Does health literacy explain the link between structural stratifiers and adolescent health?

BACKGROUND: The concept of health literacy (HL) may help us to better understand the mechanisms leading to health disparities, and to focus on the factors that can be influenced. However, not much is yet known about how HL is related to health disparities, or whether the association exists among adolescents. The aim of the study was to examine the associations between structural stratifiers, HL and health indicators among adolescents. METHODS: The nationally representative Finnish Health Behaviour in School-aged Children survey data (n=3833) were collected from 13- and 15-year-old pupils in the spring of 2014. Pearson correlation coefficients were calculated, and separate path models were estimated for the perceived health and health behaviour measures. RESULTS: HL was found to be an independent factor explaining disparities in health. Higher HL was related to positive health outcomes. HL also acted as a mediator between health behaviours and structural stratifiers, except for gender. School achievement and educational aspirations were among the factors explaining the HL level, which in turn, explained the health indicators. CONCLUSION: The concept of HL is of use in understanding health disparities. In particular, HL provides a mechanism via which school achievement and educational plans affect health outcomes. Low HL places adolescents who have poor school achievement and who do not intend to continue on an academic path in an unequal position with respect to their health.

Secular trends in moderate-to-vigorous physical activity in 32 countries from 2002 to 2010: a cross-national perspective.

BACKGROUND: Sufficient levels of moderate to vigorous physical activity (MVPA) give substantial health benefits to adolescents. This article examines trends in physical activity (PA) from 2002 to 2010 across 32 countries from Europe and North America. METHODS: Representative samples included 479 674 pupils (49% boys) aged 11 years (n = 156 383), 13 years (n = 163 729) and 15 years (n = 159 562). The trends in meeting the recommendations for PA (at least 60 min daily) were evaluated using logistic regression. RESULTS: There was a slight overall increase between 2002 and 2010 (17.0% and 18.6%, respectively). MVPA increased significantly (P ≤ 0.05) among boys in 16 countries. Conversely, nine countries showed a significant decrease. Among girls, 10 countries showed a significant increase (P ≤ 0.05). Eight countries showed a significant decrease. For all countries combined, girls were slightly less likely to show an increase in PA over time. CONCLUSIONS: The majority of adolescents do not meet current recommendations of PA. Further investment at national and international levels is therefore necessary to increase PA participation among children and adolescents and reduce the future health burden associated with inactivity.

Is physical activity associated with low-risk health behaviours among 15-year-old adolescents in Finland?

AIMS: To investigate the associations between physical activity and the pattern of risk health behaviour consisting of smoking, alcohol consumption, snuff (snus), cannabis, and condom use among 15-year-old adolescents, taking their educational aspirations and family affluence into account. METHODS: The data were collected in the Health Behaviour in School-aged Children (HBSC) study in Finland in 2006. Standardised questionnaires were issued at schools to a 15-year-old nationally representative sample, of which 84.5% (1710 pupils) participated. Logistic regression analysis was used to explore the associations between physical activity, pattern of risk health behaviour, family affluence, and educational aspirations. Separate models for daily moderate-to-vigorous physical activity (MVPA) and leisure-time physical activity (LTPA) were tested. Multi-level analysis was performed in order to control the nested characteristics of the data. RESULTS: Boys were significantly more physically active and used alcohol, cannabis, and snuff more often than girls. Girls had used a condom in their last intercourse less often than boys. The educational aspirations for higher education had the strongest association with the low-risk health behaviour, with the odds ratios in the MVPA model 3.30 (95% CI 2.41-4.55) for the boys and 3.46 (95% CI 2.56-4.67) for the girls. In the LTPA model, the corresponding odds ratios were 3.31 (95% CI 2.40-4.56) for the boys and 3.52 (95% CI 2.60-4.56) for the girls. CONCLUSIONS: Physical activity was not significantly associated with the low-risk health behaviour, whereas educational aspirations for higher education showed the strongest association. The results support the earlier studies indicating a social gradient in health-related behaviour already in adolescence.