🇺🇸United States of America

United States • Health of Young People (15–24)

Growing Up in America: A Health Check on the Next Generation

A land of huge opportunity — and huge gaps — where youth mental health, obesity, violence and vaping collide with creativity, activism and resilience.

The U.S. has some of the best hospitals and technology in the world — yet many young Americans struggle to see a doctor, afford therapy, feel safe at school, or believe in their future. This page pulls together the latest evidence and lived realities to show how U.S. teens and young adults are really doing, from small towns to big cities, from the coasts to the heartland.

≈43M youth age 10–19 (about 13% of the population)4 in 10 high-schoolers feel persistently sad or hopeless≈1 in 5 teens live with obesityFirearms now a leading cause of death for youthVaping about 1 in 10 U.S. high-school students.

Who Are America’s Young People?

In 2023, the United States had roughly 40–45 million adolescents and young people in their mid-teens. They live in every imaginable context: skyscraper apartments in New York and Chicago, farm towns in Iowa and Kansas, border communities in Texas and Arizona, tribal nations, suburbs, refugee resettlement cities and remote rural counties hours from the nearest paediatrician.

Today’s American youth are:

• The most racially and ethnically diverse generation in U.S. history.
• More likely than previous generations to identify as LGBTQ+ or gender diverse.
• More likely to grow up with smartphones, social media and streaming platforms from childhood.
• More exposed to climate disasters, school lockdown drills and political polarisation.

Population share

≈13%

Roughly 1 in 8 Americans are 10–19 years old.

Mental health

4 in 10

High-schoolers reporting persistent sadness or hopelessness.

Teen obesity

≈1 in 5

Adolescents 12–19 with obesity.

Uninsured children

≈1 in 17

Children under 19 without health insurance in 2023.

When U.S. youth are asked what worries them most, common answers include mental health, school pressure, money and housing, gun violence, racism, climate change and division in the country. Many are also deeply hopeful — leading movements on climate, racial justice, gun safety and mental health.

The Health Status of Young People in the U.S.

Mental Health: A National Youth Crisis

Multiple national surveys now describe a youth mental health crisis. Among U.S. high-school students:

• About 4 in 10 report persistent feelings of sadness or hopelessness.
• Roughly 1 in 5 have seriously considered attempting suicide in the past year.
• Nearly 1 in 10 report at least one suicide attempt in the past year.
• Girls and LGBTQ+ students report the highest levels of distress and self-harm.

Did you know? Suicide is now one of the leading causes of death for U.S. adolescents — and many who die by suicide never had a documented mental-health diagnosis in their medical record. That means we cannot rely only on clinics to catch risk — schools, families, coaches and peers all matter.

The drivers include academic pressure, social media comparison, cyberbullying, family conflict, discrimination, economic stress, trauma, exposure to violence, and the emotional weight of climate disasters and political chaos. Poor sleep, loneliness and constant online connectivity magnify these pressures.

Obesity, Chronic Conditions & Body Image

The United States has some of the highest youth obesity rates in the world. National health surveys show that:

• About 1 in 5 adolescents age 12–19 live with obesity.
• Across all 2–19-year-olds, nearly 1 in 5 have obesity — roughly 15 million children and adolescents.
• Rates are higher among Black, Hispanic and Native American youth, and in lower-income communities.

Obesity in childhood is linked to higher risk of type 2 diabetes, high blood pressure, joint problems, sleep apnoea and later heart disease. But weight is only part of the picture: body-image pressure is intense, fueling disordered eating, chronic dieting and muscle dysmorphia — especially in a culture saturated with filters, “fitspiration” and unrealistic ideals.

Disability, Neurodiversity & Accessibility

Millions of American youth live with disabilities — physical, sensory, intellectual, developmental, or mental-health-related. Many are also neurodivergent (for example, autistic or ADHD). With the right supports, these young people thrive in school, work and community life.

But barriers remain:

• Schools without enough special education staff or assistive technology.
• Public transport and buildings that are still not fully accessible.
• Over-discipline and under-support of disabled and neurodivergent students, particularly Black and Indigenous youth.

Inclusion is not just a rights issue — it’s a health issue. When young people are excluded, their risk of anxiety, depression, school dropout and poverty all rise.

Injuries, Firearms & Deaths

For Americans aged 15–24, the leading causes of death are largely preventable:

• Unintentional injuries (especially road crashes, poisoning and overdoses).
• Suicide.
• Homicide.

Firearms now play a central role in these deaths. In recent years, firearms have become the leading cause of death among U.S. children and teens, surpassing motor vehicle crashes. Many youth suicides and homicides involve guns, and access to firearms at home is a major risk factor.

Behind each statistic is a school desk forever empty, a jersey never worn again, a TikTok account that suddenly stops posting — and a family whose world has been permanently changed.

Risk Factors: Food, Screens, Substances, Sex & Stress

Food, Movement & the Built Environment

Young Americans grow up in a powerful “obesogenic” environment:

• Ultra-processed foods and sugary drinks are cheap, heavily marketed and everywhere — from corner stores to school vending machines.
• Many neighbourhoods lack safe sidewalks, bike lanes and green spaces, especially in low-income and segregated communities.
• School sports may be expensive, selective, or limited — leaving many teens on the sidelines.

At the same time, some youth face food insecurity — not knowing if there will be enough food at home. That can mean skipping meals, relying on cheap fast food, or stretching calories with low-nutrient options — all of which harm physical and mental health.

Fun Reality Check

The stereotype is “American kids only eat burgers and watch TV”. The reality is more mixed: one teen might grab a drive-thru dinner before a three-hour basketball practice, while another eats instant noodles and games all night because there’s no safe park nearby and no money for sports.

When communities add free sports leagues, safe parks, walking paths and affordable fresh food, youth activity shoots up — not because teens suddenly become “more disciplined”, but because the healthy choice finally becomes the easy choice.

Digital Life, Screens & Sleep

U.S. teens are among the most connected in the world. Phones are alarm clock, map, classroom, friend group and stage — all at once. That brings real benefits (connection, creativity, learning) but also real risks:

• Late-night scrolling and gaming cut into sleep, which is critical for mood, learning and growth.
• Algorithms can feed young people endless content about dieting, self-harm or violence.
• Online bullying, hate speech and harassment follow youth home, 24/7.
• “Always on” culture makes it hard to truly relax — even on weekends or holidays.

Smoking, Vaping & Nicotine

There is good news: traditional cigarette smoking among U.S. teens has plummeted over the last few decades. But nicotine has not disappeared — it has shifted into vapes and other products.

• Recent national surveys show about 1 in 10 U.S. high-school students currently use e-cigarettes.
• Among youth who vape, many use flavoured products and a significant share vape daily.
• Young adults (18–24) now have some of the highest vaping rates of any age group.

Many young people say they started vaping “just to try it”, to cope with anxiety, to fit in, or to quit cigarettes — but ended up more hooked on nicotine than before. Nicotine exposure in adolescence can affect attention, mood and impulse control, and may make it harder to quit all nicotine products later.

Alcohol & Other Drugs

The story on drugs and alcohol is more complex — and surprisingly hopeful:

• National surveys show that most U.S. teens are currently abstaining from alcohol, marijuana, cigarettes and vapes.
• Teen drinking and cigarette smoking have dropped dramatically since the early 2000s.
• But among those who do use substances, risks remain high: binge drinking, DUI, blackouts, overdoses and risky sex.
• Fentanyl contamination has made experimentation with pills or powders far more lethal than in past generations.

Behind the numbers:Many young people say they use alcohol or drugs to manage stress, numb trauma, “fit in”, or sleep. That means better mental health care, safer communities and hopeful futures are also substance-use prevention strategies.

Sexual & Reproductive Health

U.S. teen pregnancy and birth rates are way down from their peaks in the 1990s — a major public health success. But challenges remain:

• Sex education varies wildly by state and district — from comprehensive and inclusive, to abstinence-only, to none at all.
• Adolescents and young adults 15–24 still bear a disproportionate burden of sexually transmitted infections, including chlamydia and gonorrhea.
• LGBTQ+ youth, youth of colour and youth in the South experience higher STI rates and more barriers to testing and care.
• Talking honestly about consent, porn, pleasure, gender identity and online safety is still taboo in many communities.

Young people themselves say they want real, practical, shame-free information about sex and relationships — from adults who listen more than they lecture.

Health Care, Insurance & Who Gets Left Out

Coverage: Better Than Before, But Not for Everyone

Thanks to Medicaid, the Children’s Health Insurance Program (CHIP) and the Affordable Care Act, most American children and youth have some form of coverage. But millions are still uninsured or underinsured.

• Roughly 5–6% of children and teens have no health insurance — several million young people.
• Uninsured rates are higher among Hispanic, Native American and low-income families, and in states that did not expand Medicaid.
• Young adults often lose coverage at age 26 when they age off parents’ plans and may not qualify for affordable alternatives.

Being uninsured doesn’t just mean skipping check-ups — it can mean ignoring injuries, untreated mental illness, missed asthma medication, and huge debts if a young person ends up in the emergency room.

Access to Care: Depends on Your ZIP Code

Even with insurance, access to youth-friendly care is uneven:

• Some suburbs have multiple paediatric clinics, therapists and sports medicine centres.
• Rural counties may have no child psychiatrist at all and limited paediatric or obstetric services.
• Wait lists for child and adolescent mental health care can stretch months or longer.
• Language barriers, transportation, immigration fears and discrimination keep many families from seeking care.

Mental Health Services & School-Based Support

To respond to the crisis, schools, community health centres and universities are expanding:

• School counsellors, social workers and psychologists (though ratios are often far below recommended levels).
• School-based health centres that provide primary care, mental health services and sexual health services on campus.
• Telehealth therapy, especially in rural and underserved areas.
• Peer-support programs, youth advisory councils and digital tools that help students check in on their mental health.

These services save lives — but many are funded year-to-year and are not yet accessible to all.

Public Health Wins: Vaccines & Injury Prevention

There are bright spots. Over the past several decades, U.S. public health efforts have:

• Raised coverage of childhood and adolescent vaccines, including HPV, meningitis and Tdap (tetanus, diphtheria, pertussis).
• Reduced deaths from car crashes for youth through seatbelt laws, safer cars, DUI enforcement and graduated driver licensing.
• Slashed teen cigarette smoking through taxes, smoke-free laws and hard-hitting media campaigns.

These successes prove that when the U.S. chooses to act, youth health can change dramatically in a single generation.

Who Hurts the Most? Inequities Across Race, Class, Place & Identity

Health in America has never been equal — and young people feel those gaps early. Some of the deepest divides show up along lines of race, income, geography, disability and LGBTQ+ identity.

Race, Racism & Structural Inequality

• Black, Hispanic, American Indian and Alaska Native youth face higher rates of poverty, food insecurity and housing instability.
• These same groups are more likely to live in neighbourhoods with environmental hazards, underfunded schools and fewer health services.
• They also bear a disproportionate burden of STIs, maternal mortality, firearm violence and some chronic conditions.
• Everyday racism and discrimination take a toll on mental health and stress hormones, even before birth.

Rural vs Urban

• Rural youth may benefit from close-knit communities but face longer travel to care, fewer specialists and less privacy.
• Rural areas often have higher rates of unintentional injury, suicide and opioid overdose among youth and young adults.
• Broadband gaps can limit access to telehealth, online schooling and digital support.

LGBTQ+ Youth

LGBTQ+ teens and young adults experience some of the highest levels of bullying, family rejection, homelessness and mental distress. Surveys show:

• LGBTQ+ youth are far more likely to report seriously considering suicide or attempting suicide.
• Transgender and non-binary youth face especially high levels of anxiety, depression and self-harm.
• Affirming families, schools and health providers dramatically reduce these risks.

Inequities are not accidents — they are the result of policy choices and power structures. That means they can be changed through different choices: better funding, fairer laws, safer housing, and genuine youth voice in decision-making.

How Do U.S. Youth Compare to Young People in Other Countries?

United StatesCanadaUnited KingdomAustraliaJapanChinaSouth AfricaMexicoNew Zealand

Weight, Food & Movement

Mental Health, Violence & Safety

On mental health, U.S. patterns look similar to other high-income countries: rising depression, anxiety, self-harm and suicide among youth. But on violence, the U.S. stands out:

• The U.S. is an extreme outlier in youth firearm deaths compared with peer nations like Canada, the UK, Australia and most of Europe.
• School shootings, community gun violence and firearm suicides among youth are far more common than in other wealthy countries.
• At the same time, U.S. teens share global concerns about climate, inequality and the future of work with youth in many other nations.

If the U.S. matched the average youth firearm death rate of other rich countries, thousands of American children and teens would still be alive today. That gap is not about “bad kids” — it is about policy.

10 Ways to Improve the Health of Young People in America

The good news: the U.S. has the tools to do much better. The question is whether we choose to use them — in families, schools, communities, health systems and Congress.

For Families & Caregivers

• Protect sleep and meals. Phones out of bedrooms, screens off at night, and shared meals (even if it’s pizza) protect mental health and grades.
• Talk early and often. Ask “What’s been hardest this week?” and listen without immediately fixing or judging.
• Normalize help. Seeing a therapist, calling 988, or talking to a school counsellor should be framed as strength, not weakness.
• Lock up lethal means. Safely store or remove firearms and medications, especially if anyone in the home is struggling emotionally.

For Schools, Colleges & Universities

• Make belonging a core goal. Clubs, mentoring, advisory periods and safe spaces for LGBTQ+ and minority youth reduce isolation.
• Rethink PE and sport. Offer a mix of team sports, dance, yoga, walking clubs and strength training, with low or no fees and inclusive culture.
• Teach real-life health skills. Mental health literacy, consent, digital literacy, money skills and bystander training for bullying and harassment.
• Invest in counsellors and nurses. Lower ratios mean students can get help before crisis hits.

For Communities, Health Systems & Government

• Design neighbourhoods for youth health. Safe parks, libraries, youth centres, public transport and sidewalks are health infrastructure.
• Strengthen safety nets. Expand Medicaid and CHIP, simplify enrolment, and protect coverage for children, teens and young adults.
• Regulate what targets kids. Stronger rules on marketing junk food, flavoured vapes and high-risk products to minors — online and offline.
• Address gun violence like a public health issue. Evidence-based policies (safe storage, background checks, community violence interruption) save young lives.
• Put youth at the table. From city councils to school boards to national commissions, young people should co-design the policies that shape their futures.

Wisdom to take away:If we want a healthier, safer America in 20 years, we have to make it easier for young people today to find good food, safe homes, fair schools, trusted adults, clean air, green spaces, decent work and real hope. Youth health is not a side issue — it is the foundation of the country’s future.

Global Series

“Health of Young People” — Country by Country

This United States page is part of a global series exploring youth health around the world — from Canada, Mexico and Brazil to the UK, South Africa, India, China, Japan, Australia, New Zealand and beyond. Each page looks at mental health, obesity, substance use, sexual health, violence, school life and the big forces shaping the next generation.

The goal is simple: turn data into understanding and understanding into action — in homes, schools, clinics, legislatures and youth groups everywhere.

Need help now in the U.S.?

988 Suicide & Crisis Lifeline: Call or text 988, or chat at 988lifeline.org

Crisis Text Line: Text HOME to 741741

The Trevor Project (LGBTQ+ youth): Call 1-866-488-7386, text START to 678678, or chat online

Love is Respect (healthy relationships & dating abuse): Call 1-866-331-9474 or text LOVEIS to 22522

Emergency: 911

TeenThreads Content Team