such as restrictions on physical education. Health disparities remain a challenge throughout the country; reducing them will require more extensive data-driven problem solving at state and local levels.
authors.affiliation: Duval County Health Department, 900 N University Blvd, Jacksonville, FL 32211, USA. William_Livingood@doh.state.fl.us
authors.forename: William C
authors.initials: WC
authors.lastname: Livingood
authors.forename: Thomas
authors.initials: T
authors.lastname: Bryant
authors.forename: Kathy
authors.initials: K
authors.lastname: Bowles
authors.forename: Dale
authors.initials: D
authors.lastname: Bell
authors.forename: Marcy
authors.initials: M
authors.lastname: LaVine
authors.forename: Rick
authors.initials: R
authors.lastname: Kane
authors.forename: Ryan
authors.initials: R
authors.lastname: Butterfield
authors.forename: Luminita
authors.initials: L
authors.lastname: Razaila
authors.forename: Rebecca
authors.initials: R
authors.lastname: Filipowicz
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking; D004032:Diet; D015444:Exercise; D005431:Florida; D015438:Health Behavior; D006801:Humans; D012309:Risk-Taking; D012725:Sexual Behavior; D012907:Smoking; D019966:Substance-Related Disorders; D013405:Suicide; D014754:Violence