International Adolescent Health Survey Results Released
sak2 at cdc.gov
Fri Feb 4 14:18:26 PST 2000
Please pardon the cross-posting.
Hello. Below is a description of the report on an
international adolescent health survey recently
posted on the World Health Organization website.
The survey included physical fitness and dietary
behavior measures. United States students were
included in the survey.
Public Health Nutritionist
Centers for Disease Control and Prevention
sak2 at cdc.gov
NATIONAL INSTITUTES OF HEALTH
National Institute of Child Health and Human Development
NIH NEWS RELEASE
EMBARGOED FOR RELEASE
Monday, January 31, 2000
6:00 p.m. EST
rb96a at nih.gov
U.S. 15 YEAR OLDS LESS LIKELY TO WATCH
TELEVISION OR SMOKE THAN CHILDREN IN
MANY OTHER INDUSTRIALIZED COUNTRIES
Compared to adolescents in other parts of the
industrialized world, U.S. students are less likely to
watch television. Moreover, although 15 year old U.S.
adolescents were among the least likely to smoke, U.S.
11 year olds began smoking at rates as high as those
of 11 year olds in other countries.
U.S. adolescents were also less likely to exercise
frequently, and less likely to have a good diet than were
students in other countries, according to a new report
issued by the World Health Organization (WHO).
Coordinated by the WHO, the Health Behaviors in
School-Aged Children (HBSC) Study looked at 11, 13,
and 15-year old children's attitudes and experiences
concerning a wide range of health related behaviors
and lifestyle issues in 26 European countries and
regions, Canada, and the United States. The U.S.
component of the study was funded and coordinated
by the National Institute of Child Health and Human
A copy of the report will be posted on the WHO website
"The study's findings are of crucial importance for the
development of timely and relevant health promotion and
health education initiatives at local, national, and
international levels," said NICHD Director Duane Alexander,
M.D. "The information will be helpful to U.S. policy
makers in designing a variety of local, state, and national
The findings were derived from a 1997-98 survey of more
than 120,000 students in: Belgium (both Flemish and
French), Canada, the Czech Republic, Denmark, England,
Estonia, Finland, France, Germany, Greece, Greenland,
Hungary, Republic of Ireland, Israel, Latvia, Lithuania,
Northern Ireland, Norway, Poland, Portugal, the Russian
Federation, Scotland, the Slovak Republic, Spain, Sweden,
Switzerland, the United States, and Wales.
The study is conducted every four years, and this marks
the first year of full U.S. participation. Specifically, the
study focuses on the period of transition from
preadolescence into mid-adolescence, said the NICHD
epidemiologist, Mary Overpeck, Dr.P.H. By conducting
the survey every four years, she said, patterns and trends
can be identified and related to national policies and other
influences on health behaviors of youth.
SMOKING AND ALCOHOL USE
Smoking on a daily basis is common in the youth of all
countries in the study and increases dramatically between
ages 11 and 15. However, the U.S. ranks only 24th out of 28
for daily smoking, with 12 percent of 15 year olds smoking
daily. Austria, France, Germany, Hungary and Greenland
report the highest smoking rates, with more than 25 percent
of 15 year olds smoking daily.
U.S. students ranked in the middle for alcohol consumption.
About 23 percent of U.S. 15 year olds reported drinking
weekly, as compared with 53 percent in Wales, 52 percent in
Greece, 47 percent in England and 46 percent in Denmark.
The percentage of children who reported having been drunk
at least twice in their lives was lowest in Switzerland,
Israel, Portugal, Greece and France, ranging from 16
percent to 29 percent, with the U.S. around the middle at
HEALTH AND WELL BEING
According to the report, 91.8 percent of all 11, 13, and 15
year olds consider themselves healthy, with U.S. children
ranking 21st in this survey category. Students in the U.S.
and Israel reported the highest frequency of health-related
problems and symptoms and were more likely to take
medications for these symptoms. For the symptoms surveyed
--among them headache, stomachache, backache, nervousness,
feeling tired, feeling lonely, and feeling "low" --U.S.
students ranked among the top four countries for seven of
the nine symptoms. For all countries, young adolescent
girls consistently reported a higher frequency of general
health problems, recurrent pain symptoms, and negative
feelings (such as feeling low or lonely) than did young
adolescent boys. On the other hand, boys were more likely
to report feeling tired in the morning than were girls.
Also, U.S. children were the 3rd most likely of all groups
to report feeling tired in the morning for four or more
times a week.
The study also found that family living arrangements and
relationships varied according to national grouping. For
example, while more than 90 percent of students in Greece,
Israel, Portugal, Switzerland, Finland, and Slovakia live
with both parents, only 64 percent of U.S. students
reported living with both parents--lower than for all other
countries except Greenland. In addition, along with youth
in two other countries, U.S. youth at all three ages were
among those most frequently reporting that they have
difficulty talking to their mothers. In all countries,
children were more likely to report more difficulty
communicating with their fathers than with their mothers.
(Compared to the children from the other countries, U.S.
children ranked in the middle on these measures.) For all
countries, difficulty with parental communication was
strongly associated with feeling less happy, with smoking,
and with drinking alcohol.
Regarding their relationship with their schools, the study
also found that students who felt involved in school, and
who received support from their teachers and other
students, were more likely to feel healthier, be physically
active, and were less likely to smoke.
Student satisfaction with school decreased with age among
most countries. For most countries, girls tended to like
school better than did boys. Students in the U.S. were
among those least likely to feel that they took part in
decision making at school, together with parts of the
Russian Federation, Flemish Belgium, the Czech Republic and
Finland. Students from Switzerland, Greece, France and
Germany were among those who felt best about participation
in rule making. Along with Flemish Belgium, Israel, and
Northern Ireland, students in the U.S. also were among
those who most felt that rules were too strict. For all
countries, boys consistently were more likely to find the
rules too strict than were girls.
Expectations and demands by teachers and parents were not
considered excessive by the majority of U.S. students, even
though U.S. students were most likely to feel a lot of
pressure from their school work. Along with students in
the Czech Republic and Lithuania, U.S. students were among
those least likely to feel that their fellow students were
kind and helpful. Students in Portugal, Denmark, Sweden,
and Switzerland felt best about the supportiveness of other
Students in the U.S. were less likely to exercise
frequently than were students in most other countries, with
about two-thirds of U.S. students exercising two or more
times a week or for more than two hours a week. By
comparison, 80 percent of students in Austria, Germany and
the Slovak Republic reported exercising regularly. For all
countries, boys were more likely to exercise regularly than
were girls. Similarly, students in all the countries were
more likely to report that regular exercise was associated
with feeling healthier, confidence, making friends, and
higher measures of affluence.
In contrast to students in all the countries, 15 year olds
in the U.S. were less likely to watch television-with one
fourth reporting they watched TV more than 4 hours a day.
Younger U.S. children were more likely to watch television,
with about one-third of 11 year olds watching more than
four hours a day-- higher than for 22 of the other 28
countries and regions surveyed on this question. Boys were
more likely to watch TV this often than were girls.
Students who watched more television were more likely to
eat junk food than were students who spent less time TV
For the most part, U.S. students were less likely to have
a good diet than were children in other countries. U.S.
students were less likely to eat fruit and vegetables each
day than were students in the majority of other countries.
They also were more likely to eat potato chips and French
fries than were students in most other countries. For
students age 15, the U.S. ranked among the top three
countries for consuming sweets, chocolate, and soft drinks
every day. For all countries, girls were more likely to
eat fruit and vegetables each day, while boys were more
likely to drink more milk but also to eat more junk foods
and fried foods. Fruit and vegetable consumption, however,
was found to decrease with age.
Dieting behavior and concerns about body size increased
with age for girls in all countries, while decreasing for
boys. U.S. students were more likely than students in any
other country to report that they were dieting or to feel
that they should be on a diet (almost half of 11 year old
U.S. girls and two-thirds of U.S. 15 year old girls.)
The NICHD is one of the Institutes comprising the National
Institutes of Health, the Federal government's premier
biomedical research agency. NICHD supports and conducts
research on the reproductive, neurobiological,
developmental, and behavioral processes that determine and
maintain the health of children, adults, families, and
populations. The NICHD website, http://www.nichd.nih.gov,
contains additional information about the Institute and its
This is the second international report on the HBSC study.
The first, The Health of Youth, reported the findings of
the 1993-1994 Survey. The current report is part of a new
WHO document series, "Health Policy for Children and
Adolescents," targeting experts in all parts of the world
who are concerned with health-related issues or whose area
of work directly or indirectly affects the health of young
people. Press releases from the WHO are available at
The survey was conducted in the U.S. schools by Macro
International Inc., which also is participating with the
NICHD in the analysis.
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