7.1 General context
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Main trends in the health conditions of young people
The following trends in health conditions of young people are based on the latest international report of the Health Behaviour School Age Children 2017/2018
Overweight and Obesity
There has been a rise in levels of overweight and obesity among young people since 2014. One in five adolescents is overweight or obese, with boys of all age groups more likely to be affected. On the other hand, the prevalence of underweight has remained stable since 2014, with younger girls and boys more likely to report low body weight. Overweight, obesity, and underweight decline with age, meaning older adolescents are more likely to have healthy body weight. These patterns though may reflect maturational processes to some extent but may also indicate increasing sociocultural pressures to conform to certain body stereotypes as adolescents grow older and become more body-conscious.
Body Image
Over one in four adolescents consider themselves too fat, with this negative body perception being especially pronounced in girls. This persists despite a significant decline in negative body image, notably among girls, since 2014. As they grow older, adolescents’ perceptions of their bodies become increasingly negative. Both underweight and overweight undermine adolescents’ capacity for healthy development and can lead to serious health, educational and economic consequences. Adolescents from lower socioeconomic backgrounds are especially vulnerable since they are more likely to be overweight or obese and perceive themselves as too fat. Poverty, food insecurity, unhealthy food, and urban environments are potential drivers of overweight and obesity, while negative body image may be influenced by a wide range of factors, including social media.
Healthy Eating and Oral Health
Most Maltese adolescents are failing to meet nutritional recommendations, undermining their capacity for healthy development. 54 percent of girls and 56 percent of boys do not eat either fruit or vegetables daily. Only 25 percent of Maltese 15-year old adolescents claim that they eat vegetables every day. Sweet consumption increased between 2014 and 2017/8 among Maltese adolescents of the same age (27 percent boys and 17 percent girls). However, a 16 percent drop in sugary soft drink consumption was observed since 2014 among 13-year-old boys. The prevalence for the recommended toothbrushing at least twice daily was observed among 24 percent of Maltese 15-year-old adolescents.
Physical Activity
Physical activity guidelines and participation in physical activity were observed to be particularly low among boys from poorer families.
Life Satisfaction, School pressure, and Family-Peer Support
Most Maltese adolescents rated themselves as feeling satisfied with their lives with a score of 7.2 out of 10.
Most Maltese adolescents reported feeling some or a lot of pressure from schoolwork, especially by 15-year-old girls.
Most adolescents (76 percent) in Malta live with both parents and many reported high family and peer support. However, levels were generally much lower among adolescents from the lowest affluent families. Social inequalities in Malta were also observed to be particularly high among boys.
Sexual health and substance abuse
The prevalence of Maltese adolescents (boys and girls combined) not using either condom or pill at last sexual intercourse was found to be 52 percent.
Adolescence is a critical period in life where risks associated with substance use are particularly high. A significant decline of over a 10 percent in drunkenness among Maltese 15-year-old girls was observed whereas the prevalence of drunkenness among boys remained stable at 26 percent.
Main concepts
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO)
Mental Health Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community (WHO)
Wellness: the optimal state of health of individuals and groups. There are two focal concerns: the realization of the fullest potential of an individual physically, psychologically, socially, spiritually, and economically, and the fulfillment of one’s role expectations in the family, community, place of worship, workplace, and other settings (WHO).
Obesity: the condition of severe overweight where a person has a body mass index (BMI) equal to or greater than 30. The obesity rate is the proportion of the total population (or of a subgroup based on gender, age, etc.) with a BMI of 30 or above (Eurostat)
Drugs: All drugs including medicines, volatile substances, alcohol, tobacco and illegal drugs (World Health Organisation WHO).
Drug use: Drug taking through which harm may occur, whether through intoxication, breach of laws or school rules, or the possibility of future health problems, although such harm may not be immediately perceptible. Drug use will require interventions such as management, education, advice and information, and prevention work to reduce the potential for harm.
Drug misuse: Drug taking which harms health or functioning. It may take the form of physical or psychological dependence or be part of a wider spectrum of problematic or harmful behaviour. Drug misuse will require treatment.
Harm reduction techniques: A range of public health policies designed to reduce the harmful consequences associated with human behaviours, even if these behaviours are risky or illegal.