Adam Bello Michael D.

Mendoza, MD, MPH, MS

County Executive Commissioner of Public Health

2021-22 School Year

Monroe County
Youth Risk Behavior Survey
Report

Prepared by the Monroe County Department of Public Health

111 Westfall Road
Rochester, NY 14620

For questions about this report, please contact Anne Kern via email at
[email protected] or by phone at (585)-753-5332
Contents
EXECUTIVE SUMMARY .......................................................................................................................1

READERS GUIDE .................................................................................................................................3

MENTAL HEALTH .............................................................................................................................. 12

ADVERSE CHILDHOOD EXPERIENCES (TRAUMA) ................................................................................ 15

GRIEF ............................................................................................................................................... 17

EXPERIENCES OF RACISM AND DISCRIMINATION .............................................................................. 17

VIOLENCE/BULLYING ........................................................................................................................ 18

SOCIAL MEDIA-BULLYING AND SAFETY ISSUES .................................................................................. 20

VAPING AND TOBACCO USE ............................................................................................................. 21

MARIJUANA USE AND CBD ............................................................................................................... 24

ALCOHOL USE .................................................................................................................................. 26

USE OF OTHER DRUGS ...................................................................................................................... 28

PARENTAL INFLUENCES .................................................................................................................... 28

DISTRACTED DRIVING AND DRIVING UNDER THE INFLUENCE ............................................................ 29

SEXUAL RISK BEHAVIORS.................................................................................................................. 30

PREVENTION OF PREGNANCY AND STDS........................................................................................... 32

PHYSICAL ACTIVITY/SCREEN TIME AND SLEEP ................................................................................... 35

ASSETS ............................................................................................................................................ 36

APPENDIX A ..................................................................................................................................... 38

APPENDIX B ..................................................................................................................................... 42
Executive Summary
The Youth Risk Behavior Survey (YRBS) results provide a snapshot of the most critical health
risks Monroe County’s public high school students are facing. The data in this report is intended
to help school districts, community partners and families assess the needs of our young people,
and develop systems and programs to address those needs. By working together, we can
improve the health of young people in our community.

While the Monroe County Department of Public Health (MCDPH) has conducted the YRBS 14
times since 1992, students completed the most recent questionnaire during the COVID-19
pandemic. This experience undoubtedly influenced their responses. We suspect that many of
the declines in reported risk behaviors were related to a decrease in social gatherings and
limited school attendance during the Covid-19 pandemic.

One limitation of the data is students who were not in school on the days the survey was
administered, or students who had dropped out of school were not surveyed. The reasons
youth are not in school are often related to the risk factors measured by the survey including
mental health challenges, the threat of violence, substance use and teen pregnancy1

Another limitation of these data is a lower response rate in the Rochester City School District
(RCSD) compared to previous years, which resulted in RCSD being under-represented. It should
be noted however, that we did weight the data by grade level, reported race, and location (city
or suburb) and it did not make a significant difference in the trends. This report however
contains unweighted results. A more detailed explanation of the limitations can be found in
Appendix A.

Findings Indicating Increases in Reported Health Risks

Findings of greatest concern involved Mental Health, particularly among girls, and
Discrimination and Racism. The survey indicated significant increases in:
 The percentage of girls who stopped doing their usual activities because they felt sad or
hopeless almost every day for two or more weeks.
 The percentage of girls who seriously considered attempting suicide.
 The percentage of girls who made a specific plan about how they would attempt suicide.
 The percentage of girls who did not go to school one or more days because they felt
unsafe there.
 The percentage of students who reported living with someone who was depressed,
mentally ill or suicidal.

1
Centers for Disease Control and Prevention. Health risk behaviors among adolescents who do and do not attend
school—United States, 1992. [September 8, 2020]; Morbidity and Mortality Weekly Report. 1994 43(8):129–132.
https://www.cdc.gov/mmwr/preview/mmwrhtml/00025174.htm

1
In addition, the survey indicated:
 47% of students who identify as lesbian, gay, pansexual and/or transgender reported
they were treated badly or unfairly because of their sexual orientation. 45% of Black
students and 32% of Latino students felt they were treated badly or unfairly because of
their race or ethnicity.

Findings Indicating Decreases in Reported Health Risks

The survey results showed significant declines in some reported health risks among our young
people. These include using vape products, marijuana and alcohol, and engaging in sexual
intercourse. While some of these declines may be pandemic related, previous surveys did show
declines in reported use of alcohol and sexual activity prior to the pandemic.

2
Readers Guide
This report presents the results of the Youth Risk Behavior Survey that was completed by more
than 19,000 public high school students in Monroe County during the 2021-22 school year.
Each school district attempted to survey all of its students using a confidential online
questionnaire. County-wide, the response rate was 64%. The rate in the city was 35%, which is
lower than in previous years. For more details on participation, methodology, data limitations
and differences between the national and local YRBS, please refer to Appendix A.

This Readers Guide summarizes each area of the YRBS, offering context and outlining key
findings and trends. The full list of questions with results follows this section.

For questions about the YRBS report, please email:

Anne Kern, Public Health Program Coordinator

Monroe County Department of Public Health
[email protected]

3
Mental Health

Even before the COVID-19 pandemic, Monroe County saw an increase in youth reporting
mental health struggles. This nationwide trend was undoubtedly exacerbated by the pandemic,
which disrupted young lives in many ways, including lack of in-person connections with peers,
teachers and mentors, and reduced access to health care and social services. Protecting Youth
Mental Health: The U.S. Surgeon General’s Advisory Report, released in December 2021,
highlighted the urgent need to address the nation’s youth mental health crisis. 2

Mental Health Key Findings:

 34% of students reported their mental health was not good during the COVID-19
pandemic “all” or “most of the time.”
 40% of students reported they have serious difficulty concentrating, remembering or
making decisions because of mental or emotional challenges
 46% of girls reported that their mental health was not good “always” or “most of the
time” during the COVID-19 pandemic, compared to 19% of the boys.
 42% of girls reported feeling so sad or hopeless for two or more weeks in a row in the
past year that they stopped doing usual activities (a symptom of depression), compared
to 20% of boys. 60% of students who identify as gay, lesbian, bisexual, pansexual and/or
transgender reported this symptom.
 13% of girls reported that, in the past year, they made a plan to attempt suicide, versus
6% of boys.
 7% of girls reported that, in the past year, they attempted suicide. 9% of Black, 7% of
Latino and 4% of White students reported that they attempted suicide in the past year.
16% of students who identify as gay, lesbian, bisexual, pansexual and/or transgender
reported this.

Mental Health Trends, 2015-2022:

Increasing among girls:

• Felt so sad or hopeless almost every day for two or more weeks in a row that they
stopped doing their usual activities, in the past year.
• Seriously considered attempting suicide in the past year.
• Made a specific plan about how they would attempt suicide in past year.

2
https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-health-advisory.pdf

4
Adverse Childhood Experiences (ACEs)

Research indicates that experiencing adverse childhood events, also called trauma, before the
age of 18, without intervention and support, increases the likelihood of experiencing mental
health challenges, using substances, and engaging in sexual risk behaviors.3

Adverse Childhood Experiences Key Findings:

 60% of students reported experiencing one or more ACEs.

 31% of Black, 26% of Latino and 16% of White students reported experiencing three or
more ACEs

Adverse Childhood Experiences Trends, 2015-2022:

• Increasing: Have ever lived with anyone who was depressed, mentally ill or suicidal
• Stable: students reporting they were ever forced to do something sexual
• All other reported ACES declined

Grief

Questions about grief experiences were not included in previous YRBS surveys. These
experiences often have an impact on student mental health and well-being. With input from
local school districts, MCDPH added questions about this issue in the 2021-22 YRBS.
Grief Key Findings:

 12% of students reported they were feeling depressed, anxious, afraid, empty or
confused because of the death of a close family member or friend.
 16% of Black and Latino students, and 10% of White students reported they were having
mental health challenges due to the death of a close family member or friend.
 9% of Black students reported that a close family member or friend died due to
homicide in the past 2 years

Experiences of Racism and Discrimination

Numerous studies have found negative impacts of discrimination on mental health and the
likelihood of engaging risk behaviors.4 This is the first year that MCPDH asked students about
their experience with racism and discrimination.

3
https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html, accessed August 209,
2019
4
Lei Y, Shah V, Biely C, et al. Discrimination and Subsequent Mental Health, Substance Use, and Well-being

5
Racism and Discrimination Key Findings:

 45% of Black students felt they were treated badly/unfairly because of their race and/or
ethnicity at least some of the time
 32% of Latino students felt they were treated badly or unfairly because of their race
and/or ethnicity at least some of the time
 47% of students who identify as lesbian, gay, bisexual, pansexual or transgender felt
they were treated badly or unfairly because of their sexual orientation at least some of
the time

Violence/Bullying
Exposure to violence has a major impact on school attendance and performance, mental health
and overall well-being.5

Violence/Bullying Key Findings:

 9% of students reported they carried a weapon in the past month
 12% of students reported they engaged in a physical fight in the past year
 21% of Black students and 20% of Latino students reported having witnessed someone
get shot, stabbed or beaten in their neighborhood, compared to 5% of White students.
 8% of students reported they did not go to school on one or more days in the past
month because they felt unsafe
 13% of Latino students and 10% of Blacks students reported they did not go to school on
one or more days in the past month because they felt unsafe, compared to 6% of White
students
Violence/Bullying Trends 2015-2022
• Increasing among females: Did not go to school on one or more days in the past month
because they felt unsafe
• Stable: Ever forced to do anything sexual
• Declining: All other indicators

Social Media Bullying and Safety

Social Media Bullying and Safety Key Findings:
 14% of students reported they were electronically bullied in the past year
 13% of students reported they ever sent a nude or semi-nude picture/video of
themselves or someone else

5
https://www.cdc.gov/injury/features/teen-violence-impact/index.html

6
 Social Media Bullying and Safety Trends 2015-2022
• Declining: All indicators

Vaping and Tobacco Use

The decrease in social gatherings and limited school attendance during the Covid-19 pandemic
most likely contributed to declines in reported use of substances. Students’ first use of these
substances almost always occurs when they are with peers.
In addition, students might have been reluctant to share devices during the pandemic, or
concerned that using substances would increase their chances of severe illness if they were to
contract COVID. Mask mandates made it more difficult to discreetly use substances.

A number of other factors might have contributed to the decline in vaping since the 2019 survey
was administered. A health condition attributed to vaping called EVALI (E-Cigarette or Vaping Use
Associated Lung Injury) was identified in late 2019 and likely discouraged some use.

Vaping and Tobacco Use Key Findings:

 23% of students reported they have used an e-cigarette or vape product
 12% of students reported they used an e-cigarette or vape product in the past month
 43% of students who used an e-cigarette or vape product in the past 12 months
reported they tried to quit and no longer vape. 22% tried to quit and but still vape
 81.5% reported they think vape products are addictive
 2% reported they smoked cigarettes in the past month

Vaping and Tobacco Use Trends 2015-2022

• Declining: Use of vape products and tobacco

7
Marijuana Use

The decrease in social gatherings and limited school attendance during the Covid-19 pandemic
most likely contributed to declines in reported use of substances. Students’ first use of these
substances almost always occurs when they are with peers.

In addition, students might have been reluctant to share substances during the pandemic, or
concerned that using substances would increase their chances of severe illness if they were to
contract COVID. Mask mandates made it more difficult to discreetly use substances.

For some students who had used marijuana prior to the pandemic, they reported increase use
during the pandemic.

Marijuana Use Key Findings:

 20% of students reported they have used marijuana
 13% of students reported they used marijuana in the past month
 47% of students who ever used marijuana reported they used more during the COVID-
19 pandemic than before it started
 50% of students who used marijuana in the past month reported they vaporized it

Marijuana Use Trends 2015-2022

• Declining: Use of marijuana

Alcohol Use
Prior to the pandemic, MCDPH noted declines in reported alcohol use. The decrease in social
gatherings and limited school attendance during the Covid-19 pandemic most likely contributed
to the decline in reported alcohol use in this year’s results. Students’ first use of these substances
almost always occurs when they are with peers.
However, some students who had consumed alcohol prior to the pandemic reported increased
use during the pandemic.

Alcohol Use Key Findings:

 33% of students reported they have drank one or more alcoholic drinks
 15% of students reported they drank one or more alcoholic drinks in the past month
 8% of students reported they engaged in binge drinking in the past month (four or more
alcoholic drinks in a row within a couple of hours)
 26% of students who ever drank alcohol reported they drank more alcohol during the
COVID-19 pandemic than before it started
Alcohol Use Trends 2015-2022
• Declining: Use of alcohol

8
Use of Other Drugs

The decrease in social gatherings and limited school attendance during the Covid-19 pandemic
most likely contributed to declines in reported use of substances. Students’ first use of these
substances almost always occurs when they are with peers.

Use of Other Drugs Key Findings:

 8% of students reported they have taken prescription medicines not prescribed by their
doctor or took them differently than their doctor’s directions (including pain, sedative,
and/or stimulants)
 3% of students reported they have used over-the-counter drugs to get high
 8% of students reported that during the past year, they were offered, sold, or given
any drugs or prescription medicines, on school property or on the way to/from school

Use of Other Drugs Trends 2015-2022

• Declining: Use of other drugs

Parental Influences

Parental Influences Key Findings:

 92% of students reported their parents feel it would be wrong/very wrong for them to
use vape products
 96% of students reported their parents feel it would be wrong/very wrong for them to
smoke cigarettes
 85% of students reported their parents feel it would be wrong/very wrong for them to
use marijuana
 75% of students reported their parents feel it would be wrong/very wrong for them to
drink alcohol

Parental Influences Trends 2015-2022

• Increasing: Perception that parents would feel it would be wrong/very wrong for
them to vape

9
Distracted Driving/Driving Under the Influence
Distracted Driving Key Findings:
 30% of student drivers reported they texted, used social media, or emailed while driving
in the past month
 9% of student drivers reported they rode in a car with a driver who had been drinking
alcohol in the past month
 8% of student drivers reported they rode in a car with a driver who had been using
marijuana, pills or other drugs in the past month

Distracted Driving Trends 2015-2022

• Declining: Riding with someone under the influence and driving while under the
influence
• Stable: Distracted driving

Sexual Risks
Social isolation during pandemic may have contributed to the decline in reported sexual activity.
However, rates had been declining prior to the pandemic. The decline in reported condom use
among sexually active students is particularly concerning given that sexually transmitted disease
infection rates in Monroe County are among the highest in New York State outside of New York
City.6
Sexual Risks Key Findings:
 19% of students reported they have engaged in sexual intercourse
 13% of students reported they engaged in sexual intercourse in the past three months,
and are therefore considered sexually active
 Only 6% of sexually active girls reported they used Long Acting Reversible Contraception
AND their partner used a condom the last time they had sexual intercourse. (The
American Congress of Obstetricians and Gynecologists recommends LARC (an IUD or
implant) be offered as first-line contraception for adolescents.) Together these
interventions protect against pregnancy and sexually transmitted disease.
 51% of sexually active females reported their partner used a condom the last time they
had sex
 59% of sexually active males reported they used a condom the last time they had sex

6
NYS STI Surveillance System, data as of September 2021.
<https://webbi1.health.ny.gov/SASStoredProcess/guest?_program=/EBI/PHIG/apps/dashboard/pa_dashboard&p=
gm&ind_id=pa46_0>

10
 Sexual Risk Trends 2015-2022
• Declining: Condom use among those who are sexually active
• Declining: All other indicators

Physical Activity/Screen time/Sleep

Physical Activity Key Findings:

 49% of students reported they engaged in one hour or more of physical activity daily
during 5 of the past 7 days
 32% of students reported they spend an average of five or more hours on a typical
school day watching TV, playing video games or using the computer/smartphone for
non-school work related activities
 43% of students reported they get six hours or less of sleep on a typical school night

Physical Activity Trends 2015-2022

• Increasing: Students reporting they engaged in regular physical activity

Assets

Strengths and supports that students have in their lives, also known as assets, help guide their
choices, contribute to their success at school and improve overall mental and physical well-
being.7

Assets Key Findings:

 83% of students reported they agree or strongly agree with the statement “My family
gives me help and support when I need it”
 60% of students reported they agree or strongly agree with the statement “I get a lot of
encouragement at my school”
 58% of students reported they agree or strongly agree with the statement “In my
community I feel like I matter to people”
 82% of students reported they know of one or more adults (other than their parents)
they can go to and discuss important questions about their life

Assets Trends 2015-2022

• Declining: Agree or strongly agree with the statement “I get a lot of encouragement
at my school
• Declining: Spend one or more hours per week helping others without getting paid
• Stable: All other indicators

7
https://www.search-institute.org/our-research/development-assets/developmental-assets-framework/

11
Mental Health
Question
%
# Students Reported They:
Felt so sad or hopeless almost every day for two or more weeks in a row that they
Q21 31.6
stopped doing their usual activities, in the past year
Have serious difficulty concentrating, remembering, or making decisions because of
Q27 40.1
mental, or emotional challenges1
Mental health was not good during the COVID-19 pandemic- MOST OF THE TIME OR
Q92 33.8
ALWAYS2
Did something to purposely hurt themselves without wanting to die, such as cutting or
Q26 14.5
burning themselves during the past 12 months (self-injurious behavior)
Q22 Seriously considered attempting suicide in the past year 14.5
Q23 Made a specific plan about how they would attempt suicide in past year 10.2
Q24 Attempted suicide in the past year 5.7
Attempted suicide in the past year that resulted in an injury that needed treatment by a
Q25 1.9
doctor or nurse (injurious suicide attempt)
1New question in 2019
2New question in 2021

There were Mental Health Indicators, Females

increases in the 45
proportions of 40
females that 35
reported feeling 30
Percent

sad/hopeless and 25
those who 20
considered or 15
10
planned a suicide
5
attempt.
0
2015 2017 2019 2021/22

Sad/hopeless 2+ weeks in a row Considered suicide Made a suicide plan

12
Females were more likely than males to report mental health problems and suicidal behavior.
Mental Health Indicators by Sex

100

80
53
Percent

60 46
42
40 25
20 19
20 13
6 7 3
0
Sad/hopeless 2+ Mental/emotional Mental health not Made a suicide plan Attempted suicide
weeks health challenges good most of
time/always during
COVID-19 pandemic
Female Male

Latina and Black females were more likely than White females to report they felt sad/hopeless
for two or more weeks in a row in the past year (49%, 42% and 40%).

Latino and White students were more likely than Black students to report mental health
challenges. Black and Latino students were more likely than White students to report a suicide
attempt.

Mental Health Indicators, by Race and Latino Origin

100

80
Percent

60
45 41
34 34 36
40 28

20 9 7 4
0
Mental/emotional health Mental health not good most of Attempted suicide
challenges time/always during COVID-19
pandemic

Latino Black White

13
Students who identify as LGBTQ were more likely to report mental health challenges and
suicide risks compared to those who identify as straight, not transgender.

Mental Health Indicators Among Students Who Identify as LGBTQ

100
80 72
60 63
Percent

60
40 31 27
23 25
16
20 6 3
0
Sad/hopeless 2+ Mental/emotional Mental health not Made a suicide plan Attempted suicide
weeks health challenges good most of
time/always during
COVID-19 pandemic
LGBTQ Straight, not transgender

14
Adverse Childhood Experiences (Trauma)
Students were asked a series of 11 questions about traumatic experiences and events during their life.

Quest Students Reported They: %

ion #

Q28 Often or repeatedly a parent or adult in their home swore at them, insulted them or put them
11.6
down (verbal abuse)
Q29 Often or repeatedly a parent or adult in their home hit, beat, kicked or physically hurt them in
1.7
any way (physical abuse)
Q31
Often or repeatedly parents or adults in their home hit, beat, kicked or beat each other up 1.5
Q30
Often or repeatedly, their family has not had enough money to buy food or pay for housing 3.3
Q32 Ever lived with anyone who was an alcoholic, problem drinker, used illegal street drugs, took
16.8
prescription drugs to get high, or was a problem gambler
Q33
Have ever lived with anyone who was depressed, mentally ill or suicidal 28.2
Q34
Ever had anyone in their household go to jail or prison 12.1
Q35
Ever witnessed someone get shot, stabbed or beaten in their neighborhood 9.7
Q36 They were ever forced to do any of the following: have sexual intercourse, touch someone
9.8
sexually, or be touched by someone sexually
Q37 They disagree or strongly disagree with the statement, “my family gives me the help and
6.3
support I need”
Q38
They currently do not live with both parents 35.4
We added up the total number of reported events for each student, and then calculated
percentages by the number of experiences. If a student left a question blank, and the sum of
the remaining questions equaled zero, their responses were set to missing.
Sixty percent of students reported
one or more adverse experiences # of Traumatic Life Events Reported by Students %

and twenty (20%) reported three or

more. no reported ACES 40.5
1 or more 59.5
3 or more 19.6

There was an increase in students who reported they ever lived with someone who was
depressed, mentally ill or suicidal from 22% in 2015 to 28% in 2022. Declines were seen in all of
the other indicators except students reporting they were ever forced to do something sexual,
which remained stable.

15
Females were more likely to report ACES compared to males.

ACES by Sex
100
80 66
52
60
Percent

36
40 19 24
15 15 8 14
20 7 3 4
0
Experienced Ever lived with Ever forced to do Strongly 1 or more ACES 3 or more ACES
verbal abuse someone who was anything disagree/disagree
often/repeatedly depressed, sexual with the
mentally ill or statement Female Male
suicidal "My family gives
me the help and
support I need"

Black and Latino students were more likely to they report ACES.

ACES, by Race and Latino Origin

100
76 79
80

60 53
Percent

40 32 29 31 26
21 20 21 16
20
5 5 2 5
0
Their family has not Ever lived with Ever witnessed 1 or more ACES 3 or more ACES
had enough money someone someone get shot,
for food/housing who was depressed, stabbed or beaten in Latino Black White
often/repeatedly mentally ill or suicidal their neighborhood

Students who identify as LGBTQ were more likely to report ACES.

ACES Among Students Who Identify as LGBTQ

100 82
80
51 53
60
Percent

39
40 24 22 25
8 15 14
20 6 4
0
Experienced Ever lived with Ever forced to do Strongly 1 or more ACES 3 or more ACES
verbal abuse- someone who anything sexual disagree/disagree
often/repeatedly was depressed, with the
mentally ill or statement "My LGBTQ Straight, not transgender
suicidal family gives me
the help and
support I need"

16
Grief
Twelve percent of students reported that at this time they were feeling depressed, anxious,
afraid, empty or confused because of the death of a close family member or friend. Sixteen
percent of Black and Latino students reported they were currently having mental health
challenges due to the death of a close family member or friend compared to 10% of White
students.

Students were also asked if they had a family member or friend who died in the past 2 years
and if the death was due to any of the following. The table below shows responses
%

A sudden or unexpected death like from a car crash, suicide, drug overdose or heart attack 9.9
COVID-19 5.8
Violence/homicide 2.5
A death due to another reason 27.1

Nine percent of Black students reported that a close family member or friend died due to
homicide in the past 2 years.

Experiences of Racism and Discrimination

The tables below show the % of youth who reported they experienced racism and
discrimination
Question
# Students Reported: %

They felt they were treated badly or unfairly because of their race or ethnicity at least some of
the time (SOMETIMES, MOST OF THE TIME, OR ALWAYS)

students who identify as LATINO 32.0

Q90
students who identify as WHITE 6.7

students who identify as BLACK 45.4

students who identify as ANOTHER RACE OR MULTIPLE RACES 38.3

Question
# Students Reported: %

They felt they were treated badly or unfairly because of their sexual orientation at least some
Q91
of the time (SOMETIMES, MOST OF THE TIME, OR ALWAYS)

students who identify as LBGTQ 46.8

17
Violence/Bullying
Question Students Reported They: %
#

Q13 Carried a weapon in the past month 9.4

Q14 Carried a weapon on school property in the past month 1.4

Q15 Carried a gun in the past year 2.1

Q16 Engaged in a physical fight in past year 11.5

Q18 Did not go to school on one or more days in the past month because they felt unsafe 8.2

Q17 Were threatened/injured on school property 1 or more times during past year 5.5
Were bullied on school property or on the way to and from school in the past 12 months.
(Bullying is when 1 or more students tease, threaten, spread rumors about, hit, shove, or
Q19 13.4
hurt another student. It is not bullying when 2 students of about the same strength or
power, argue, fight or tease each other in a friendly way.)1
In the past year, were physically hurt by someone they were dating, “talking to” or going out
Q20 3.9
with
Were ever forced to do any of the following: have sexual intercourse, touch someone
Q36 9.8
sexually, or be touched by someone sexually
1 New question in 2019

There was an increase in female students reporting they did not go to school because they felt
unsafe from 6% in 2015 to 10% in 2022. Declines were seen in all of the other indicators except
students reporting they were ever forced to do something sexual, which was stable.
Males were more likely than females to report weapon carrying and fighting. Females were
more likely than males to report they were victims of violence.

Violence Indicators by Sex

80

60
Percent

40

14 17 15
20 12 9 10
7 8
3 3
0
Carried a weapon in Engaged in a physical Were bullied Were ever forced to Did not go to school
the past month fight in the past year at school do something sexual one or more days in
in the past year the past month
because they felt
Female Male
unsafe

18
Black and Latino students were more likely than White students to report they engaged in a
fight in the past year and they did not go to school in the past month because they felt unsafe.
White students were more likely than Black and Latino students to report they were bullied at
school.

Violence Indicators by Race/Latino Origin

80

60
Percent

40
15 19
20 13 10 13 11 14
8 6
0
Engaged in a physical fight Did not go to school Were bullied on school property in
in the past year on one or more days the past year
in the past month because
they felt unsafe
Latino Black White

Students who identify as LGBTQ were more likely than students who identify as straight, not
transgender to report they engaged in fighting. They were also more likely to report not going
to school because they felt unsafe and to report they experienced bullying.

Violence Indicators Among Students Who Identify as LGBTQ

80
60
Percent

40 26
14 11 15 10 10
20 6 4
0
Engaged in a physical fight Did not go to school Were threatened/injured Were bullied on school
in past year on one or more days on school property 1 or property in the past year
in the past month because more times during past
they felt unsafe year

LGBTQ Straight, not transgender

19
Social Media-Bullying and Safety Issues
Question
Students Reported They: %

Q77 Were cyber bullied in the past 12 months1 14.1

Ever used a cell phone, computer or other electronic device to SEND/POST nude or semi-
Q78 13.3
nude pictures or videos of themselves or someone else
Ever used a cell phone, computer or other electronic device to RECEIVE nude or semi- nude
Q79 18.2
pictures or videos of someone else
Q80 Gambled one or more times the past 12 months2 8.8
1
Cyber bullying is when another student teases, threatens, spreads rumors about you, or sends pictures or videos of you, through texting,
gaming sites, or social media websites like Facebook, Tik Tok, Twitter, Discord, Instagram, SnapChat, You Tube etc.]
2Gambled on the Internet (example Draft Kings), gambled on a sports team, gambled when playing cards or a dice game, or bet on a game of

personal skill such as pool or a video game)

The proportions of students who reported they were cyberbullied and who reported they
engaged in sexting declined.
Females were more Social Media Safety Indicators, by Sex
likely than males to 50
40
report social media
Percent

30
safety issues, while male 20
18 15 13
9 11
were more likely to 10 4
report gambling. 0
Were cyberbullied Ever used a cell phone, Gambled in the past year
in the past year computer or other electronic
device to
SEND/POST nude or semi-
nude pictures or videos of
Female Male
themselves or someone else

Social Media Safety Issues, Females, by Race/Latino Origin

Latina and White
females were more 50
likely to report social 40
Percent

media safety issues. 30

18 20
20 15 16
11 12
10
0
Were cyberbullied in the past year Ever used a cell phone, computer or other
electronic device to SEND/POST nude or
Latino Black White semi- nude pictures or videos of themselves
or someone else

Students who identify as LGBTQ were more likely to report they were cyberbullied compared to
students who identify as straight and not transgender (27% compared to 11%).

20
Vaping and Tobacco Use
Question Students Reported They: %
#

Q52 Ever used a vape product1 22.6

Q53 Used an vape product before age 131 3.6
Q54 Used vape product on one or more of the past 30 days1 12.1
Q74 Ever tried smoking cigarettes, even one or two puffs 7.2
Q74 Tried cigarette smoking, even one or two puffs, before age 13 2.8
Q75 Smoked cigarettes on one or more days in the past 30 days [Current smoker] 1.7
Q76 Smoked cigars or Black & Milds in the past month 1.8
1Slight
change in question in 2021- used the term “vape products” instead of e-cigarettes. Added newer products in description including Hyde,
SMOK, Puff Bar and Suorin

Declines were seen Vaping and Tobacco Product Use

in vaping and in 60
use of tobacco
products. 40
Percent

20

0
2015 2017 2019 2021/22

Ever used a vape product Used a vape product in the past month
Smoked cigarettes in the past month Smoked Black and Milds in the past month

Females were more likely to Vaping, by Sex

report vaping compared to 60
males.
40
Percent

26
19
20 14
10

0
Ever used a vape product Used a vape product in the past
month
Female Male

21
Black and Latino students
Vaping, by Race/Latino Origin
compared to White students
60
were more likely to report
vaping. 40

Percent
28
23 22
20 15 13 11

0
Ever used a vape product Used a vape product in the
past month

Latino Black White

Reported Vaping Among Students Who Identify as LGBTQ

Students who identify as
LGBTQ were more likely to 60
report vaping compared to 34
Percent

40
students who identify as 20 20
20 10
straight and not
transgender. 0
Ever used a vape product Used a vape product in the past
month

LGBTQ Straight, not transgender

Reported vaping increased Reported Vaping, by Grade

by grade. 60

40 34
Percent

27
20 19
20 13 14
7 10

0
Ever used a vape product Used vape product on one or more of
the past 30 days

9th 10th 11th 12th

22
Main reason use e-cigarette or One Main Reason they Now Use E-cigarettes or Vape Products (Q55) %
vape products
To relax or de-stress 28.4
Students were asked to select the To get a nicotine buzz 14
one main reason they now use e- My friends use them 13.8
cigarettes or vape products. Nearly I can’t quit/I crave them/I’m addicted 8.5
one third responded they use them I like the flavors 8.3
to relax or de-stress. To do tricks or make shapes with the vapor 7.6
To try to quit using other tobacco products 0.9
They are less harmful than other tobacco products 0.9
Other reasons 17.8

Experiences with Quitting Vaping in the Past 12 months (Q56)

Of those who vaped in the past 12 months:
 43.1% said they tried to quit and no longer vape
 22.2% said they tried to quit, but are still using vape products
 34.7% said they did not try to quit

Perception about Vape Products Being Addictive (Q57)

81.6% of students reported that they think vape products are addictive. Black and Latino
students (75% and 69%) were less likely than White students (86%) to report they think vape
products are addictive.

23
Marijuana Use and CBD
%
Question # Students Reported They:

Q62 Ever used marijuana 19.9

Q62 Used marijuana before age 13 2.7

Q63 Used marijuana in the past month [Current users] 12.6

Used marijuana more during the COVID-19 pandemic than before it started, of those who 47.0
Q94
ever used marijuana, of those who ever used marijuana - Agree or Strongly agree
Q65 Ever used CBD (cannabidiol) in any form (edibles, vapes, liquid, lotion, etc.) 19.9

Marijuana Use, 2015-2021/22

Reported marijuana 60
use declined
between 2015 and 40
2021.
Percent

20

0
2015 2017 2019 2021/22

Ever used marijuana Used marijuana in the past month [Current users]

Females were more likely than males to report ever using marijuana (22% compared to 17%).

Black and Latino students were Marijuana Use, by Race/Latino Origin

more likely than White students to 60
report marijuana use.
40
Percent

24 24
19 16
20 15
11

0
Ever used marijuana Used marijuana in the past
month [Current users]

Latino Black White

24
Students who identify as LGBTQ
were more likely to report Marijuana Use Among Students Who Identify as LGBTQ
marijuana use compared to
60
students who identify as straight,
not transgender.

Percent
40 30
18 21
20 11

0
Ever used marijuana Used marijuana in the past
month [Current users]
LGBTQ Straight, not transgender

Marijuana Use, by Grade

Reported marijuana use increases 60
with increasing grade. 34
Percent

40
24 21
16 15
20 9 6 10

0
Ever used marijuana Used marijuana in the past month
[Current users]

9th 10th 11th 12th

How Marijuana was Used, Reported by those Who

The table to the right shows how Used it in the Past Month (Q64)1,2 %
marijuana was used, by those
I smoked it in a joint, bong, pipe, or blunt 75
who reported using it in the past
month. Of note, half reported I vaped it (examples include carts/cartridges, THC oil ) 50

vaping it. I ate it in food/edibles such as brownies, cakes, cookies, or

34
candy
I dabbed it using shatter, crumble, wax, etc. 13
I drank it in tea, cola, alcohol, THC lean or other drinks 5
I used it some other way 6
1
Trend data not available as there were changes in the description of
vaporizing. – included “cart/ cartridges, THC oil. Separated out dabs.
2
Students were allowed to select more than one response

25
Alcohol Use
Question Students Reported They: %
#

Ever drank one or more drinks of alcohol in their lifetime (not including for religious
Q58 32.7
purposes)
Q58 Had their first drink of alcohol before age 13, other than a few sips 6
Q59 Had at least one drink of alcohol in the past month 14.5
Engaged in binge drinking one or more times during the past month
Q60 8.3
(4 or more drinks of alcohol in a row, within a couple of hours)
Drank more alcohol during the COVID-19 pandemic than before it started, of those who ever
Q93 26
drank alcohol- Agree or Strongly agree

Reported alcohol use

declined overall since Alcohol Use, 2015-2021/22
80
2015.
60
Percent

40

20

0
2015 2017 2019 2021/22

Ever drank one or more drinks of alcohol

Had at least one drink of alcohol in the past month

Females were more likely than males to report alcohol use. Latino and White students were
more likely than Black students to report alcohol use.

Alcohol Use, by Sex Alcohol Use, by Race/Latino Origin

80 80
Percent

60 60
Percent

36 35 35
40 29 40 24
16 12 17
20 13 20 10

0 0
Ever drank one or more Had at least one Ever drank one or Had at least one drink of
drinks of alcohol drink of alcohol more drinks of alcohol alcohol in the past
in the past month month

Female Male Latino Black White

26
Students who identify as LGBTQ were
Alcohol Use Among Students Who Identify as
more likely to report alcohol use LGBTQ
compared to students who identify as 80

straight, not transgender. 60

42

Percent
40 31
18 14
20
0
Ever drank one or more Had at least one drink of
drinks of alcohol alcohol in the past month

LGBTQ Straight, not transgender

Reported alcohol use

Alcohol Use, by Grade
increases with increasing
100
grade.
80
Percent

60 51
40
40 28 28
17 18
20 5 11 6 11 17
3
0
Ever drank one or more Had at least one drink Engaged in binge
drinks of alcohol of alcohol drinking one or more
in the past month times during the past
month
9th 10th 11th 12th

The table below shows how students reported that they usually got their alcohol, among those
who drank in the past month.

Q61 How they usually got alcohol, reported by those who drank alcohol in past month %
A friend gave it to me 27.7
A family member gave it to me 20.7
I took it from my home, garage, porch or deck 18.5
I got it some other way 13.1
I gave someone else money to buy it for me 6.9
I bought it in a store such as a liquor store, convenience store, supermarket, discount store, or gas station 6.5
I took it from another person's home, garage, porch or deck 3.1
I stole it 2.7
I bought it at a restaurant, bar, club or a public event such as a concert or sporting event 0.9
*Trend data not available

27
Use of Other Drugs
Students Reported They: %
Question
#
Q66 Ever used cocaine1,2 1.4
Q67 Ever used heroin2 1
Q68 Ever used ecstasy2 1.4
Q69 Ever used hallucinogenic drugs such as LSD, acid, PCP, angel dust, mescaline or mushrooms2 2.9
Q70 Ever injected any illegal drug into their body 0.9
Q71 Ever took any form of over-the-counter (OTC) drug to get high2 2.7
Q72 Ever misused prescription PAIN MEDICINE (examples, OxyContin, Hydrocodone, Percocet)2,3 5
Ever misused prescription SEDATIVE MEDICINE (examples, Xanax, Zannie bars, Klonopin, K-
Q72 2.1
pins, Valium)2,3
Ever misused prescription STIMULANT MEDICINE (examples, Adderall, Ritalin, and other ADHD
Q72 4.6
medicine)2,3
Q72 Ever misused prescription PAIN, SEDATIVE AND/OR STIMULANT MEDICINE2,3 8.4
During the past year, were offered, sold, or given you any drugs on school property or on the
Q73 way to/from school (count marijuana, cocaine, heroin, etc. and prescription medicines that 7.8
were not yours)3
1Question changed in 2017 to “ever” using from using in the past month.
2Changed to yes/no question
3Description changed, so trend data not available. Misuse defined as taking someone else’s medicine (medicine not prescribed to you) or taking

your medicine differently than how a doctor told you how to use it (example- taking more)
3Changed question to specify types of drugs

Reported use of other drugs declined overall since 2015.

Parental Influences
Students Reported Their Parents Feel: %
Question
#
Q84 It would be very wrong or wrong for them to use vape products 92
Q84 It would be very wrong or wrong for them to smoke 96.2
Q84 It would be very wrong or wrong for them to use marijuana 84.5
Q84 It would be very wrong or wrong for them to drink alcohol 75.4

Between 2017 and 2022, there was increase in students who reported that their parents feel it would be
wrong/very wrong for them to use vape products from 83% to 92%.

28
Students in 11th and 12th grades were less likely than younger students to report their parents
feel it would be wrong/very wrong for them to use substances.

Parents Feel It Would be Wrong/Very Wrong for them to Use, by Grade

94 93 91 90 90
100 87 86
82 80
80 73 71
61
Percent

60
40
20
0
Vaping Marijuana Alcohol

9th 10th 11th 12th

Distracted Driving and Driving Under the Influence

Students Reported They: %
Question #

Looked at their phone to change the music, use social media or text, while driving a car or
Q12 30
other vehicle - of those who drove in the past month [Distracted driving]
Q8 In the past month, rode in a car with a driver who had been drinking alcohol 8.5
Q9 Drove a car after drinking alcohol – of all students 1.6
Q9 Drove a car after drinking alcohol-only of those who drove in the past month 3.5
In the past month, rode in a car with a driver who had been using marijuana, pills or other
Q10 8
drugs
Q11 Drove a car when they had been using marijuana, pills or other drugs– of all students 2.5
Drove a car when they had been using marijuana, pills or other drugs– only those who drove
Q11 5.4
a car in the past month

Reported distracted driving was stable, while driving under the influence declined since 2015.

29
Sexual Risk Behaviors
Students Reported They: %
Question
#
Q41 Ever engaged in sexual intercourse 18.7
Q42 Had sexual intercourse before age 13 2.3
Q44 Engaged in sexual intercourse in the past 3 months [currently sexually active] 13.2
Q43 Had sexual intercourse with 4 or more partners in their lifetime 3.4
Used alcohol or drugs before they had sex the last time, of currently sexually active
Q45 20.3
students
Q49 Ever participated in oral sex 19.3
Q50 Participated in oral sex before age 13 2.3

Declines were seen in reported sexual activity and sexual risk behaviors.

Reported Sexual Activity, 2015-2021/22

80

60
Percent

40

20

0
2015 2017 2019 2021-22

Ever engaged in sexual intercourse

Engaged in sexual intercourse in the past 3 months

Reported Sexual Risks, 2015-2021/22

80

60
Percent

40

20

0
2015 2017 2019 2021/22
Had sexual intercourse with 4 or more partners in their lifetime
Used alcohol or drugs before they had sex the last time, of currently sexually active students

Males were more likely than females to report they engaged in sexual intercourse with 4 or
more partners in their lifetime (4% compared to 2%)

30
Black and Latino males were more likely than White males to report sexual risks.

Reported Sexual Risks among Males, by Race/Latino Origin

80

60
Percent

40
25 26 23 22 19
17 15 16
20 13
5 5 6 7
1 3
0
Ever engaged in sexual Engaged in sexual Currently sexually Ever participated in Had sexual intercourse
intercourse intercourse before age active oral sex with 4 or more
13 partners in their
Latino Black White lifetime

Students who identify as LGBTQ were more likely to report sexual risks.

Reported Sexual Risks Among Students Who Identify as LGBTQ

80
60
Percent

40 26 28
17 17 17
20 12
5 1 6 3
0
Ever engaged in sexual Engaged in sexual Currently sexually Had sexual intercourse Used alcohol or drugs
intercourse intercourse before age active with 4 or more before they had sex
13 partners in their the last time, of
lifetime currently sexually
LGBTQ Straight, not transgender active students

Reported sexual risks increase with increasing grade.

Reported Sexual Risks, by Grade

80
60
37
Percent

40 28
23
13 16
20 7 9 8
4 1 2 4
0
Ever engaged in sexual intercourse Currently sexually active Had sexual intercourse with 4 or more
partners in their lifetime

9th 10th 11th 12th

31
Prevention of Pregnancy and STDs
Of sexually active youth: (Q46)

 51% of females reported their partner used a condom the last time they had sex.
 59% of males reported they used a condom the last time they had sex.

Reported Condom Use by Sex, Among Sexually Active Students, 2015-2021/22

condom use 80
declined
60
overall
Percent

40
among both
females and 20
males
0
2015 2017 2019 2021/22
Females Males

The graphics below and on the next page show the pregnancy prevention methods reported by
sexually active youth. Of note, only 6% of sexually active females reported that long acting
reversible contraception (an IUD or implant) and a condom were used the last time they had
sexual intercourse.

Reported Pregnancy Prevention Method Used, and Condom Use

Last Time Had Sexual Intercourse, Sexually Active FEMALES

50
Percent

40
30 15
20
12
10 8 22 8
2 1 2
6 10 8
0 2 2 3
IUD or Implant Birth control A shot Emergency Withdrawal/ Nothing Not Sure
pills, patch or Contraception pull out
ring

and a Condom and no Condom

32
 Reported Pregnancy Prevention Method Used, and Condom Use
Last Time Had Sexual Intercourse, Sexually Active MALES

50
40
30
11
Percent

20 14
10 21 7
5 1 1 16 3
10
0 4 1 2 5
IUD or Implant Birth control A shot Emergency Withdrawal/ Nothing Not Sure
pills, patch or Contraception pull out
ring

and a Condom and no Condom

The graphics below and on the next page, show the proportions of sexually active students and
all students, who reported their health care provider discussed various pregnancy prevention
methods with them at their last checkup.
Females were more likely than males to report their doctor discussed various pregnancy
prevention methods other than condoms. Males were more likely than females to report their
health care provider discussed using a condom to prevent pregnancy. Sexually active males
were more likely than sexually active females to report their doctor did not discuss any
pregnancy prevention method with them.

Health Care Provider Discussed Pregnancy Prevention Methods

During Last Checkup, SEXUALLY ACTIVE STUDENTS, by Sex

70 59
56
60
50 42
Percent

40 29
28
30 20
20 15 13
7 9 7
10 5
0
IUD or Implant Birth control pills, A shot Emergency Condoms Health care
patch or ring Contraception provider did not
discuss
Females Males

33
 Health Care Provider Discussed Pregnancy Prevention Methods
During Last Checkup, ALL STUDENTS, by Sex
80
70
55 56
60
Percent

50
33 36
40
30 23
20 11
7 6 5
10 3 2 3
0
IUD or Implant Birth control pills, A shot Emergency Condoms Health care
patch or ring Contraception provider did not
discuss
Females Males

34
Physical Activity/Screen Time and Sleep
Students Reported They: %
Question
#

Q81 Engaged in one hour or more of physical activity daily during the past seven days 25.1
Q81 Engaged in one hour or more of physical activity daily during five of the past seven days 48.9
Q81 Did not engage in one hour of physical activity on any of the past seven days 14.4
On an average school day, spend 3 or more hours in front of a TV, computer, smart phone
Q82 or other electronic device watching shows or videos, playing games, accessing the 73.8
Internet, or using social media1
On an average school day, spend 5 or more hours in front of a TV, computer, smart phone
Q82 or other electronic device watching shows or videos, playing games, accessing the 32.5
Internet, or using social media1
Q83 Get 8 or more hours of sleep on an average school night 28.5
Q83 Get 6 or less hours of sleep on an average school night 43.1
1Also called screen time. Does not count time spent on school work. This question changed so trend data are not available. In previous surveys,
this was asked in 2 questions.

Females were less Physical Activity, Screen Time and Sleep, by Sex
likely than males 80
to report 56
60 47
engaging in 43 39
35
Percent

40 29
physical activity
20
and were more
0
likely to report
Engaged in 1+ hours of physical 5 or more hours screen time 6 hours or less of sleep per night
excessive screen activity on 5 of last 7 days
time and lack of
sleep.
Female Male

Black and Latino Physical Activity, Screen Time and Sleep, by Race/Latino Origin
students were 80
less likely than 55
60 50 50
White students to
Percent

38 41 40
36 35
report engaging 40 29
in physical activity 20
on 5+ days, and 0
were more likely Engaged in 1+ hours of physical 5 or more hours screen time 6 hours or less of sleep per night
to report activity on 5 of last 7 days

engaging in
excessive screen Latino Black White

time and getting

less than 6 hours of sleep per night.

35
Assets
Question
Students Reported They: %
#

Q37 Agree or strongly agree with the statement “My family gives me help and support when I
82.8
need it”
Q85 Agree or strongly agree with the statement “In my family there are clear rules about what I
86.5
can and cannot do”
Q86 Agree or strongly agree with the statement “I get a lot of encouragement at my school” 59.8
Q87 Agree or strongly agree with the statement “In my community I feel like I matter to people” 57.5
Q88 Know of one or more adults (other than their parents) they can go to and discuss important
81.8
questions about their life
Q89 Spend one or more hours per week helping others without getting paid (volunteering)1 36.3
1
(Count such things as helping out at church/temple/mosque, a hospital, daycare center, food shelf, youth program, community service agency
or doing other things to make your city/town a better place for people to live)

Females were less likely than males to report they get support and encouragement and feel like
they matter.
Students Reported they Agree/Strongly Agree, by Sex

100 88
79
80 64 64
57
Percent

60 53

40
20
0
“My family gives me help and “I get a lot of encouragement “In my community I feel like I matter
support when I need it” at my school” to people”

Female Male

Black and Latino youth were less likely than White you to report they get support and
encouragement and feel like they matter.

36
 Students Reported they Agree/Strongly Agree, by Race/Latino Origin

100 85
78 79
80
60 61 61
56
Percent

60 49 53

40

20

0
“My family gives me help and “I get a lot of encouragement “In my community I feel like I matter
support when I need it” at my school” to people”

Latino Black White

Students who identify as LGBTQ were less likely than those who identify as straight, not
transgender to report they get support and encouragement and feel like they matter. They are
also less likely to report having a supportive adult they can talk with.

Assets Reported, Students Who Identify as LGBTQ

100 89 84
76
80 66 64 64
Percent

60 48
38
40
20
0
“My family gives me help “I get a lot of “In my community Know of one or more adults
and support when I need encouragement at my I feel like I matter to they can go to and discuss
it” - Agree/Strongly Agree school”- Agree/Strongly people” - Agree/Strongly important questions about
Agree Agree their life

LGBTQ Straight, not transgender

37
Appendix A
Participation

 Of the 18 school districts in Monroe County, 17 school districts participated.

o 15 suburban school districts administered the survey between October-

December.

o 1 suburban school district administered the survey in January.

o Rochester City School District administered the survey in March.

 The response rate was calculated by dividing the number of surveys by enrollment.
County-wide the response rate was 64%.

 19,282 students participated in the 2021-22 school year.

Methodology

All surveys were administered using a confidential computer based survey platform. This year,
we included all valid surveys in the analysis. In previous years, MCDPH used a random sample of
surveys based on school enrollment, with a projected 5% margin of error and an 80% response
rate. The change allowed for a larger sample size and a greater ability to examine sub-groups.

To track trends, MCDPH included all valid surveys from 2015, 2017, 2019 and 2021 and
weighted them, adjusting the sample to match student enrollment.8 The raking method was
used to weight by grade level, reported race, and location (city or suburb) to account for
demographic differences between respondents and those who did not complete the survey.
The weighted results did not significantly differ from the unweighted results, so MCDPH used
the unweighted results in this report. Both results however, are included in Appendix B.

Demographic Characteristics of Respondents

A total of 19,282 students participated in the survey this year. The demographic characteristics
of the sample are shown in the tables on the next page. Students that selected “Latino” were
counted only in this category, regardless of which race they selected. Students that selected a
single race and “not-Latino” were counted in the race category they selected. Those that selected
multiple races and “not Latino” were counted in the “other races/more than one race” category.
Students that selected all races and Latino origin were put into the missing category.

8
New York State Education Department enrollment was used to develop the weights. The 2021-22 school year
enrollment was considered preliminary.

38
 Sex # % Race/Ethnicity # %
Female 9,509 49.4 Latino 2,419 12.7
Male 9,243 48
White, not Latino 11,790 61.8
Preferred not to 491
answer 2.6 Black, not Latino 2,554 13.4
Total 19,243
Other races, and
Did not answer 39 multiple races, not 12.1
2,314
Latino
Total 19,077
Age # %
13 or younger 207 1.1 Unknown 205
14 years old 4,539 23.6
15 years old 5,252 27.3
16 years old 4,691 24.4
17 years old 3,906 20.3
18 years old or older 652 3.4
Total 19,247
Did not answer 35

Students Who Identify as LGBTQ

This year we included a question about whether or not students identify as transgender and a
question about sexual orientation. In this report, students were considered identifying as LGBTQ
group if they answered yes to the question are you transgender or non-binary and/or they
answered gay, lesbian, bisexual or pansexual to the question “Which of the following describes
you?” Below are the number and proportion of students that responded to these questions

Gender Identity # % Sexual Orientation # %

No I am not Heterosexual 13,618 73.7
transgender or
16,826 89.3 Gay or lesbian 759 4.1
non-binary
Yes, I am Bisexual 2,086 11.3
transgender or 823 4.5
939 5 Pansexual
non-binary
I am not sure if I Not sure 1,203 6.5
am transgender 793
540 2.9 Did not answer
or non-binary
I don’t know
what this
545 2.9
question is asking
Did not answer 432

39
Data Limitations

 The overall response rate for participating districts was 64%, compared to 66% in 2019.

 The response rate for the suburban school districts was 74%, with a range of 38-
90%. This is slightly lower than in 2019, when the response rate was 76%.

 The response rate of 35% in the Rochester City School District was much lower than the
response rate in previous years, which ranged between 40-49%. In addition, the RCSD
response rate for boys was significantly lower than for girls (31% and 38% respectively).

 Some school districts indicated they administered multiple surveys in the fall of 2021.
As a result, districts believe some students may have had survey fatigue and chose not
to participate or did not finish the YRBS. The low response rates, especially in the city,
most likely impacted results.

 The survey did not include students who were not in school on the days the survey was
administered, or students who had dropped out of school. The reasons youth are out of
school are often related to the risk factors measured by the survey. These include
mental health challenges, the threat of violence, substance use and teen pregnancy.
Students who drop out or are frequently absent are more likely to experience health
risks compared to other students.9

 The interpretation of questions may differ based on knowledge, experience, culture,

and beliefs. For example, symptoms of depression such as sleeping too much may be
interpreted as “a phase” or laziness, and therefore not recognized as a mental health
issue. In cultures where mental health problems are viewed as a sign of weakness,
students might not acknowledge the challenges they face. The sexual intercourse
questions do not provide a definition of the behavior. Research has shown that
adolescents may have varying definitions of what sexual intercourse is which can impact
how they interpret the questions.10

9
Centers for Disease Control and Prevention. Health risk behaviors among adolescents who do and do not attend
school—United States, 1992. [September 8, 2020]; Morbidity and Mortality Weekly Report. 1994 43(8):129–
132. https://www.cdc.gov/mmwr/preview/mmwrhtml/00025174.htm
10
Diamond LM, Savin-Williams RC. In: Handbook of adolescent psychology: Individual bases of adolescent
development. Lerner RM, Steinberg L, editors. Hoboken, NJ: John Wiley & Sons, Inc; 2009. Adolescent sexuality;
pp. 479–524.

40
Comparison to National and State Youth Risk Behavior Surveys

Monroe County YRBS was different than the national YRBS survey administered by the CDC:

 While many of the CDC survey questions were included in the local survey, some were
slightly modified. MCDPH also inserted some of its own questions to reflect local
concerns.

 The local survey did not include internal reliability checks.11

 The local survey report includes all public school district students who completed the
survey on the days that it was administered. The national YRBS uses a 3-stage cluster
sampling design to create a nationally representative sample.

 The CDC report used weighted results based on sex, race/ethnicity and grade, and
adjusts for school and student nonresponse.

 Students filling out the national survey generally used paper and pencil. In Monroe
County, they used a confidential online portal.

11
Internal reliability checks: Sets survey response to “Missing” when the responses are not consistently answered.
For example, the responses of a student who reports vaping in the past month and reports never having vaped are
set to “Missing.”

41
Appendix B
The following table show trend data, when available, for the MC YRBS and includes unweighted and
weighted results by year of survey administration. The weighting methodology is described on page 40
of the report.

Students Reported They: U=Unweighted 2015 2017 2019 2021

W=Weighted

Felt so sad or hopeless almost every day for two or more U 27.4 28 31.9 31.6
weeks in a row that they stopped doing their usual
activities, in the past year W 27.3 27.7 31.6 32
Have serious difficulty concentrating, remembering, or U 37.7 40.1
making decisions because of mental, or emotional
challenges* W 36.6 39.7

During the COVID-19 pandemic, mental health was not U 33.8

good, most of the time or always W 33.4
Did something to purposely hurt themselves without U 12.9 14.5
wanting to die, such as cutting or burning themselves during
the past 12 months W 12.4 14.0
U 13.9 14.3 15.1 14.5
Seriously considered attempting suicide in the past year
W 13.6 13.8 14.7 14.3
Made a specific plan about how they would attempt suicide U 10.3 10.3 10.8 10.2
in past year W 10.1 9.9 10.5 10.1
U 7.6 6.5 6.7 5.7
Attempted suicide in the past year
W 7.3 6.3 6.7 5.9

Attempted suicide in the past year that resulted in an injury U 3.4 2.5 2.3 1.9
that needed treatment by a doctor or nurse W 3.2 2.4 2.2 1.8

Often or repeatedly a parent or adult in their home swore at U 14.7 13.5 12.7 11.6
them, insulted them or put them down (verbal abuse) W 14.4 13.2 12.4 11.2
Often or repeatedly a parent or adult in their home hit, U 3.3 2.6 2 1.7
beat, kicked or physically hurt them in any way (physical
abuse) W 3 2.4 2 1.7

Often or repeatedly parents or adults in their home hit, U 2.8 2.1 1.6 1.5
beat, kicked or beat each other up W 2.5 2.1 1.6 1.5

Often or repeatedly, their family has not had enough money U 5 4.8 4.3 3.3
to buy food or pay for housing W 4.8 4.7 4.4 3.4

Ever lived with anyone who was an alcoholic, problem U 20.9 20.7 20.6 16.8
drinker, used illegal street drugs, took prescription drugs to
get high, or was a problem gambler W 20.8 20.5 20.2 16.7

42
Students Reported They: U=Unweighted 2015 2017 2019 2021
W=Weighted

Have ever lived with anyone who was depressed, mentally U 22.1 24.1 27.2 28.2
ill or suicidal W 21.8 23.5 26.6 27.7
U 19.2 15.5 15.3 12.1
Ever had anyone in their household go to jail or prison
W 19.6 16.7 16.7 13.8
Ever witnessed someone get shot, stabbed or beaten in U 17.3 13 13 9.7
their neighborhood W 17.6 14.2 14.6 11.3
They were ever forced to do any of the following: have U 10.7 8.6 9.1 9.8
sexual intercourse, touch someone sexually, or be touched
W 10.6 8.6 8.9 9.6
by someone sexually
They disagree or strongly disagree with the statement, “my U 7.7 5.9 5.8 6.3
family gives me the help and support I need” W 7.4 5.9 5.9 6.5
U 38.8 37.6 37.4 35.4
They currently do not live with both parents
W 39.8 40 40.5 39.8
U 68.8 62.4 63.1 59.5
Reported ACES 1 or more
W 69.3 64.2 65.3 62.8
U 25.9 21.9 22.3 19.6
Reported ACES 3 or more
W 25.9 22.4 23 20.6
U 13.5 13.8 11.4 9.4
Carried a weapon in the past month
W 13 13.4 11.1 9.2
U 4.6 3.6 2.6 1.4
Carried a weapon on school property in the past month
W 4.2 3.4 2.6 1.3
U 3.6 2.8 2.1
Carried a gun in the past year
W 3.4 2.8 2
U 20 17.8 17.9 11.5
Engaged in a physical fight in past year
W 20 18.3 18.4 12.2
Did not go to school on one or more days in the past month U 7.1 6.1 7.3 8.2
because they felt unsafe W 6.6 5.9 7.3 8.8
Were threatened/injured on school property 1 or more U 7 5.1 6.1 5.5
times during past year W 6.6 4.9 5.9 5.5
Were bullied on school property or on the way to and from
school in the past 12 months. (Bullying is when 1 or more U 18.5 13.4
students tease, threaten, spread rumors about, hit, shove,
or hurt another student. It is not bullying when 2 students
of about the same strength or power, argue, fight or tease W 17.7 13
each other in a friendly way.)
In the past year, were physically hurt by someone they were U 7.8 6.7 5.6 3.9
dating, “talking to” or going out with W 7.5 6.6 5.8 4.1
Were ever forced to do any of the following: have sexual U 10.7 8.6 9.1 9.8
intercourse, touch someone sexually, or be touched by
W 10.6 8.6 8.9 9.6
someone sexually
Were cyber bullied in the past 12 months [Cyber bullying is
when another student teases, threatens, spreads rumors U 17.9 17.5 16.9 14.1
about you, or sends pictures or videos of you, through
texting, gaming sites, or social media websites like
Facebook, Tik Tok, Twitter, Discord, Instagram, SnapChat, W 17.5 16.9 16.1 13.5
You Tube etc.]

43
Students Reported They: U=Unweighted 2015 2017 2019 2021
W=Weighted

Ever used a cell phone, computer or other electronic U 17 21.9 18 13.3

device to SEND/POST nude or semi- nude pictures or
videos of themselves or someone else W 16.9 21.5 17.7 13.2
Ever used a cell phone, computer or other electronic U 30.4 25.2 18.2
device to RECEIVE nude or semi- nude pictures or videos
of someone else W 30.1 25.1 18.2
Gambled one or more times the past 12 months U 10.9 8.8
(gambled on the Internet (example Draft Kings), gambled
on a sports team, gambled when playing cards or a dice
game, or bet on a game of personal skill such as pool or W 10.5 8.3
a video game)
U 31.6 31.5 36.2 22.6
Ever used a vape product
W 31.4 30.3 34.8 23.4
U 3.7 4 4.4 3.6
Used an vape product before age 13
W 3.3 3.7 4.1 3.3
U 3.7 4 4.4 3.6
Used an vape product before age 13
W 3.3 3.7 4.1 3.3
U 20.1 19.8 22.2 12.1
Used vape product on one or more of the past 30 days
W 19.8 18.8 21.3 12.6
U 4 3.5 5.4 3.6
Used vape daily during the past 30 days
W 3.7 3.3 5.1 3.5
U 13 7.2
Ever tried smoking cigarettes, even one or two puffs
W 13 7.3
Tried cigarette smoking, even one or two puffs, before U 5.2 2.8
age 13 W 5.2 2.9
Smoked cigarettes on one or more days in the past 30 U 7.8 5.1 3.3 1.7
days [Current smoker] W 7.5 4.8 3.3 1.5
U 10.8 8.2 5.1 1.8
Smoked cigars or Black & Milds in the past month
W 10.7 8.1 5.3 1.8
U 31 29.8 29.5 19.9
Ever used marijuana
W 31.7 30.4 30.3 21.3
U 6.4 5.2 4.7 2.7
Used marijuana before age 13
W 6.2 5.3 4.8 2.8
U 20 19 19.1 12.6
Used marijuana in the past month [Current users]
W 20.2 19.4 19.6 13.5
Used marijuana more during the COVID-19 pandemic U 47
than before it started, of those who ever used
marijuana, of those who ever used marijuana - Agree or W 46.2
Strongly agree
Ever used CBD (cannabidiol) in any form (edibles, vapes, U 47
liquid, lotion, etc.) W 46.2
U 50.2 48.7 42.5 32.7
Ever drank one or more drinks of alcohol in their lifetime
(not including for religious purposes) W 50.8 48 42.4 32.6

Had their first drink of alcohol before age 13, other than U 11.7 10.6 10.0 6.0
a few sips W 11.2 10.2 9.7 6.0

44
Students Reported They: U=Unweighted 2015 2017 2019 2021
W=Weighted
U 27.2 26.2 21.7 14.5
Had at least one drink of alcohol in the past month
W 27.4 25.7 21.4 14.5
Engaged in binge drinking one or more times during the U 11.2 8.3
past month (4 or more drinks of alcohol in a row, within
a couple of hours) W 11.1 8.2
Drank more alcohol during the COVID-19 pandemic than U 26
before it started, of those who ever drank alcohol- Agree
or Strongly agree W 25.4
U 3.7 2.7 1.4
Ever used cocaine
W 3.5 2.6 1.3
U 3.9 2.6 2 1
Ever used heroin
W 3.5 2.4 1.9 0.9
U 5.6 3.6 2.8 1.4
Ever used ecstasy
W 5.1 3.4 2.8 1.4
Ever used hallucinogenic drugs such as LSD, acid, PCP, U 6.5 5.1 4.3 2.9
angel dust, mescaline or mushrooms W 6.1 4.8 4.1 2.7
U 3.1 2.3 1.6 0.9
Ever injected any illegal drug into their body
W 2.7 2.1 1.6 0.8
Ever took any form of over-the-counter (OTC) drug to U 6.6 5.7 5.3 2.7
get high W 6.2 5.4 5.1 2.6
Ever misused prescription PAIN MEDICINE (examples, U 9.2 5
OxyContin, Hydrocodone, Percocet) W 9.2 5.3
Ever misused prescription SEDATIVE MEDICINE U 4.6 2.1
(examples, Xanax, Zannie bars, Klonopin, K-pins, Valium) W 4.5 1.9
Ever misused prescription STIMULANT MEDICINE U 7.1 4.6
(examples, Adderall, Ritalin, and other ADHD medicine) W 6.9 4.5
Ever misused prescription medicine -PAIN, SEDATIVE U 14.1 8.4
AND/OR STIMULANT MEDICINE W 14 8.6
During the past year, were offered, sold, or given you U 7.8
any drugs on school property or on the way to/from
school (count marijuana, cocaine, heroin, etc. and W 7.7
prescription medicines that were not yours)
Parents feel it would be wrong or very wrong to: drink U 70.4 75.2 75.4
alcohol W 70.9 75.5 75.2
Parents feel it would be wrong or very wrong to: smoke U 94.6 96.4 96.2
cigarettes W 94.6 96.4 96
Parents feel it would be wrong or very wrong to: use U 84.1 84.8 84.5
marijuana W 83.7 84.2 83
Parents feel it would be wrong or very wrong to: use a U 83.1 87.5 92
vape product W 83.4 87.6 91.1
Looked at their phone to change the music, use social U 30.7 28.5 30
media or text, while driving a car or other vehicle - of
W 30 28.3 29.9
those who drove in the past month (distracted driving)

45
Students Reported They: U=Unweighted 2015 2017 2019 2021
W=Weighted

In the past month, rode in a car with a driver who had U 16.9 15 13 8.5
been drinking alcohol W 16.6 14.7 13 8.9
Drove a car after drinking alcohol – of all students U 3.8 2.9 1.6
W 3.6 2.9 1.6
Drove a car after drinking alcohol-only of those who U 7.1 5.8 3.5
drove in the past month W 6.6 5.5 3.3
In the past month, rode in a car with a driver who had U 17.3 15.4 14.9 8
been using marijuana, pills or other drugs W 17.3 15.5 15 8.4
Drove a car when they had been using marijuana, pills U 6.6 5.9 2.5
or other drugs– of all students W 6.4 5.9 2.4
Drove a car when they had been using marijuana, pills U 12.2 11.5 5.4
or other drugs– only those who drove a car in the past W 11.7 11.3 5.1
month
Ever engaged in sexual intercourse U 32.2 29.7 28.4 18.7
W 33.3 31 29.9 19.9
Had sexual intercourse before age 13 U 5.4 4.0 3.5 2.3
W 5.3 4.3 3.6 2.3
Engaged in sexual intercourse in the past 3 months U 24.4 22.6 20.8 13.2
[currently sexually active] W 25 23.5 21.8 13.8
Had sexual intercourse with 4 or more partners in their U 9.8 7.9 6.5 3.4
lifetime W 9.9 8.3 6.9 3.4
Used alcohol or drugs before they had sex the last time, U 28.7 23.7 21 20.3
of currently sexually active students W 27.3 22.6 19.9 19.1
Ever participated in oral sex U 30.3 32 29.7 19.3
W 30.7 32.2 30.4 19.9
Participated in oral sex before age 13 U 3.7 3.3 2.3
W 3.7 3.4 2.2
Used a condom the last time they had sex of those U 59.9 55.8 57.4 53.8
currently sexually active
W 60.5 56.1 57.3 53.6
Engaged in one hour or more of physical activity daily U 22.2 21.4 22.4 25.1
during the past seven days W 22 21.1 21.7 23.9
Engaged in one hour or more of physical activity daily U 44.6 42.5 44.2 48.9
during five of the past seven days W 44.2 41.5 42.4 46.5
Did not engage in one hour of physical activity on any U 18.1 19.4 16.8 14.4
of the past seven days W 18.3 20.8 18.9 16.4
On an average school day, spend 3 or more hours in U 73.8
front of a TV, computer, smart phone or other
electronic device watching shows or videos, playing
games, accessing the Internet, or using social media W 73.2
(also called “screen time”) (not counting time spent
doing schoolwork)
On an average school day, spend 5 or more hours in front of a U 32.5
TV, computer, smart phone or other electronic device W 33.3

46
Students Reported They: U=Unweighted 2015 2017 2019 2021
W=Weighted

Get 8 or more hours of sleep on an average school U 27.5 26.9 26.8 28.5
night W 27.3 27.1 27.1 28.4
Get 6 or less hours of sleep on an average school night U 45.1 46.1 45.1 43.1
W 45.3 46.3 45.5 43.9
Agree or strongly agree with the statement “My family U 82.3 84.6 84.4 82.8
gives me help and support when I need it” W 82.8 84.5 84.1 82.5
Agree or strongly agree with the statement “In my U 82.8 84.7 86.5 86.5
family there are clear rules about what I can and cannot
W 83.1 84.9 86.3 86.2
do”
Agree or strongly agree with the statement “I get a lot U 65.6 65 62.6 59.8
of encouragement at my school” W 66.1 65.2 63 60
Agree or strongly agree with the statement “In my U 57.7 59.2 58.1 57.5
community I feel like I matter to people” W 57.8 59.1 58 56.5
Know of one or more adults (other than their parents) U 82.7 82.9 83 81.8
they can go to and discuss important questions about W 83.1 83 82.6 81.6
their life
Spend one or more hours per week helping others U 53.6 52.3 54.2 36.3
without getting paid (volunteering) (Count such things
as helping out at church/temple/mosque, a hospital,
daycare center, food shelf, youth program, community W 53.6 52 53.9 36.1
service agency or doing other things to make your
city/town a better place for people to live)

47