Abstract
Adolescents' engage in new behaviours such as substance use and change others, such as reducing physical activity. Risks to health from these tend to be considered separately. We examined the association between multiple risk behaviours at age 16 years and outcomes in early adulthood.5591 young people enrolled in the Avon Longitudinal Study of Parents and Children provided data on at least one of seven adverse outcomes at age ~18 years. We used logistic regression to examine associations between total number of risk behaviours and rates of depression, anxiety, problem gambling, getting into trouble with the police, harmful drinking, obesity and not in education, employment or training (NEET) at age 18 years.We found strong associations between multiple risk behaviours and all seven adverse outcomes. For each additional risk behaviour engaged in the odds of harmful drinking increased by OR = 1.58[95%CI:1.48,1.69], getting into trouble with the police OR = 1.49[95%CI:1.42,1.57], having depression OR = 1.24[95%CI:1.17,1.31], problem gambling OR = 1.20[95%CI:1.13,1.27], NEET OR = 1.19[95%CI:1.11,1.29], anxiety OR = 1.18[95%CI:1.12,1.24] and obesity OR = 1.09[95%CI:1.03,1.15]. Neither adjustment for sex, parental socio-economic position and maternal risk behaviours, nor confining analyses to adolescents with no previous presentation of these adverse outcomes, resulted in any notable reductions in the odds ratios.Investment in interventions and environments that effectively prevent multiple risk behaviour is likely to improve a range of health outcomes in young adults.
Highlights
Smoking tobacco, alcohol use, being physically inactive and eating an unhealthy diet are the principal causes of non-communicable diseases (NCDs)1 (Alwan, 2011)
In a related study we have shown performance in General Certificate of Secondary Education (GCSE) examinations in the UK at age 16 to be equivalent to a reduction in more than one grade for every multiple risk behaviours (MRBs) engaged in (Wright et al, 2018)
Data were drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC) (Boyd et al, 2013; Fraser et al, 2013), an ongoing population-based study investigating the effects of a range of influences on the health and development of children and their parents
Summary
Smoking tobacco, alcohol use, being physically inactive and eating an unhealthy diet are the principal causes of non-communicable diseases (NCDs) (Alwan, 2011). Predominantly related to transport and vehiclerated behaviour, is the dominant cause of death among adolescents (Mokdad et al, 2016; Viner et al, 2011). These behaviours are all modifiable through policy, environmental, community, family and individually targeted interventions, there is considerable scope to improve young people's health in both the short- and long-term. Adolescence is a time to embed healthy habits and foster resilience but engagement in behaviours such as smoking tobacco, drinking alcohol, and physical inactivity generally begin in adolescence and affect health in later life as important contributors to Preventive Medicine 138 (2020) 106157 the epidemic of NCD (Gore et al, 2011). That many NCDs have their origin in early life is well understood by international bodies and in 2019 UNICEF issued guidance on its approach to early life prevention of NCDs which included action to influence government policy to ‘support the development of programmes for protective environments that discourage risk behaviours’ (unicef, 2019)
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