OBJECTIVES: The goal stated in the United States (US) Healthy People is that third-quarters of adults will use sun protection by 2020 to reduce the risk of skin cancer. Prior studies largely focused on examining sun protective behaviors across gender and race. However, little is known about whether/how sun protective behaviors differ by age. Thus, we examined the association between age and sun protective behaviors, adjusting for potential confounders.

METHODS: This cross-sectional study included a nationally representative of US adults without any skin cancer from the 2015 National Health Interview Survey. Age was categorized into 18-29, 30-49, 50-69, and ≥70 years old. Sun protective behaviors included: 1)wearing sun-protective clothing, 2)shade use, 3)hat use, 4)sunscreen use, and 5)infrequent indoor tanning device use. We estimated the national prevalence for having sun protective behaviors (and any individual behavior) by age group. We used a weighted multivariable logistic regression model to examine the association between age and sun protective behavior adjusting for sociodemographic and health status factors (e.g., smoking). Adjusted odds ratios (aORs) with 95% confidence interval (95%CI) were reported.

RESULTS: Among eligible 236,234,809 participants in 2015, 21.6% aged 18-29, 34.6% aged 30-49, 31.8% aged 50-69, and 12.0% aged ≥70. When compared with participants aged 18-29, participants aged 50-69 (aOR=1.83, 95%CI=1.49-2.25) and aged ≥70 (aOR=6.24, 95%CI =4.07-9.58) were associated with having more sun protective behaviors. Findings were consistent for wearing sun-protective clothing (age 50-69:OR=1.61, 95%CI=1.45-1.79;age ≥70:OR=3.64, 95%CI=3.21-4.12), shade use (age 50-69:OR=1.41, 95%CI=1.27-1.56;age ≥70:OR=2.14, 95%CI=1.88-2.43), and using indoor tanning device (age 50-69: OR=0.64, 95%CI=0.54-0.74; age ≥70: OR=0.22, 95%CI=0.17-0.28).

CONCLUSIONS: Younger Americans were less likely to have sun protective behaviors compared to older adults. The findings suggest that healthcare providers may encourage younger individuals wearing sun-protective clothing and shade protection, and reducing indoor tanning exposure. Environmental and policy strategies can focus on provision of shade in school and recreational settings.