7.1 General context
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Main trends in the health conditions of young people
Long-term data about health conditions of children and young people in the Czech Republic are available from the Institute of Health and Information and Statistics of the Czech Republic, and also from international comparative studies such as HBSC and ESPAD. In 2019 the Palacky University also published the National report on sport activity of Children and Youth.
According to those studies:
The majority of Czech children see their own health and well-being positively. In international comparison, however, Czech Kids are in the lowest numbers in those categories.
In general, four out of 10 children among all age categories and genders have had an injury, which needed to be treated by a doctor.
Czech Children start drinking alcohol and smoking cigarettes and marijuana significantly earlier than the international average. Even if the trend of consumption is slowing down in recent years, Czech Children and Young people are still among the highest consumers of these substances among European Youth.
European Drugs Report on Trends and Development 2018 showed that in the Czech Republic there is the highest lifelong prevalence of Cannabis use in Europe (37 %) by students. Up to 8 % of Czech Students reported Cannabis use in the last 30 days. As problematic in the Czech Republic was mentioned also use of Metamfetamine which is the second highest in Europe after Latvia. On the other hand, the use of Heroin is on sinking in the Czech Republic as well as in Denmark. Positive can be seen the lowest rate of the Hepatitis C type by the injected drug users among youth up to 25 years of age but also by the adult population even if there have been new cases in 2016 observed. The supportive programmes for drug users are labelled between low and medium counts in European comparison.
By 15 years old, 20 % of boys and 14 % of girls regularly drink alcohol. Around 30 % of 15-year-olds report repeated alcohol intoxication, which is significantly higher than the international average.
The Czechs' experience with bullying and cyberbullying is significantly lower, but in contrast, Czech Children are on top in fighting in international comparison. However, bullying is also one of the most reported issues for young people through the structured dialogue with youth.
An overwhelming majority (80 %) of Czech Children are lacking enough physical activity; however, in international comparison, Czech Children are above average.
According to a 2018 study by HBSC (publication of the updated study is expected in 2023), boys more often then girls play team sports – 58 % vs. 35 %. Children from richer families also play more often than children from poorer ones. 38 % of 11-15-year-olds play sports with their parents at least once a week.
Overweight is nearly twice as high for boys as for girls. 15-year-old boys are overweight by 23%. This is similar in international comparison. However, Czech young people 15 years old are significantly more likely to have special diets or do activities for lowering their weight (19 % of boys and 37 % of girls).
Around 50 % of 15-year-olds skip breakfast, which is below the international average. At the same time, approximately 70 % do not eat dinner with their families, which brought Czech children and young people to the lowest international rating.
Consumption of fruits is average in international comparison; however, consumption of vegetables is slightly lower than the average (24 % of 15-year-olds).
The vast majority of Czech youngsters clean their teeth at least once a day, which brought them above average in international comparison.
The 15-year-old youngsters are a bit below international average in sexual activity but above average in using sexual preventive means.
More than 40 % of young people (15 and 16 years of age) spend more than 4 hours on the computer during weekdays and more than 53 % during the weekends.
Around 9 % of 16-year-olds have been gambling in the last 12 months, nearly 3 % have problems with gambling.
Adolescents aged 13-15 can be divided into three categories in terms of health literacy. Almost a fifth of them (18.2%) are at a low level, the largest group of schoolchildren (63.2%) is aware of health issues at a medium level. Another roughly one-fifth of children (18.6%) are very good at gaining information about health, their understanding and use.
For young people aged 15-24 is suicide is the second leading cause of death. In terms of counties with the highest suicide rates, the
are Tachov, Sokolov, Česká Lípa and Trutnov, for both sexes. For comparison: the suicide rate in Europe in 2016 was 15.4 suicides per 100,000 inhabitants, above the global 10.6 suicides per 100,000 inhabitants (WHO, 2018). For the same period, the Czech Republic's suicide rate was 13.1 cases per 100,000 inhabitants, slightly below the European rate and above the global average (WHO, 2018).
Children with autism spectrum disorders and other neurodevelopmental disorders are on the rise, behavioural and anxiety disorders are more common among children, and a new and alarming trend is the increasing frequency of self-harm and suicide attempts among adolescents.
The impact of the COVID-19 pandemic and the measures fighting against it hit seriously children and youth population in school as well as out of school environment. Those were documented by several projects such as Life during Pandemic and by the National Institute of Mental Health. Also the Ministry of Education, Youth and Sports initiated several methodical supports and subsidy schemes to support the mental health of pupils and young people related to education and social re-socialization.
In autumn 2021 results of a survey among school directors on the topic well being in primary education was published by the Partnership for Education 2030+. Among the trending results were mentioned:
The term well-being is not a familiar concept among public school principals and superintendents. A quarter of respondents (27%) have an idea of what it means. Conversely, half (49%) had not heard the term at all.
Nevertheless, after explaining the term, a clear majority of respondents state that its content is understandable and even that they create appropriate conditions for the well-being of pupils and teachers at school. But it should be added that this is mostly a more hesitant "rather yes" answer, which suggests that principals are not so convinced about the fulfilment of wellbeing as a whole in their school.
The basic assessment of wellbeing in education among the representatives of the primary schools involved in the research is positive: they see it as necessary for good educational outcomes for pupils and for the working atmosphere in the school (which are, of course, linked areas) and do not see it as a short-term fashion trend.
Health and well-being policies are very much in line with the EU and WHO standards. The Czech Republic is one of the countries on the top in the care of babies and children, and many international and European standards were inspired by the Czech experience, e.g. European standards on the quality of toys for children up to 3 years of age. Quality care for children is seen in long-term as the best prevention base for young people and adults.
In the Czech Republic, there is a specific healthcare system of professionals for children and adolescents so-called 'Praktický lékař pro děti a dorost' (practical doctor for children and adolescents, also a paediatric practitioner). These professionals provide a specialised health care service from the first days after birth up to 18 years of age (inclusive). These professionals have a particular medical approbation for the child and youth care, which is unique in the European as well as global context. However, in 2016, this particular approbation was merged, and in autumn 2017 the Parliament discussed its renewal. According to the information from the association of these specialists, even young students of medicine showed increased interest in the field.
The Ministry of Health wanted to reach the goal of one basic specialisation for children and youth (paediatrics), as there is another one 'children's medicine' (paediatrics, dětské lékařství). Paediatrics offers the graduates the possibility of being employed only at children's hospitals, but not of having their own practice. It serves as a basis for further children's medical specialisations (e.g. paediatric gastroenterology etc.). The practitioners for children and adolescents are also obligated to perform ordered actions in the sense of maintaining the public health policy – vaccination, regular examination of children and youth and reporting about the state of health of children and adolescents' population and the education is thus wider in this sense.
National public health statistics usually publish information specifically for age groups 0-14 years and 15-64 or 15+ years or they use the 5 years intervals. Reporting in various medical fields by doctors is also done in the age group 0-19 years of age.
Public health issues and policies come from traditional concepts of hygiene, which refer to conditions and practices that help maintain health and prevent the spread of diseases (as national legislation and the WHO state).
There is a specific field of Hygiene for children and juveniles (hygiena dětí a mladistvých) focused on the public health policies of children and juveniles according to the Act on Protection of Public Health no. 258/2000 Sb. The field is focused especially on health conditions of children and young people in schools, school facilities, and free time and leisure activities. There is also the Concept of Safety and Health at work, ensuring safe space and conditions for children, pupils as well as workers in schools and school facilities.
An important element of the Czech health policy valid for the whole population, not only youth, is that the Charter of Fundamental Rights and Basic Freedoms (Art. 31) within the constitutional order declares the Right for free medical care and tools covered by the public health insurance system.
From the educational perspective, the Education towards Health is part of National curricula documents, even if the educational field has only limited time devoted within education.
There is no national definition of well-being in public policies related to young people. The Educational Strategy 2030+ mentioned these issues in the context of lack of a good relationship towards school, risky behaviour, poor relationships between classmates, infractions of school rules, bullying and cyberbullying, a lack of focus on psycho-hygiene, school relating depression, anxiety, distress and suicidal tendencies.
Extended definition of wellbeing in education was created by the Partnership for Education 2030+ which in complex reflect cognitive, emotional, social, physical and spiritual sphere of the phenomenon.