Abstract
We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students’ tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students’ health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools’ characteristics to equip all students with health awareness, regardless of socioeconomic status.
Highlights
non-communicable diseases (NCDs) are caused by risk factors such as smoking, unhealthy diet, physical inactivity, and harmful alcohol consumption, which start during adolescence [2,3]
The percentage of high school students who were physically active for a total of ≥60 min/day on all seven days decreased from 28.7% in 2011 to 23.2% in 2019, and the percentage of those who ate vegetables
Soda intake was not significantly different according to economic status (p = 0.448)
Summary
Global interest in non-communicable diseases (NCDs), such as cardiovascular and respiratory diseases, is increasing. NCDs are caused by the complex interaction of genetic, physiological, environmental, and behavioral factors. NCDs are caused by risk factors such as smoking, unhealthy diet, physical inactivity, and harmful alcohol consumption, which start during adolescence [2,3]. These behaviors increase young people’s risk of NCDs [1]. The Centers for Disease Control and Prevention (CDC) reported that 31.6% of adolescents had a body mass index (BMI) of 25 or higher in 2019; this figure has increased annually since 1999 [4].
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