Abstract
BackgroundLower socioeconomic position is generally associated with higher rates of smoking and alcohol consumption and lower levels of physical activity. Health-related behaviour is usually established during late childhood and adolescence. The aim of this study is to explore changes in health-related behaviour in a cohort of adolescents aged between 15 and 19, overall and by socioeconomic position.MethodsThe sample consisted of 844 first-year students (42.8% males, baseline in 1998 – mean age 14.9, follow-up in 2002 – mean age 18.8) from 31 secondary schools located in Kosice, Slovakia. This study focuses on changes in adolescents' smoking, alcohol use, experience with marijuana and lack of physical exercise with regard to their socioeconomic position. Four indicators of socioeconomic position were used – adolescents' current education level and employment status, and the highest education level and highest occupational status of their parents. We first made cross tabulations of HRB with these four indicators, using McNemar's test to assess differences. Next, we used logistic regression to assess adjusted associations, using likelihood ratio tests to assess statistical significance.ResultsStatistically significant increases were found in all health-related behaviours. Among males, the most obvious socioeconomic gradient was found in smoking, both at age 15 and at 19. Variations in socioeconomic differences in health-related behaviour were more apparent among females. Although at age 15, almost no socioeconomic differences in health-related behaviour were found, at age 19 differences were found for almost all socioeconomic indicators. Among males, only traditional socioeconomic gradients were found (the lower the socioeconomic position, the higher the prevalence of potentially harmful health-related behaviour), while among females reverse socioeconomic gradients were also found.ConclusionWe confirmed an increase in unhealthy health-related behaviour during adolescence. This increase was related to socioeconomic position, and was more apparent in females.
Highlights
Lower socioeconomic position is generally associated with higher rates of smoking and alcohol consumption and lower levels of physical activity
Changes in healthrelated behaviour (HRB) between age 15 (T1) and 19 (T2) As the results of the McNemar tests show, alcohol consumption, experience with marijuana and insufficient physical activity in males at T2 compared to T1 statistically significantly increased for each category of each socioeconomic indicator
The same applies to alcohol consumption with the exception of females at the lowest education level, unemployed females and females with parents in the lowest educational and occupational levels who did not report statistically significant increases in alcohol consumption (Table 4)
Summary
Lower socioeconomic position is generally associated with higher rates of smoking and alcohol consumption and lower levels of physical activity. The aim of this study is to explore changes in health-related behaviour in a cohort of adolescents aged between 15 and 19, overall and by socioeconomic position. Over the last thirty years a number of studies describing the relationships between socioeconomic position (SEP), health-related behaviour HRB and health have been performed [1,2,3,4,5,6,7]. The desire for novelty and the courage for experiment are much greater in adolescence than in later life [9] Despite it being illegal, many young people have experience with drinking alcohol before turning 18, likewise with using drugs such as marijuana [9,10]. Due to the characteristics mentioned above, adolescence is a very sensitive period for interventions and policies aimed at promoting health by focusing on risk behaviour [20]
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