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Parental Permission, Survey Opt Out Will Affect Data on Young Iowans, Advocates Say

Iowa won’t join Youth Risk Behavior Survey for first time since 1991.

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Plans to discontinue the Iowa Youth Risk Behavior Survey and a new barrier for surveying Iowa students pose a threat to data collected on youth behaviors, advocates say, specifically young transgender Iowans.

The Iowa Department of Health and Human Services (HHS) has no plans to administer the Youth Risk Behavior Survey this academic year, the first time since the survey started in 1991.

In a letter sent to Youth Risk Behavior Survey advisory committee members, Robert Kruse, the state medical director for the Iowa Department of HHS, announced Iowa will not participate in the 2023 Center for Disease Control and Prevention’s (CDC) youth risk behavior survey.

“The Iowa Department of HHS will not be participating in the CDC’s Youth Risk Behavior Survey in 2023 in order to focus our efforts on maximizing the state administered Iowa Youth Survey (IYS) and improving survey participation,” Kruse’s Jan. 27 letter to YRBS advisory committee members said.

The nationwide survey overseen by the CDC is administered every two years and asks students about their behaviors and relationships with authority figures, drugs, alcohol, sexual activity and gambling, to name a few.

Although students in Iowa will still be offered the IYS, they can not take it unless a parent has seen the survey in advance and given permission for their student to take it.

Parental permission

Senate File 496, signed into law by Gov. Kim Reynolds on May 26, requires that students must receive permission from their parents before taking a survey at school. The law prevents students from taking surveys “designed to assess the student’s mental, emotional or physical health that is not required by state or federal law” without first acquiring the written consent of the student’s parent or guardian.

Parents must receive at least seven days notice of the survey, as well as a copy of the survey.

The law also bans school library books containing written or visual sex acts, prohibits schools from teaching about “gender identity” or “sexual orientation” before sixth grade, prohibits a student from using a name or pronoun than they were given at birth and prevents teachers from knowingly providing “false or misleading” information on a child’s gender identity to their parents.

Jenn Turner, chapter chair for the Polk County Moms For Liberty, sees student surveys as a way for young people to get ideas about things they may not have thought about before.

“We have found that many parents are not aware of what questions are being asked,” Turner said. “It ranges from what vegetables you eat to how many sexual partners to if you have considered suicide for children as young as 11. Some parents may determine that these questions are too mature, or cover topics their children are not ready for or do not understand.”

Turner and Moms For Liberty support the recent law change, saying that it gives control to parents and allows for more transparency about what is going on in school.

“Parents are the number one advocates for their children,” Turner said. “They should ultimately be making these decisions for their children. This law provides another tool to help parents understand what is presented to their children in school.”

Advocates of the IYS say this law will limit participation and usable data. The extra step of taking home a permission slip and having it signed and returned to a classroom will keep some students from taking the survey, in addition to parents who do not permit their children to take the survey.

Anne Discher, executive director of Common Good Iowa and member of the Iowa YRBS advisory committee, acknowledges permission from parents during school registration as reasonable but believes useful data could be harder to collect with permission required for individual surveys throughout the year.

Parental permission could skew results in another way, according to Discher.

“Certainly one might assume that the types of parents who would opt out might have things in common,” Discher said. “It could skew the survey and I think generally speaking the concern would be that participation would be so low you might not get useful data anyway.”

In a Feb. 23 committee meeting for Senate File 496, State Sen. Herman Quirmbach raised a potential unintended consequence he sees with parental permission.

“The unintended consequence of that may be to protect child molesters,” Quirmbach, D-Ames, said. “If a survey to a student asking about that student’s mental state or their social state, if the parent can deny their student the ability to participate in that survey, then an abusive parent can use that denial to help shield them from any consequence of their child abuse.”

The surveys are anonymous, but survey data could skew if Quirmbach’s speculation is correct, ultimately affecting future legislation and policy decisions.

Data disaggregation

Surveys like the risk behavior survey and the IYS are used by health departments, educators, lawmakers, doctors and community organizations to make policy decisions, direct campaigns and give direction to research.

One question from the CDC’s 2021 Iowa Youth Risk Behavior Survey (Iowa Department of Health and Human Services)

The most recent risk behavior survey asked students about their gender identity; the IYS did not.

According to Discher, one of the goals of the Department of HHS in the past was to increase participation in student surveys to allow for the disaggregation of data.

“It was a strong goal to be able to disaggregate it by race and ethnicity, for example, or by LGBTQ+ status,” Discher said. “The conversations we had always had were how can we get more schools to participate so we can have better data for subgroups.”

Eventually, there was a sense of pushback contrary to the former beliefs and goals of the department, Discher says.

“I find that this pushback which came from somewhere in the department or maybe not in the department,” Discher said. “I don’t know where the push for all of this came from, but it is very much counter to all of the work that we had seen the department do up to this point, which was try to get more data, better data, to disaggregate the data so they could really understand what was happening with youth in Iowa.”

According to Kruse’s letter to the committee, the Iowa Youth Survey will be revised, but the revisions are not currently public, if finished. It is unclear if the IYS will enable disaggregation of data for students who identify as transgender.

“In advance of IYS in the fall of 2023, HHS will conduct a comprehensive review of survey administration,” Kruse said. “Most importantly, we are reviewing the analysis-to-action strategy and how HHS can tailor the data collection to inform how we meet the needs of Iowa youth, families, schools and communities.”

Without the Iowa youth risk behavior survey, and if the IYS is not revised to include a question about gender identity, disaggregating data for trans youth will not be possible.

“I find it sad that that’s a piece of data that we are going to lose,” Discher said. “I find it kind of cynical that the state Legislature took all of these moves to make life worse, in particular for trans kids. To deny them gender-affirming care, to make them feel less like they’re an important member of their community and now we aren’t going to collect data on mental health for that group.”

Although the letter sent to YRBS committee members stated Iowa would not participate in the risk behavior survey to focus efforts on maximizing the IYS participation, the survey switch-up feels more intentional than maximizing efforts, according to Discher.

“It is very hard for me to look at it and not understand it as part of a larger anti-trans push in our state,” Discher said. “In the Legislature, we passed a lot of very punitive, harmful bills and now we’re going to stop collecting data on the well-being of the kids that they’re harming. Did anyone sit and think of it in that exact way? I don’t know, but it’s very hard to not interpret it that way.”

The 2021, IYS did include a question asking students their sexual orientation, with answer options of straight, gay or lesbian, bisexual, another identity or not sure.

Explaining the examinations

The survey was first administered in 1991, with 26 states participating. Survey participation peaked at 47 four times; 2009, 2011, 2013 and 2015. 

National participation in the 2021 Youth Risk Behavior Survey. Minnesota has never participated in the survey. Oregon has participated in 8 of 16 distributions of the survey, and Washington 2 of 16. (cdc.gov)

Iowa will be one of seven states not participating in the survey in 2023, joining Colorado, Idaho, Florida, Minnesota, Oregon, Washington and Wyoming.

The reasoning for participation varies from state to state and many states have their own survey as a replacement or in addition to the CDC’s survey.

According to CDC.gov, the youth risk behavior data helps health departments, educators, lawmakers, doctors and community organizations to inform school and community programs, communications campaigns and other efforts. The survey measures health-related behaviors and experiences that may lead to death and disability among youth and adults.

Although the IYS asks similar questions as the risk behavior survey, IYS is only taken statewide, so results cannot be easily compared among other states. Data from the IYS, though, can be broken up into smaller regions of Iowa, compared to the risk behavior survey, which gives data for youth in the state as a whole.

“The national survey only reports state-level data which makes it impossible to identify areas of the state with the greatest needs,” Alex Carfrae, public information officer for the Iowa Department of HHS said in an email response to the Iowa Capital Dispatch.

IYS data is reported and analyzed at multiple jurisdiction levels, allowing more specific, targeted decisions to be made for specific areas such as counties, judicial districts and Area Education Agencies.

The two surveys have a history in Iowa, with the youth risk behavior survey taken every other year since 1991 and the Iowa youth survey taken every other year since 1999.

The IYS is answered by students in grades 6, 8 and 11, where the youth risk behavior survey has only been offered to students in grades 9-12. The CDC does offer a middle school version of the youth risk behavior survey, but Iowa has never participated.

Iowa Capital Dispatch is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Iowa Capital Dispatch maintains editorial independence. Contact Editor Kathie Obradovich for questions: info@iowacapitaldispatch.com. Follow Iowa Capital Dispatch on Facebook and Twitter.

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