Understanding relationships between education, health and well-being among young people: what can the HBSC study contribute? Professor Candace Currie HBSC International Coordinator Director, Child and Adolescent Health Research Unit (CAHRU), University of Edinburgh

Health Behaviour in School-aged Children A World Health Organisation Collaborative Cross-national Study

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC purpose and scope To gain new insight and increase our knowledge and understanding of adolescent health in social and developmental context

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC background Initiated in 1982 in three countries Initiated in 1982 in three countries Adopted as WHO Collaborative Study Adopted as WHO Collaborative Study First cross-national survey in 1983/4 in 5 countries First cross-national survey in 1983/4 in 5 countries Gradual growth in study membership Gradual growth in study membership Now 43 participating countries: Europe/ North America Now 43 participating countries: Europe/ North America HBSC international network of ~ 300 researchers from different disciplines HBSC international network of ~ 300 researchers from different disciplines Growing interest in HBSC globally Growing interest in HBSC globally

Health Behaviour in School-aged Children: WHO collaborative cross-national study

HBSC development Drivers Perceived need for comparative data Perceived need for comparative data To describe how health varies among young people in different countries To describe how health varies among young people in different countries To understand determinants of health and patterns of health and behaviour To understand determinants of health and patterns of health and behaviour Need for reliable research evidence to inform policy and practice for health improvement Need for reliable research evidence to inform policy and practice for health improvement

Health Behaviour in School-aged Children: WHO collaborative cross-national study Conceptual framework HBSC Broad definition of health – encompassing WHO (1948) concept of complete complete physical, mental and social well-being; not merely the absence of disease Broad definition of health – encompassing WHO (1948) concept of complete complete physical, mental and social well-being; not merely the absence of disease Health related behaviours are part of adolescent lifestyles Health related behaviours are part of adolescent lifestyles Health and behaviour considered in social context – socio-ecological perspective Health and behaviour considered in social context – socio-ecological perspective

Health Behaviour in School-aged Children: WHO collaborative cross-national study Scientific challenges HBSC Development of common indicators (e.g. mental health, alcohol use, school environment) Development of common indicators (e.g. mental health, alcohol use, school environment) Development of common measures translated to produce comparable data Development of common measures translated to produce comparable data Based on common concepts Based on common concepts Systematic methods of data collection Systematic methods of data collection Quality control at all stages Quality control at all stages

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC surveys Surveys conducted every four years at same time in each country Surveys conducted every four years at same time in each country School based surveys of 11, 13 and 15 year olds: nationally representative random samples School based surveys of 11, 13 and 15 year olds: nationally representative random samples Self-complete questionnaire administered in class time Self-complete questionnaire administered in class time National data files combined to create international data file National data files combined to create international data file

Health Behaviour in School-aged Children: WHO collaborative cross-national study Well-being among adolescents Many dimensions of well-being in this age group Many dimensions of well-being in this age group Young people’s feelings about their health and about their lives Young people’s feelings about their health and about their lives Expressed in their behaviour and lifestyles Expressed in their behaviour and lifestyles Quantified by their life circumstances Quantified by their life circumstances

Health Behaviour in School-aged Children: WHO collaborative cross-national study Health related behaviours HBSC Tobacco, alcohol and cannabis Tobacco, alcohol and cannabis Physical activity Physical activity Consumption of food and drinks Consumption of food and drinks Toothbrushing Toothbrushing Weight control behaviour Weight control behaviour Fighting and bullying Fighting and bullying Sexual behaviour Sexual behaviour TV and computer use TV and computer use Electronic communication Electronic communication

Health Behaviour in School-aged Children: WHO collaborative cross-national study Health and well-being HBSC Self-rated health Self-rated health Life satisfaction Life satisfaction Health complaints Health complaints Body image Body image Body Mass Index (BMI) Body Mass Index (BMI) Injuries Injuries

Health Behaviour in School-aged Children: WHO collaborative cross-national study Social context HBSC Social context HBSC School experience School experience Peer relations Peer relations Family life Family life Socioeconomic circumstances Socioeconomic circumstances

Health Behaviour in School-aged Children: WHO collaborative cross-national study Inequalities in adolescent well-being According to: Gender Gender Age Age Socioeconomic status Socioeconomic status Geography Geography ‘Inequalities in Young People’s Health’ ‘Inequalities in Young People’s Health’ Currie et al (2008). WHO Copenhagen Findings from HBSC 2005/6 Survey

boys girls Life Satisfaction Inequalities in Young People’s Health (Currie et al, 2008).

Family Affluence Life satisfaction Inequalities in Young People’s Health (Currie et al, 2008).

Family Affluence Perceived school Performance Inequalities in Young People’s Health (Currie et al, 2008).

Age, Gender, and Geography Inequalities in Young People’s Health (Currie et al, 2008).

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC evidence of school effects on health and well-being Low school satisfaction has negative impact seen in smoking, alcohol and cannabis use; poorer self rated health; higher rates of somatic and psychological symptoms Low school satisfaction has negative impact seen in smoking, alcohol and cannabis use; poorer self rated health; higher rates of somatic and psychological symptoms High academic achievement impacts positively on reported health complaints; life satisfaction; smoking and alcohol use; and healthy eating High academic achievement impacts positively on reported health complaints; life satisfaction; smoking and alcohol use; and healthy eating School stress impacts negatively on health complaints, self-reported health, life satisfaction and well-being School stress impacts negatively on health complaints, self-reported health, life satisfaction and well-being

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC evidence of school effects on health and well-being HBSC 2002 International Report HBSC 2002 International Report ‘The Social Context of Young People’s Health’ HBSC 2006 International Report HBSC 2006 International Report ‘Inequalities in Young People’s Health’ See publications page for list of journal articles on this topic See publications page for list of journal articles on this topicwww.hbsc.org

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC contribution Understanding the role school can play in adolescent well-being is a main area of HBSC research activity Understanding the role school can play in adolescent well-being is a main area of HBSC research activity Investigating impact that health and well-being can have on school related indices - less HBSC research in this area to date Investigating impact that health and well-being can have on school related indices - less HBSC research in this area to date Explaining geographic inequalities in school and health experience – requires understanding of social, cultural and economic determinants Explaining geographic inequalities in school and health experience – requires understanding of social, cultural and economic determinants

Health Behaviour in School-aged Children: WHO collaborative cross-national study HBSC future work Developing a range of indicators to capture school experience – expanded set of optional modules in 2009/2010 survey Developing a range of indicators to capture school experience – expanded set of optional modules in 2009/2010 survey Continuing to develop new indicators of adolescent well-being for next survey in 2013/2014 Continuing to develop new indicators of adolescent well-being for next survey in 2013/2014

Health Behaviour in School-aged Children: WHO collaborative cross-national study Young people we study Young people we study The HBSC Network The HBSC Network The HBSC partner WHO The HBSC partner WHO Funding organisations Funding organisations HBSC Acknowledgements Further information at