Analysis of sunburn prevalence among US high school students by sex and race/ethnicity (2015-2023)

Summary: Abstract Body: Sunburn in adolescents increases skin cancer risk in some and may signal underlying photosensitivity in others. Photosensitivity, resembling sunburn, can indicate increased risk of systemic conditions like lupus erythematosus (SLE), more common in Black female adolescents. Those with perceived higher Fitzpatrick skin types (FSTs) may not be asked about sunburn, leading to under-recognition of sun sensitivity and related risks. This study examined sunburn prevalence trends among U.S. high school students from 2015 to 2023, analyzing variations by sex and race/ethnicity. We conducted a retrospective analysis of data from the 2015-2023 Youth Risk Behavior Surveys. Sunburn history was defined as ≥ one sunburn in the past 12 months. Linear trend analysis using logistic regression was performed to assess prevalence trends. From 2015-2023, sunburn prevalence among U.S. high school students decreased from 55.8% to 54.7% (p < 0.05). Among males, prevalence decreased from 61.5% in 2021 to 52.0% in 2023; females decreased from 67.9% in 2021 to 57.9% in 2023. By race/ethnicity, Hispanic/Latino students’ prevalence rose from 40.8% in 2015 to 55.2% in 2021, then declined to 41.4% in 2023. Prevalence in White students increased from 72.5% in 2015 to 82.9% in 2021, then decreased to 78.7% in 2023. Black students reported stable rates (15% in 2015, 14.3% in 2023). Black females had higher sunburn rates than Black males across all years. Despite the overall decrease, sunburn remains prevalent and varies significantly by race/ethnicity in high school students. Continued sun safety initiatives are needed to further reduce sunburn rates, especially among individuals with lighter skin phototypes who face higher skin cancer risks. Assessing sunburn history in all individuals, regardless of FST, is essential for identifying photosensitivity in clinical practice. Given their increased risk for SLE, Black adolescents, their families, and clinicians may benefit from tailored interventions addressing the impact of sun-related history on health. DanTasia Welch¹, Arsema Zadu¹, Willow Pastard¹, E. Nikki Pritchett¹, Angel S. Byrd¹, Candrice R. Heath¹ 1. Dermatology, Howard University College of Medicine, Washington, DC, United States. Clinical Research: Epidemiology and Observational Research