Healthy settings for young people in Canada

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Executive Summary

The Health Behaviour in School-aged Children study is a continuing, cross-national research project conducted in collaboration with the WHO Regional Office for Europe. There are now 41 research teams from WHO Europe countries and regions and from North America. The study aims to contribute to new insight and increased understanding with regards to the health, well-being, and health behaviours of young people (aged 11 to 15 years) and their social settings and conditions, especially the school environment. HBSC is Canada’s only national-level health promotion database for this age group. It is based on a broad determinants-of-health model with both individual data and school-level data such as current policies and programs. The federal government has supported the Canadian HBSC study since 1988.

This report presents key findings from the 2006 cycle of HBSC.

What are some of the main causes for concern identified in this report?

Healthy living practices and outcomes	Almost half of Grade 6 to 10 young people in Canada are physically inactive, with the problem being particularly worrisome in girls and older students. Fewer than half of students indicate that they consume fruits or vegetables at least once a day. Approximately 26% of boys and 17% of girls are either overweight or obese. Obesity among young people shows an increase from 4% in 2002 to 6% in 2006.
Risk behaviours that impact on health	Just under one-third of Canadian Grade 9 and 10 students indicate that they have smoked a cigarette. Over half of Grade 9 and 10 students report having tried alcohol by the time they were 15 years old. Twenty-two percent of students in Grades 9 and 10 report having had sexual intercourse.
Bullying and fighting behaviours and their outcomes	Just under two-fifths of students report being victims of bullying. Reports of racial bullying show a slight increase from 2002 to 2006. Fourteen percent of boys who carry weapons report that they carry handguns or other firearms. More girls than boys who carry weapons report carrying tear gas or pepper spray.
Activities and outcomes related to injuries	About 1 in 5 students typically miss one or more days of school or other usual activities in a 12-month period due to an injury. The percentage of injuries that happen during organized activities tends to increase with advancing grade.
Emotional health status or outcomes	By Grade 10, girls clearly are experiencing poorer emotional health than boys.

What is the encouraging news?

Physical activity shows an increase from 2002 to 2006.

Frequent consumption of sweets (i.e., candy or chocolate) and non-diet soft drinks is down compared to 2002.

Daily smoking shows a downward trend for both genders since 2002.

Reports of drinking beer at least once a week by girls and boys in Grades 6 and 8 have declined over the five Canadian HBSC survey years.

Getting “really drunk” twice or more shows a slight decline from 2002 to 2006.

Reports of trying cannabis show a significant drop for boys in 2006. Overall results from 2006 show that just under two-fifths of boys and girls report ever having tried the drug.

Use of cannabis on a monthly basis among students in Grades 9 and 10 in the HBSC sample is quite low.

Condom use during their last sexual intercourse is reported by four-fifths of sexually active boys in Grades 9 and 10.

Prevalence of sexual harassment has declined since 2002.

Why is context important to young people’s health?

The home setting	Students with low parent trust and communication are significantly more likely to report getting drunk more than twice. Young people living with both parents are less likely to be involved with bullying.
The school setting	The rate of serious injury among students reporting high academic achievement (average mark) is less than half that of those reporting the lowest academic achievement. Higher academic achievement and quality of school experience (attitude towards school) are both strongly related to emotional health.
The peer context	Better communication with one’s friends is strongly related to more risk behaviours, but not to more smoking. Young people who report having peers with higher levels of pro-social attitudes are much less likely to be involved in bullying.
Socio-economic conditions	Problems of inactivity, poor nutrition, and obesity are particularly apparent in young people from homes with the lowest level of family affluence. Young people from families with greater affluence report higher rates of serious injury, as well as higher rates of bullying.

What do we conclude for Canadian young people?

1. Assets at the school level are consistently and strongly associated with positive health behaviours and outcomes.
2. Home and family assets are usually associated with positive health behaviours and outcomes.
3. Socio-economic advantages are associated with some positive health behaviours and outcomes, but also with higher risks of injury and bullying others. Socio-economic assets are not, however, associated with alcohol or cannabis use.
4. Peer and friend assets have both positive and negative associations with health (i.e., mixed influences on risk behaviours).

We conclude that the above order of these four contexts could indicate the best opportunity for success in interventions, that is, a focus on the school and home settings. At the same time, the reverse order could indicate the greatest need for interventions within the peer context and in social income policy.

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