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EAGLE COUNTY’S

HEALTHY KIDS COLORADO 2013-2014
HIGHLIGHTS OF LOCALLY RELEVANT RESULTS
A PROJECT OF THE EAGLE RIVER YOUTH COALITION

AUGUST 18, 2014
ANDREJ A. BIRJULIN, PH.D.
CONFLUENCE RESEARCH AND TRAINING, LLC

TABLE of CONTENTS

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Section I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Section II. Tobacco, Alcohol, Marijuana and Other Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Section III. Violence and Bullying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Section IV. Suicide and Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Section V. Nutrition and Physical Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 2

EXECUTIVE SUMMARY
In general, the 2013 results show mixed results regarding the health of youth in Eagle County.
Where trend data are available, the following domains showed significant improvements from
2011 on many of the individual items, including:
• Drinking alcohol,
• Using marijuana in high school,
• Using most other illicit substances,
• Engaging in physical activity,
• Eating habits, and
• Engaging in extracurricular activities
Additionally, alcohol use in particular, showed a dramatic decrease between 2009 and 2013 and
closed previously existing gaps with national rates.
Much of these gains can be attributed to the efforts of the Eagle River Youth Coalition to expand
public awareness and provide leadership on priority issues facing youth, increase early
intervention services for substance abuse, expand environmental prevention and intervention
strategies, and promote best practices. Gains are also largely due to improved services and better
coordination among youth serving organizations in Eagle County
At the same time, the 2013 results also point to areas of concern for youth in the county.
Specifically, perception of risk or harm from marijuana use and ease of obtaining the substance
have both moved in a negative direction. Additionally, the frequency of using marijuana for
those that are regular users of the substance is relatively high.
Bullying is another area of concern. While it is not surprising that middle school incidence of
bullying is greater than in high school, local high school rates are greater than national rates and
2013 saw a considerable increase of bullying among middle school students as compared to
2011.
Finally, the depression and suicide indicators have moved in a negative direction since 2011.
The negative trends were especially strong for feeling sad or hopeless and seriously considering
suicide for both middle and high school students, and also for making a suicide plan among
middle school students only. A total of 47 middle and high school students reported that they
made a suicide attempt that needed to be treated aby a doctor or nurse in 2013.
Although there are a number of heightened areas of concern that the 2013 HKCS survey results
point to, there were also areas that were indicative of increased protections that are present.
Specifically, the profile of local youth on the various physical health and nutrition measures
show that local youth generally fare better than youth in the United States overall. This type of
protection can help offset some of the deleterious effects of the various risk-factors that are
present in the county.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 3

I. INTRODUCTION
The Eagle River Youth Coalition has been surveying students on alcohol, tobacco and other drug
(ATOD) use, engagement in other risky behaviors, and key risk and protective factors at the
county’s high schools every two years since the 2001-2002 school year. Starting with the 20072008 school year, Eagle County adopted the use of the Healthy Kids Colorado Survey (HKCS).
HKCS was adopted locally to enable stronger comparisons of Eagle County results to statewide
and national trends.
The HKCS was designed to be administered in grades 6-12 and includes the following domains:
• Physical activity and nutrition,
• Unintentional injuries and violence,
• Mental health,
• Alcohol, tobacco and other drug use,
• School and family, and
• Sexual health (high school only).
The survey is also given every two years at the state level and the administration window is
roughly concurrent with the local administration effort. During the 2013 administration, a hybrid
version was used at the state level, but Colorado was unable to meet the minimum requirements
to secure a representative sample to produce weighted results that enable comparisons to other
states. Therefore, caution must be used with interpretation on the 2013 state level data
comparisons. Additionally, Gypsum Creek Middle School (GCMS) participated in the state
level version of the survey and therefore, only about half of the HKCS survey items include that
school’s results. The presentation of middle school results throughout this report will include a
notation whenever GCMS students are not included.
There have been four administrations of the HKCS in Eagle County: 2007, 2009, 2011, and
2013. This report focuses on results, trends and comparisons to state and national results, as
available, across this period of time. Historically, Eagle County focused on only surveying high
school (HS) students, but in 2009 moved to also include 7th and 8th grade middle school (MS)
students. Survey size and response rates are shown in Table 1. It is important to note that while
Eagle County includes the towns of El Jebel and Basalt, located in the extreme southwest part of
the county, youth from these communities are served by Roaring Fork School District and are
not included in the Eagle County survey sample.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 4

Table 1. HKCS Response Rate by Grade and Year.
Year

Level
MS

2007
HS

MS
2009
HS

MS
2011
HS

MS
2013
HS

Grade

Total Students

Students Surveyed

Response Rate

7th
8th
Total
9th
10th
11th
12th
Total
7th
8th
Total
9th
10th
11th
12th
Total
7th
8th
Total
9th
10th
11th
12th
Total
7th
8th
Total
9th
10th
11th
12th
Total

384
398
782
412
419
364
368
1,563
402
447
849
447
404
401
445
1,697
443
449
892
445
435
394
423
1,697
517
515
1,032
484
464
448
501
1,897

N/A
278
248
183
148
857
307
352
659
346
315
274
262
1,197
389
376
765
374
365
302
275
1,316
455
468
923
433
396
372
375
1,576

N/A
67%
59%
50%
40%
55%
76%
79%
78%
77%
78%
68%
59%
71%
88%
84%
86%
84%
84%
77%
65%
78%
88%
91%
89%
89%
85%
83%
75%
83%

Results from this survey are used locally to:
• Inform planning efforts and needs assessments,
• Monitor how alcohol, tobacco and other drug attitudes and use change over time,
• Monitor how health attitudes and behaviors change over time,
• Identify areas for additional prevention and intervention programming,
• Evaluate the impact of local prevention and intervention programs,
• Persuade additional resource investment in local programming.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 5

The aim of this report is to provide a concise and locally relevant summary of the 2013 results
for key sections of the survey. Longitudinal trends are examined and comparisons made to
statewide and national results. Specific areas of focus for this report are on alcohol, marijuana
and other drugs; bullying; suicide and depression; and nutrition and physical health.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 6

II. ALCOHOL, MARIJUANA and OTHER DRUGS
Alcohol
Figure 1 shows that the percent of high school students who had their first drink of alcohol
before the age of 13 has steadily decreased since 2007. 2013 saw the largest drop between
survey administrations and closed the gap between the Eagle County and national rate. Figure 2
shows that while both the local and national rates for students that currently use alcohol has been
steadily decreasing since 2009, the decline in Eagle County has been steeper and has nearly
closed the gap by 2013. The drop between 2011 and 2013 was 7%, a substantial improvement
over this period of time. Similarly, the percent of high school students that binge drink saw a
steep decline since 2009, a 7% drop since 2011, and has now closed the gap between the local
and national rate.
Figure 1. Age of First Use Before 13: Alcohol (Grades 9-12).
29

30

Percent

27
25

26
24

21
19

24

23

23

21
Eagle County
National
Colorado*

21
19

17

19
17

2007

2009

2011

2013

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 7

Figure 2. Past 30 Days Use: Alcohol (Grades 9-12).
49
48
47

47

45

45

Percent

43

42

41

43
41

39

39
Eagle County

37

National

35

36

Colorado*

36
35

33
31

31
2007

2009

2011

2013

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
Figure 3. Past 30 Days Use: Binge Drinking (Grades 9-12).
35
33

33
31

31

29
Percent

28

27
26

25

25
23
21
19

24
Eagle County

22
22

National

21

Colorado*
17

17
2007

2009

2011

2013

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
Figure 4 shows the percent of middle school students surveyed that had their first drink before
the age of 13, currently use alcohol, and indicate binge drinking in the past 30 days. Since 2011,

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 8

use of alcohol before age 13 has decreased about 4%, current use has come down 1%, and binge
drinking has held steady.
Figure 4. Alcohol Consumption for Students in Grades 7 & 8.
25

25.1
22.4

20
18.7

Percent

16.6

15
10

11.7

10.5

4.4

4.1

7.4

5

Any Alcohol, 30 Days
Binge Drinking, 30 Days

0

Age of First Use Before 13*

2009

2011

2013

Figure 5 shows the frequency of using alcohol in the past 30 days among current alcohol drinkers
in grades 7-12. These results show that frequency of alcohol consumption among those that
drink goes up over time, with the most dramatic shift occurring between grades 9 and 10. By
grade 11, 14% of current drinkers consume alcohol on six or more days per month. This is a
dramatic improvement from 2011, where 36% of the 11th graders that were current drinkers
reported to using alcohol on 6 or more days per month.
About 40% of the current drinkers in grades 7 and 8 binge drink at least once per month, a rate
which has held steady from 2011. Over half (52%) of current drinkers in grades 9 and 10 do so.
By grade 11, this rate increases to 57% (the rate was 72% in 2011), and then increases to 70%
into grade 12.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 9

Figure 5. Number of Days Drank Alcohol among Current Drinkers by Grade (7-12).
70
60

Percent

50

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

40
30
20
10
0
1‐2 Days

3‐5 Days

6‐9 Days

10‐19 Days 20‐29 Days All 30 Days

Not surprising is the finding that there are dramatic differences between perceived use of alcohol
among both middle and high school students in Eagle County and actual frequency of alcohol
drinking. While 2013 results show that 36% of 9th – 12th graders indicate use of alcohol in the
past 30 days, survey respondents believe that 73% of students in their school consume alcohol at
least once per month. Similarly, 21% of 9th – 12th graders acknowledge that they binge drink at
least once per month, but survey respondents believe that 64% of students at their school do so.
Interestingly, as previously noted, current alcohol use and binge drinking have declined since
2011, but so has perception of use among peers – by 7% and 8%, respectively.
In terms of obtaining alcohol, the 2013 results show that 31% of high school students feel that it
is very easy to get and another 30% feel that it is “sort of easy.” In comparison to 2011, these
results show a 3% improvement for those that said “very easy” and a 1% negative change for
those that said “sort of easy”. Fortunately, middle school students, as a whole, felt that it was
substantially more difficult to obtain alcohol. About 14% of 7th and 8th graders report that it is
very easy to obtain alcohol, and another 18% “sort of easy.”
The 2013 survey results show that very few of the current high school alcohol drinkers typically
buy their alcohol in a store (3.5%), restaurant/club (1.3%), or at a public event (0.9%). Rather,
the majority (34.5%) indicate that someone gave alcohol to them, followed by about 22.5%
saying that they gave money to someone else to get it for them. A few (12.9%) took alcohol
from a store or family member and 22.5% say they usually get it “some other way.” In
comparison to 2011, those who said someone gave them alcohol or said that they gave money to
someone to purchase it both declined (9% and 4%, respectively), but those that took it increased
by 6% and those that got some other way increased by 5%.
Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 10

For high school students that drank alcohol in the past 12 months, the percentage who typically
consumes it in someone else’s home is 42% among 9th graders and increases to 56% by 12th
grade. Conversely, 40% of 9th grade drinkers consume alcohol in their own home and this rate
drops to 29% by 12th grade. This shows a shift from 2011 in that the differences of at home
versus someone else’s home between 9th and 12th graders has softened substantially For high
school students as a whole, alcohol consumption on school property in the past 12 months has
dropped from 6.9% in 2011 to less than 1% in 2013.
In general, the pattern of results for how current drinkers at middle school acquired alcohol was
roughly similar to high school students, although giving money to someone else to get it for them
was very rare. The most common way of 7th and 8th graders obtaining alcohol was someone
giving it to them (38%), followed by taking it from a store or family member (38%). In terms of
where middle school students report typically drinking, 49% said their own home and 28% in
someone else’s home, 11% at a place such as a park, beach, or parking lot, and 6% at a
restaurant, bar, or club. The remaining choices were selected by five or less students each.
Marijuana
Figure 6 shows an inverse trend on the percent of high school students that ever used marijuana
in Eagle County as compared to the national rates between 2007 and 2011, but then tracks
similarly between 2011 and 2013. Figure 7 shows that local current use (past 30 days) of
marijuana has declined slightly since 2009 while the national trend has been climbing slowly or
holding steady.
Figure 6. Lifetime Use: Ever Used Marijuana (Grades 9-12).
44
43

43

Eagle County

42

National
Colorado*

Percent

41
40

41

41
40

40

40

39

40

39

38
37

37

37

37

36
2007

2009

2011

2013

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 11

Figure 7. Past 30 Days Use: Marijuana (Grades 9-12).
26
Eagle County

25

25

National
Colorado*

Percent

24
23

23
22

22

22

22

21
20

21

21

20

23

20

19
2007

2009

2011

2014

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
Figure 8 shows little change from 2011 in the percentage of students in the middle school grades
that used marijuana at least once in their lifetime, and a 1% increase in those that are current
users. Although the increases since 2007 in current marijuana use among those in grades 7 and 8
are small, they are steady and a cause for concern as these students may represent the first cohort
that is being negatively impacted by the legalization of marijuana in Colorado.
Figure 8. Marijuana Use for Students in Grades 7 & 8.
10
8.8

9

8.9

8

Percent

7
6

6.5

5

5.2

4.3

4
3

2.7

Ever Used

2

Use in the Past 30 Days

1
0
2009

2011

2013

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 12

Figure 9 shows that frequency of marijuana use among current users goes up as high school
grade level increases, but that even in 9th grade, about 38% of current users of marijuana engage
in the activity more than 10 times a month. About 1 out of 5 use it more than 40 times a month.
Middle school respondents were not included in this chart because only a very small number of
7th and 8th grade students report 30-day use of more than 1 or 2 days. The pattern overall for
high school students in comparison to alcohol, shows that among users, there is a substantial
proportion of students at all grade levels that use marijuana quite frequently.
Figure 9. Number of Times Used Marijuana among Current Users by Grade (9-12).
45
40
9th Grade

35

10th Grade

11th Grade

12th Grade

Percent

30
25
20
15
10
5
0
1‐2 Times

3‐9 Times

10‐19 Times

20‐39 Times 40 or More Times

Among high school students, perceived ease of obtaining marijuana has changed slightly since
2011. The percentage that said it is “very easy” or “sort of easy” increased from 54% in 2011 to
56% in 2013.
Not surprisingly, high school students believe that marijuana is much easier to get than students
in grades 7 and 8. However, middle school students reported a stronger shift in the ease of
getting it now as compared to 2011 than what was seen among high school students. For
students in grades 7 and 8, those that said it was “very easy” or “sort of easy” went up from 15%
in 2011 to 19% in 2013.
The 2013 survey results indicate that among current marijuana users, 42% of high school
students and 54% of middle school students indicate they typically get marijuana by someone
giving it to them. About one-third (32%) of high school users 26% of middle school users
indicate they get it “some other way.” At least a portion of the latter percentages likely reflect
the students that typically purchase it from an illegal marijuana dealer since that choice was not
provided as an option on the survey.
Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 13

The percentage that said they obtained marijuana from someone with a medical card increased
from 8% in 2011 to 16% in 2013 among current users in high school, but stayed steady at about
8% among users in middle school. The remaining options (at a public event, at school, take it
from a family member) were selected by 6% or less of high school students and only three
students or less at the middle school grades.
Among all 2013 high school survey respondents, 38% know someone with a medical marijuana
card, which increases from 26% in 9th grade to 50% in 12th grade. For those that are current
marijuana users, 71% know someone with a medical marijuana card, which increases from 58%
in 9th grade to 78% in 12th grade. This large disparity between all respondents and users of
marijuana suggests that users are likely under-reporting the extent to which they get the
substance from someone that has a medical marijuana card. At the middle school grades, 44% of
current marijuana users indicate that they know someone with a medical marijuana card.

Alcohol and Marijuana
The percent of high school students who use marijuana at least once a month among those that
also indicate current use of alcohol is over double the rate that is reported for the general high
school population. This rate was 43% in 2007 and 2009, 45% in 2011, and 42% in 2013.
Similarly, past 30-day alcohol use among those that indicate current marijuana use is 75%, which
represents a decline from about 85% during the previous three survey administrations. These
results underscore the fact that many students both use marijuana and drink alcohol each month.
Among the entire high school student population, 14% used both in 2013, which is down from
17% in 2011.
Figure 10 shows that perceived risk of harm from marijuana and alcohol use among high school
students changed substantially over the past four administrations of the survey. In 2007,
perceived risk of using marijuana regularly was significantly higher than weekly binge drinking
and drinking 1-2 times nearly every day was perceived as more harmful than binge drinking
weekly. By 2011, perceptions switched and regular and binge drinking of alcohol was rated as
more harmful than using marijuana regularly. Between 2011 and 2013, perceived harm from
drinking alcohol remained steady while for use of marijuana it declined substantially.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 14

Figure 10. Perceived Risk of Harm: Alcohol and Marijuana, 1=No Risk, 2=Slight Risk,
3=Moderate Risk and 4=Great Risk (Grades 9-12).
3.1
3.04

3.05

3.04

Mean Rating

3
2.95
2.9
2.85
2.8
2.75
2.7

3.05
3.01

2.94
2.91

2.9

2.9
2.84
2.84

2.84

1‐2 Drinks Nearly Every Day
Binge Drinking 1‐2 Times per Weekend
2.72

Use Marijuana Regularly

2007

2009

2011

2013

Figure 11 shows the perception of harm trends between 2009 and 2013 for the middle school
students surveyed. Similar to the high school student results, in 2009 this group felt that drinking
1 to 2 drinks nearly every day was significantly more harmful than binge drinking once or twice
per week. In 2011, the level of perceived harm for these two behaviors was equivalent and
although both decreased slightly in 2013, they remained equivalent. However, unlike high
school student results, middle schools students perceive more risk from using marijuana than
drinking alcohol. At the same time, perceived risk of harm for marijuana in grades 7 and 8
declined substantially between 2011 and 2013.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 15

Figure 11. Risk of Harm: Alcohol and Marijuana, 1=No Risk, 2=Slight Risk, 3=Moderate Risk
and 4=Great Risk (Grades 7 & 8).
3.5
3.48

3.45

3.4

Mean Rating

1‐2 Drinks Nearly Every Day

3.3

Binge Drinking 1‐2 Times per Weekend

3.32

Use Marijuana Regularly

3.2

3.16
3.09

3.1
3

3.13

3.08

3
2.92

2.9
2009

2011

2013

Other Illicit Drugs
Figure 12 shows the percent of high school students that ever used each of the other substances
asked about in the survey by year. With the exception of ecstasy, all substances saw a downward
trend between 2007 and 2013. Use of ecstasy in their lifetime increased slightly between 2007
and 2011 and then came down slightly between 2011 and 2013. Not shown in the chart is that
about 9% of high school students indicate illegal use of prescription drugs in the past 30 days
(the only of these substances for which 30 day use was asked about.
In 2013, Eagle County lifetime use rates for these substances in comparison to the national
averages are as follows:
• 7.8% over for cocaine,
• 3% over for ecstasy,
• 2.7% over for illegal prescription drugs,
• 1.6% over for methamphetamines,
• 0.2% over for illegal steroid use,
• 1% under for inhalants,
• 1.4% under for heroine, and

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 16

Figure 12. Lifetime Use: Ever Used Other Drugs (Grades 9-12).
Cocaine
Heroin
Ecstasy
Steroids

25

Glue/Inhalants
Methamphetamines
Illegal Prescription Drugs

Percent

20
15
10
5
0
2007

2009

2011

2013

Summary
Excellent progress continues to be made on reducing alcohol use and most of the other illicit
drugs asked about on the survey, with particularly steep declines in regular alcohol use and binge
drinking. Marijuana use has declined slightly since 2007 at the high school level and increased
slightly at the middle school level. This modest high school positive change and minimal
negative change at middle school can be considered a positive finding, however, in light of the
recent legalization of recreational use of marijuana in Colorado. The most recent survey results
show that the percent of current marijuana users among high school students in Eagle County
compares favorably to national use rates. However, frequency of use among current users
remains high.
An area of heightened concern is the decreasing perception of harm of marijuana across all grade
levels. This finding, coupled with an increase in reported ease of obtaining marijuana, especially
for students at the lower grade levels, suggests that younger students may be at greater risk for
later use.
Overall progress has been good and underscores the positive impact that the additional
coordination, messaging, programs, and provision of resources by ERYC and other non-profits
in Eagle County are having on youth.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 17

III. VIOLENCE and BULLYING
According to the Center for the Study and Prevention of Violence (CSPV) at the University of
Colorado’s Institute of Behavioral Violence (http://www.colorado.edu/cspv/), homicide is the
second leading cause of death for youth between the ages of 10 and 24, youth are three times
more likely than adults to be victims of violence and the cost of youth violence exceeds $158
billion each year. Moreover, the impact of school-based bullying has not only been linked to an
increased risk of suicide for victims, but also to the possibility that the victim will react violently,
as demonstrated by the Columbine High School tragedy in Colorado in 1999. Deleterious effects
of bullying are not limited to the victim only. Bystanders of bullying and acts of violence in
schools are also negatively impacted and a high incidence of bullying can create a pervasive
climate of discomfort and tension that severely undermines the ability of students to focus on
learning.
Table 2 shows the results from the various items on the HKCS that are related to violence and
bullying. Although most rates are at or below the national results, being bullied on school
property in the past 12 months is 3.1% higher than the national rate and electronic bullying is
about 1% higher.
Table 2. 2013 High School Violence and Bullying Compared to State and National (Grades 912).
Eagle
Item
Colorado* Nationwide
County
16.6%

17.9%

Carried a Weapon on School Property at Least Once
4%
4.5%
During the Past 30 Days
Threatened or Injured with a Weapon on School Property
4.7%
5.1%
at Least Once During the Past 12 Months
21.3%
20.4%
In a Physical Fight at Least Once in the Past 12 Months
22.7%
20%
Bullied on School Property in the Past 12 Months
15.6%
15.1%
Electronically Bullied During the Past 12 Months
Did not Go to School Because of Safety Concerns at
5.2%
5.2%
Least Once in the Past 30 Days
8.0%
6.6%
Forced to Have Sex During the Past 12 Months
6.9%
9.6%
Dating Violence During the Past 12 Months
*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.

5.2%

Carried a Weapon at Least Once During the Past 30 Days

14.4%

4.9%
24.7%
19.6%
14.8%
7.1%
7.3%
10.3%

Figure 13 shows that the rate of bullying in grades 7 and 8 combined are significantly higher
than in the high school grades combined and although the rate for high school has only gone up
1% since 2011, the rate for middle school has increased more than 8% over the same period. In
terms of not going to school because of safety issues on the way to or from school in the past 30
days, in 2013 5.2% of high school students report that this is an issue, about the same as in 2011.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 18

In middle school, this percentage is 6%, which is up slightly from 2011, but less than prior years.
Figure 14 shows the 2013 versus 2011 rates of electronic bullying for the middle school and high
school grades, an item that was first included on the 2011 version of the survey. Electronic
bullying among middle schools students is 16.8% and is about 1% higher than in 2011. It is also
about 1% higher than the current high school rate.
Figure 13. Bullying Past 12 Months and Not Going to School Past 30 Days Because of Safety
Concerns.
45
44.2

41

40
35
Percent

30
25
20
15
10

32.2

33.6

Bullied at School During Past
Year, Grades 9‐12
Bullied at School During Past
Year, Grades 7 & 8
Did Not Go to school Because of
Safety Concerns, Grades 9‐12
Did Not Go to school Because of
Safety Concerns, Grades 7 & 8*
7.7

9

2007

21.6

22.7

6

5.7
5.3

6.6

5

33.9

2009

5.2

2011

2013

* Does not include GCMS, question was not on statewide survey.

Percent

Figure 14. Electronic Bullying.
18
17
16

Grades 9‐12
Grades 7 & 8

16.8

16.5
15.7

15.6

15
2011

2013

Summary
Many violence and bullying indicators measured by the survey compare favorably to national
results, except for bullying, electronic bullying, and forced sex, which are higher. Both high
school and middle school bullying has gone up since 2011 and this increase was substantial for
7th and 8th graders. Taken together, these results underscore that bullying is an issue that needs to
continue to be addressed by the local community. Additionally, the finding that bullying is
higher in middle school than in high school is consistent with national studies and highlights that
bullying prevention needs to start in elementary school and both prevention as well as robust
intervention programs are needed in middle school.
Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 19

IV. SUICIDE and DEPRESSION
Suicide is the third leading cause of death among teenagers, and although females are more
likely to attempt suicide than males, males are four times more likely to complete suicide. The
U.S. Department of Justice estimates that 500,000 teenagers attempt suicide each year. The most
common current methods used for suicide of young people are hanging/suffocation and
poisoning.
According to the U.S. Department of Justice, risk factors for suicide include:
• Past suicide attempts. Approximately one-third of teens who successfully commit suicide
have made a previous attempt.
• A close family member who attempted or committed suicide.
• The presence of a loaded and accessible gun in a teen’s home and a recently publicized
suicide or suicide attempt.
• Recent losses or certain stressful situations, such as getting into trouble at school,
fighting/breaking up with a boyfriend or girlfriend, the breakdown of the family unit,
fighting with friends, trouble with the police, moving, and the pressure to
perform/achieve, etc.
Table 3 shows the 2013 high school results from the five items on the HKCS that are directly
linked to suicide and depression and compares these to national results. While both local and
national rates were higher in 2013 than in 2011, 2013 results for Eagle County on all items
remain similar or lower than national results. Of particular concern, however, is that feeling sad
and hopeless was nearly 4% higher locally in 2013 compared to 2011, and nationally it rose less
than 2% over the same time period. Additionally, seriously considering suicide rose 3% locally,
and only about 1% nationally.
Table 3. 2013 High School Suicide and Depression in the Past 12 Months Compared to State
and National (Grades 9-12).
Eagle
Item
Colorado* Nationwide
County
Felt Sad or Hopeless

27.3%

24.3%

29.9%

Seriously Considered Attempting Suicide

15.6%

14.5%

17.0%

Made a Suicide Plan

11.7%

12%

13.6%

Attempted Suicide

6.9%

6.6%

8.0%

Suicide Attempt Treated by a Doctor or Nurse

2.6%

2.3%

2.7%

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
Figures 15 and 16 show the trends on the suicide and depression items over the past four
administrations of the survey by school level. The dashed lines in the charts represent the results
from grades 7 and 8 combined and the solid lines for grades 9-12 combined. As seen in these
figures, all trends on the suicide and depression questions moved in a negative direction between
2011 and 2013. Taken together, these results show that most of the gains that were made
Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 20

between 2009 and 2011 were lost between 2011 and 2013, especially for feeling sad or hopeless
and seriously considering suicide.
While the suicide and depression and indicators are all more negative at the high school level as
compared to grades 7 and 8, an area of concern at the middle school level it the nearly 4%
increase between 2011 and 2013 in those that indicated that they made a suicide plan.
Figure 15. Feeling Sad or Hopeless and Seriously Considering Suicide by School Level and
Year.
30
27.9

26.3

25

Percent

20
15

27.3
23.6

23.5

Felt Sad or Hopeless, Grades 9‐12
Felt Sad or Hopeless, Grades 7 & 8
Seriously Considered Suicide, Grades 9‐12
Seriously Considered Suicide, Grades 7 & 8
14.2

23.1

18.8
15.6

15.3
12.6

11.5

11.8

10
8.7

5
2007

2009

2011

2013

Figure 16. Making a Suicide Plan and Attempting Suicide by School Level and Year.
Made a Suicide Plan, Grades 9‐12
Made a Suicide Plan, Grades 7 & 8
Attempted Suicide, Grades 9‐12
Attempted Suicide, Grades 7 & 8
Attempted Suicide Treated by Doctor/Nurse, Grades 9‐12
Attempted Suicide Treated by Doctor/Nurse, Grades 7 & 8

20

15
Percent

12.3

10

14.3

11.3

10.6

10.9

8.9

9.6

5

5

6.7
4.1
2.3

0
2007

2009

11.7

6.4
5
4.8
2.2
0.8

2011

6.9
6
2.6
1.1

2013

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 21

Summary
Unfortunately, the progress made between 2009 and 2011 in the area of suicide and depression
was largely lost between 2011 and 2013. While the negative gains were also seen at the national
level, the magnitude was especially large locally among high school students for feeling sad or
hopeless and seriously considering suicide. Additionally, students in grades 7 and 8 that made a
suicide plan rose considerably between 2011 and 2013.
Moreover, the severity of each completed suicide is such that even very small percentages belie
situations that need to be addressed by the larger community. The 2013 finding that eight middle
school students and 39 high school students made a suicide attempt that needed to be treated by a
doctor or nurse indicates that Eagle County has many youth that are coming very close to
completion, signifying that this continues to be an area of high need.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 22

V. NUTRITION and PHYSICAL HEALTH
According to the Center for Disease Control and Prevention
(http://www.cdc.gov/obesity/data/index.html), during the past 20 years, there has been a
dramatic increase in obesity in the United States and both adult and child rates remain high.
Overall, obesity among children, adolescents, and young adults age 2 to 19 is at 17% and has not
changed substantially since 2003. There are both short-term as well as long-term effects of
obesity on youth health. Short-term impacts include bone and joint problems, pre-diabetes, high
cholesterol, and high blood pressure. There are also negative impacts from stigmatization that
can lead to social and psychological problems such as social ostracization, poor self-image and
low self-esteem. Long-term impacts include increased risk of a large number of health issues,
such as heart disease, type 2 diabetes, many types of cancer, and osteoarthritis. Obesity in the
United States has reached epidemic proportion as vast portions of the population are making
increasingly poor nutritional choices and leading sedentary lifestyles. Although Colorado has
historically had one of the lowest obesity rates of all states in the country, obesity rates have
nonetheless also climbed in the state as well.
Table 4 shows how Eagle County high school students in 2013 compare to national results on the
various survey questions that deal with health and nutrition. Overall, and as expected, the local
results compare quite favorably to national results, with the exception of eating fruits and
vegetables at least once a day. However, note that the item asking about fruit consumption was
different on the national YRBS than the HKCS version employed locally.
In comparison to 2011, 2013 results were within 2% point or less on all items, except drinking
soda one or more times per day, which decreased by about 7% and watching television three or
more hours per day, which decreased by 6.6%. Additionally, the national rate for non-school
related computer use of three more hours per day rose by 10% between 2011 and 2013, but
locally it rose by less than 2%.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 23

Table 4. 2011 High School Nutrition and Health Results Compared to State and National
(Grades 9-12).
Eagle
County

Colorado*

Nationwide

Described Themselves as Overweight

24.1%

27.2%

31.1%

Were Trying to Lose Weight

42.4%

40.1%

47.7%

Ate Fruit One or More Times per Day during the Past 7 Days**

46.4%

45.1%

62.6%**

Ate Vegetables One or More Times per Day during the Past 7
Days

44.4%

45.2%

61.5%

Drank Soda One or More Times per Day during the Past 7 Days

13.7%

18%

27.0%

Ate Breakfast on All 7 Days during the Past 7 Days

42.6%

41.9%

38.1%

Physically Active at Least 60 Minutes per Day on 5 or More Days

50.6%

49.1%

47.3%

Played Video Games or Non-School Related Computers Use 3 or
More Hrs. per Day on an Avg. School Day
Watched Television 3 or More Hrs. per Day on an Avg. School
Day

23.5%

32.6%

41.3%

17.3%

20.9%

32.5%

Played on at Least One Sports Team during the Past 12 Months

68.0%

61.4%

54.0%

Item

*2013 Colorado sample did not meet criteria to derive nationally comparable weighted results.
**National results include fruit juice, while locally and statewide it does not.

Figure 17 shows the middle and high school trends on frequency of physical activity and amount
of television watching on a typical school day across the past four administrations of the survey.
The frequency of at least 60 minutes of physical activity in the past 7 days increased among
students in grades 7 and 8, but not among high school students. Additionally, middle school
students are more likely to engage in at least 60 minutes of physical activity than are high school
students. The amount of television watched decreased for both middle and high school students,
but the decline was greater for high school students.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 24

Figure 17. Average Frequency of at Least 60 Minutes of Physical Activity in the Past 7 Days and
TV Watching on a Typical School Day by Year and School Level. Freq. of Physical Activity:
3=2 Days, 4=3 days, 5=4 Days and 6=5 Days. TV Watching: 3=1 Hour per Day and 4=2 Hours
per Day.
5.93

5.9
5.64

Mean Rating

5.4

5.21

4.9

5.12
Freq. of 60 Mins. of Activity
During Past 7 Days, Grades 9‐12
Freq. of 60 Mins. of Activity
During Past 7 Days, Grades 7 & 8
Hours of TV on Average School
Day, Grades 9‐12
Hours of TV on Average School
Day, Grades 7 & 8

4.86

4.4
3.95

3.94

3.9
3.4

3.37

3.31

3.2
3.18

3.37

2.9
2007

2009

2011

3.18
2.97

2013

Figure 18 compares middle and high school student results on the nutrition and physical health
questions included in the HKCS. Not surprisingly, these results show that middle school
students lead a healthier lifestyle than high school students overall. The chart also shows that the
majority of both middle and high school students play on at least one sports team per year and
the middle school rate that is shown is an increase of nearly 6% at that school level. Also,
relatively few drink soda daily, but note that the question wording does not include diet soda and
the inclusion of energy drinks is ambiguous. Given recent research of the deleterious effect of
both on health and wellness, the results from this single item should not be overstated.
Overall, the largest differences between middle and high school students are participation on
team sports, the amount of physical activity, and eating breakfast.
In comparison to 2011, middle school students not only saw a sizable increase in participation on
sports teams as described above, but also showed significant change on the following health and
nutrition indicators:
• 7% decrease in those that play video games or use their computers for non-school related
purposes more than three hours per day.
• 6.8 % increase in those that participate in extracurricular activities.
• 6.5% increase in those that eat breakfast seven days per week.
• 4.8% decrease in those that consume soda at least one time per day.
• 4.7% increase in those that engage in physical activity at least five days per week.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 25

While both high school and middle school students moved in a positive direction since 2011, the
overall pattern of results show that middle school students had more growth on a greater number
of health and nutrition indicators.
Figure 18. 2013 High School versus Middle School Responses on HKCS Nutrition and Health
Items.
24.1
18.7

Self‐Described as Overweight
Trying to Lose Weight

35

42.4
46.4

Fruit 1+ Times/Day

54.2

44.4
48.9

Vegetables 1+ Times/Day

High school

13.7
11.1

Soda 1+ Times/Day

Middle School
42.6

Breakfast 7 Days/Week

56.4
50.6

Physically Active 5+ Days/Week
Video Games/Non‐School Related
Computer Use 3+ Hours/Day

64.7

23.5
26.2
17.3
20.3

TV Watching 3+ Hours/Day

68

Played on at Least 1 Team, Past 12 Mos.
Participated in Extracurricular Activities,
Past 12 Months

69.2
0

20

40

60

83.9
78
80

Percent

Summary
Results on the various nutrition and physical health attitudes and behaviors are quite positive
overall and support the conclusion that this is an area that provides a level of protection for local
youth, which may offset some of the negative impacts of existing risk factors, such as high
alcohol use in the community and a high percentage of families living in poverty. Local results
are considerably more positive than the national results and have generally moved in a positive
direction since 2011, especially for middle school students.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 26

While results are relatively positive, there is still room for improvement. Large percentages of
students are skipping breakfast at least one day per week and do not eat fruits and vegetables
regularly. Additionally, 8.2% of all students surveyed play video games or use computers for
non-school related use five or more hours per day on a typical school day and 4.3% watch five or
more hours of TV per day, both of which are considered very unhealthy for physical as well as
mental health, especially if these types of use patterns remain steady over longer-term periods of
time.

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 27

Acknowledgements
The Eagle River Youth Coalition greatly appreciates the funding and other support provided for
this work by the following entities:
™
™
™
™
™
™

Eagle County Schools (www.eagleschools.net)
Vail Mountain School (vms.edu)
United Way of Eagle River Valley (unitedwayeagle.org)
Vail Valley Medical Center (vvmc.com)
Substance Abuse and Mental Health Services Administration (www.samhsa.gov)
Colorado Office of Behavioral Health ( www.colorado.gov/cs/Satellite/CDHSBehavioralHealth/CBON/1251581077594)

Mailing Address: P.O. Box 4613 | Edwards, CO 81632
Phone: 970.949.9250 | info@eagleyouth.org
www.eagleyouth.org

Eagle County’s Healthy Kids Colorado Survey Highlights 2013- 2014 28