Despite efforts to drum good health habits into young American adults early, they still make harmful choices.
They binge drink, smoke cigarettes and develop sexually transmitted diseases. They exercise less than they did when they were teens and are less likely to carry health insurance or visit doctors or dentists.
It's unclear whether such declines are more proof that young people go through a brief period of sowing wild oats or that this generation is launching a lifetime of trouble.
A large study led by UNC-Chapel Hill researchers, the first of its kind, aims to answer those questions. But findings released Wednesday are already turning heads among public health experts.
"It's stunning," said UNC-Chapel Hill researcher Kathleen Mullan Harris. "We looked at 20 areas, and 16 out of the 20 showed declines in health indicators."
Using data collected by nearby Research Triangle Institute, Harris and her team analyzed information on about 14,000 young people ages 18 to 26 from across the country. All had participated in earlier surveys that captured their pre-adult behaviors.
The results are clear on one important fact: Young people from distinct racial groups wade into different types of trouble.
African-Americans, for instance, generally smoke and drink less than others. But they are more likely to risk obesity by eating junk food and skipping exercise.
Whites are most likely to indulge in binge drinking and light up cigarettes. But they work out more and are more likely to have health insurance.
Hispanics are least likely to have medical coverage. Native Americans score poorly on developing asthma and using illegal drugs.
Young Asian-Americans appear to sustain the healthiest habits.
"The disparities vary so much. It isn't one race or ethnic group that's always worse off," Harris said.
Kelli Post, a 24-year-old manager of a Starbucks in the American Tobacco Historic District in Durham, wasn't surprised Wednesday by news that young adults slide into bad habits.
As a high school student, Post ran track and ate her vegetables. While an undergraduate at East Carolina University, she indulged in a lot of Bojangles and Papa John's dinners, smoked cigarettes and drank "whatever was on sale" beer.
In retrospect, she credits much of that to losing a specific influence in her daily life.
"When I was in high school, I was health-conscious about everything because my mom was," Post said. In the past year, she has worked hard to break some bad habits, giving up the smokes and exercising more.
"Once you get to a certain age and get a couple of wrinkles and put on a couple of pounds, you start taking care of yourself," she said.
People who observe young adults up close hope that is usually the case. But they are not sure it is.
Dr. Tanika Day, a Duke University community and family doctor, sees a troubling rate of obesity among teenage and young adult patients. She blames parents' worries that outside play is dangerous and too much time playing computer games. And low-cost, high-fat fast food is prevalent in every town, which doesn't help.
"I think it's a new thing we're dealing with," Day said, noting that many of the young people don't heed the health warnings that abound.
Knowing for sure that young adults practice poorer health habits than teenagers could be highly useful to public health experts, said Christine Bachrach, chief of the demographic and behavioral science branch of the National Institute of Child Health and Human Development.
"We've been very focused on teenagers. Maybe we need to look beyond the teenage years," said Bachrach, whose institute has funded Harris' surveys.
Bachrach wonders whether young people today are slower to slip into stages -- say, marriage or launching careers -- that tend to moderate risky behaviors.
Harris, the UNC researcher, says high schools may have to better prepare adolescents about the importance of taking care of themselves after they graduate.
"They need to know about the long-term consequence of engaging in such behaviors," she said.
Harris landed $50 million from NIH to capture the health habits of the same group as teenagers and young adults. Now she is working to get more funding to check back with them as they age into their early 30s.
"Maybe this is a transitional period with no impact. Maybe these young people get married, cut back drinking, quit smoking and their diet improves," Harris said. "I can't wait to find out."
Staff writer Catherine Clabby can be reached at 956-2414 or firstname.lastname@example.org.