Education, cognition, health knowledge, and health behavior

Assessing geographical variation in ovulatory cycle knowledge among women of reproductive age in Sierra Leone: Analysis of the 2019 Demographic and Health Survey

BACKGROUND

Sierra Leone has poor indicators of reproductive health and a high prevalence of unintended pregnancies. To date, no study has explored determinants of ovulatory cycle knowledge in Sierra Leone. We investigated geographic region to determine where the needs for improved ovulatory cycle knowledge are greatest in Sierra Leone.

METHODS

This is a cross-sectional study of women of reproductive age (n = 15,574) based on the 2019 Sierra Leone Demographic and Health Survey. Geographic region and sociodemographic covariates were included in a multivariate logistic regression model predicting the odds that participants possessed accurate knowledge of when in the ovulatory cycle pregnancy initiation is most likely.

RESULTS

In Sierra Leone, 39.8% (CI = 37.4-40.9) of 15-49-year-old women had accurate knowledge of the ovulatory cycle. Women in the Northern and Southern regions possessed the highest prevalence of correct knowledge (46.7%, CI = 43.1-50.3 and 45.1%, CI = 41.9-48.2, respectively). Women from the Northwestern (AOR = 0.29, CI = 0.22-0.38), Eastern (AOR = 0.55, CI = 0.41-0.72), and Western regions (AOR = 0.63, CI = 0.50-0.80) had significantly lower odds of accurate ovulatory cycle knowledge compared to others. Women aged 15-19, those with a primary school education, and participants with a parity of none all had the lowest odds of correct ovulatory cycle knowledge as well.

CONCLUSION

Less than four in ten women in Sierra Leone had accurate knowledge of when in the ovulatory cycle pregnancy is most likely to occur. This suggests that family planning outreach programs should include education on the ovulatory cycle and the importance of understanding the implications of its timing. This can reduce the risk of unintended pregnancies throughout Sierra Leone, and can have an especially positive impact in the Northwestern, Eastern, and Western regions, where ovulatory cycle knowledge was significantly lower.

Assessing postnatal care for newborns in Sub-Saharan Africa: A multinational analysis

BACKGROUND

No doubt providing optimal postnatal care (PNC) prevents both maternal and neonatal deaths, in addition to the prevention of long-term complications. Sub-Saharan Africa (SSA) had the highest neonatal mortality rate, despite this adequate content of PNC for the newborn is not explored in SSA, therefore, it is important to identify the factors affecting adequate content of PNC for the newborn in the region. This may assist the program and policymakers to give an intervention based on the findings of the study.

METHODS

A secondary data analysis was performed using 21 SSA countries' Demographic and Health Surveys. A total weighted sample of 105,904 respondents were included in this study. A multilevel binary logistic regression model was fitted. The odds ratios along with the 95% confidence interval were generated to determine the individual and community-level factors of adequate PNC for the newborn. A p-value less than 0.05 was declared as statistical significance.

RESULTS

Adequate PNC for newborns in sub-Saharan Africa was 23.51% (95% CI: 23.26, 23.77). Mothers age ≥ 35(AOR  =  1.21,95% CI: 1.06,1.16), mothers' primary education (AOR  = 1.18, 95% CI: 1.13, 1.23), secondary education (AOR  = 1.58, 95% CI:1.51,1.66), higher education (AOR  = 1.61,95% CI:1.49,1.75), rich wealth status (AOR  = 1.05,95% CI = 1.01,1.10), ANC visits 1-7 (AOR  = 1.61,95% CI:1.51, 1.73), antenatal care (ANC) visit 8 and above (AOR  = 2.54,95% CI: 2.32, 2.77), health facility delivery (AOR  = 4.37, 95% CI:4.16,4.58), lived in east (AOR = 0.23,95% CI = (0.20,0.26), central(AOR = 0.21,95% CI = 0.19,0.24), west African sub-regions (AOR = 0.23,95% CI = 0.21, 0.27), Urban dwellers (AOR = 1.22,95% CI: 1.17,1.27), and low community poverty (AOR = 1.21 (95% CI = 1.11,1.31) were associated with adequate content of PNC for the newborn.

CONCLUSION

The finding of this study showed that the overall prevalence of adequate content of PNC for a newborn in SSA countries was low. The low prevalence of adequate content of postnatal care for newborns in SSA countries is a concerning issue that requires immediate attention. Age of the respondents, level of education, wealth status, ANC visits, place of delivery, residence, community-level poverty, and sub-region of SSA were the individual-level and the community-level variables significantly associated with adequate PNC for the newborn. Strategies should focus on increasing access to antenatal care services, particularly for vulnerable populations, such as younger mothers, those with lower education levels, and individuals residing in impoverished communities to improve PNC for the newborn.

Knowledge of prevention of mother-to-child transmission of HIV among reproductive age women in high HIV/AIDS prevalent countries: A multilevel analysis of recent Demographic and Health Surveys

BACKGROUND

A lack of enough knowledge about the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) among reproductive-age women is thought to be a key contributor to new pediatric HIV infections worldwide, and rising HIV-related infant mortality, particularly in resource-limited countries. Knowledge of MTCT of HIV is key to halt the progression of HIV/AIDS. Therefore, this study aimed to assess knowledge of MTCT of HIV and its associated factors among reproductive-age women in high HIV/AIDS prevalent countries.

METHODS

A secondary data analysis was performed using 8 HIV/AIDS prevalent countries' Demographic and Health Surveys. A total weighted sample of 97,130 respondents was included in this study. Stata 17 was used for data extraction, coding, and analysis. A multilevel binary logistic regression model was fitted. The odds ratios along with the 95% confidence interval were generated to determine the factors of good knowledge of MTCT of HIV among reproductive-age women. A 95% confidence interval and a p-value of less than 0.05 were used to declare statistical significance.

RESULTS

The prevalence of good knowledge of MTCT HIV was 57.89% (95% CI: 57.67,58.29). Mothers aged 25-34 (AOR  =  1.37, 95% CI = 1.32, 1.42), 35 and above(AOR  =  2.46,95% CI = 1.41, 1.52), mothers' primary education (AOR  = 1.32, 95% CI = 1.26, 1.38),), secondary education (AOR  = 1.65,95% CI = 1.56, 1.74), higher education (AOR  = 1.72,95% CI = 1.58,1.86), exposed to mass media (AOR  = 1.12, 95% CI = 1.08,1.16) rich wealth status (AOR  = 1.11 (95% CI = 1.06,1.15), talked about MTCT (AOR  = 1.70,95% CI = 1.64, 1.76), visited by field worker (AOR  = 1.09, 95% CI = 1.03,1.14), health facility visit (AOR  = 1.15, 95% CI = 1.11, 1.18), urban dwellers (AOR = 1.09, 95% CI = 1.04,1.14), ever tested for HIV(AOR = 2.18 (95% CI = 2.10,2.27), currently working status (AOR = 1.15, 95% CI = 1.12,1.19) were factors associated with good knowledge of MTCT of HIV/AIDS among reproductive age women.

CONCLUSIONS

Overall, the prevalence of good knowledge of MTCT was low in high HIV/AIDS prevalent countries. Maternal age, primary education and above, exposed to media, having higher wealth status, talked about MTCT during ANC visits, being visited by a field worker, visited a health facility, currently working, living in the urban area, and ever been tested for HIV were positively associated with knowledge of MTCT. Health policy and programs should focus on educating mothers, encouraging women to contact health facilities and a well-targeted communications program is required to enhance knowledge of MTCT of HIV.

Determinants of knowledge of the highest conception probability period among reproductive age women in Low-Income African countries: A multilevel analysis based on the recent Demographic and Health Survey

BACKGROUND

Adequate knowledge about the highest conception probability period in the reproductive cycle allows individuals and couples to attain or avoid their fertility probabilities. Poor knowledge of conception probability period leads to undesirable outcomes like unwanted pregnancy, miscarriage, and abortion. Determinants of knowledge of highest conception probability period were not well studied on economically disadvantaged countries. Therefore, our study aimed to identify individual and community level factors of knowledge of the highest conception probability period among women of reproductive age in low income African countries.

METHODS

The appended and latest Demographic and Health Survey datasets of 15 low-income African countries was used for analysis. Model fitness was done using the Intraclass correlation coefficient, median odds ratio, and deviance. A model with the lowest deviance (model-III) was selected as the best model. Multilevel logistic regression model was used to identify determinant factors of knowledge of the highest conception probability period. In the final model, adjusted odds ratio with 95% confidence interval was reported and variables with p<0.05 were considered as statistically significant with knowledge of the highest conception probability period.

RESULTS

Total weighted sample of 235,574 reproductive aged women with a median age of 27 years were included. The correct knowledge of the highest conception probability period among the study participants was 24.04% (95%CI = 23.87-24.22%). Maternal age groups ((20-24 (AOR = 1.49; 95%CI = 1.44-1.55), 25-29 (AOR = 1.62; 1.56-1.68), 35-39 (AOR = 1.76; 1.68-1.84), 40-44 (AOR = 1.75; 1.67-1.83), and 45-49 (AOR = 1.83; 1.74-1.93)), marital status((currently in union (AOR = 1.75; 1.16; 1.13-1.20), formerly in union (AOR = 1.75; 1.11; 1.06-1.16)), better educational status ((secondary (AOR = 2.08; 2.01-2.14) and higher(AOR = 3.36; 3.18-3.55)), higher wealth index ((middle (AOR = 1.08; 1.04-1.12), richer (AOR = 1.24; 1.20-1.28), and richest (AOR = 1.51; 1.45-1.57)), knowledge of contraceptive methods (AOR = 2.63; 2.49-2.77), current contraceptive use (AOR = 1.14; 1.11-1.16), and urban residency (AOR = 1.26; 1.21-1.29) were statistically significant with knowledge of the highest conception probability period.

CONCLUSION

In this study, knowledge of the highest conception probability period among women of reproductive age in low-income African countries was low. Therefore, improving the fertility awareness through comprehensive reproductive education or counseling could be one of the operational ways to control unintended pregnancy.

Does Education Influence Life-Course Depression in Middle-Aged and Elderly in China? Evidence from the China Health and Retirement Longitudinal Study (CHARLS)

Mental health problems have become a major public health problem worldwide and are more common among middle-aged and elderly people in China. Research on the effect of education on depression is limited, and whether the relationship between education and depression changes over the life course remains unclear. This study was based on the cross-sectional data of 15,767 middle-aged and elderly individuals in the 2018 tracking survey (Wave 4) of the China Health and Retirement Longitudinal Study (CHARLS) database. Multiple linear regression and bootstrap methods were developed to detect the mediating effect of education on depression. In all samples or different age groups, education was significantly positively associated with depression. Three mediators (economic level, health-related lifestyle, and cognitive level) were significantly positively associated with depression, and cognitive level had a greater effect on depression than economic level and health-related lifestyle. The total, direct, and indirect effects of the whole samples and elderly samples were significant; however, the direct effect of the middle-aged samples was insignificant, and the total and indirect effects of the three mediating pathways were all significant, that is, economic level, health-related lifestyle, and cognitive level should produce complete mediation. The multiple linear regression and bootstrap methods could successfully detect the mediating effect of education on depression. On the basis of the education, economic level, health-related lifestyle, cognitive level, and depression of middle-aged and elderly people, we established and compared the total, direct, and mediating effects of education on depression under the life course. The mediating variables should be further increased, and the measurement methods of depression should be developed to improve the credibility of the research results.

Association between reading and depression in Chinese adults

Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.

Eliminate the hardware: Mobile terminals-oriented food recognition and weight estimation system

Food recognition and weight estimation based on image methods have always been hotspots in the field of computer vision and medical nutrition, and have good application prospects in digital nutrition therapy and health detection. With the development of deep learning technology, image-based recognition technology has also rapidly extended to various fields, such as agricultural pests, disease identification, tumor marker recognition, wound severity judgment, road wear recognition, and food safety detection. This article proposes a non-wearable food recognition and weight estimation system (nWFWS) to identify the food type and food weight in the target recognition area via smartphones, so to assist clinical patients and physicians in monitoring diet-related health conditions. In addition, the system is mainly designed for mobile terminals; it can be installed on a mobile phone with an Android system or an iOS system. This can lower the cost and burden of additional wearable health monitoring equipment while also greatly simplifying the automatic estimation of food intake via mobile phone photography and image collection. Based on the system's ability to accurately identify 1,455 food pictures with an accuracy rate of 89.60%, we used a deep convolutional neural network and visual-inertial system to collect image pixels, and 612 high-resolution food images with different traits after systematic training, to obtain a preliminary relationship model between the area of food pixels and the measured weight was obtained, and the weight of untested food images was successfully determined. There was a high correlation between the predicted and actual values. In a word, this system is feasible and relatively accurate for one automated dietary monitoring and nutritional assessment.

Prevalence of drinking or eating more than usual and associated factors during childhood diarrhea in East Africa: a multilevel analysis of recent demographic and health survey

Background

Diarrhea is the second most common cause of death in under-five children. Fluid and food replacement during diarrheal episodes have a paramount effect to avert morbidity and mortality. However, there is limited information about feeding practices. This study aimed to assess the prevalence of drinking or eating more and associated factors during diarrhea among under-five children in East Africa using demographic and health surveys (DHSs).

Methods

Secondary data analysis was done on DHSs 2008 to 2018 in 12 East African Countries. Total weighted samples of 20,559 mothers with their under-five children were included. Data cleaning, coding, and analysis were performed using Stata 16. Multilevel binary logistic regression were performed to identify factors associated with drinking or eating more during diarrheal episodes. Adjusted Odds Ratio (AOR) with a 95% CI, and p-value < 0.05 were used to declare statistical significance.

Results

Prevalence of drinking or eating more than usual during diarrhea disease in East Africa was 26.27%(95% CI: 25.68–26.88). Mothers age > 35 years (AOR: 1.14, 95% CI: (1.03, 1.26), mothers primary education (AOR: 1.17, 95% CI: 1.06,1.28), secondary education (AOR: 1.43,95% CI: 1.27,1.61), and higher education (AOR: 1.42,95% CI: 1.11,1.81), occupation of mothers (agriculture, AOR: 2.2, 95% CI: 1.3–3.6), sales and services, AOR = 1.20, CI:1.07,1.34), manual, AOR =1.28,95% CI: 1.11,1.44), children age 1–2 years (AOR =1.34,95% CI: 1.22,1.46) and 3–4 years (AOR =1.36,95% CI: 1.20,1.55), four and more antenatal visits (AOR: 1.14,95% CI: 1.03,1.27), rich wealth status (AOR:1.27,95% CI: 1.16,1.40), birth in health facility (AOR = 1.19, 95%CI: 1.10, 1.30) and visit health facility (AOR = 1.12, 95%CI: 1.03, 1.22) were associated with drinking or eating more.

Conclusion

The prevalence of drinking or eating more is low in East Africa. Maternal age, occupation, antenatal care visit, marital status, educational status, wealth status, place of delivery, visiting health facility, and child age were significantly associated with drinking or eating more during diarrheal episodes. Health policy and programs should focus on educating mothers, improving the household wealth status, encouraging women to contact health facilities for better feeding practices of children during diarrheal episodes.

Individual and community-level determinants of knowledge of ovulatory cycle among women of childbearing age in Ethiopia: A multilevel analysis based on 2016 Ethiopian Demographic and Health Survey

BACKGROUND

Knowledge of the ovulatory cycle (KOC) aids women to refrain and engage in sexual intercourse to avoid and to get pregnancy, respectively. The effect of community-level factors on KOC was not yet known in Ethiopia. Therefore, we aimed to investigate the community- and individual-level determinants of KOC among women of childbearing age.

METHODS

We used the 2016 Ethiopian Demographic and Health Survey, and total weighted samples of 15,683 women were included. Intra-class correlation, median odds ratio, and deviance were executed for model comparison in which a model with the lowest deviance was the best model i.e. model III in this case. A multivariable multilevel logistic regression model was employed to identify community- and individual-level factors of correct KOC. In the ultimate model, an adjusted odds ratio (AOR) with a 95% confidence interval was reported and variables with a p<0.05 were considered as statistically significant.

RESULTS

In this study, 3,698 [23.58% (95% CI; 22.92-24.25)] participants had correct KOC. Women's age in years, i.e. 20-24 (AOR = 1.46;1.28-1.68) 25-29 (AOR = 1.72; 1.49-1.99), 30-34 (AOR = 2.21; 1.89-2.58), 35-39 (AOR = 1.78; 1.51-2.09), 40-44 (AOR = 1.97; 1.65-2.37), and 45-49 (AOR = 1.78; 1.44-2.19), knowledge of contraceptive methods (AOR = 3.08; 2.07-4.58), increased women's educational level, i.e. higher (AOR = 4.24; 3.54-5.07), secondary (AOR = 2.89; 2.48-3.36), and primary (AOR = 1.57; 1.39-1.78), higher household's wealth index, i.e. richest (AOR = 1.71; 1.35-2.16), richer (AOR = 1.42; 1.16-1.72), middle (AOR = 1.29; 1.07-1.56), and poorer (AOR = 1.24; 1.03-1.48), current contraceptive use (AOR = 1.26; 1.13-1.39), menstruating in the last six weeks (AOR = 1.13; 1.03-1.24), women's media exposure (AOR = 1.20; 1.07-1.35), and being in the community with a high level of media exposure (AOR = 1.53; 1.24-1.88) were statistically significant with KOC.

CONCLUSIONS

Knowledge of the ovulatory cycle was low in this study, which demands health education for women of childbearing age. Special attention should be given to teenagers, those with lower educational, and lower economic status. Besides, the strengthening of media campaigns could increase women's KOC, which is crucial for preventing unintended pregnancy.

Factors Influencing Gambling Behavior Among Employees in Macau Gambling Industry

Casino staff of the gambling industry seem to have a higher risk of pathological gambling than the general public because they share many previously identified risk factors, such as easy access to gambling activities. The studies in western countries reported casino staff have a higher prevalence of problematic gambling than the general public. However, some studies in Macau revealed gambling behavior among casino staff is not more common than among other residents there. A quantitative study was conducted with employees of Macau's casinos (N = 714) to understand gambling behavior among casino staff. Structural equation modeling was developed with time spent on gambling as a dependent variable, and awareness of responsible gambling, sensation-seeking tendency, psychological distress, demographic factors, peer/family pressure against gambling, and perception of expected rewards as independent variables. T-test, ANOVA, and correlations were computed for analyzing the obtained data. The structural equation modelling with the time spent on gambling as a dependent variable showed an acceptable model fit (The Chi-square = 5.567, Probability level = .696, CMIN/DF 0.696; NFI = 0.976; NNFI = 1.072; CFI = 1.000; RMSEA = 0.000). Psychological distress, sensation-seeking tendency, peer/family pressure against gambling all have significant effects on time spent on gambling. Perception of expected rewards showed the highest R square in the structural equation modeling and accounted for 77.9% cases of variance for the time spent on gambling. It is predicted that protective factors against pathological gambling include prohibition of gambling in the working venue, a satisfactory salary, and exposure to negative impacts of gambling via their job duties. Given that a high proportion of staff share most risk factors and less than 30% of respondents participated in gambling in the past year, further exploration of the protective factors from casino employees' point of view and further research on casino workers' "expected rewards" are recommended to generate ideas for improving the effectiveness of responsible gambling campaigns in future.

Cognitive ability and teen smoking

We use data on 11-15-year-old boys in the West Bank to study the empirical link between cognitive ability and health behavior, specifically (teen) smoking. Adjusting for both age in months and grade level allows us to effectively shut down any simultaneous effect of maturation and schooling on cognitive ability and smoking. We find that those at the lower end of the cognitive ability distribution are more than twice as likely to smoke than those at the upper end (approximately 25 versus 10%) also after adjusting for parental background and peer composition in a generalized propensity score approach. Further, we find that the cognitive ability-smoking gradient is fairly flat at the lower end of the cognitive ability distribution and steep at the upper end.

The health knowledge mechanism: evidence on the link between education and health lifestyle in the Philippines

Studies have found substantial differences in health-related behavior and health care usage between educational groups, which may explain part of the well-documented educational gradient in health. The allocative efficiency hypothesis offers a behavioral explanation for these reported differences. According to this theory, the educated possess more health knowledge and information, allowing them to make better health choices. We perform a mediation analysis to study this mechanism using original survey data from the Philippines, a lower-middle-income country. As an extension of previous empirical research, we construct a comprehensive index that captures different dimensions of health knowledge. Using generalized propensity scores, we find strong support for the allocative efficiency argument. Schooling is significantly associated with health knowledge levels, which explain up to 69% of the education effect on health lifestyle. This corresponds to twice the mediation strength of economic resources, suggesting an important role of this factor in explaining education effects on health decisions.

The Impact of Education on Health Outcomes and Behaviors in a Middle-Income, Low-Education Country

Although the impact of education on health is important for public policy everywhere, the overwhelming majority of research identifying the health returns to education has focused on developed countries. We use data from multiple waves of nationally-representative Health and Tobacco Surveys in Turkey, and exploit an education reform that increased the mandatory years of schooling from 5 to 8 years in 1997. Using exposure to the reform as an instrument for completing at least eight years of schooling, we examine the impact of education on health indicators and smoking among young adults. We find that extending schooling on this margin impacts men and women differently. Our results indicate that while a one-year of extra schooling increases the likelihood of being obese among males by 9.9 percentage points, the same increase in schooling improves the probability of women being in the healthy weight range by 15.5 percentage points. Consistent with this result, an extra year of education increases women's propensity to self-evaluate their health as excellent by 4.3 percentage points. Additional analyses reveal that education makes men (but not women) more likely to spend time on computers, using the internet, and to spend time on social media, suggesting that differential time allocation between men and women, triggered by enhanced education, may be a mechanism behind the differential results between the sexes. Education has no impact on smoking for men or women regardless of the measure of smoking.

Healthier lifestyles after retirement in Europe? Evidence from SHARE

This paper investigates changes in health behaviours upon retirement, using data drawn from the Survey of Health Ageing and Retirement in Europe. By exploiting changes in eligibility rules for early and statutory retirement, we identify the causal effect of retiring from work on smoking, alcohol drinking, engagement in physical activity and visits to the general practitioner or specialist. We provide evidence about individual heterogeneous effects related to gender, education, net wealth, early-life conditions and job characteristics. Our main results--obtained using fixed-effect two-stage least squares--show that changes in health behaviours occur upon retirement and may be a key mechanism through which the latter affects health. In particular, the probability of not practicing any physical activity decreases significantly after retirement, and this effect is stronger for individuals with higher education. We also find that different frameworks of European health care systems (i.e. countries with or without a gate-keeping system to regulate the access to specialist services) matter in shaping individuals' health behaviours after retirement. Our findings provide important information for the design of policies aiming to promote healthy lifestyles in later life, by identifying those who are potential target individuals and which factors may affect their behaviour. Our results also suggest the importance of policies promoting healthy lifestyles well before the end of the working life in order to anticipate the benefits deriving from individuals' health investments.

Health behaviors: is there any distinction for teachers? A cross-sectional nationwide study

Background

Health behaviors, as important modifiable determinants of health, are consistently targeted by prevention messages. Teachers, as educators and role models, may play a key-role in bringing such messages to children and adolescents. It is not clear which areas of prevention could be improved in collaboration with teachers to promote healthy behaviors at the population level through health education in schools.

Methods

to evaluate teacher’s health awareness, we compared their health/risk behaviors to those of non-teachers, taking into account demographic and socioeconomic factors that could confound crude differences. We used data from the 2010 Health Barometer, a cross-sectional nationally-representative French survey conducted by telephone among 27,653 persons aged 15–85. Adjusting sequentially for potential confounders, we compared six indicators of lifestyle and risky conducts (at-risk drinking, current smoking, cannabis use, gambling, corpulence, sleep duration) between teachers (n = 725) and two comparison groups: other occupations (n = 12,483) on the one hand, and other intermediate and managerial/professional occupations (n = 6,026) on the other.

Results

In the fully-adjusted models, teachers were less likely than other occupations to smoke, to have used cannabis in the last 12 months, to gamble regularly and to be overweight or obese. When restricting the comparison group to other occupations belonging to the same socio-professional category, differences were attenuated, but remain highly significant for tobacco, cannabis and gambling. No significant differences were observed between teachers and non-teachers regarding alcohol use and sleep duration, once important confounders had been adjusted for.

Conclusions

Our results suggest that teachers behave on the whole more healthily than other adults with a similar demographic and socioeconomic profile. The absence of a teacher distinction toward at-risk drinking needs to be examined in more detail.