7.1 General context
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Youth health and well-being is a concept focused not only on preserving and improving their physical health but also creating a significant wider social context which would influence the well-being and health of young people, including illness prevention and health promotion in order for young people to achieve their full health potential.
Faced with a significant burden of chronic non-communicable diseases and premature deaths, a number of western countries started intensive programmes of prevention and suppression. However, it was shown that the traditional approach of primary, secondary and tertiary prevention was not having the desired effect on the population level. This led to the idea of health promotion, with the goal of not only preventing disease but boosting the health level of the entire population; focused on the entire populace and its environment, instead of only focusing on groups at higher risk. Intervention measures relate to health determinants, which also points out that the performers are almost all segments of society.
The population of Croatia has finished its “demographic transition” and it belongs to the “ageing population” group with a high percentage of the population aged 65 and over. Trends point to a poor condition of “demographic health” which presents a significant challenge for the sustainable development of society as a whole, but also for the health system which will have to respond to the health needs of a growing number of elderly citizens.
Main trends in the health conditions of young people
The most important youth health and well-being trends in Croatia refer to the increase in the number of young people suffering from chronic non-communicable diseases or disorders and injuries arising as a consequence of behaviours, habits, and lifestyles, which also speaks of their social causes. In the last 10 years we are seeing an increase in:
- the number of young people excessively consuming alcohol, tobacco products and psychoactive drugs
- engaging in risky sexual behaviour
- showing high incidence of sexually transmitted diseases
- having poor nutritional habits and not getting enough physical activity
- suffering from eating disorders
- having consequences from traffic accidents
- having psycho-social problems resulting in suicides
- mental disorders
- injuries and deaths caused by easily accessible firearms
Infectious diseases are not an expressed problem among the youth due to the many years of systematic vaccination programmes.
The Croatian Public Health Institute publishes annually the Croatian Health Statistics Yearbookand according to the latest issue from 2019 data among the diseases present in the primary healthcare clinics, predominant, are respiratory diseases, with about 322 733 cases in the 7-19 age group (not including the young 15-30).
According to HBSC(Health Behaviour in School-aged Children)– a survey conducted from in 2018 in Croatia, 33% of 15-year-old girls rated their health as excellent, in comparison to 48% of boys. 15-year-old young people who report multiple health complaints more than once a week are 46% girls and 23% boys. 15-year-old young people who report at least one medically attended injury in the last 12 months are 36% girls and 50% boys. 15-year-olds who are overweight or obese are 13% girls and 23% boys. 15-year-olds who think they are too fat are 29% girls and 19% boys. 15-year-olds who eat breakfast every weekday 38% girls 50% boys. 15-year-olds who eat fruit daily are 30% girls and 25% boys. 15-year-olds who consume soft drinks daily are 17% girls, 18% boys.
According to ESPAD(European School Survey Project on Alcohol and Other Drugs) – a study conducted in 2019, 2 772 Croatian participants of median age 15.7 years. 29% of young people in Croatia stated that they consumed tobacco in the past month, and 54% tried tobacco at least once in their life. It is interesting to note that since 1995, when Croatia first participated in the ESPAD study, the difference between the numbers of young girls and boys smoking has drastically reduced, which is a trend also seen in other countries. According to the information on smoking in the past month, 29% of young boys and 30% of young girls smoke, which ranks Croatia among the countries with the highest prevalence of smokers that age.
According to the data on using new psychoactive substances, in the last 12 months in Croatia, 5.1% of young people used new psychoactive substances, which ranks Croatia among the countries with the highest prevalence, alongside Czechia Estonia, Lithuania and Latvia. It is also important to note that Croatia is a country with the second highest prevalence of inhalants use, at 15%, and the differences between the countries which participated in the study are quite pronounced.
87% of young people in Croatia consider alcohol fairly or very easily available:
- 69% of consider cigarettes fairly or very easily available
- 40% consider cannabis, and 16% consider ecstasy easily available
- 42% tried alcohol before the age of 13
- 22% tried cigarettes before the age of 13
- around 58% have consumed alcohol in the past month
- 90% consumed alcohol at least once in their life
Painkiller use for intoxication among young people is also at a significant rate, at 5.7%, which is above the European average of 4%.
In conclusion, the trends between 1995 and 2019 show that among young people in Croatia substance use is slightly declining.