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1. Main trends in the health conditions of young people

2. Main concepts

Main trends in the health conditions of young people

Self-perceived health

According to the European Health Survey in Spain (Encuesta europea de salud en España 2020, EHSS), 75.5% of people aged 15 and over rated their health as good or very good. Among young people aged 15–24, self-perception of health was significantly higher, with 93.9% of young men and 90.7% of young women reporting good or very good health.

Although chronic health problems are generally less common among youth, the survey indicates that certain conditions are more prevalent in this age group, particularly allergies, migraines, chronic anxiety, and depression.

Substance use

The Survey on Drug Use in Secondary Education in Spain (La Encuesta sobre uso de drogas en Enseñanzas Secundarias en España, ESTUDES) is carried out bi-annually by the  Ministry of Health in collaboration with the Autonomous Communities and the Ministry of Education and Professional Training. 

This survey is carried out throughout Spain among secondary school students between 14 and 18 years of age to study the situation and evolution of drug use and behavioural addictions, the profiles of users, level of exposure, age of onset and risks.

According to the latest ESTUDES 2023 data, substance use among Spanish secondary students (14–18 years) continues to show a downward trend for alcohol and tobacco, but cannabis use remains stable and hypnosedative use is rising :

• Alcohol: 72.8% of students have consumed alcohol at some point in their lives; 67.9% in the last year and 51.2% in the last month. Among younger students (ages 12–14), 31.6% reported lifetime alcohol use, and 18.2% had consumed alcohol in the last 30 days
• Tobacco: 35.8% have smoked at some point; 28.47% in the last year and 21.7% in the last month. Among younger students (ages 12–14), 16.1% reported lifetime tobacco use, and 7.9% had smoked in the last 30 days.
• Cannabis: 35.6%  have consumed cannabis at least once in their lifetime, 30.7% in the last year and 23.9% in the last month. Among younger students (ages 12–14), 7.2% reported lifetime cannabis use, and 3.2% had used it in the last 30 days.
• Other illegal drugs (ecstasy, cocaine...) Remain below 5% for all periods analysed.
• Hypnosedatives (with or without prescription): 20.1% have used them at some point, with higher prevalence among girls. With the rate doubling from 10% in 2004.

The average age of consumption is between 14 and 15 years of age, with illegal drugs typically initiated later. The use of legal drugs is more common among women, with hypnosedatives showing the greatest difference (almost 9 percentage points). Men show a greater tendency to use illegal drugs.

The ESTUDES 2023 data shows that 93% of students aged 14 to 18 consider it easy or very easy to obtain alcoholic beverages.

According to the CIS Barometer 2021, 83.5% of people in Spain consider underage alcohol consumption to be a 'fairly or very important' problem, and 84.6% believe that public administrations should implement measures to prevent this consumption.

Behavioural addictions

Behavioural addictions are increasingly prevalent among adolescents, particularly in the areas of internet use, video games, and gambling. 

According to the 2024 OEDA report on behavioural addictions (Informe sobre adicciones comportamentales y otros trastornos adictivos 2024):

• Problematic Internet Use: 23.2% of students aged 14–18 show signs of problematic internet use, with higher prevalence among girls (26.2%) than boys (20.3%)
• Video Games: 16.4% of students are at risk of problematic gaming behaviour, with a significant gender gap: 24.1% of boys vs. 8.4% of girls. This is a significant increase from the 2021 figure of 9.2%.
• Gambling: 7.4% of students aged 14–18 reported gambling online in the last 12 months. Among them, 3.5% did so with money, and 1.6% did so weekly or more often. Gambling with online money multiplies the risk of developing a gambling addiction in the medium or long term, which has increased following the COVID-19 pandemic.

Sexual health and exposure to pornography

According to the HBSC 2018 study in Spain (Estudio HBSC 2018 en España sobre Conducta Sexual) 35.1% of adolescents aged 15–18 reported having had coital sexual intercourse. This includes 20.0% of those aged 15–16 and 48.3% of those aged 17–18. Contraception use during the last sexual encounter was reported by 75.4% of sexually active adolescents (79.5% of boys and 71.2% of girls). Usage was higher among younger adolescents (15–16: 79.2%) than older ones (17–18: 74.1%).

A 2020 report by Save the Children Spain ((Des)información Sexual: Pornografñia y Adolescencia) found that 54% of children ages 6-12 have viewed online pornography, with 85% of them being boys, which is associates with a negative impacts on youth regarding sexual attitudes and risk behaviours . 

The 2023 study  Experiences and Psychological Impact Derived from Unwanted Exposure to Online Pornography in Spanish Adolescents surveyed 500 adolescents aged 13–18. It found that 88.2% had experienced unwanted exposure to online pornography, with many reporting negative emotional reactions such as disgust, shame, and shock.

Weight, diet and eating disorders 

According to the most recent disaggregated data available, 37.7% of youth aged 18 to 24 are overweight and 12.2% are underweight (INE, 2021 data). The percentage is higher among women (8.9%). 

A 2023 study by the Spanish Agency for Food Safety and Nutrition (AESAN) (ALADINO 2023, Study on Nutrition, Physical Activity, Child Development and Obesity in Spain), 36.1% of children aged 6 to 9 in Spain are overweight or obese, with 15.9% classified as obese. While this data focuses on younger children, its findings on obesity trends may offer early indicators of patterns that persist into adolescence and young adulthood.

In terms of eating disorders, a 2025 nationwide study, published in the Journal of Eating Disorders, found that anorexia nervosa (AN) accounted for 12.9% of all mental disorder-related hospitalizations among adolescents aged 11 to 18, with a median age of 15 and 90% of cases involving girls. Notably, hospital admissions for AN surged by 89% after the first year of the COVID-19 pandemic, highlighting the impact of mental health stressors and social media exposure.

Physical Activity and Sedentarism

The Spanish Youth Report 2024 (Informe Juventud en España 2024) report that 67% of young people aged 15-34 engage in sports or physical activity. However, gender differences remain significant: 43% of young women say they do not practice sport or only do so occasionally, compared to 24% of young men, confirming that women are more sedentary than men. 

According to the Survey of Sporting Habits in Spain 2022, conducted by the Ministry of Culture and Sport in collaboration with INE, 82.9% of young people aged 15 to 24 reported practicing sports in the past year, with 74.6% of those aged 25 to 34 also engaging in physical activity. 

Regular weekly practice was reported by 52.5% of the population aged 15 and over, while 23.8% practiced daily. Gender differences persist: 63.1% of men reported engaging in sports annually compared to 51.8% of women, confirming that women remain more sedentary than men across all age groups.

Sleep

According to the most recent disaggregated data available from 2020 (the Spanish Youth Report 2020) 43% of young people sleep 8 hours a day, 33.7% around 7 hours, 14.1% less than 7 hours and 8.6% more than 8 hours.

The Spanish Youth Report 2024 (Informe Juventud en España 2024) does not provide updated quantitative data on sleep duration among youth, it notes a growing concern among youth about mental health and emotional well-being, including sleep-related issues, though these are discussed qualitatively rather than with specific metrics.

Suicide and Mental Health

Suicide remains the leading cause of death among youth aged 15–29 in Spain (Annual Report on the National Health System of Spain, 2023). According to the National Institute of Statistics, in 2023 the suicide rate in the 15 to 19 age group was 4.3% (first absolute cause of death in this age range), in the 20 to 24 age group 6.9% and in the 25 to 29 age group 10.8%. Suicide rates remain significantly higher in men than in women across all age groups, especially ages 25 to 29. 

Alarmingly, the highest number of suicides ever recorded among children under 15 was recorded in 2021 (Observatorio del Suicidio en España 2021). However, data on suicidal ideations and attempts continue to show a higher prevalence among in women, highlighting gendered differences in mental health expression and help-seeking behaviour.

A recent national study conducted in 2023 by Fundación ColaCao and the Universidad Complutense de Madrid on bullying and cyberbullying in Spain during childhood and adolescence (Acoso escolar y ciberacoso en España en la infancia y en la adolescencia, 2023),  with participation from over 20,000 students aged 9–16 across Spain, revealed that: 

• 17.8% had experienced cyberbullying
• 15.2% had suffered bullying in person.

Girls were more likely to report being victims of cyberbullying, while boys were more frequently identified as perpetrators. The most common forms of aggression included insults, rumour-spreading, exclusion, and threats—both online and offline. These experiences are strongly associated with emotional distress, anxiety, depression, and suicidal ideation, reinforcing the need for integrated mental health support in schools.

Main concepts

The Ministry of Health uses the WHO health promotion glossary  (1984, Ottawam 1986, Jakarta 1997, and subsequent updates) as its conceptual framework, with the Spanish Health Promotion and Prevention Strategy in the National Health System (Estrategia de Promoción de la Salud y Prevención en el Sistema Nacional de Salud) explicitly adopting the WHO 2021 glossary[SB1]  as its conceptual foundation:

• Health: A state of complete physical, mental and social well-being, and not only the absence of sickness or ailment (...) Health is a resource for everyday life, not the goal of life. It is a positive concept that emphasises social and personal resources as well as physical aptitudes. There are certain prerequisites for health, such as peace, access to economic resources, food, housing, stable ecosystem and sustainable use of resources. It is a fundamental human right.
• Health Promotion: The process that allows people to increase control over their health to improve it. It considers both actions aimed at increasing the skills and capacities of people, as well as those aimed at changing the social, environmental and economic conditions that have an impact on the health determinants.
• Health-oriented behaviour: Behaviours that are deliberately adopted in order to promote or protect health and are distinguished from the risky behaviours which are those behaviours associated with greater susceptibility to a specific cause of ill health.
• Lifestyle: A way of life that is based on identifiable patterns of behaviour, determined by the interaction between individual personal characteristics, social interactions and socio-economic and environmental conditions of life.
• Living conditions: It is the everyday environment of people, where they live, coexist, work, study, etc. These conditions of life are the product of social and economic circumstances, and of the physical environment, all of which can exert an impact on health, being largely out of the immediate control of the individual.
• Quality of life: it is the perception of the individual about their position in life within the cultural context and the system of values in which they live and with respect to their goals, expectations, norms and concerns. It is a concept that encompasses physical health, the psychological state, the level of independence, social relationships, personal beliefs, and the relationship with the outstanding characteristics of the environment.
• Physical activity: Physical activity is any voluntary movement performed by muscles, which produces an extra energy expenditure that our body needs to maintain vital functions (breathing, blood circulation, etc.). Walking, transporting an object, playing football, dancing, cleaning the house, etc., are considered some of the main physical activities. Physical activity that is beneficial to health is that which is of moderate intensity, done daily or almost every day and with a minimum duration of 30 minutes per session.
• Sedentary lifestyle: Activities performed while awake that require low energy expenditure, such as sitting during transport, work, or leisure.