Factors associated with unhealthy behaviours and health outcomes: a cross-sectional study among tuscan adolescents (Italy)

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Abstract

Background

We aimed to determine the extent to which three core variables (school environment, peer group and family affluence) were associated with unhealthy behaviours and health outcomes among Tuscan adolescents. The unhealthy behaviours considered were smoking, alcohol consumption, sedentary lifestyle and irregular breakfast consumption; health outcomes were classified as self-reported health, multiple health complaints and life satisfaction. School environment was measured in terms of liking school, school pressure, academic achievement and classmate support; peer groups were evaluated in terms of the number of peers and frequency of peer contact. Family affluence was measured on a socioeconomic scale.

Methods

Data were taken from the Tuscan 2009/10 survey of “Health Behaviour in School-aged Children”, a WHO cross-national survey. A binary logistic multiple regression (95% confidence intervals) was implemented.

Results

The total sample comprised 3291 school students: 1135 11-year-olds, 1255 13-year-olds and 901 15-year-olds. Peer group and school environment were associated with unhealthy behaviours such as smoking, alcohol consumption and sedentary lifestyle. Family affluence proved to have less impact on unhealthy behaviours, except in the case of adolescents living in low-income families. Poor health outcomes were directly related to a negative school environment. Regarding the influence of family affluence, the results showed higher odds of life dissatisfaction and poor self-reported health status in medium-income families, while low-income families had higher odds only with regard to life dissatisfaction. A consistent pattern of gender differences was found in terms of both unhealthy behaviours and health outcomes.

Conclusions

Unhealthy behaviours are strongly related to the school environment and peer group. A negative school environment proved to have the strongest relation with poor health outcomes.

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Most cited references 31

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Subjective health complaints in adolescence--reliability and validity of survey methods.

B Wold, S Haugland (2001)

This paper studies test-retest reliability and validity of one measure of adolescent health complaints. The test-retest included an eight-item symptom checklist developed for the survey of Health Behaviour in School-aged Children (n=344). Qualitative analysis showed adequate validity for most items. For the total sample, all items were found to have adequate intraclass correlation coefficients (ICC) in the range 0.61-0.75. There were inter-item differences and girls generally received the higher values. Most changes were within one category. Adolescents' understanding of 16 complaints was studied by interviews with 38 adolescents. A few items showed ambiguity in interviews despite adequate test-retest stability. Copyright 2001 The Association for Professionals in Services for Adolescents.

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Health inequalities in the early years: is there equalisation in youth?

Keith P. West (1997)

In the light of a still prevalent view that health inequalities are an invariant feature of the life-course, this paper re-examines the thesis that youth, in contrast to childhood, is characterised by relative equality in health, and proposes a process of equalisation to account for changes in the social class patterning of certain dimensions of health between these life stages. The evidence relating to the relationship between class of background and health over the early years is first reviewed, focusing on seven dimensions of health: mortality, chronic illness, specific conditions, self-rated health, symptoms of acute illness, accidents and injuries, and mental health. The overall picture is consistent with a conclusion of relative equality of health in youth with one major exception, severe chronic illness, which particularly on the evidence of the 1991 British Census is class differentiated from infancy. In respect of other dimensions of health, notably symptoms, non-fatal accidents and (probably) mental health, there is evidence of a change in class patterning between childhood and youth consistent with a hypothesis of equalisation. Within a theoretical perspective that juxtaposes class and age (youth) based influences, it is suggested that this could occur when effects associated with the secondary (high) school, the peer group and youth culture cut across those of the family, home background and neighbourhood in such a way as to reduce or remove class differences in health. In later youth, in the post-school period, the relative balance of class and age based shifts once more to produce a "re-emergence" of class gradients in adulthood. Youth may be a barometer of the relative power of post-modern consumer culture and traditional class based structures to shape the pattern of health inequalities over the early years into adulthood.

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Overweight in school-aged children and its relationship with demographic and lifestyle factors: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study.

Ulrike Ravens-Sieberer, M R Iannotti, Colette Kelly … (2009)

To examine overweight prevalence and its association with demographic and lifestyle factors in 11-15 year olds in the HBSC 2005-2006 survey. Self-reports of height, weight, eating patterns, physical activity and sedentary behaviours were obtained from nationally representative samples in 41 countries (n=204,534). Overweight prevalence was highest in USA (28.8 %) and lowest in Latvia (7.6 %). In most countries, overweight was more prevalent in boys than girls. Overweight was consistently negatively associated with breakfast consumption and moderate to vigorous physical activity; OR range: 0.48-0.79 and 0.50-0.78, respectively. Overweight prevalence in youth remained high across the countries examined. The primary factors linked to overweight were breakfast consumption and physical activity. These data should contribute to formulating preventive programs and policies.

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Author and article information

Contributors

Giacomo Lazzeri: lazzeri@unisi.it

Elena Azzolini: elenazzolini@hotmail.com

Andrea Pammolli: pammolli2@unisi.it

Rita Simi: simir@unisi.it

Veronica Meoni: asianica2003@yahoo.it

Mariano Vincenzo Giacchi: giacchi@unisi.it

Journal

Journal ID (nlm-ta): Int J Equity Health

Journal ID (iso-abbrev): Int J Equity Health

Title: International Journal for Equity in Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-9276

Publication date (Electronic): 25 September 2014

Publication date PMC-release: 25 September 2014

Publication date Collection: 2014

Volume: 13

Issue: 1

Electronic Location Identifier: 83

Affiliations

[ ]CREPS-Research for Health Education and Promotion, University of Siena Italy, Siena, Italy

[ ]Department of Molecular and Developmental Medicine, University of Siena Italy, Via A. Moro 2, 53100 Siena, Italia

[ ]Department of Public Health, Catholic University of the Sacred Heart, Roma, Italy

[ ]Local Health Unit 7, Siena, Italy

Article

Publisher ID: 83

DOI: 10.1186/s12939-014-0083-5

PMC ID: 4188876

PubMed ID: 25252790

SO-VID: 270542bf-4b25-4c79-bd6c-f4d5513ac1d6

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 26 March 2014

Date accepted : 10 September 2014

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ScienceOpen disciplines: Health & Social care

Keywords: inequalities in health,peers,school environment,fas,nutritional status

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ScienceOpen disciplines: Health & Social care

Keywords: inequalities in health, peers, school environment, fas, nutritional status

Factors associated with unhealthy behaviours and health outcomes: a cross-sectional study among tuscan adolescents (Italy)

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Tobacco Prevention & Cessation

Most cited references 31

Subjective health complaints in adolescence--reliability and validity of survey methods.

Health inequalities in the early years: is there equalisation in youth?

Overweight in school-aged children and its relationship with demographic and lifestyle factors: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study.

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