Self-rated health in adolescence as a predictor of 'multi-illness' in early adulthood: A prospective registry-based Norwegian HUNT study

The Effect of Environmental Factors, Health Behaviors, and Psychosocial Aspects on Allergic Diseases in Korean Adolescents

Background and Objectives: Adolescence is a critical period of physical and mental development, yet allergic diseases are often poorly managed. Factors such as sleep deprivation, obesity, smoking, and mental stress can worsen allergic conditions and complicate treatment. This study examines the environmental, behavioral, and psychosocial factors influencing allergic diseases in Korean adolescents using data from the Korean National Health and Nutrition Examination Survey (KNHNES). Materials and Methods: From the 25,534 participants in the Fifth KNHNES, 1630 adolescents (aged 13-18 years) were selected. We analyzed demographic and lifestyle factors, including gender, age, housing type, family size, economic status, obesity, tobacco and alcohol use, sleep duration, and physical activity. Psychosocial factors such as stress perception, suicidal ideation, depressive symptoms, mental health counseling, and self-rated health were also examined. Results: The prevalence rates of allergic diseases were 23% for allergic rhinitis (AR), 11% for atopic dermatitis (AD), and 9.8% for asthma (AS), with 35.8% of adolescents having at least one allergic condition. Smoking was significantly associated with AS (odds ratio [OR] 1.753, p = 0.006), while shorter sleep durations increased AR risk (p = 0.000). Male adolescents had a lower risk of AD (OR 0.706, p = 0.046), and high economic status was inversely correlated with AD (OR 0.445, p = 0.006). Positive self-rated health was linked to lower AS risk (OR 0.447, p = 0.000). AR was significantly associated with male gender (OR 1.391, p = 0.045), high economic status (OR 1.784, p = 0.026), and high stress perception (OR 1.479, p = 0.013). Conclusions: Low self-rated health and high stress perception have been identified as risk factors for allergic diseases during adolescence. Integrating psychosocial counseling with medical treatment may improve management and outcomes.

The Associations between Depressive Symptoms and Self-Rated Health in Relation to Sense of Coherence among Adolescents: Cross-Sectional Study

BACKGROUND

We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7-8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors.

METHODS

A total of 2104 7th-8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors.

RESULTS

Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized β = 0.309, p < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized β = -0.266, p < 0.001).

CONCLUSIONS

We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future.

Comparative study on health behaviors among adolescents with chronic allergic disease before and during COVID-19 using data from the Korean Youth Health Panel Surveys

BACKGROUND

This study aimed to investigate the changes in the health behaviors and subjective health perception of adolescents with chronic allergic disease, including atopic dermatitis, asthma, and allergic rhinitis, amidst the coronavirus disease 2019 (COVID-19) pandemic in South Korea.

METHODS

This study used the 15th (2019) and 17th (2021) raw data obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS), conducted by the Ministry of Health and Welfare of South Korea. Data were analyzed using multiple logistic regression with complex sampling using weighted values. Odds ratios with 95% confidence intervals for six health behaviors and subjective health perception were used as the major variables.

RESULTS

Six health behaviors (dietary habits, weight gain, smoking, alcohol consumption, sleep time, and physical activity) changed substantially during COVID-19. There was an increase in the duration of sedentary activities, a slight increase in BMI, and improvements in mental health. Concurrently, there was a decrease in alcohol consumption, sleep duration, and the consumption of sweetened beverages. Despite these improvements in big six health behaviors, adolescents with chronic illnesses continue to perceive themselves as unhealthy.

CONCLUSIONS

These findings suggest that the follow-up and monitoring of health behaviors and subjective health perception in adolescents with chronic allergic diseases during the COVID-19 pandemic are necessary. Understanding the mechanisms underlying sustained behavioral change can inform the development of interventions to promote healthy behavior after the pandemic has passed.

The impact of internet use on adolescents' health: empirical evidence from China

Background

With the continuous improvement in economic levels in various countries and the rapid development of the Internet, adolescents' Internet use has become increasingly frequent. Many studies have explored the relationship between Internet use and adolescent health, but the possible mechanisms involved are unclear, and few have focused on Chinese adolescents.

Methods

Based on the data from the China Family Panel Studies 2010, 2014, 2016, 2018, and 2020, this study used the ordered probit model and OLS model to explore the impact of Internet use on self-rated health and mental health of Chinese adolescents and analyzed the possible mechanisms and heterogeneity involved.

Results

The results revealed that adolescents' Internet use negatively affected their physical and mental health. Parent-child conflict, academic performance, and self-efficacy were the important mechanisms of internet use affecting adolescents' health. Moreover, the negative effects of Internet use on adolescents' physical and mental health were heterogeneous in boarding, mother's education level, and family per capita income.

Conclusion

Adolescents exhibit a pattern of using the internet that influences their health status. Our finding that internet use may decrease adolescents' health provides important insights into understanding the relationship between internet use behavior and adolescents' health and suggests that intervention should be taken on adolescents' internet use.

Decomposition and comparative analysis of health inequities between the male and female older adults in China: a national cross-sectional study

BACKGROUND

This study aimed to examine the factors influencing self-rated health (SRH) among Chinese older adults by gender differences and provide suggestions and theoretical references to help make policies for older adults' health concerns by government agencies.

METHODS

Chinese Longitudinal Health Longevity Survey (CLHLS) in 2018 was adopted, the chi-squared test and the logistic regression analysis were performed to analyse self-rated health reported by Chinese female and male older adults and its influencing factors. In addition, Fairlie decomposition analysis was performed to quantify the contribution level of different influencing factors.

RESULTS

Among older adults, males (48.0%) reported a significantly higher level of good self-rated health than females (42.3%). Residence, body mass index (BMI), self-reported income, smoking, drinking, exercise, and social activity were the factors that influenced SRH reported by male and female respondents, with age, marital status and education reaching the significance level only in women. The Fairlie decomposition model can explain the underlying reasons for 86.7% of the gender differences in SRH, with self-reported income (15.3%), smoking (32.7%), drinking (42.5%), exercise (17.4%), social activity (15.1%) and education (-14.6%) being the major factors affecting gender differences in SRH.

CONCLUSIONS

The study results can help promote the implementation of the Healthy China Initiative, inform intervention measures, and offer new proposals on creating policies for older adults' health issues by the Chinese government to improve health equity.

Managing persistent physical symptoms when being social and active is the norm: a qualitative study among young people in Denmark

BACKGROUND

An increasing number of young people in Western countries report persistent physical symptoms (PPS). PPS may disturb everyday activities and they may have negative consequences for later adult mental and physical health. Still little is known about how young people handle PPS in their everyday lives. This study examines how young people with PPS attempt to manage their symptoms while staying engaged in their daily activities and what is at stake in these attempts.

METHODS

This qualitative study involved semi-structured interviews with 11 young people with PPS. Photo-elicitation was used to capture the participants' experiences as they occurred in their everyday lives. The data material was analysed using a thematic analysis approach, as well as theory on subjectivity and social acceleration.

RESULTS

The participants employed alleviating measures and tried to find patterns between their activities and the severity of their symptoms in order to adjust their activity level. Decisions not to participate in social activities were accompanied by feelings of missing out. The participants' attempts at adjusting their activity level was challenged by norms of being social and active, and they experienced difficulty prioritizing their activities and explaining their symptoms to others.

CONCLUSION

PPS shaped the participants' sense of how to act towards their bodies and social relationships in interaction with societal norms. The participants' subject formation and symptom experiences should thus be seen as a biosocial process.

Associations between sedentary behavior and health and the moderating role of physical activity in young people within a cross-sectional investigation

The purpose of this study was to determine the influence of sedentary behavior (SB) on the frequency of health complaints (fHC) as well as on self-rated health (SRH) and body mass index (BMI), and to determine whether physical activity (PA) moderated this influence. Data were obtained from the Youth Survey Luxembourg 2019 (N = 2,802), a nationally representative stratified random sample of all youths aged 16 to 29 years who were living in Luxembourg. fHC is a composite measure of eight common psychosomatic health complaints, SRH was measured on a five-point scale, and BMI was calculated by dividing participants' body weight by the square of their body height (kg/m2). PA and SB values were obtained from factor analyses of the relevant questionnaire items. SB was evaluated as both leisure-time SB and gaming-associated SB. Multiple regression analyses adjusted for age, sex, socioeconomic status, and migration status were used to determine the association between SB, fHC, BMI, and SRH. We found that leisure-time SB was positively associated with fHC, but not with SRH or BMI. Gaming-associated SB was positively associated with fHC and BMI but was negatively associated with SRH. PA was negatively associated with fHC, BMI and SRH. No statistically significant moderating effects were observed. We found that both leisure-time and gaming-associated SB showed statistically significant impacts on health. Although PA is known to be beneficial to health, we conclude that its potential to mitigate the negative effects of SB is limited in young people.

Differential Associations of Sports Participation With Self-Rated Health and Depressive Symptoms Among Japanese Adolescents

INTRODUCTION

We aimed to evaluate the associations of sports participation with self-rated health and depressive symptoms in a nationally representative sample of Japanese adolescents.

METHODS

A questionnaire survey was conducted with 1,658 adolescents aged between 12 and 21 years. Sports participation levels were divided into high-frequency, moderate-frequency, low-frequency, and no-participation groups. Self-rated health was evaluated using a four-grade scale. Depressive symptoms were assessed using the Japanese version of the Patient Health Questionnaire-8. Other lifestyle behaviors were also surveyed. The associations of sports participation with self-rated health and depressive symptoms were examined using multiple logistic regression analysis.

RESULTS

The participants in the high- (odds ratio (OR), 0.45) and moderate-frequency (OR, 0.46) groups were less likely to self-report poor health than those in the non-participation group. By contrast, a U-shaped association was found between sports participation and depression, in which the participants in the moderate-frequency group (OR, 0.52) were less likely to have depressive symptoms. The OR for the high- (0.89) and low-frequency (0.91) groups were not significant. Furthermore, eating regular breakfasts, six or more days/week, and having shorter screen times of less than two hours/day were negatively associated with poor self-reported health and depressive symptoms.

CONCLUSION

Moderate- to high-frequency sports activities are associated with a reduced risk of poor self-rated health among Japanese adolescents. However, only moderate-frequency activities were associated with a reduced risk of depression. Participation in optimal sports activities may effectively lower the risk of poor health in adolescents.

Mental health profiles of Finnish adolescents before and after the peak of the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had implications for adolescents' interpersonal relationships, communication patterns, education, recreational activities and well-being. An understanding of the impact of the pandemic on their mental health is crucial in measures to promote the post-pandemic recovery. Using a person-centered approach, the current study aimed to identify mental health profiles in two cross-sectional samples of Finnish adolescents before and after the peak of the pandemic, and to examine how socio-demographic and psychosocial factors, academic expectations, health literacy, and self-rated health are associated with the emerging profiles.

METHODS AND FINDINGS

Survey data from the Health Behaviour in School-aged Children (HBSC) study conducted in Finland in 2018 (N = 3498, age M = 13.44) and 2022 (N = 3838, age M = 13.21) were analyzed. A four-profile model using cluster analysis was selected for both samples. In Sample 1, the identified profiles were (1) "Good mental health", (2) "Mixed psychosocial health", (3) "Somatically challenged", and (4) "Poor mental health". In Sample 2, the identified profiles were (1) "Good mental health", (2) "Mixed psychosomatic health", (3) "Poor mental health and low loneliness", and (4) "Poor mental health and high loneliness". The results of the mixed effect multinomial logistic regression analysis showed that in both samples, being a girl and reporting lower maternal monitoring; lower family, peer, and teacher support; higher intensity of online communication; a less positive home atmosphere and school climate; and poor self-rated health were most strongly linked to belonging to a poorer mental health profile. In addition, in Sample 2, low subjective health literacy was a key factor associated with poorer mental health profiles, and teacher support was more important than before COVID.

CONCLUSIONS

The current study stresses the importance of identifying those vulnerable to developing poor mental health. To maximize post-pandemic recovery, the role of schools, especially teacher support and health literacy, along with the factors that remained important over time should be taken into account in public health and health promotion interventions.

Self-rated physical health, health-risk behaviors, and disparities: A cross-sectional study of youth in the slums of Kampala, Uganda

Self-rated physical health (SRPH) has been extensively used to assess health status. In this study, we examine how youth living in the slums of Kampala perceive their physical health and the psychosocial correlates of poor health. Cross-sectional data from the 2014 Kampala Youth Survey (N = 1,134) of youth ages 12-18 years was used to conduct the analyses. Chi-square tests and logistic regression analyses were conducted to determine associations between SRPH, demographic and psychosocial characteristics. Overall, 72% of youth rated their health as 'excellent' or 'good.' Poor SRPH was associated with older age and lower education, but not with sex. Also, orphans (OR = 2.03; 95%CI:1.51-2.72), those who lived on the streets (OR=3.09; 95%CI:2.30-4.15), who did not have electricity (OR = 2.83;95%CI:2.12-3.78), who initiated alcohol use early (OR = 2.08; 95%CI:1.47-2.94), who frequently get drunk (OR = 5.67; 95%CI:2.69-11.96), who were HIV positive (OR = 2.18; 95%CI:1.47-3.23), who had been injured due to their drinking (OR = 2.09; 95%CI:1.44-3.03), who thought about hurting themselves (OR = 2.09; 95%CI:1.60-2.73), and those who often felt lonely (OR = 2.54; 95%CI:1.61-4.02) had higher odds of poor SRPH compared to their peers without these characteristics. Poor SRPH may serve as a marker for multiple health-risk behaviors and severe health disparities among youth in vulnerable and resource-limited settings.

Disparity between Subjective Health Perception and Lifestyle Practices among Korean Adolescents: A National Representative Sample

Background

The relationship between subjective health perception (SHP) and lifestyle practices brings into question the future health status of an individual. Recognition of the disparity between one's health consciousness to the real practices encourages change and promotes development of better health programs. The adolescent stage is the best time to identify this disparity wherein lifestyle practices are still being developed. In Korea, adolescents experienced significant shifts in lifestyle due to the fast economic growth and the breakthrough of the digital era. Thus, determining the disparity between SHP and lifestyle practices among Korean adolescents poses a great deal of interest and importance.

Methods

Utilizing the 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS), self-reported data with a national representative sample-57,303 respondents-of Korean adolescents in the 7-12^th grades, was used from a multistage sampling, stratification, and clustering was obtained. SHP and lifestyle practices were collected and analyzed.

Results

The findings revealed that most respondents with poor diet, exercise, and sleep behaviors perceived themselves to be normal, healthy, or extremely healthy, which resulted in a negative correlation between SHP and lifestyle behaviors-except in the case of substance use.

Conclusion

There is a significant disparity between Korean adolescents' SHP and lifestyle practices. This highlights the need for lifestyle interventions and re-education among Korean adolescents. Their current lifestyle practices may extend into adulthood, thereby increasing the risks of cardiovascular and other lifestyle-induced diseases.

How do multimorbidity and lifestyle factors impact the perceived health of adults with intellectual disabilities?

BACKGROUND

Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID.

METHOD

The North Health in Intellectual Disability study is a community based cross-sectional survey. The POMONA-15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied.

RESULTS

The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P < 0.05], level of ID (OR 0.65, P < 0.05), numbers of physical health conditions (OR 1.6, P < 0.001) and lower motor function (OR 1.5 P < 0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30 min of physical activity daily (OR 2.0, P = 0.07).

CONCLUSION

Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health.

Excellent Self-Rated Health among Swedish Boys and Girls and Its Relationship with Working Conditions in School: A Cross-Sectional Study

The aim of this study was to investigate the extent to which school demands, teacher support, and classmate support were associated with excellent self-rated health among students, and to examine if any such statistical predictions differed by gender. Data were drawn from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, performed among adolescents in grades five, seven, and nine (n = 3701). Linear probability models showed that school demands were negatively associated with excellent self-rated health, whereas teacher and classmate support showed positive associations. The link with school demands was stronger for girls than boys, driven by the finding that in grades five and nine, school demands were associated with excellent self-rated health only among girls. In conclusion, the study suggests that working conditions in school in terms of manageable school demands and strong teacher and classmate support may benefit adolescents’ positive health. The finding that the link between school demands and excellent self-rated health was more evident among girls than among boys may be interpreted in light of girls’ on average stronger focus on schoolwork and academic success. The study contributes with to knowledge about how working conditions in school may impede or promote students’ positive health.

Maternal depression and non-specific health complaints in the offspring: a cross-sectional study in Danish primary care

Background

Maternal depression has been linked to adverse outcomes in the offspring. Existing literature is mainly based on parental reports, which can be an unreliable source when the parent has depression.

Aim

To explore if maternal depression was associated with daily health complaints and low self-assessed health (SAH) in the offspring.

Design and setting

Participants were 45 727 children from the Danish National Birth Cohort recruited between 1996 and 2002. At 11-year follow-up, mothers and their children were invited to complete a questionnaire. Maternal depression was categorised into: no depression, first-time treatment, continued treatment, post-treatment, and relapse.

Method

Binomial regression was used to estimate the adjusted prevalence proportion ratio (aPPR) of frequent health complaints and low SAH in children of mothers with depression compared to children of mothers without depression.

Results

The prevalence of any daily health complaint was 11.4%, daily somatic complaints 4.1%, daily mental complaints 8.9%, both daily mental and somatic complaints 1.5%, and low SAH 5.3%. Children of mothers with depression (any category) were more likely to report a daily health complaint: first-time treatment aPPR 1.35 (95% confidence interval [CI] = 0.96 to 1.85), continued treatment aPPR 1.59 (95% CI = 1.37 to 1.85), post-treatment aPPR 1.30 (95% CI = 1.20 to 1.41), and relapse aPPR 1.56 (95% CI = 1.35 to 1.79). Children of mothers with depression were also more likely to report low SAH: first-time treatment aPPR 1.58 (95% CI = 0.99 to 2.54), continued treatment aPPR 1.86 (95% CI = 1.51 to 2.28), post-treatment aPPR 1.34 (95% CI = 1.19 to 1.50), and relapse aPPR 1.56 (95% CI = 1.26 to 1.93). Girls had a higher prevalence of mental and somatic health complaints and more often reported low SAH compared to boys.

Conclusion

Treatment of maternal depression was associated with higher prevalence of daily health complaints and low SAH in the offspring at age 11 years. The association was strongest for children of mothers with continued depression or relapse.