Main trends in the health conditions of young people

Several scientific institutions monitor the health and well-being of young people periodically. Both positive and negative trends are visible in the data. 

Positive trends

Decreasing Child Mortality: Child mortality in Belgium has been decreasing for years. In 2018, the probability of death between birth and 5 years was 4 per 1000 births, down from 6 per 1000 in 2000 (Situation analysis JKP).

Generally Positive Mental Well-being: The JOP monitor 2023 shows that most Flemish young people are satisfied with their lives, experience positive emotions, and are generally resilient (JOP-monitor 2023). The majority of young people in 2022 were satisfied with their lives (90.6%) according to the HBSC survey (Factsheet Health and Wellbeing). Compared to 2018 there is a slight decrease. Back then, 92.8% had a high life satisfaction. 

Generally Positive Physical Health: In 2022, in Flanders, 82.7% of young people believes  that they have good health according to the survey of the Department of Public Health of the University of Ghent (Factsheet Health and Wellbeing). This percentage remained stable in 2022 compared to 2018.

Increasing Physical Activity: The Flemish Sport & Exercise Monitor is a research instrument of Sport Flanders. In 2023, 91.3% of children and 89.5% of young people reported exercising weekly. Between 2014 and 2022, the percentage of young people meeting physical activity guidelines increased from 14.2% to 20.1% (Situation analysis JKP). However,  research by Sciensano found that the proportion of children and adolescents meeting the recommended levels of physical activity decreased between 2014-2015 and 2022-2023.

Resilience: Overall, most young people appear to be resilient (JOP-monitor 2023). Thus 68.5% indicate that they can usually manage themselves out of difficult situations. Furthermore, about  four in five young people usually get there, one way or another (80.6%).  Finally, slightly less than half of young people indicate that they can do many things at once cope (46.0%)

Points of concern

Increase in psychological complaints: In terms of psychological complaints, there is a negative evolution. The percentage of young people who felt moody, nervous, unhappy or experienced problems falling asleep increased significantly. In 2018, this prevalence was 21.4%, 21.6%, 14.1% and 26.6% respectively and these increased to 29.4%, 31.0%, 19.7% and 32.0% respectively in 2022. The increase in the prevalence of nervousness was particularly remarkable, amounting to more than 10 percentage points. A sharp increase was also observed in the prevalence of suicidal thoughts from 17.6% in 2018 to 22.3% in 2022, as well as in self-harming behaviour from 14.5% to 18.8% (Factsheet Health and Wellbeing). 

Increase in health problems: With regard to health problems, young people mention suffering from headaches several times a week (19%), bellyache several times a week (12.7%), backache (17.4%), dizziness (15%). The survey revealed that the prevalence of headache, bellyache, backache, dizziness had increased compared to 2018. Generally, 35% of people in the survey reported to have one or more physical complaints in a week. Generally, this percentage is higher for girls than for boys (Factsheet Health and Wellbeing).

Higher prevalence of loneliness among girls and older young people: In 2022 around 16% of young people reported having felt lonely in the past 12 months with clear differences by gender in the survey (Factsheet Health and Wellbeing). One in ten (10.0%) boys were lonely, compared to more than one in five (21.6%) girls. Furthermore, about one in ten of all young people were found to be struggling with emotional (10.6%) and social loneliness (9.5%). Again, prevalence rates were higher among girls (14.0% for both forms of loneliness) than among boys (7.3% and 5.2%, respectively). Feelings of loneliness occurred more frequently among the older age groups.

Impact of socio-economic factors: Young people from families with a lower socioeconomic status (SES) - with factors like family income, parents' education level, and (foreign) background - more often report poorer mental well-being (JOP monitor 2023). Significantly more males than females indicate that they have good health: respectively 86.2 per cent and 79.2 per cent. The survey also mentions that young people in vocational training and technical secondary education have less good health than young people in general secondary education: 73.8%, 77.4% and 84.8% respectively (Factsheet Health and Wellbeing).

Access to help: Although young people are generally familiar with support organizations, they do not always use them. Access to (mental) health care for young people, particularly vulnerable groups, needs improvement (JOP-monitor 2023). 

Suicidal thoughts: The percentage of young people who reported having had suicidal thoughts more than once was 22.3%. The prevalence of suicidal thoughts shows an increasing trend as age rises. Among boys aged 13 to 14, 11.5% indicated that they had thought more than once about ending their lives. By the age of 17 to 18, this had increased to 21.2%. Among girls, an increase can also be observed—though less pronounced—from 23.7% at ages 13 to 14 to 30.6% at ages 17 to 18 (Factsheet Health and Wellbeing)

Flanders in comparison: in 2018, Flanders participated for the first time in ISCWeB (International Survey on Children’s Well-Being). From a comparative perspective, it appears that Flanders is not doing as well as other European countries. In terms of satisfaction regarding other life domains and contexts, Flanders scores rather low to moderate compared to other European countries, although the differences are not always very large (ISCWeB).

Impact of covid-19: ISCWeB learns us that the corona crisis has had a major impact on the general wellbeing of young children (fourth to sixth grade primary school). They feel less comfortable in their own skin, have less confidence in the future and are less satisfied with their lives in general. In 2021, young children report feeling less happy, having less energy and being sad or bored more often than their peers in 2018. They also feel less confident about their health and appearance, and are more likely to worry about their material situation and independence. In addition, the researchers find that they are less likely to feel supported at home and at school. They also experience more conflict and even verbal and physical violence in their home situation and at school. On a positive note, however, the children report that they feel relatively well informed about the coronavirus and that they feel well supported by their friends.Young children's leisure activities have also evolved considerably. Since the corona crisis, children spend more time on caring tasks and housework, play outside more often and spend more time playing online games. Extracurricular activities, such as music school and drawing school, on the other hand, have declined markedly, with the exception of sports activities. Overall, children report being less satisfied with their leisure activities in 2021 than in 2018. A particular focus on children in vulnerable home situations seems appropriate here. For example, 14% of children indicated that they did not have enough to eat every day during the lockdown, 23% admitted that they did not manage to study at home, 18% felt that their opinions were not taken seriously at home, and 6% of 10-12-year-olds did not maintain any contact with friends during the lockdown. 

Main concepts

In the Decree on preventive health policy ‘health’ is defined as ‘state of physical, mental and social well-being in humans’ ‘health promotion’ is defined as ‘prevention method, used within preventive health policy, which aims to promote, protect or maintain health by supporting those processes that enable individuals and groups to positively influence the determinants of their health’. ‘Health impact due to climate change’ is defined as ‘current or future, direct and indirect health effects caused by biotic, physical, chemical, spatial or material factors resulting from climate change’, ‘health gain’ is defined as: ‘the positive result of a systematic and generally accepted measurement process using parameters related to the longevity and quality of life of a given population’.

In the Decree on the organisation and support of mental health services ‘mental health’ is defined as a state of well-being in which each person realises his own potential, in which he can cope with the pressures of everyday life, and in which he can contribute to the community to which he belongs. Mental health is inherently part of health. 

In 2024, the Department of Care developed a lexicon on preventive health. It contains an alphabetical list of terms in the preventive health sector. ‘Health’ is defined as follows: Health is a complex and dynamic concept. Moreover, health is defined differently within different movements and by different authors. WHO defines health as a state of complete physical, social and psychological well-being and not just the absence of disease. ‘Wellbeing’ is described as follows: Well-being refers to the overall life satisfaction experienced by people and communities. Health is an important facet of wellbeing. But besides health, wellbeing has several other facets that contribute to life satisfaction; such as respect, connectedness and self-determination. There are also living conditions that contribute to well-being: a quality and safe home, a safe and pleasant working environment, sufficient financial resources, and so on. And then there are broader political and social facets that also contribute to well-being, including the safety and stability of the country/region, social security, and gender and sexual orientation equality. 

While Flanders does have a wide range of services in the field of family support not all of these are as accessible as they should be for all families and not all of these have been closely linked or integrated. That is why the Decree organising preventive family support introduced the concept of family centres, the House of the Child (Huis van het Kind) as a new approach. The goal is to stimulate inter-professional collaboration between local actors to provide a range of family support services in an integrated and accessible way and attuned to the local needs. The decree points out some principles and goals, but at the same time leaves quite some margin as well to partners on the local level to shape their own House of the Child to best fit the local context. This way, cooperation is stimulated and facilitated rather than obligatory.