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Health Behaviour in School-aged Children (HBSC): World Health Organization Collaborative Cross National Study

Findings from the 2014 HBSC study for England

This report presents the findings for England from the 2014 Health Behaviour in School-aged Children (HBSC) World Health Organization (WHO) collaborative study. It provides an up to date view of adolescent health and well-being in England, and provides an overview of trends in these areas spanning more than a decade (2002-2014).

HBSC continues to provide evidence on young people’s lives and the broad determinants of their health and well-being, including their experiences of friendships, school, family, and community life. In addition, this report also presents new measures that are increasingly being seen as influential health determinants and behaviours for the current generation of young people, including sleep, self-harm, health service use, love and relationships, and spirituality.

Why adolescents?
There are 7.4 million adolescents aged 10-19 living in the UK, accounting for 12% of the population and forming part of 4.8 million UK households (Hagell, Coleman, & Brooks, 2013). Adolescence is a key period of transition within the life course, the navigation of which provides a secure basis for future adult life. The developmental tasks of adolescence are by definition those that mark profound physical, psychological and social changes (Christie & Viner, 2005). Research also indicates that brain development continues throughout adolescence and early adulthood until around 25 years of age (Giedd, 2004). During this period of cognitive development young people develop skills in weighing up risk, moral thinking, political thought and learning from their experiences (Coleman, 2011). Adolescence is also a time of emotional development in terms of identity formation, selfesteem
and resilience (Coleman, 2011) and how emotional health and well-being is constructed during adolescence has important consequences for future life chances.

During this second decade of life the challenges faced by young people in England are considerable, and within the UK there are differences in health and well-being between regions, age groups and the genders that warrant further exploration (Brooks et al., 2009). Poor health in the first two decades of life, possibly more than at any time in the life course, can have a highly detrimental effect on overall life chances, impacting on educational achievement and the attainment of life goals as well as restricting social and emotional development (Currie, Nic Gabhainn, et al., 2008). Prior to 2005, indicators of young people’s health had remained fairly static despite considerable improvements in health outcomes of infants and older people (Viner & Barker, 2005). However in the last decade interest in young people’s health has grown, with “momentum gathering to put adolescents into the centre of global health policies” (Wessely, 2012, p. 1). The increased focus on the health of young people has been mirrored by a number of health improvements, including a reduction in teenage pregnancies, alcohol consumption and tobacco smoking (Hagell et al., 2013). While these changes are positive, Coleman and Hagell (2015) highlight that adolescent health goes beyond simply risk behaviours, and the absence of risk does not necessarily indicate positive health and well-being (Magnusson, Klemera, & Brooks, 2013).

Young people also hold their own generation-specific attitudes and definitions relating to health and well-being which greatly influence how they perceive and act in relation to health behaviours, and which can be very different from adult perspectives (Brooks & Magnusson, 2006; Wills, Appleton, Magnusson, & Brooks, 2008). Consequently, understanding how young people subjectively view their own health, health risks, and quality of life becomes a vital task if effective health promotion and health policies are to be developed.

The health and well-being of children and adolescents in England has attracted increasing attention over the past four years since the publication of the 2010 HBSC England report; notably the Chief Medical Officer dedicated the CMO’s annual report 2012 to young people (Department of Health, 2013).