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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

     Report 2021 about Drug uses in Secondary Education in Spain (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: 22.321 students in total. Its objective is to study the situation and evolution of drug use and behavioral addictions, the profiles of users, level of exposure, age of onset and risks.

The most widespread addictions among schoolchildren are shown below:

- Alcohol: it is the most consumed drug: 73.9% of the people surveyed say they have consumed alcohol at some time; 70.5% in the last year and 53% in the last month.

- Tobacco: It is the second most widely used drug, with 38.2% having smoked at some time in their lives; 30.7% in the last year and 23.9% in the last 30 days of the year.

- Cannabis: This is the most frequent illegal drug, with 38.2% having consumed cannabis at least once in their lifetime, 30.7% in the last year and 23.9% in the last month.

- Other illegal drugs (ecstasy, cocaine...) show a consumption of less than 5% in all the time periods analyzed.

The average age of consumption is between 14 and 15 years of age, with illegal drugs being the latest. Although alcohol and tobacco show a higher prevalence, their use has declined slightly in recent years. On the other hand, the consumption of hypnosedatives (tranquilizers, sleeping pills, etc.) with or without prescription continues to rise: 19.6% have taken them at some time in their lives. 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.

- Non-substance addictions: 75 % of youth aged 14 to 29 years spent in 2019 more than two hours a day connected to the Internet, especially the group between 14 and 19 years (60 % were connected more than 3 hours a day) 98.5 % of ESO students are registered in at least one social network. 22.5 % of the adolescent population has been a victim of cyberbullying, 52.4 % of whom have also been victims of this type of aggression. 48.8 % of people who suffer bullying at school continue to suffer it outside the classroom through mobile devices, with a significant impact on mental health. In addition, 26.5% of adolescents play video games online every day or almost every day, especially. It is estimated that this pattern is a problem for 37.7 % of them and an addiction for 8.1 %. Between 15 and 29 years of age, 16.2 % of young people admit to regularly playing games of chance, especially sports betting. 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 relations and education: 86% of respondents to sexual matters affirmatively answer the question of having had complete sexual intercourse (penetrative), 4% incomplete, and 9% have not had sex of any kind. In relation to the use of contraceptive methods or prophylaxis during sexual intercourse, 85% replied that they had used some method in their last complete sexual relationship, the condom being the most used: 81% for men and 65% for women. Also noteworthy is the viewing of online pornography by 53.8% of people between 6 and 12 years of age, 85% of whom are men, which has a negative impact on affective-sexual behaviors and the risk of contracting sexually transmitted diseases.

- Eating disorders: 37.7% of people between 18 and 24 years of age are overweight and 12.2% are underweight. The percentage is higher among women (8.9%). 65% of young people play sports on a regular basis, and this has increased in recent years. Eating disorders are also increasing due to elements related to mental health, COVID-19 and exposure to social networks.

- Rest and physical form: 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. 52% of young people say they train physically several times a week, compared to 33% who do not exercise at all, or just occasionally. 43% of women do not do any sport at all or only occasionally, compared to 24% of males, females being more sedentary than males.

- Suicides: According to the National Institute of Statistics, in 2021 the suicide rate in the 15 to 19 age group was 4.5% (first absolute cause of death in this age range), in the 20 to 24 age group 7.1% and in the 25 to 29 age group 11.2%. The suicide rate is higher in men than in women in any of the age groups studied, especially in the 25 to 29 age group with 8.3%. The highest number of suicides in history was also recorded in children under 15 years of age. The number of suicidal ideations and attempts was higher in women than in men.

Main concepts

The Ministry of Health has as a conceptual framework reference to the health promotion glossary developed by the WHO in its constitution in 1984, as well as its subsequent reviews at the international Conferences on Health Promotion in Ottawa (1986) and Jakarta (1997). It is from this glossary that the normative definitions of the Ministry of Health emerge.

• 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: It is 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 behavior: Behaviors that are deliberately adopted in order to promote or protect health and are distinguished from the risky behaviors which are those behaviors associated with greater susceptibility to a specific cause of ill health.

• Lifestyle: It is a way of life that is based on identifiable patterns of behavior, 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: The term sedentarism-from the Latin sedere, which means to sit down- describes different types of activities that develop in a waking state and require low levels of energy expenditure. These activities include sitting while commuting, in the workplace, in the domestic environment, and during leisure time.