Health-risk behaviors among youth may lead to early morbidity and mortality, commonly extend into adulthood, are often interrelated, and are preventable. The Navajo YRBS survey was administered to identify patterns and trends, to develop and implement interventions, and to evaluate and monitor youth and school health programs to reduce potential behavioral risks factors among Navajo youths. The Survey monitors six categories of priority risk behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted disease (STDs), including human immunodeficiency virus (HIV) infection; unhealthy dietary behaviors; and physical inactivity and overweight.

With each administration of the survey, the Navajo YRBS included more schools to increase representation and to measure health risk behavior patterns. In 2003, the survey design included 109 middle and high schools, on or near the Navajo Nation, and with at least 50 percent Navajo student enrollment. The Centers for Disease Control and Prevention (CDC) YRBS sampling, data processing, and prevalence analysis methods were used.

In 2003, 74 middle schools with 8493 students, and 35 high schools with 8630 students participated. For middle school students, 40% had ever drank alcohol, 36% did not engage in vigorous physical activity at least three times a week, 36% had ever used marijuana, and in the 30 days preceding the survey, 33% rode with a driver who had been drinking, and 32% had carried a weapon. Among high school students, 71% did not have physical education class daily, 62% did not eat at least five fruits and vegetables per day, and 40% indicated ever having sexual intercourse in their lifetime. The lack of proper exercise and nutrition, and exposure to alcohol and marijuana risk behaviors of the middle school students were also reported by high schools students.

To provide more comprehensive information on youth health status and trends, the Navajo Area Indian Health Service Coordinated School Health (CSH) Program overview, the 1998 - 2002 Navajo Fitnessgram Report, the System for Observating Fitness Instruction Time, 1998 - 2003, Summary and Abstract, and CSH Component Worksheet Summary were included in this report.

The intent of the information in this report is to help youth programs, school teachers and administrators, public health practitioners, researchers, and policy makers to evaluate programs, establish priorities, and secure resources that will address and prevent health risk behaviors.