How does the sexual, physical and mental health of young adults not in education, employment or training (NEET) compare to workers and students?

Clare Tanton,John Saunders,Lorraine Mcdonagh,Melissa Cabecinha,Jackie Cassell,Kirstin R Mitchell,Catherine H Mercer,Greta Rait,Rebecca Geary,Chris Bonell,Soazig Clifton

doi:10.1186/s12889-021-10229-6

Abstract

BackgroundSyndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Young adults not in education, employment or training (NEET) are more likely to experience disadvantage and poorer general health outcomes. However, there is little research on their sexual health, or the extent to which this clusters with mental and physical health outcomes.MethodsAnalysis of data from 16 to 24 year olds (1729 men, 2140 women) interviewed 2010–12 for Britain’s third National Survey of Sexual Attitudes and Lifestyles. Natsal-3 is a national probability sample survey using computer-assisted personal interviewing with computer-assisted self-interviewing. Participants were classified as workers, students or NEET. We used multivariable logistic regression to examine associations between being NEET (relative to worker or student) and risk behaviours and outcomes in physical, sexual and mental health domains. We then examined how risk behaviours and poor health outcomes cluster within and across domains.Results15% men and 20% women were NEET; 36% men and 32% women were workers; and 49% men and 48% women were students. Young people who were NEET were more likely to report smoking and drug use (men) than other young people. There were few differences in sexual health, although NEETs were more likely to report condomless sex, and NEET women, unplanned pregnancy (past year). Risk behaviours clustered more within and across domains for NEET men. Among NEET women, poor health outcomes clustered across mental, physical and sexual health domains.ConclusionsHarmful health behaviours (men) and poor health outcomes (women) clustered more in those who are NEET. This points to a possible syndemic effect of NEET status on general ill health, especially for women. Our paper is novel in highlighting that elevated risk pertains to sexual as well as mental and physical health.

Highlights

Syndemic theory highlights the potential for health problems to interact synergistically, compounding impact
We explore the extent to which risk behaviours and poor health outcomes cluster both within and across these health domains for NEETs vs. workers and students, to capture the extent to which these inequalities are heightened for NEETs
Socio-demographic characteristics Among young adults aged 16–24, just under half of males and females (49.0 and 47.8%, respectively) were defined as students, 35.7% of males and 32.3% of females were defined as workers and 15.3% of males and 19.8% of females were categorised as NEETs (Additional file 1)

Summary

Introduction

Syndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Adulthood is a period of key transitions and a time when sexually-intimate relationships are first established This raises a number of challenges regarding physical, psychological, and sexual health. Young adults are at higher risk of poor sexual health outcomes including sexually transmitted infections (STIs), unplanned pregnancy and sexual violence [1,2,3,4]. This life-stage is when patterns of risk behaviours begin, for example, in terms of substance use [5, 6]. Death by accident is higher, reflecting greater risk-taking at this time of life [9]

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