WHO/Europe has published the latest report from the Health Behaviour in School-aged Children (HBSC) study, based on interviews with over 200 000 young people. The study collects data and produces an international report every four years on the health, well-being, social environments and health behaviours of 11-, 13- and 15-year-old boys and girls.

Professor Candace Currie, the study’s International Coordinator, explains some of its key findings, current trends and how HBSC began.

What are the major trends in the study’s findings?

Gender differences

The continuing focus on issues relating to girls’ body image and dieting from report to report is a concern. A lot of these gender differences appear to be really embedded and persistent, as are the inequalities related to affluence.

Girls tend to rate themselves poorly. They report that they think they’re too fat; they don’t feel very well; they have lower life satisfaction. We also know that, later on, some serious mental health problems emerge for young men, and we don’t know if it’s that girls just express themselves more in their teenage years. Perhaps boys feel unable to explain how they’re feeling, or the prevailing culture is that you don’t complain about how you feel if you’re a boy. There’s quite a lot of debate about what these gender differences really show.

Socializing online

There are some areas that have really changed in young peoples’ lives. The whole emergence of electronic media and communications has changed. Going out in the evening is dropping and spending time on electronic communications is increasing. I think the whole way in which young people socialize is changing.

We have yet to see the impact of this change in social terms and I don’t think it’s necessarily going to be that easy to understand. While there’s good evidence that children are at risk from cyber-bullying and so on, these forms of communication also give children who would normally find it difficult to make friends a new route. In this way they can identify people like them, befriend them and, in a gradual, uninhibited way, they can build groups. However, we really don’t know the impact on being physically active. If your social life is sitting in your bedroom online, then you’re not running around.

Risky behaviour

There also seem to be some quite strong trends in risk behaviour that are starting to emerge. We see big differences between the west and the east. In some aspects of risk taking, there’s quite clear gender equalization going on in the western countries, whereas there are still quite big gender gaps in drinking and sexual behaviour in the east. That’s an oversimplification but it’s giving us an insight. We’re still in the process of trying to understand what these gender patterns signify.

If girls are now behaving like boys in terms of risk, but they’re still showing worse mental health outcomes, then that leads to the conclusion that girls are under a greater burden of potential ill health than boys. They’re suffering at two levels. Previously, on the whole girls had healthier lifestyles but more mental health issues than boys. Now they’re adopting risk behaviour that was previously in the male domain.

Should we be worried about teenagers?

Being worried is the wrong way of putting it! We should be paying attention to them and listening to them. It’s well known that parental support is crucial for happy children and the development of well-being, but often, as children emerge into their teenage years and the relationship becomes more challenging in some cases, there’s a tendency for parents to stand back and say, oh, well, they’re spending more time with their friends and our role might not be so great.

Need for support within the family

But actually you’ll see there’s a big variation between countries in how much time they spend out with friends and how easy they find it to communicate with their parents, particularly with fathers. There’s not a huge amount of cross-national variation with mothers, but there is with fathers. It’s definitely evident that young people who have good parental support do better. What we need to pay attention to, is the fact that young people need to talk; they need guidance and support and they still need to be embraced within the family. It’s less about being worried about them from a distance and more about thinking how we can support them through these years when their lives are changing.

How can we support adolescents?

Some things are quite concerning: the mental health changes that happen and particularly how that’s affected by affluence, and also we see these emerging gender differences. So we have to ask ourselves what it is about society that’s giving less support to young people who are less affluent, or less support to girls for that matter. We have to ask ourselves what we need to do to provide a supportive environment so young people can grow up and have positive health. It’s not just so that they’re healthy adults, but so that they’re happy healthy adolescents, including being happy at school and getting good grades, making friends and becoming socially skilled. They need support for that.