Anticipation of an early death may be a marker of negative health trajectories. The primary aim of this study was to investigate the impact of perceived chances of living to age 35 (perceived survival expectations, PSE) on socioeconomic status and risk behaviors in young adulthood (age 24-32). The secondary aim was to examine predictors of PSE and change in PSE. These aims were met through analyses of the National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-2002 (Wave III) and 2008 (Wave IV; ages 24-32).

At Wave I, one in seven adolescents reported that their chance of living to age 35 was 50-50 or worse. Older adolescents reported lower PSE than their younger-aged peers. Among the foreign-born, increasing time in the U.S. was related to higher PSE. Most respondents reported high or higher PSE at Wave III compared to Wave I. High neighborhood poverty rate, low parental education, black race and perceptions that the neighborhood was unsafe were related to low PSE at Waves I and III. Low Waves I and III PSE predicted lower education attainment and personal earnings at Wave IV controlling for confounding factors like previous family socioeconomic status, sociodemographic characteristics, and depressive symptoms. Low PSE also predicted an increased risk of suicidal ideation and suicide attempt in young adulthood controlling for depressive symptoms and history of suicide among family members and friends. Low PSE additionally predicted smoking at least a pack a day; consuming more than the recommended daily limits for moderate drinking; and using illicit substances other than marijuana at least weekly controlling for previous substance use and depressive symptoms.

PSE can be utilized to identify at-risk youth. Its assessment can be incorporated into discussions with youth about their expectations for their future and prospects for education and employment. Because beliefs about the future are informed by evaluations of present conditions, the promotion of positive future orientations necessitates investment in resources that promote youth development, security and health.