KNOXVILLE, Tenn. — The Knox County Health Department's Roberta Sturm said as the times change, so do risk rates among young people.
"Some of these behaviors don't just occur in high school they happen earlier than that," she said.
Its new survey takes a look at just that.
"The risk behaviors that we look at lead to leading causes of death among our youth," Sturm said.
She is talking about behaviors like self-harm, violence, alcohol and drug use and weight control.
"Our goal is to always prevent disease and prevent illness and to prevent death," she said.
The department's findings show almost 1 out of 5 middle school students reported trying alcohol other than a few sips. While nicotine use among middle school students was cut in half the CDC added another form of smoking to the survey.
"This is the first time we have added a question about vaping, vaping products," she said.
It found nearly 9% used a vapor product at least once in the last 30 days. Early risky behaviors is something licensed therapist Melissa Rose said experts are seeing nationwide.
"These behaviors begin very early even in elementary school," she said. "Kids are not as healthy as they used to be."
The survey also shows 1 out of 4 students describe themselves as overweight, which Rose said is also an important part of the conversation.
"All of those things contribute to a healthy kiddo," she added.
That includes mental health. The numbers note 11% of students reported making a suicide plan. Sturm said that matters.
"Things like being bullied can contribute to a suicidal ideation," she said.
While some of the data may be surprising, the health department said it is necessary to warn parents and the community.
"The earlier it's addressed, the earlier these children can get help," she said.