Often
when young people’s health feature in the media, the focus is on ‘problem-behaviour’
issues like alcohol consumption, smoking, teenage pregnancy, or poor diet and
lack of physical exercise. Adolescents on the whole are perceived as being
physically healthy and mostly at risk from behaviours that they themselves
control, and which may be perceived as a normative part of being a young
person. Teenagers are stereotypically portrayed as risk takers, and the potentially
negative outcomes of their behaviour has led to a strong focus on reducing risk
taking as a priority for young people’s health initiatives. In 2010 the UK
government published the White Paper ‘Healthy lives, healthy people’1,
which recognises the distinct needs of different age groups and the necessity
for approaches that are tailored to best meet individual circumstances. It
reinforces the importance of people being ‘in charge’ of their own health, and
of access to appropriate information and genuine dialogue with health care
professionals. However, the concerns listed specifically in relation to
adolescents are very much focused on the stereotypical issues listed above,
with little or no mention of other types of health concerns.
There
is no denying that involvement in risk behaviours can at times result in
significant and detrimental consequences for young people, both in terms of
health and more generally for academic achievement and maintenance of positive
relationships. However, just focusing on the problem behaviours of adolescence
may lead to other concerns being marginalised or ignored altogether. The latest
National Report for HBSC England2 shows that in 2009/ 10, 7% of boys
and 10% of girls aged 11-15 years reported smoking at least sometimes; a sharp
decrease since 2002 when 15% of boys and 21% of girls said they smoked at least
sometimes. When it comes to drinking alcohol, at age 11, 4% of boys and 2% of
girls say they drink alcohol every week; the figures for 15 year olds are 32%
of boys and 23% of girls who report weekly alcohol consumption. Again, these
figures have reduced dramatically since 2002 – for some age groups they have
more than halved. We know from other statistics that teenage conceptions are at
their lowest rate since 19693. Meanwhile,
the latest HBSC England report also show that many young people suffer from a
range of physical health concerns. Headaches are the most prevalent, with 33%
of all young people aged 11-15 years saying that they experience headaches
every week. Among 15 year old girls, weekly headaches are reported by almost
half (48%). Around a fifth (22%) of 11-15 year olds say they suffer from weekly
stomach aches, and 14% from weekly back aches. More than half of young people
aged 11-15 years (51% of boys and 62% of girls) suffer at least one physical
symptom weekly (HBSC England unpublished data). Furthermore, unlike many of the
risk behaviours, reported incidences of physical symptoms like headaches are
increasing among young people.
Our
findings that headaches are the most commonly reported physical symptom by
young people is backed up by other research.4 Frequent somatic
symptoms have been identified by children themselves to be related to the
school environment (pressure of studying, noisy classrooms)5, and
insecurity or conflict within the family.6 Other research has
confirmed the association between somatic complaints and school-related stress7
and several studies have found the presence of functional symptoms to correlate
negatively with young people’s quality of life.8-10 Complaints like headaches and stomach-aches may have
physical causes, which need to be investigated, or may be symptoms of other
problems and stress. It is important not to dismiss young people presenting
with such complaints as malingering, but to understand that regardless of the
origins these symptoms can be indicative of serious problems and, consequently,
lead to negative outcomes. Children and young people presenting in health care settings
are also far more likely to discuss physical health symptoms than they are to
discuss risk behaviours, meaning that such concerns may be more amenable to
intervention.
Seeing adolescent health mainly from the perspective of
problematic risk taking could result in overlooking the physical health complaints
experienced by this age group; this tendency is already evident in both
national and international policy. Meanwhile, we suggest that physical health
complaints are far more frequently occurring among adolescents than are risk
behaviours, that they are on the increase and can have a significantly negative
impact on young people’s lives, and therefore deserve greater attention and
respect than is currently the case.
Josefine Magnusson
References
- Department of Health (2010) Healthy lives, healthy people. Department of Health
- Brooks, F., Magnusson, J., Klemera, E., Spencer, N., and Morgan, A. (2011) HBSC England National Report:Findings from the 2010 HBSC study for England. University of Hertfordshire
- Office for National Statistics (2013) Conceptions in England and Wales, 2011. Statistical Bulletin, Office for National Statistics
- Shannon, R.A., Bergren, M.D., and Matthews, A. (2010) Frequent Visitors: Somatization in School-Age Children and Implications forSchool Nurses. The Journal of School Nursing, 26:169-182
- Hjern, A., Alfven, G., and Östberg, V. (2008) School stressors, psychological complaints and psychosomatic pain. Acta Paediatrica, 97 (1): 112-117
- Odegaard, G., Lindbladh, E., and Hovelius, B. (2003) Children who suffer from headaches – A narrativeof insecurity in school and family. British Journal of General Practice, 53 (488): 210-213
- Henriksen, R.E., and Murberg, T.A. (2009) Shyness as a risk factor for somatic complaints amongNorwegian adolescents. School Psychology International, 30 (2): 148-162
- Langeveld, J.H., Koot, H.M., and Passchier, J. (1997) Headache Intensity and Quality of Life inAdolescents. How are Changes in Headache Intensity in Adolescents Related toChanges in Experienced Quality of Life? Headache: The Journal of Head and Face Pain, 37 (1): 37-42
- Youssef, N.N., Murphy, T.G., Langseder, A.L. and Rosh, J.R. (2006) Quality of life forchildren with functional abdominal pain: A comparison study of patients’ andparents’ perceptions. Pediatrics, 117 (1): 54-59
- Hunfeld, A.M., Perquin, C.W., Duivenvoorden, H.J., Hazebroek-Kampschreur, A.J.M., Passchier, J., van Suijlekom-Smit, L.W.A., and van der Wouden, J.C. (2001) Chronic pain andits impact on quality of life in adolescents and their families. Journal of Pediatric Psychology, 26 (3): 145-153
