2015

Prepared for the Colorado Department of Education,

Colorado Department of Human Services, and Colorado
Department of Public Health & Environment by the
University of Colorado Denver Community Epidemiology
& Program Evaluation Group.

Executive Summary

Introduction
The Healthy Kids Colorado Survey (HKCS) is an essential
tool that state and local communities use to better
understand the health of middle and high school
students so we can help them make healthy choices.
The HKCS collects anonymous, self-reported
information from Colorado middle and high school
students every other year. In 2015, the state
departments of health, education and human services
jointly surveyed about 17,000 randomly selected
students from more than 157 middle schools and high
schools. This report presents results from 2015 Healthy
Kids Colorado Survey.
The State launched the survey in 2013 as a unified
effort to meet the needs of multiple agencies and
organizations for youth health data and state and
regional results. The State administered HKCS in the
fall of 2015 and will be repeated in odd-numbered
years, with the next survey in 2017.
The data include weight, nutrition, physical activity,
suicide, bullying, mental health, tobacco, alcohol,
marijuana, drugs, sexual health (high school only),
school and community engagement, access to trusted
adults, and many more topics. The data also reflect
student attitudes and perceptions that address health
behaviors and the influences that can support a
students healthy choices.

whose sex at birth aligns with the gender they know

themselves to be on the inside. Results below may not
show transgender data if the sample size was too small.
These results do not reflect middle school data because
the sample size is much smaller compared to the high
school sample, so comparisons between race and
ethnicity data is often not shown due to the small
number of responses within each identity group. The
middle school survey also does not include questions
about sexual orientation or gender identity.

This report highlights select measures. However, there

are numerous additional measures within each topic
area and questions outside these topic areas as well.
There are more than 160 high school questions across
two survey modules. Multiple topic area reports will be
released between through the administration of the
2017 survey.

The Colorado Department of Public Health and

Environment (CDPHE), Colorado Department of
Education (CDE) and Colorado Department of Human
Services (CDHS) support the HKCS. The Community,
Epidemiology & Program Evaluation Group at the
University of Colorado Anschutz Medical Campus
administers the survey. The survey incorporates the
Centers for Disease Control and Preventions (CDC)
Youth Risk Behavior Surveillance System.1 HKCS results
represent Colorado's middle and high school
populations statewide as well as regional estimates for
each of the twenty-one health statistics regions for
high school. School and district level results are
provided to the respective school or district.

Results include data about healthy behaviors for high

school students, with comparison by demographic
characteristics (sex, race/ethnicity, sexual orientation,
and gender identity).

Public and private organizations including schools,

parents and youth across Colorado use this surveys
state and regional health data to identify trends and
enhance school- and community-based programs that
improve the health and well-being of young people.

The survey advisory committee, consisting of local

public health departments, school districts, and
community organizations, determined it was important
to include a question on gender identity on the 2015
survey instrument. This is the first year that the survey
results will include the health outcomes of transgender
students compared to cisgender students. Cisgender
refers to a person who is not transgender or a person

Centers for Disease Control and Prevention, Youth Risk

Behavior Surveillance System (YRBSS),
http://www.cdc.gov/HealthyYouth/yrbs/index.htm.

Survey Participants and Response Rates

Students from a random sample of selected schools and
randomly selected classrooms within those schools
complete the surveys. Data is aggregated to maintain
anonymity and in order to protect student
confidentiality we don't release estimates that are 0%,
100%, or if fewer than 30 students answer the question
at all, or if fewer than three responded "Yes" to the
question. Results are weighted to represent student
enrollment in all Colorado public middle and high
schools. HKCS and other sample-based surveys use
weights to account for the fact that information is
obtained from a sample and used to represent the
larger population. The weights account for sampling
design, school and student nonparticipation and
nonresponse, and discrepancies in grade, sex and
ethnicity between the sample and the population.

Overall response rate (RR) is the product of the school

participation rate and the student response rate:
A total of 15,970 randomly high school students from
127 high schools, and 997 randomly selected middle
school students from 30 middle schools participated in
the 2015 state sample. There was an overall response
rate of 46.5 percent for high schools and 48.1 percent
for middle schools. An additional 26 high schools and 69
middle schools opted in to the administration for a
total of more than 40,000 participating students. The
remainder of this report presents estimates for those
schools and students comprising the high school state
sample.

Methods
Each topic area notes the prevalence, or the proportion of students reporting a behavior. We evaluated
differences between groups using Rao-Scott chi-squared tests and logistic regression for complex survey
design. The reference group is a group to which an individual or another group is compared. For
example, when reporting on sexual orientation, heterosexual is the reference group. For gender
identity, cisgender is the reference group. For race/ethnicity, all race/ethnic groups white students
are the reference group. This analysis is done to find the probability that there is a statistically
significant difference between the health outcomes of the reference group with other groups. When
the statistical probability or P-value is less than or equal to .01, this indicates that the results are
significant meaning they are accurate with 99% or more confidence. Statistically significant results are
noted by an asterisk. Differences between state and national estimates are determined by nonoverlapping confidence intervals.

Demographics
Overall, 49 percent of the high school students surveyed are male, 51 percent are female, 2.2 percent
identify as transgender, and 9 percent self-identify as lesbian, gay or bisexual (LGB; Table 1) and 2.2
percent self-identify as transgender, and 1.5% are questioning their gender identity. High school
students are 56 percent white, 24 percent Hispanic/Latino, 11 percent multiracial, 5 percent AfricanAmerican, 3 percent Asian, 1 percent American Indian/Alaskan Native, and <1 percent Native
Hawaiian/Pacific Islander. The number of Native Hawaiian/Pacific Islander respondents is low and are,
therefore, not presented with the race/ethnicity data in this report.

Table 1. Demographics of the (weighted) Colorado students, HKCS 2015.

Race/Ethnicity

Percent

Sex

Percent

African American/Black

4.9

Female

51.4

American Indian/ Alaskan Native

.8

Male

48.6

Asian

3.4

Hispanic/Latino

24.1

Gender Identity

Percent

Multiracial

11

Cisgender (non-transgender)

96.2

Native Hawaiian/Pacific Islander

.2

Transgender

2.2

55.6

Questioning

1.6

White

Sexual Orientation

Percent

Bisexual

7.2

Gay/Lesbian

2.2

Heterosexual/Straight

86.2

Unsure

4.4

Results
* Indicates there is a statistically significant difference between populations

Weight, Nutrition, and Physical Activity

Colorado students are aligned with the national average when it comes to weight, nutrition and physical activity.
HKCS measures a variety of indicators related to weight, nutrition and physical activity. The figures below outline
students categorized as obese, who ate breakfast daily and participated in daily physical activity. Students are
categorized as obese based on body mass index (BMI) 2 at the time of the survey.
Colorado students are less likely to be obese compared to those nationally. The CDC recommends at least 60 minutes
of physical activity daily (7 days a week). Within Colorado, males are more likely than their female counterparts to be
obese; however, males are more likely to both eat breakfast and be physically active daily (Figure 1).
Students questioning their gender identity are more likely to be obese compared to cisgender students. Students selfidentifying as lesbian, gay, bisexual or transgender (LGBT) are less likely to eat breakfast. LGB students along with
those who are not sure are less likely to have daily physical activity compared to heterosexual students.

Body mass index is calculated from self-reported height and weight (kg/m ). BMI values are compared with sex- and age-specific
th
th
th
references data and obese is defined as a BMI> 95 percentile and overweight is >85 and <95 percentile for age and sex.
3

Obesity rates vary by race/ethnicity ranging from 33 percent of American Indian/Alaska Natives to 6.7 percent for
Asians (Figure 1c). African American/Black, Hispanic/Latino, and multiracial students are less likely to eat breakfast
compared to white students.

Figure 1a. Weight, Nutrition and Physical Activity, High School 2015
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%

44.8%
36.3%

39.2%

35.7%

33.2%
27.1% 27.8%
19.8%

13.9%

9.9%

13.2%
6.4%

Obese

Daily physical activity

(at least 60 minutes)

Ate breakfast daily

Figure 1b. Weight, Nutrition and Physical Activity, High School 2015
45%

41.3%

39.4%

40%

27.3%

30%

23.9%

25%
20%
15%
10%

33.0%

32.6%

35%

15.9%
15.8%
11.8%10.6%
9.6%
9.5%

22.1%
19.1%

29.3%

28.2%
19.6%20.2%

14.7%

22.2%
17.8%

5%
0%

Obese

Ate breakfast daily

Daily physical activity

(at least 60 minutes)

Figure 1c. Weight, Nutrition and Physical Activity, High School 2015
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%

46.6%

42.9%

36.6%

33.0%

34.1%33.2%

28.0%
13.8%15.4%

15.0%
6.9%

35.7%
28.5%29.5%

32.4%

24.6%
19.0%

6.7%

Obese

Ate breakfast daily

Daily physical activity

(at least 60 min)

Tobacco Use
Youth tobacco usage rates continue to decline, and have reached a new all-time low. However, use of electronic
smoking devices usage has skyrocketed. The use of electronic vapor products in the past 30 days is higher than
cigarette, cigar, or smokeless tobacco products (Figure 2a). Colorado has a lower level of smokeless tobacco products
compared to the national average. Males are more likely than females to use cigars or smokeless tobacco products in
the past 30 days.
LGBT high school students use most tobacco products at higher
rates. Transgender students have the highest prevalence rate
of all four tobacco use indicators (Table 2b). Asians have lower
rates of cigar and electronic vapor products than white
students. Hispanic/Latino students have lower rates of
smokeless tobacco products, African American/Black students
have lower rates of electronic vapor products and multiracial
students have higher rates of cigarette use compared to white
students.

Figure 2a. Tobacco Use, High School 2015

30%

26.1%25.5%26.6%
24.1%

25%
20%
15% 10.8%
8.6% 8.3% 8.7%
10%

10.3% 8.9%

11.0%
7.3%

6.4%

5%

4.9%

7.3%
2.2%

0%

Current cigarette

Current cigar use

Current electronic
vapor product

Current smokeless
tobacco

Figure 2b. Tobacco Use, High School 2015

47.2%

50%
45%
40%

39.2%
36.9%

34.3%

35%

27.3%

30%
20%
15%

24.1%

22.4%

25%

17.8%
14.7%

10% 6.8%

17.2%

7.8%

18.0%

13.0%
12.4%
11.1%
8.3%
8.1%

5%

24.7%

29.6%
25.9%
15.8%

10.3%
9.8%
7.9%
4.5% 4.7% 4.2%

Heterosexual
Lesbian/Gay*
Bisexual*
Not sure*
Cisgender
Transgender*
Questioning*

Heterosexual
Lesbian/Gay
Bisexual*
Not sure*
Cisgender
Transgender*
Questioning

Heterosexual
Lesbian/Gay
Bisexual*
Not sure*
Cisgender
Transgender*
Questioning*

Heterosexual
Lesbian/Gay
Bisexual*
Not sure
Cisgender
Transgender*
Questioning

0%

Current cigarette
use

Current cigar use

Current smokeless
tobacco

Current electronic
vapor product

Figure 2c. Tobacco Use, High School 2015

35%
28.6%29.9%
30%
26.4%
23.0%
25%
20%
15.9%
13.2%
12.7%
12.2%
12.1%
15%
9.3%
8.8%
8.4%
8.3%
8.3%
8.6%8.0%
7.4%
10%
5.6%
5.3%
4.7%
2.4%
2.4% 2.8%3.3%
5%
0%

Current cigarette

Current cigar use

Current smokeless

Current electonic
vapor product

Alcohol Use
Compared to other substances, students in Colorado are
most likely to drink alcohol. Colorado does not
significantly differ from the national average for alcohol
use. Males are less likely than females to have drank
alcohol in the past 30 days (Figure 3a). A majority of
students say alcohol is easy or sort of easy to get. LGBT
students are more likely to have drank alcohol in the past
30 days compared to heterosexual and cisgender students.
In general, white students drink alcohol at higher rates
compared to other race/ethnicity and report easier access
to alcohol if they wanted it (Figure 3c).

Figure 3a. Alcohol Use, High School 2015

70%
60%
50%
40%
30%
20%
10%
0%

57.2% 57.8% 56.8%

32.8% 30.2% 32.9%
27.7%
17.7% 16.6% 17.3% 15.9%
N/A

Current alcohol

Binge drink in past 30

Easy/sort of easy to get

Figure 3b. Alcohol Use, High School 2015

66.1%
65.0%
61.3%
57.6% 59.5%
58.0%

70%

56.7%

60%
44.9%
43.2%
40.2%
34.2%
40%
30.2%
28.6%
30%
23.4%
50%

20%

25.0%
29.2%
24.0% 21.4%
16.4% 13.7%
15.5%

10%
0%

Current alcohol

Binge drink in past 30

Easy/sort of easy to get

alcohol

Figure 3c. Alcohol Use, High School 2015

100%
80%
61.0%

56.0%53.4%55.6%
38.2%39.8%

60%
40% 32.7%
20%

29.6% 29.9%
18.6%
15.6%17.9%

18.2%
14.5%18.2%
14.3%
9.2%
8.4%

0%

Current alcohol

Binge drink in past 30

Easy/sort of easy to get

alcohol

Marijuana Use
Four out of five Colorado high school students have not used marijuana in the last 30 days, a rate
that remains relatively unchanged since 2013. Colorado does not significantly differ from the
national average in lifetime or current marijuana use (Figure 4a). Also, there are not significant
differences by sex (Figure 4a). Bisexual students report higher rates of ever and current marijuana use
compared to heterosexual students, and easier access to marijuana (Figure 4b). Asian, Hispanic/Latino
and multiracial students report lower rates of ever or current marijuana use compared to whites
(Figure 4c).

Figure 4a. Marijuana Use, High School 2015

60%
50%
40%
30%
20%
10%
0%

55.7% 56.2% 55.5%

38.6% 38.0% 38.4% 37.5%

21.7% 21.2% 21.0% 21.4%
N/A

Ever used marijuana

Current marijuana use

Easy/sort of easy to get

marijuana

Figure 4b. Marijuana Use, High School 2015

70%
60%
51.1%54.1%
46.7%
50%
38.1%
36.5%
37.9% 35.4%
40%
30%
20%
10%
0%

Ever used marijuana

66.2% 56.5%
54.9%54.8% 55.9% 55.5%
48.4%
36.6%
36.5%
29.3% 27.7%
20.8% 19.6%
19.5%

Current marijuana use

Easy/sort of easy to get

Figure 4c. Marijuana Use, High School 2015

70%
60%
45.1%47.8%
50%
40.6%37.2%
40% 34.1%
30%
19.9%
20%
10%
0%

Ever used marijuana

53.7%56.0%

59.5%62.3%

47.1%
39.3%

28.0%
23.6%
19.5%22.7%20.1%
10.3%

Current marijuana use

Easy/sort of easy to get

Other Substance Use

Among other illicit drugs, Colorado students are most likely to use prescription drugs without a
doctors prescription. Colorado does not significantly differ from the nation on these indicators. Males
are more likely than females to have ever used ecstasy. Across other illicit substances there are
substantial differences by sexual orientation and gender identity, with transgender students having
particularly high rates (Figure 5b). As a general pattern, those identifying as multiracial were more
likely than whites to have ever used illicit drugs. American Indians did not have a statistically
significant difference in substance use rates.

National
Colorado
Females
Males
National
Colorado
Females
Males

Ecstasy

National
Colorado
Females
Males*
National
Colorado
Females
Males

Prescription
drugs w/o
prescription

5.2%
5.6%
4.8%
6.3%
7.0%
6.2%
6.9%
5.5%
2.1%
2.0%
1.6%
2.3%

National
Colorado
Females
Males

Steroids

Methampheta
mines

Inhalants

National
Colorado
Females
Males

Heroin

Cocaine

Figure 5a. Lifetime use of other Drugs, High School 2015

3.0%
2.4%
2.0%
2.7%
5.0%
5.5%
4.4%
6.5%
3.5%
2.7%
2.5%
2.8%

National
Colorado
Females
Males

16.8%
13.7%
14.4%
12.9%
0%

10

5%

10%

15%

20%

Prescription drugs
w/o prescription

Steroids

Ecstasy

Methamphetamines

Heroin

Inhalants

Cocaine

Figure 5b. Lifetime use of other Drugs, High School 2015

Questioning*
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

11.0%
29.1%
4.9%
13.3%
9.1%
11.7%
4.8%

Questioning*
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

25.4%
34.1%
5.3%
14.3%
15.2%
14.6%
4.8%

Questioning*
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

4.3%
25.3%
1.4%
10.5%
3.5%
6.9%
1.3%

Questioning*
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

5.4%
24.9%
1.7%
12.0%
4.4%
8.4%
1.5%

Questioning
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

6.5%
30.1%
4.9%
14.8%
9.8%
12.4%
4.5%

Questioning*
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay*
Heterosexual

8.7%
23.2%
2.0%
10.3%
4.2%
8.4%
2.0%

Questioning
Transgender*
Cisgender
Not sure*
Bisexual*
Lesbian/Gay
Heterosexual

18.7%
30.9%
13.4%
27.3%
26.1%
18.5%
11.8%
0%

11

5%

10%

15%

20%

25%

30%

35%

40%

Prescription drugs
w/o prescription

Steroids

Ecstasy

Methamphetamin
es

Heroin

Inhalants

Cocaine

Figure 5c. Lifetime use of other Drugs, High School 2015

White
African American
American Indian
Asian
Hispanic*
Multiracial*

4.2%
3.0%
11.0%
5.5%
6.9%
11.0%

White
African American
American Indian*
Asian
Hispanic
Multiracial*

5.3%
5.7%
18.2%
4.4%
6.4%
10.7%

White
African American
American Indian*
Asian*
Hispanic
Multiracial*

1.3%
2.1%
6.8%
5.2%
1.7%
4.8%

White
African American
American Indian
Asian*
Hispanic
Multiracial*

1.5%
2.9%
6.9%
5.7%
2.2%
5.7%

White
African American
American Indian
Asian
Hispanic
Multiracial*

4.6%
4.6%
9.3%
6.2%
5.8%
10.1%

White
African American
American Indian
Asian*
Hispanic*
Multiracial*

1.7%
2.7%
6.7%
4.0%
3.1%
6.0%

White
African American
American Indian
Asian
Hispanic
Multiracial*

13.8%
9.4%
15.2%
9.1%
13.0%
18.3%
0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Colorado high school students are less likely than the national average to have been offered drugs on
school property in the past 12 months. Students identifying as bisexual or not sure (compared to
heterosexual) and those identifying as transgender (compared to cisgender) were more likely to have
been offered drugs. American Indian/Alaska Native and multiracial students reported a higher rate of
having been offered drugs on school property in the past 12 months than white students. Asian
students, compared to white students, had a lower rate of being offered drugs on school property
(Figure 6).
12

Figure 6. Offered Drugs on School Property in Past 12 Months, High School 2015
45%
38.8%

40%
35%
30%
25% 21.7%
20%

16.5%15.1%17.9%

24.1%
21.7%20.7%
15.6%

16.1%

15%

22.7%
18.4%

16.4%
12.8%

20.6%
16.6%

11.5%

10%
5%
0%

Bullying, Personal Safety and Violence

LGBT students experience the highest rates of bullying,
threats to personal safety and violence. Females are more
likely than males to report having been bullied on school
property and bullied electronically (through e-mail, text,
chat rooms, messaging applications, or websites) in the past
12 months (Figure 7a). There were large inequities in the
prevalence of having been bullied by sexual orientation and
gender identity compared to heterosexual or cisgender
students.
LGBT students report higher rates for almost every bullying
indicator, with transgender students reporting the highest
rates of bullying, more than double that of cisgender
students. Hispanic/Latino students report lower levels of having been bullied at school and
electronically than white students. African American/Black students also reported lower prevalence of
having been bullied electronically or because of perceived sexual orientation than white students.
Multiracial students reported a higher prevalence of having been bullied because of perceived sexual
orientation than white students (Figure 7c).

13

Figure 7a. Bullying, High School 2015

30%
25%
20%
15%
10%
5%
0%

23.9%

20.7%

20.2% 20.1%
16.4%

15.5% 15.1%
9.5%

8.9%

9.7%

8.0%

NA

Been bullied at school, past 12 months

Been electronically bullied, past 12

months

Been bullied because perceived sexual

orientation, past 12 months

Figure 7b. Bullying, High School 2015

60%
48.1%

50%

37.6%
31.7%
26.1%
30%
19.2%
18.2%
20%

40.5%

40%

28.2%

29.3%
28.9%
23.2%
14.5%
13.1%

44.7%

42.8%
33.3%

20.2%
5.5%

10%

19.9%

14.9%
7.9%

0%

Been bullied at school, past

12 months

Been electronically
bullied, past 12 months

Been bullied because perceived

sexual orientation, past 12 months

Figure 7c. Bullying, High School 2015

25% 22.3%
20%
15%

21.0% 21.0%

15.6%

22.9%
18.1%

17.1%
14.7%

10%

14.3%
11.1%
7.2%

6.0%

5%

13.8%
9.6%
4.1% 4.2% 5.0%

6.6%

0%

Been bullied at school,

past 12 months

14

Been electronically
bullied, past 12 months

Been bullied because perceive

sexual orientation, past 12 months

Colorado does not significantly differ from

the nation in personal safety and violence
indicators. Males are more likely than
females to have been in a fight or been
threatened or injured with a weapon
(Figure 8a). Students identifying as LGB, or
not sure and those identifying as
transgender or questioning their gender
identity had significantly higher rates of
one or more indicators of violence or
personal safety. For example, about one in
three transgender students reported having
been in a fight in the past 12 months, been
threatened or injured on school property in
the past 12 months, and missed school
because they felt unsafe in the past 30
days. Multiracial students were more likely than white students to report having been in a fight in the
past 12 months, been threatened or injured on school property in the past 12 months, and missed
school because they felt unsafe in the past 30 days compared to white students. African
American/Black, American Indian, and Hispanic/Latino students were more likely to report having been
in a physical fight in the past 12 months compared to white students.

Figure 8a. Personal Safety and Violence, High School 2015

30%
25%

25.0%

22.6%
20.1%

20%
15%

14.7%

10%

6.0%

5%

5.6%

6.9%
4.1%

5.6%

5.5%

6.3%

4.6%

0%

Been in a fight, past 12 months

15

Been threatened/injured with a

weapon on school property, past 12
months

Missed school because felt

unsafe, past 30 days

Figure 8b. Personal Safety and Violence, High School 2015

42.3%
45%
40%
35%
30.8%
27.9%
27.7% 26.1%
30%
25%
19.2%
18.7%
20%
15%
10%
5%
0%

Been in a fight, past 12

months

32.1%

16.7%

15.4%

12.8%
10.9%
4.8%

4.6%

31.5%

18.1%

4.6%

4.1%

Been threatened/injured with a

weapon on school property, past 12
months

15.5%

13.0%
10.2%

Missed school because felt

unsafe, past 30 days

Figure 8c. Personal Safety and Violence, High School 2015

35%
30%

30.5%
28.6%

25%

28.6%
21.2%

20% 17.8%

15.6%

15%
7.4% 8.6%

10%
4.8%

5%

10.8%
6.0%

4.7%

4.6%

6.4%

8.1% 7.9%

8.9%
5.4%

0%

Been in a fight, past 12 months

16

Been threatened/injured with a

weapon on school property, past 12

Missed school because

felt unsafe, past 30 days

Mental Health
Colorado students experience depression and suicide at a
similar rate to the rest of the nation. Approximately twice as
many females as males reported having been sad, considered
suicide or attempted suicide in the past 12 months. There were
also dramatic differences by sexual orientation and gender
identity with LGBT students reporting higher rates of all three
mental health indicators (Figure 9b). Multiracial students
reported higher rates of all three mental health indicators
compared to white students. African American/Black students had
lower rates of having considered suicide as compared to white
students (Figure 9c).

Figure 9a. Mental Health and Suicide, High School 2015

45%
40%
35%
30%
25%
20%
15%
10%
5%
0%

39.9%
29.9% 29.5%
19.2%

22.9%
17.7% 17.4%
12.0%

8.6% 7.8%

4.4%

Attempted suicide
in past 12 months

Considered suicide
in past 12 months

Been sad or hopeless

every day for 2 weeks

11.2%

Figure 9b. Mental Health and Suicide, High School 2015

70%
60%

63.2%
55.2%

50%

57.7%

44.0%

49.0%

45.3%

47.3%

37.4%

40%
30% 25.3%

27.7%

27.2%

20%

35.6%

13.8%

35.5%
24.1% 25.8%

16.6%
5.6%

10%

13.3%
7.0%

0%

Been sad or hopeless

every day for 2 weeks

17

Considered suicide
in past 12 months

Attempted suicide
in past 12 months

13.7%

Figure 9c. Mental Health and Suicide, High School 2015

36.6%
40%
35%
31.3%
30.8%
28.0%
30%
25%
18.2%19.5%
20%
15%
10%
5%
0%

Been sad or hopeless

every day for 2 weeks

22.4%
17.8%

16.8%15.6%
14.7%
11.2%

14.6%
6.9% 5.6% 6.2%

Considered suicide
in past 12 months

7.9%
4.4%

Attempted suicide
in past 12 months

Sexual Health
Colorado students are significantly less likely to be sexually active than the nation (as defined by
having had sex in the past three months). Males were more likely than females to have ever had sex
(Figure 10a). LGBT students were more likely to have ever had sex and not use birth control the last
time they had sex. Bisexual students were more likely than heterosexual students to be sexual active
and students questioning their gender identity were more likely than cisgender students to not use
birth control the last time they had sex. For the three sexual health indicators, Asian students are less
likely than white students to have ever had sex or be sexually active but more likely to not use birth
control the last time they had sex compared to white students. Hispanic/Latino students were more
likely than white students to have ever had sex and not use a birth control the last time they had sex.
Multiracial students were more likely than white students to have ever had sex (Figure 10c).

Figure 10a. Sexual health, High School 2015

45%
40%
35%
30%
25%
20%
15%
10%
5%
0%

41.2%
35.4%

38.2%
32.5%

25.1% 23.8% 26.3%

13.8% 11.6% 14.5%

Ever had sex

18

30.1%

Had sex in
past 3 months

8.6%

Did not use birth control

before sex

Figure 10b. Sexual health, High School 2015

90%
80%
70%
58.2%
60%
50.0%50.4%
50%
34.9% 33.6%
32.9%
40% 33.9%
30%
20%
10%
0%

Ever had sex

79.2%

46.8%
39.0%
29.1% 27.6%
23.7%
24.7% 23.0%

38.2%
30.7%

7.9%

Had sex in
past 3 months

24.1%
19.7%
10.1%

Did not use birth control

before sex

Figure 10c. Sexual health, High School 2015

50%
43.0%
40.1%
45%
37.0%
40% 33.5%
32.6%
35%
30%
25%
20%
14.1%
15%
10%
5%
0%

Ever had sex

24.1%24.7%25.9%

31.6%
26.4%

30.3%
27.3%

13.4%

15.7%
8.3%

Had sex in
past 3 months

School Engagement
High school students are less likely to engage in risky behaviors if they have a
trusted adult in their lives. The HKCS includes a number of questions related to
school engagement and climate as well as relationships with parents, teachers,
and other trusted adults. These questions are not collected on a national level.
The majority of high school students agree or strongly agree that teachers care
about them and encourage them and a majority participated in extracurricular
activities at school (Figure 11a). Less than one in four students has skipped a
whole day of school in the past four weeks. Bisexual students are less likely than
heterosexual students to agree that teacher care and encourage them, less likely
to participate in extracurricular activities, and more likely to have skipped school.
Transgender students were more likely than cisgender students to have skipped a
day of school in the past four weeks (Figure 11c).

19

15.4%14.3%

Did not use birth control

before sex

Figure 11a. Youth Engagement in School, High School 2015

80%

60.9%

60.3%

69.3%

61.7%

70.1%

68.4%

60%
40%

22.9%

24.0%

21.6%

20%
0%
Colorado Females Males
Agree that teachers care
and encourage

Colorado Females Males

Participate in
extracurricular activities

Colorado Females Males

Skipped at least one day
in past 4 weeks

Figure 11b. Youth Engagement in School, High School 2015

80%
60%

62.6%
60.9%

61.7%
57.7%
51.0%
48.4%
47.9%

70.1%
69.3%
67.7% 65.0%
65.8%
62.4%
57.0%
38.4%
33.5% 29.0%
29.3%
22.4% 22.4%
22.9%

40%
20%
0%

Agree that teachers care and encourage

Participate in extracurricular activities

Skipped at least 1 day in past 4 weeks

Figure 11c. Youth Engagement in School, High School 2015

80%
69.0%
70% 63.2%
60.8%
58.3%
57.3%
60%
53.0%
50%
40%
30%
20%
10%
0%

Agree that teachers care and

encourage

20

74.8%
68.8%
65.9%
64.4%
59.2%
58.5%

33.9%
26.6%
26.4%
25.8%
17.7%19.6%

Participate in extracurricular
activities

Skipped at least 1 day in past 4

weeks

Putting Data into Action

Despite the fact that Colorado is seeing positive impacts on the overall health and
well-being of young people, health equity plays an increasingly important role. This
means ensuring that all young people in Colorado - including young people of color,
lesbian, gay, bisexual, transgender, queer, and questioning young people and those
living in poverty and/or experiencing homelessness - have access to caring supportive
adults, safe neighborhoods and high-quality schools, inclusive community resources,
culturally responsive physical and mental health providers and healthy foods.
The Healthy Kids Colorado Survey data can be used to assess the health of young
people in local communities across Colorado. It can be used to:
Identify trends and changes in healthy behaviors over time.
Build community partnerships to collaboratively address community health
issues, overcome barriers and measure success.
Assess student health needs and school climate.
Determine gaps in health services for young people in a specific school,
district, region, or statewide.
Justify the use and measure the effectiveness of evidence-based interventions
or promising health programs that improve health outcomes.
Secure program funding for schools, community organizations, and local public
health agencies.
Improve health equity among all young people.
The Healthy Kids Colorado Survey is one important tool for decision-makers,
communities, families and youth that supports communities all across Colorado
through providing a lens into their ongoing needs and allowing Colorado to encourage
the growth of the healthiest youth in the nation.

To learn more about the survey effort, visit:

www.healthykidscolo.org
To access tables of results, topic-specific reports, and survey methodology
information, visit:
www.chd.dphe.state.co.us
Email questions to:
cdphe_healthykidscolorado@state.co.us

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