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The Youth Risk Behavior Surveillance System (YRBS) is the primary public health surveillance architecture in the United States tracking health-risk behaviors and protective factors among high school youth. Established in 1991 by the Centers for Disease Control and Prevention (CDC), the system monitors epidemiological shifts to inform adolescent health policies and school programs.
What It Is
The Youth Risk Behavior Surveillance System (YRBSS) is a biennial, school-based survey network. It measures behaviors established during youth that contribute directly to adolescent morbidity and mortality. Behavioral scientists and epidemiologists use YRBS datasets to assess trends, evaluate community frameworks within what is public health infrastructure, and allocate resources toward adolescent wellness.
What is the yrbs survey?
The Youth Risk Behavior Survey (YRBS) is the survey instrument administered in classrooms to students in grades 9 through 12. While the surveillance system encompasses state, territorial, tribal, and district components, the national survey provides an independent snapshot of student health across public and private secondary schools nationwide. Participation is voluntary and anonymous, operating under local parental permission protocols.
Who Runs It and What It Covers
Federal coordination operates alongside state and local education and health departments to gather comprehensive surveillance data.
Who runs the YRBSS?
The YRBSS is administered by the Centers for Disease Control and Prevention (CDC), specifically through the Division of Adolescent and School Health (DASH) within the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). CDC DASH designs questionnaires, coordinates sampling matrices, and processes raw microdata. State departments of health and education, territorial agencies, tribal nations, and local school districts coordinate local survey cycles under CDC guidance.
What are the top 6 risk behaviors?
Surveillance focuses primarily on six categories of priority health-risk behaviors established by the CDC:
- Behaviors contributing to unintentional injuries and violence: Motor vehicle safety (seatbelts, driving impaired), weapon carrying at school, fighting, dating violence, and bullying victimization.
- Sexual behaviors linked to unintended pregnancy and STIs: Lifetime intercourse, early sexual debut, condom use, and contraception to track risks for HIV and other sexually transmitted infections.
- Alcohol and other drug use: Lifetime and past-30-day alcohol consumption, binge drinking, cannabis use, prescription opioid misuse, and illicit substance exposure.
- Tobacco product use: Use of electronic vapor products (e-cigarettes), combustible cigarettes, cigars, and smokeless tobacco.
- Unhealthy dietary behaviors: Dietary intake of fruits, vegetables, sugar-sweetened beverages, fast food, and daily breakfast habits.
- Inadequate physical activity: Adherence to physical activity guidelines (60 minutes daily), physical education participation, sports teams, and recreational screen time.
Recent cycles also evaluate adolescent mental health, suicidal ideation, adverse childhood experiences (ACEs), and school connectedness.
What does the 2023 YRBS reveal about the mental health of high school students?
The 2023 YRBS release and CDC MMWR Supplement (often queried as 2023 or 3023 YRBS data) revealed ongoing mental health distress among high school students:
- Persistent Sadness or Hopelessness: 39.7% of students felt persistently sad or hopeless in the past year, impairing regular activities.
- Poor Recent Mental Health: 28.5% reported their mental health was mostly not good during the past 30 days.
- Suicidal Ideation and Attempts: 20.4% of students seriously considered attempting suicide, and 9.5% attempted suicide.
- Disproportionate Demographic Impact: Female students reported higher rates of persistent sadness (52.6% vs 27.7% for males) and suicidal ideation (27.1% vs 14.1% for males). Among LGBQ+ students, 65.7% experienced persistent sadness and 41.0% seriously considered suicide. In national tracking, 52.9% of transgender students seriously considered suicide.
- Digital and Protective Factors: 77.0% of students reported frequent social media use (several times daily), while strong school connectedness significantly buffered against depression and suicidal behaviors.
How to Search or Use It
Researchers access YRBS data through the online YRBS Explorer or public-use microdata archives. Follow these steps to query and extract surveillance data:
1. Navigate to the YRBS Explorer
Open the official CDC YRBS Explorer portal (cdc.gov/yrbs/) to view web-based tables and charting tools without statistical software.
2. Select Geographic Scope
Choose between the national high school dataset, state datasets, territories, tribal organizations, or participating large urban school districts.
3. Choose Health Topic and Question
Select from the six core health-risk categories or supplemental modules to view specific survey items.
4. Stratify by Demographics
Apply cross-tabulations to stratify prevalence estimates by sex, race and Hispanic ethnicity, grade level, or sexual identity.
5. Export Visual Tables and Trend Charts
View longitudinal trends from 1991 to the present and export prevalence summary tables as CSV files or chart figures.
6. Download Public-Use Microdata
For multivariable modeling, navigate to “Data & Documentation” to download the raw public-use ASCII data file and the variable codebook.
7. Apply Complex Survey Weights in Statistical Software
Download CDC SAS, SPSS, or Stata input syntax scripts. Specify primary sampling units, stratification clusters, and sampling weights before calculating an odds ratio or estimating a relative risk across exposure cohorts.
Strengths and Limits
Evaluating YRBS methodology helps ensure appropriate statistical usage and valid causal inference.
Strengths
- Nationally Representative Scale: The three-stage cluster design samples 15,000 to 20,000 students per cycle for statistical power across demographic subgroups.
- Longitudinal Comparability: Standardized biennial cycles since 1991 offer over three decades of consistent trend monitoring.
- Free Microdata Access: Datasets, syntax files, and documentation are openly available without licensing restrictions.
Limits
- Exclusion of Non-Enrolled Youth: Classroom sampling excludes adolescents who have dropped out, are institutionalized, or experience chronic absenteeism.
- Cross-Sectional Architecture: Independent biennial samples capture cross-sectional snapshots rather than longitudinal cohorts, which prevents tracking individual trajectories and introduces risks of reverse causality.
- Self-Report Bias: Data rely on student self-reporting, subject to recall limitations, although anonymous settings mitigate deliberate misreporting.
Alternatives
Researchers examining adolescent health and risk behaviors frequently compare YRBS with other federally funded surveillance systems:
| Surveillance System | Administering Agency | Sampling Frame & Setting | Primary Topical Focus | Longitudinal Cohort Follow-up | Biomarker / Physical Exams |
|---|---|---|---|---|---|
| YRBS | CDC (DASH / NCHHSTP) | School-based; grades 9–12 in public and private schools | Comprehensive health-risk behaviors, violence, and mental health | No (repeated independent cross-sectional cycles) | No (strictly self-administered questionnaires) |
| NSDUH | SAMHSA | Household-based; civilian non-institutionalized population age 12+ | Substance use disorders, mental health conditions, clinical DSM criteria | No (annual independent cross-sectional survey) | No (audio computer-assisted self-interviews) |
| Monitoring the Future (MTF) | University of Michigan / NIDA | School-based; 8th, 10th, and 12th grades nationwide | Substance use trends, tobacco/nicotine, and student attitudes | Yes (annual longitudinal panel follow-ups of 12th-grade cohorts) | No (self-administered paper and web surveys) |
| NHANES | CDC (NCHS) | Household sample; all ages across civilian non-institutionalized population | Nutritional status, chronic disease markers, and general health | No (continuous cross-sectional national survey) | Yes (direct physical examinations, laboratory blood/urine biomarkers) |
Frequently Asked Questions
What is the yrbs survey?
The Youth Risk Behavior Survey (YRBS) is a biennial, school-based survey administered to students in grades 9 through 12 across the United States. It measures health behaviors and environmental factors influencing adolescent safety, wellness, and long-term health outcomes.
Who runs the YRBSS?
The Youth Risk Behavior Surveillance System is managed and coordinated by the Centers for Disease Control and Prevention (CDC) through the Division of Adolescent and School Health (DASH), in partnership with state, territorial, tribal, and local authorities.
What are the top 6 risk behaviors?
The CDC monitors six priority health-risk behavior categories: behaviors contributing to unintentional injuries and violence, sexual behaviors related to unintended pregnancy and STIs/HIV, alcohol and other drug use, tobacco product use, unhealthy dietary behaviors, and inadequate physical activity.
What does the 2023 YRBS reveal about the mental health of high school students?
The 2023 YRBS data reveal that 39.7% of high school students experienced persistent sadness or hopelessness, 20.4% seriously considered suicide, and 9.5% attempted suicide. Female, LGBQ+, and transgender students reported disproportionately higher rates of psychological distress.
How can researchers download YRBS public-use microdata?
Researchers can download raw YRBS data files, SAS/SPSS/Stata input scripts, and comprehensive codebooks directly from the CDC Division of Adolescent and School Health data portal without requiring special data use permits.
Sources
- Centers for Disease Control and Prevention. (2026). Youth Risk Behavior Surveillance System (YRBSS) Overview and Data Access. U.S. Department of Health and Human Services. URL: https://www.cdc.gov/yrbs/index.html. Read 2026-11-07.
- Centers for Disease Control and Prevention. (2024). Youth Risk Behavior Surveillance — United States, 2023. Morbidity and Mortality Weekly Report (MMWR) Supplement. URL: https://www.cdc.gov/mmwr/. Read 2026-11-07.
- Substance Abuse and Mental Health Services Administration. (2024). National Survey on Drug Use and Health (NSDUH) Methodological Comparison and Summary. SAMHSA Center for Behavioral Health Statistics and Quality. URL: https://www.samhsa.gov/data/report/2023-nsduh-detailed-tables. Read 2026-11-07.
- National Institute on Drug Abuse & University of Michigan. (2024). Monitoring the Future Survey: Purpose and Methodology. Institute for Social Research. URL: https://monitoringthefuture.org/. Read 2026-11-07.
