Health-related behaviours cluster
Many of the health-related behaviours that emerge during adolescence tend to cluster in certain individuals.37 For example, adolescents who use tobacco are more likely to drink alcohol as well, to be involved in bullying or fighting and to be injured.38 This clustering is even more likely when the onset of tobacco use or drinking or sexual behaviour occurs in early adolescence, rather than after age 15 or 16, which appears to be more normative in many countries. This clustering may result from interactions among the social determinants of health. Thus, interventions that focus on these determinants may influence more than one health-related behaviour.
Positive health indicators
While most student health surveys monitor health risks and problems, increasingly these surveys are also monitoring protective or preventive health-related behaviours or measures of positive youth development and health.
Self-rated health is a measure of quality of life and strongly linked to both measures of actual health status and lower involvement in health-compromising behaviours.39 The question is asked in the HBSC but not the GSHS. Among countries in Europe and North America that participated in the HBSC, the majority of younger adolescents rated their health as “good” or “excellent”, although the percentages varied among countries. In most countries boys were more likely than girls to rate their health as good or excellent.
Supportive relationships. Measures of positive or supportive relationships with parents or of family connectedness are strongly linked to adolescents’ healthy development. Several different questions have been developed that measure various aspects of supportive relationships. Generally, a combination of measures shows the strongest correlation with health and well-being.40 Still, a few specific indicators are illustrative.
For example, the GSHS asks how much adolescents feel that their parents understand their problems and worries, an important gauge of parental support. The percentage of younger adolescents who feel that their parents understand their problems most of the time or always ranges from two-thirds of boys in Uruguay and 68% of girls in Sri Lanka to 15% of boys and girls in Kiribati.
Adolescents’ perception that parents’ know of their daily activities, in combination with warm parental relationships, has been shown to contribute over time to fewer health-compromising behaviours.41 In about one-third of the 67 countries with GSHS data, more than half of adolescent girls report that their parents always or mostly know what they are doing during their free time. Parents appear to be less likely to know what their sons are doing. More than half of boys report that their parents always or mostly know about their activities during free time in only 12 of the 67 countries.
Parental and peer support (HBSC)School connectedness is another important protective factor, linked to positive youth development in a number of surveys over the years. One measure of school climate has been survey respondents’ perception whether students are mostly or always kind (GSHS) or classmates are kind and helpful (HBSC). These measures vary widely, from more than 80% of students in countries such as Sweden and Iceland to 11% for boys and 5% for girls in Barbuda. In general, girls appear to be slightly more likely than boys to feel that students are kind.
Parental and peer support (GSHS)
Adolescent on bad habits: To party and escape your daily troubles!
male, 15-17, France
Sometimes it's just hard to pass up on something that tastes so good even if it is bad for your body. I have to remind myself that part of the reason it does taste so good is because of the added artificial flavouring or excess sugar content.
female, 18-19, United States of America
I feel stress over sexual issues - no one wants to give me information, and I also get anxious because I feel that I am doing something wrong.
male, 15-17, Mexico
Adolescents on what should be done to improve their health: Raising awareness about sexual identities and orientation.
trans, 12-14, Argentina
I think I am physically and mentally healthy, but I feel emotional pain as a result of many different things that have happened over time.
female, 18-19, Mexico
I love drinking and partying, I do it quite often. I also smoke quite often.
male, 18-19, France
I haven’t learned about what I should and shouldn’t eat.
female, 18-19, Mexico
It’s basically a thing you do, in part because of the social aspect of these activities, in part, and this especially counts for the cigarettes, as a stress reliever.
male, 18-19, Denmark
Adolescents on bad habits: Sometimes laziness and inactivity, I'm not doing sports, and excessive eating of sweets and harmful foods and soft drinks and fruit after midnight.
female, 15-17, Saudi Arabia
When I became sexually active I never wore a condom, and I didn’t know how to use one.
male, 18-19. Mexico
I just wanted to test it out, then it became a habit.
female, 15-17, France
To be in good health not only means taking care of your body (through participating in sports, eating well, etc.) or just the absence of illness; it also equally involves feeling good in your own skin, being happy with your choices in life and doing what you love.
female, 15-17 Canada
Give us real information about our rights and about sexual health. Also information about nutrition and healthy behaviours.
male, 15-17, Mexico
Each individual has his or her own life philosophy. I have my own life philosophy: Enjoy the present moment and take each day at a time. Enjoy the moments of youth that are supposed to be the greatest of our existence. It is the age of excess.
male, 18-19, France
I love sweets, and I haven’t found a balance between normal and excessive consumption.
female, 18-19. Venezuela
Adolescents on definition of health: To have the ability to do things well, without any sort of discomfort or pain. To ensure a comfortable future, without any complications like diabetes or any sort of cardiac disease, etc., caused by what was done in the past.
female, 18-19, Mexico
Physically I am in good health, but mentally only partially because several obstacles find their way along my path, affecting my mental health, and I have to overcome them.
female, 15-17, Canada
Adolescents on bad habits: it’s a quicker and easier way to satisfy my hunger. I like to eat.
female, 12-14, Peru
That cigarettes, alcohol and drugs not be in style anymore.
female, 15-17, France
Adolescents on definition of health: To find myself comfortable with body, and to feel nothing that could make me feel bad about or within myself.
female, 18-19, Spain
