7.1 General context
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For more than twenty years, the aim of the French "Baromètre" surveys has been to monitor the main behaviours, attitudes and perceptions associated with risk-taking and the health of the French population: smoking, alcoholism, illegal drug use, nutrition, quality of life, etc. A specific version of this extensive scientific survey, conducted through interviews, has been produced on the subject of young people's health.
The study entitled "Youth health survey 2010" (Baromètre santé Jeunes 2010) by the agency Santé publique France is the largest ever study to have been carried out to date in terms of data on young people's health. It is based on a sample of 6,000 young people and gives an idea of the behaviours evident among 15 to 30 year olds – in all their diversity.
The survey shows that young people's health differs depending on their social background, gender and age group – but that 96% of 15-30 year olds claim to be in good health. Among other things, the survey describes health behaviour trends as regards diet, mental health, alcohol, smoking and drugs.
Data from the study of the last "Nutrition survey 2008" (Baromètre nutrition 2008_Last survey available on nutrition) shows that, when compared with adults, young French people eat more or less healthily; that said, distinct characteristics can be observed in terms of their dietary habits, which differ depending on their social background and gender. Young people consume a lot more drinks that are high in sugar – one of the factors associated with obesity – than adults do. What is more, obesity and overweight rates are still high despite having levelled out. According to the Bulletin épidémiologique hebdomadaire [Weekly Epidemiological Bulletin/BEH] published in June 2017, the prevalence of obesity was 16% among boys and 18% among girls.
On a final note, obesity is higher among low-income families. What is clear from the data is that social inequalities have consequences on dietary practices: the children of blue-collar workers and employees do not eat fruit and vegetables as often as those born into higher socio-economic categories.
Regarding mental health, according to the Health youth Survey 2010 (Baromètre Santé 2010 last study specifically on yourth available), almost one young person in ten (9%) admits to have suffered about of depression.
- 3.4% of 15-30 year olds claim to have considered suicide over the past twelve months.
- 0.9% of 15-30 year olds (0.5% of men and 1.3% of women) have attempted to commit suicide over the past twelve months. This makes this age group the most concerned by suicide – for women in particular. These figures have remained stable since 2000, however.
Alcohol consumption studies show that consumption goes up with age, and becomes more of a regular occurrence. Only 2.5% of 15-30 year olds drink alcohol on a daily basis. That said, between 15 and 30 years of age, monthly, one-off consumption rates and episodes of drunkenness during the year are very high – 25.5% and 38.6% respectively. Alcohol consumption appears to be most common among males. But the trends concerning all of the indicators are pointing to increasingly similar consumption between men and women. Similar levels are now particularly evident among the 20-25 year-old age group.
According to the European School Survey Project on Alcohol and other Drugs – ESPAD 2015, France ranks alongside those European countries with the highest smoking rates.
According to the Health Survey 2017( Last data available) Baromètre Santé 2017, 18-34 year olds smoke the most.
In 2017, 32.1% of 18-24 year olds and 36.5% of 25-34 year olds were smokers. However, the prevalence of smoking in this age group decreased in 2017.
The barometer shows that:
- "Smoking has decreased among adolescents in France, at all ages: among middle and high school students and among 17-year-olds, among whom daily tobacco consumption has dropped from 32% in 2014 to 25% in 2017".
- "the prevalence of daily smoking has decreased by about 10 points since 2000 among 18-24 year olds, men and women"
Smoking is also increasingly coming across as a social marker. Howerver, in 2017 according to the 2017 Health barometer, on the contrary, The prevalence of daily smoking decreased among people with a diploma below the baccalaureate, (29.3% in 2017). "Entre 2016 and 2017, social inequalities in terms of smoking were stable in 2017".
According to the report "Jeunes et Jeunes addiction" [Young people and addiction] by the OFDT - French Monitoring Centre for Drugs and Drug Addiction (Observatoire Français des Drogues et des Toxicomanies), published in December 2016 (data still avalaible), cannabis is far and away the most commonly tried and consumed illicit substance among the French population – young people in particular. It is widely available to adolescents, since 28% of 15 year olds and half of 17 year olds (47.8%) claim to have already smoked it. Cannabis use is higher among boys than girls. Other illicit psychotropic substances (such as amphetamines, cocaine or ecstasy for example) tend to be used in the latter years of adolescence and among young adults. The data shows that, among 18-25 year olds, ecstasy is the second most commonly consumed illicit substance (3.8%), after cannabis and ahead of cocaine (3.1%). More generally, as we get older such drugs are used more seldom and for only limited periods of time.
In addition, according to the report, Drugs and Addictions, Essential Data - 2019 Edition, "the ages of experimentation with the main psychoactive substances have been characterized by relative stability since 2000, and even marked a significant decline since 2014"
- "La santé des 15-30 ans. Une lecture du baromètre santé" [The health of 15-30 year olds. An analysis of the health survey) Agora débats/jeunesses [debates/youth forum] 2013/1 (No. 63) INJEP, SciencePo Jeunesse.
- Baromètre Santé 2017, volet tabagisme
- European School Survey Project on Alcohol and other Drugs – ESPAD 2015
- Drogues et addictions, données essentielles - Édition 2019
Young people are the age group who do the most exercise, with 15-29 year olds exercising more than their elders: 46% of them play sport more than once a week, compared with 39% among 30-49 year olds. The most popular sports among young people are: swimming, football, cycling and jogging.
Several concepts and notions help to gain a clear idea of public health policies, particularly those focusing on young people. The notions of "Public Health", "general law" and "access to healthcare" define and characterise the French public health system.
Youth health policies normally fall within the Public Health sphere – which goes beyond the scope of curative medicine and encompasses all the factors which contribute to the development and determination of individuals' health: including the social environment and living conditions (housing, employment, recreation, etc.). Part of the objectives of Public Health is to limit health risks, guarantee the very best quality of care and ensure the greatest possible equality among the population in terms of health. Public Health forms part of a general law health service.
General law health service
The French health service is governed by general law, which designates all of the health service to which any resident must have access, pursuant to the "right to health protection" as recognised by the Preamble of the 1946 French Constitution. Since health comes under the general law system, it is therefore accessible to all; but the population is first required to become a member of a Compulsory Health Insurance Scheme: in this way they benefit from basic social cover. The range of available general law medical care is provided by both public facilities (hospitals, health centres, mother and child protection centres, etc.) and liberal medical practice (private clinics, physicians, etc.). In the general law health service, everyone is free to choose where they want to be treated.
"Access to health care"
Although health education and prevention do feature in the policies that the public authorities put into practice, the French health service is primarily based on a curative approach and access to health care. Access to health care means an individual's ability to access health resources and services.
It is influenced by social, economic (level of education, etc.), geographic, cultural and organisational factors which can either help or hinder a person in accessing such services. It is closely tied in with the notion of accessibility, which refers more to the reimbursement of services, but also the proximity or distance of healthcare services (medical cover, insurance, doctor's surgery, health centre, etc.). Unequal access and accessibility in terms of health care are issues that the public authorities need to address.