American teens say they are not getting enough sleep and they are feeling the weight of stress, according to a teen-led research study of nearly 1,000 youth ages 13 to 19. The news comes as part of the Teens Take on Health report released by National 4-H Council and Molina Healthcare at the 4-H Congressional Breakfast on Capitol Hill yesterday. The report is the culmination of a teen-led, health-focused research initiative that spanned 15 months.

According to the report, American teens are thinking just as much about their emotional and mental health as they are about their physical health, indicating they see health as holistic—mind, body, and soul. Other key report insights include:

  • Obesity is top of mind for American youth. Teens said they knew they and their families needed to eat healthier, drink more water, and exercise more to prevent and reduce obesity.
  • Youth are paying attention to healthcare access issues. Teens indicated that they and their families needed access to healthcare, that healthcare costs are high, and that health insurance is important. Notably, teens also recognized that policymakers played an important role in supporting them, their families, and their communities in their efforts to live healthier.
  • Youth are sleep-deprived and stressed. Perhaps one of the most resounding themes, which emerged across all racial, ethnic, and economic groups, is teens reported they weren’t getting enough sleep, needed help managing and reducing stress, and were concerned about mental health needs in their communities.

The Teens Take on Health initiative began in 2012 with 4-H teen leaders mobilizing their peers in a series of engagement forums, including a social media survey, video response campaign, and town hall meetings across the country. University of Maryland School of Public Health researchers Dr Bonnie Braun and Dr Virginia Brown conducted a qualitative, thematic analysis of the feedback youth shared and identified key themes in the Teens Take on Health report.

“We [young leaders] participated in every critical phase of this study—from helping with research questions and leading the dialogue to confirming the themes—so we are taking seriously teen concerns about sleep, stress, obesity, and health care access,” says Andrea Vessel, youth trustee, National 4-H Council Board of Trustees; member, 4-H Healthy Living Youth Management Team; and student, American University.

Recent studies support the report findings about the sleep-stress-health connection among America’s youth, including:

  • CDC reports only 31% of high school students get the recommended 8 hours of sleep on an average school night. (CDC Youth Risk Behavior Surveillance Survey)
  • Sleep-related problems affect 25% to 40% of children and adolescents. (Journal of Mental Health Policy and Economics)
  • Nearly 1 in 5 teens (18%) say that when they do not get enough sleep, they are more stressed. (American Psychological Association)

“It really is a vicious cycle: sleep-deprivation leads to stress in school, including daytime drowsiness and poor school performance; emotional and mental stress, such as depression and mood problems; physical health problems, including obesity; and high-risk behaviors, such as substance abuse and drowsy driving,” says Dr Martha Molina Bernadett, family physician and founder, Molina Foundation.

Jennifer Sirangelo, president and CEO, National 4-H Council, says,”For more than 100 years, 4-H youth have been on the front lines of providing real-world solutions to urgent priorities, such as the health of our nation. It was only natural that this partnership with Molina Healthcare was birthed out of our organizations’ shared commitment to engaging young people as assets to drive positive change. The next phase of Teens Take on Health will include collaborating with Molina and 4-H youth to assess implications for school and public health policies, as well as for 4-H programming.”

To begin engaging teens on solutions to the sleep-stress-health problem raised in this report, National 4-H Council and Molina Healthcare convened about 100 teens at a Teens Take on Health Action Summit during National 4-H Conference on April 5. During the Action Summit, teens proposed school policy recommendations such as later school start time and time management classes in course curricula; public health guidelines focused on energy drink consumption among the young; and programming and youth development solutions focused on timing for after-school and extracurricular programs.

The full Teens Take on Health report is available at, along with an infographic on the problem of the sleep-stress-health connection among US teens.