224. Associating The Social Determinants of Health With The Dreams And Hopes of Teenagers Who Stray In Downtown Areas Late At Night In Japan

Abstract

Social determinants of health are the economic, social, and cultural conditions that affect health and development. We have been conducting late-night adolescent health volunteer activities for the teenagers who stray in downtown areas for over 10 years. Some of the teenagers had failed at home and school but still had dreams and hopes. We aimed to clarify the relationship between social determinants of health and teenagers’ likelihood to have dreams and hopes. Between September 2007 and July 2018, every Saturday night, we conducted health research and support activities for teenagers in public spaces in the downtown areas of Nagoya, Japan. After receiving informed consent, 142 teenagers were interviewed, and field notes were recorded. We asked them about their current life and behavior, connections with friends, school life, economic situation, future dreams and hopes, etc. Then, explanatory variables related to social determinants of health were set with “dreams and hopes” as the dependent variable, and relations for each factor were analyzed by multiple regression model. Girls made up 47.9% (68) of the participants. For all the teenagers, high living standards, high school graduation, and self-esteem were significantly correlated with dreams and hopes (p<0.05). On the other hand, those who were current students showed a significant negative correlation to dreams and hopes. Those who had communication with their families tended to say that they had dreams, however, no significant correlation to dreams and hopes was shown among those with experiences of child maltreatment, self-mutilation, suicidal intention, or drug use, and those who had involvements with the sex industry, gangster organization, or motorcycle gangs. Among the teenagers, 107 (75.4%) answered that they had dreams and hopes. In terms of gender, girls tended to respond that they had dreams. Regarding the contents of these dreams and hopes, 16 girls and three boys had dreams involving marriage or happiness; thus, significant differences were found gender wise (p <0.01). The study revealed that social determinants of health correlated with teenagers’ likelihood to have dreams and hopes. Higher living standards may reflect an economic foundation for the realization of dreams, but parental values regarding professions and education may be confounding factors. In addition, family environments, such as lack of family bonds, may influence teenagers’ dreams and hopes. In addition, girls’ desire to settle and create a happy family after marriage rather than enter society could reflect the gender inequality that has long existed in Japan. Furthermore, students may experience unstable social status and school life due to the stress caused by excessive examination competition. However, we also observed that high school graduation lead to acceptance of dreams and hopes among teenagers. Thus, our results show that it is necessary to exclude the social factors and social disparity that interfere with high school life, encourage teenagers to stay in high school, provide educational support, and make improvements in teenagers’ social environments so that they can have the opportunity to study, work, and live.