This survey on the health status of Native American adolescents living on or near reservations was completed by 14,000 American Indian and Alaska Native youths from 50 tribes attending 200 schools in 12 states. Results indicate that most Native teenagers felt their family cared about them a great deal, and many would go to a family member first for help. Youths whose parents had high expectations of them did better in school. Twenty percent of respondents reported their health as only fair or poor. Those with poor health also reported numerous other problems in school and at home and tended to abuse drugs and be suicidal as well. Obesity was a serious problem, which was compounded in many communities where diabetes was a significant risk. Deaths from unintentional injuries, particularly motor vehicle injuries, were higher among American Indian youth than among any other ethnic and age group. These youth frequently engaged in behaviors that increased their risk for injuries. Alcohol use and tobacco use were very prevalent, followed by marijuana and inhalant use. Heavy use of substances, particularly alcohol and marijuana, was linked to every risk behavior discussed in this report. As the second leading cause of death for American Indians, suicide is a serious problem, and was strongly associated with emotional stress, substance abuse, and family problems. About two-thirds of American Indian high school seniors reported sexual activity, but contraceptive use was inconsistent. Challenges and opportunities related to these findings are discussed. (TD)