A descriptive study of youth risk behavior in urban and rural secondary school students in El Salvador

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Abstract

Background

Adolescence is an important stage of life for establishing healthy behaviors, attitudes, and lifestyles that contribute to current and future health. Health risk behavior is one indicator of health of young people that may serve both as a measure of health over time as well as a target for health policies and programs. This study examined the prevalence and distribution of youth health risk behaviors from five risk behavior domains–aggression, victimization, depression and suicidal ideation, substance use, and sexual behaviors–among public secondary school students in central El Salvador.

Methods

We employed a multi-stage sampling design in which school districts, schools, and classrooms were randomly selected. Data were collected using a self-administered questionnaire based on the United States Center for Disease Control and Prevention's Youth Risk Behavior Survey. Sixteen schools and 982 students aged 12–20 years participated in the study.

Results

Health risk behaviors with highest prevalence rates included: engagement in physical fight (32.1%); threatened/injured with a weapon (19.9%); feelings of sadness/hopelessness (32.2%); current cigarette use (13.6%); and no condom use at last sexual intercourse (69.1%). Urban and male students reported statistically significant higher prevalence of most youth risk behaviors; female students reported statistically significant higher prevalence of feelings of sadness/hopelessness (35.6%), suicidal ideation (17.9%) and, among the sexually experienced, forced sexual intercourse (20.6%).

Conclusion

A high percentage of Salvadoran adolescents in this sample engaged in health risk behaviors, warranting enhanced adolescent health promotion strategies. Future health promotion efforts should target: the young age of sexual intercourse as well as low condom use among students, the higher prevalence of risk behaviors among urban students, and the important gender differences in risk behaviors, including the higher prevalence of reported feelings of sadness, suicidal ideation and forced sexual intercourse among females and higher sexual intercourse and substance use among males. Relevance of findings within the Salvadoran and the cross-national context and implications for health promotion efforts are discussed.

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Most cited references 32

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Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health.

M D Resnick, P. S. Bearman, R W Blum … (1997)

The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. A total of 12118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90118 adolescents from 80 high schools plus their feeder middle schools. The interview was completed in the subject's home. Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P<.001) and violence (grades 7-8: P<.001; grades 9-12: P<.001). Access to substances in the home was associated with use of cigarettes (P<.001), alcohol (P<.001), and marijuana (P<.001) among all students. Working 20 or more hours a week was associated with emotional distress of high school students (P<.01), cigarette use (P<.001), alcohol use (P<.001), and marijuana use (P<.001). Appearing "older than most" in class was associated with emotional distress and suicidal thoughts and behaviors among high school students (P<.001); it was also associated with substance use and an earlier age of sexual debut among both junior and senior high students. Repeating a grade in school was associated with emotional distress among students in junior high (P<.001) and high school (P<.01) and with tobacco use among junior high students (P<.001). On the other hand, parental expectations regarding school achievement were associated with lower levels of health risk behaviors; parental disapproval of early sexual debut was associated with a later age of onset of intercourse (P<.001). Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.

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Emergence of gender differences in depression during adolescence: national panel results from three countries.

Joseph Wade, D Pevalin, John Cairney (2002)

Although the gender gap in depression among adults is well established, the age at which this phenomenon appears during adolescence is less clear. To address this, the authors present a cross-national examination of the emergence of the gender gap in depression during adolescence using national longitudinal panel data from Canada, Great Britain, and the United States. The two-wave, 1994-1996 Canadian National Population Health Survey uses a diagnostic measure across a 24-month interval, providing 12-month prevalence rates of major depressive disorder. The British Youth Panel measures depressive symptomatology across five annual waves beginning in 1995. The two-wave, 1995-1996 National Longitudinal Study of Adolescent Health uses a measure of depressive symptomatology across a 12-month interval. Females have significantly higher rates of depression for each sample overall. When samples are decomposed by age, the gender gap in depression consistently emerges by age 14 across all three national samples, irrespective of the measure used or whether categorical cutoffs or untransformed scale scores are used to assess depressive symptomatology. There is a consistent pattern in the onset of the gender gap in depression at age 14 across all three countries and measures. This consistency provides important etiologic clues concerning underlying causes of depression and identifies at what age diagnosis, treatment, and intervention strategies should be directed.

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Obesity prevalence and trends in Latin-American countries.

C Mazza, C Filozof, Carlos Gonzalez … (2001)

The prevalence of obesity in some lower-income and transitional countries is as high as, or even higher than, the prevalence reported in developed nations, and it seems to be increasing rapidly. In most countries, the prevalence of obesity is higher in women than in men, and higher in urban than in rural areas. Preobesity prevalence is very high in most Latin-American countries. Sixty per cent of the population in Venado Tuerto (Argentina) has a body mass index (BMI) of > or = 25 kg m-2, as do 35% of the population in Brazil, 60% in Mexico, 68% in Paraguay and 53% in Peru. Trends are available from Brazil, where marked increases in the prevalence of obesity have occurred, except in women from higher-income groups. Women from the higher-income quartiles in urban regions experienced a marked reduction in obesity prevalence from 1989 to 1997 (12.8 to 9.2%). Although data in children is scant, the prevalence of undernutrition is decreasing and the prevalence of obesity is high also in Latin-American children. The prevalence of obesity is high even in minority Indian groups. Rapid changes in dietary structure (in particular associated with urbanization) and major changes in the levels of physical activity, both occupationally and during leisure time, may explain these changes.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Int Health Hum Rights

Title: BMC International Health and Human Rights

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-698X

Publication date Collection: 2006

Publication date (Electronic): 11 April 2006

Volume: 6

Page: 3

Affiliations

[1 ]Center for Health for Health Promotion and Prevention Research, University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA

[2 ]Division of Management, Policy and Community Health,, University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA

Article

Publisher ID: 1472-698X-6-3

DOI: 10.1186/1472-698X-6-3

PMC ID: 1459212

PubMed ID: 16608519

SO-VID: b4165522-418d-47da-9153-8c5823483c28

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A descriptive study of youth risk behavior in urban and rural secondary school students in El Salvador

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Abstract

Background

Methods

Results

Conclusion

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Tobacco Prevention & Cessation

Most cited references 32

Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health.

Emergence of gender differences in depression during adolescence: national panel results from three countries.

Obesity prevalence and trends in Latin-American countries.

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