Men and women between the ages of 15 and 24 should have healthy bodies in peak condition. Reproductive systems are fully matured and one’s capacity for physical fitness is at its peak. At the same time, however, the transition to adulthood is a time of enormous change.

Young people who experimented with smoking, drinking and drugs in their younger teens make health behaviour decisions that will have dramatic consequences on their health in later life. Young people also make many other decisions related to their health. They become involved in sexual relationships. They leave school and home. They move, get jobs, fall in love, find an intimate mate and set up new homes. While many of these changes are positive ones, they are also stressful.

Young people who have poor control of how they react to stress or have not learned to delay gratification are more likely to engage in substance abuse, and to suffer injuries and stress-related illnesses.

Injuries, mostly in motor vehicles, are responsible for half of the deaths of older teens and young adults; young men are more far more likely to die than young women. Aboriginal youth are almost three times as likely to die from injuries than youth in the non-Aboriginal population. (184)

Suicide is the second leading cause of death among older teens and young adults of both sexes. Young men are more likely than young women to be successful at suicide attempts; however, young women try to commit suicide more often than young men. There has been a steady, significant increase in adolescent suicides in the last three decades from a low of 7 per 100,000 in 1970 to the current rate of 13 per 100,000. The suicide rate among 20 to 24-year-olds has remained at 14 per 100,000 since 1989. (304, 306) The rate of suicides among Aboriginal youth (five times the national average) is shocking.

Young adults who are working report the highest levels of job stress and the lowest levels of job satisfaction. (304) This is likely a result of large numbers of young people’s underemployment in service jobs that are high on stress and boredom and low on personal control and challenge. Young women between the ages of 15 and 19 are the most likely of any sex-age group to exhibit signs of depression (14%); women between 20 and 24 are also well above the average at 10%. (304)

Numerous studies have shown that adolescent women have lower levels of self-esteem than young men and that self-esteem declines for young women as they go through high school. (249)

Low self-esteem may be one of the factors related to the growing incidence of eating disorders among young women. The overwhelming need to be thin and sexy is fuelled by society’s expectations and media portrayals of unrealistic body shapes. Studies show that 20 percent of young women are underweight (Body Mass Index less than 20) and 56 percent are in the healthy weight range (BMI 20 to 25). Despite this, some 46% of young women between the ages of 20 and 24 say that they would like to lose weight and to have a weight that falls in the underweight category. (318)

Smoking among young adults and particularly adolescent women is a major concern. Young adults between 15 and 19 is the only age category that has shown a consistent increase in smoking over the last ten years and the only age category in which women are more likely than men to smoke. If this trend continues, we will see a virtual epidemic of lung cancer in women in the future. Lung cancer has already replaced breast cancer as the number one cancer killer of women in Canada. High levels of underage drinking is also problematic: 43% of youth between the ages of 15 and 19 report being current drinkers. (304) Excessive drinking among adolescents is highly related to experiences of unprotected sex and to drinking and driving incidences.

Socioeconomic status and peer influences are strongly linked to health behaviours. Young people from low income families and whose parents and friends smoke are far more likely to smoke themselves than youth who come from higher income families.

While people from high-income households in all age groups drink more frequently than people in other income groups, lower income individuals tend to consume greater amounts (binge) when they do drink. The 1993 General Social Survey provided a profile of the individual most likely to have a drinking problem: a young adult male, single or divorced, who is unemployed and has a relatively low-income. These are the likely to be the same young men who are responsible for most collisions related to impaired driving. (289)

Street youth are exposed to a variety of serious health threats including drug addiction (two-thirds are involved in illicit drug use), HIV infection through needle sharing, unsafe sex practices and poor hygiene. They are also more likely to be involved in criminal activities such as prostitution and drug trafficking. (289)

Sexual health has become an increasingly important aspect of healthy living given that the consequences of unsafe sex now range from infertility (caused by sexually transmitted diseases (STD)) to unwanted pregnancies, illness and even death, in the case of AIDS.

Chlamydia and gonorrhea infection rates are highest among female teens (1359 and 125 per 100,000 respectively). Syphilis infection is most common among 20 to 24 year-old men and women (rates of 1.3 and 1.6 per 100,000 respectively). (310) All of these STDs can cause illness and infertility.

AIDs statistics are not a reliable way of assessing HIV infection rates in young people due to the lengthy incubation period for HIV. HIV infection continues to be highest (between 12 and 18 percent) among gay and bisexual men. (317) Evidence suggests that Aboriginal young people are infected at younger ages and that injection drug use is an important mode of HIV transmission. Other groups at high risk for HIV infection include young gay men and street youth.

Some 450,000 young people (between the ages of 15 and 24) report activity limitations due to disability. Nervous system conditions such as vision or hearing difficulties, respiratory/digestive conditions and limb problems are the main causes of disability. (304)

Many of the concerns related to health in young adulthood are linked to personal lifestyle choices. However, all of these "choices" are linked to the capacity of the home, school, community, workplaces and governments to make "the healthy choices the easy choices" for young people. Strategies that do not address the environments in which young people learn and live will be of limited value.

School-based health instruction is essential. Extensive evaluations of health education programs have reported that 50 hours of well-planned programs can affect changes in student’s health behaviours, attitudes and knowledge. (268) Further research has shown that these benefits are enhanced by a comprehensive approach that compliments health instruction with a healthy physical and social environment in the school and collaboration with services and supports in the community. (267) This approach, which is called "comprehensive school health", has been endorsed by more than 20 national associations in Canada as well as UNESCO and UNICEF. Comprehensive school health assumes an interdependent and dynamic relationship among three components: instruction about health, community health and social services, and healthy physical and social environments that include support from family members, peers, policy makers and the community.

Efforts to increase health knowledge and to encourage positive health practices should not stop after high school. Colleges, universities, workplaces and communities have key roles to play in educating young adults about health issues.

Health promotion initiatives that encourage healthy lifestyle choices need to address gender differences in health behaviours. Studies have shown, for example, that young women may smoke for different reasons than young men (for example, because of concerns about body weight and as a coping mechanism for high perceptions of stress). Programs and support need to address the underlying reasons for taking up a negative lifestyle habit and help young people find healthy alternatives to dealing with those issues.

Community cohesion — the extent to which community members, employees or students and staff in a school feel a collective sense of responsibility to the health and well-being of their fellows — also affects the health practices of youth. When residents have little attachment to the community and each other, there are more likely to be drug and alcohol related problems. (319)

Young people and health behaviours

• Thirty-six percent of young adults between the ages of 20 and 24 are current smokers (second highest level of all age groups).

• Twenty-eight percent of male adolescents between 15 and 19, and 30 percent of females in the same age category are current smokers. This is the only age-sex category where more girls than boys smoke and the only age category in which smoking is continuing to rise. (304)

• Fifty-one percent of smokers between 20 and 24 reported having started to smoke before the age of 16. (308)

• In the age category of 15 to 19, 46 percent of males and 37 percent of females are current drinkers. Amongst people 20 to 24 years of age, 74 percent of males and 55 percent of females are current drinkers. (304)

• Young people between the ages of 15 and 19 had the highest admission rates to hospital (163 per 100,000) for medical problems caused by the abuse of illicit drugs. (308)

• There are significant differences between females and males in physical activity patterns for youth between the ages of 15 and 19. Over 50 percent of young women in this age group report that they are inactive compared to 29 percent of male youth. The number of inactive young men increases to 48 percent in the 20 to 24 age group and to 56 percent among females in this age group. (304)

• Almost half of young adults report having had sex by the age of 15 or 16. Thirty-three percent of males between the ages of 15 and 24 and 18 percent of females between 15 and 24 had two or more sex partners in the previous year. (318)

Key influences on the positive outcome: Prepared to manage their personal health and well-being

 
Capacity for self-care
 

Influence and social support of significant others

 

Supportive learning, living and working environments

 
Media

Note: These influences are also listed in the drop-down list above. Please use this menu to navigate within this page.


Capacity for self-care

Self-care relates to people’s ability to manage and improve their own health. This requires the knowledge, skills and motivation to carry out everyday tasks such as nutritious food preparation and dental care to knowing when to seek help for an emotional problem such as depression and how to access health and social services for issues such as family violence. Finding productive ways to deal with stress that do not involve substance misuse or abuse is especially important to this age group. Much of these skills are learned at home and in school, but communities and workplaces also have a role to play in assisting young people outside of school.

Self-esteem is a reccurring factor in young people’s lifestyle choices although there are gender differences. Young men with low self-esteem are far more likely to smoke; young women with low self-esteem are more likely to have trouble saying no to unhealthy sex practices.

Health promotion theory supports the notion that people must be empowered and confidant enough to manage and improve their own health and that the role of health and social service providers is to enable this to happen. Thus, young people must be intimately involved in decision-making roles in all efforts to promote their health. They must decide on their own priorities and encouraged to take action in areas that are important to them.


 

  • Help young people build a strong sense of identity and self-esteem so that they can resist pressures to use drugs, engage in unhealthy sex practices, etc.

  • Recognize your children’s uniqueness, particularly their strengths.

  • Give adolescents (both men and women) some responsibility for shopping for, preparing and cooking healthy foods.

  • Provide young people with opportunities and the equipment they need to be physically active. Encourage them to participate in sport and recreational activities at school and in the community, as well as alone or with friends.

  • Engage adolescents in straight talk about sexuality, safe sex, healthy intimate relationships, the role of alcohol in sexual encounters, family planning and reproductive health.

  • Set clear boundaries related to alcohol and drug use, behaviour when alone in the house, and honesty. Involve young people in setting these boundaries together.

  • Be aware of the signs of emotional distress in young people. Take action immediately if you suspect that your adolescent is depressed or suicidal.

  • Adopt a comprehensive school health approach that compliments high quality health instruction with a healthy physical and social environment in the school and collaboration with services and supports in the community.

  • Provide high quality health education programs that emphasize the development of attitudes, values and behaviours, not just knowledge acquisition. Use a sequential, comprehensive approach that treats health in a holistic way, rather than a host of non-integrated instructional periods about single issues.

  • Provide a lifestyle-focused physical education curriculum (rather than just competitive athletics) that focuses on fitness, fun and the development of lifetime activity skills.

  • Incorporate health messages into other subjects, for example, science, social studies and home economics.

  • Provide teachers with in-service training on emerging health issues.

  • Facilitate meetings of the principal, school nurse, guidance counsellors, social workers, police liaison officers and parent representatives.

  • Monitor students’ behaviour. Missing classes, declining participation and an inability to concentrate may be signs of substance misuse. Communicate with parents regularly about student’s health and participation in school.



  • Offer health promotion and health education programs to employees, for example, smoking cessation, and active living, so that young adults can adopt positive health practices.

  • Support local events such as health fairs, charity runs, etc.

  • Offer sport and active recreation programs to employees.

 


Influence and social support of significant others

Increasingly, as teens grow older, peers and significant adults outside the family influence their health behaviour choices. Social networks are a predisposing factor in the use of alcohol and illicit drugs by young people. Young people whose peers and parents use alcohol or drugs are much more likely to do the same. In terms of smoking, the social network is believed to be the single most important determinant of smoking onset among young people. (289)

On the other hand, there is a substantial body of evidence to support the effectiveness of peer teaching and peer helping when it comes to making healthy lifestyle choices. See The Peer Helping Annotated and Indexed Bibliography for more information.

 

Be a good role model.

• Do not smoke, use illegal drugs or engage in unsafe sex. Use alcohol in moderation (if at all) and do not drink and drive. Use prescription medications as advised by your doctor and do not misuse over-the-counter drugs.

• Enjoy healthy eating and physical activity yourself and as a family.


  • Provide peer counselling/helping programs in areas such as substance abuse prevention and the prevention of eating disorders. See The Peer Helping Annotated and Indexed Bibliography for further information.

  • Invite local athletes and celebrities to serve as role models and spokespeople for positive lifestyle choices.

  • Support parents in responding to youth crises. Parents responsiveness to problems such as drug abuse, suicide attempts, eating disorders and problems related to sexual orientation can be improved by giving them information and support. Parents need to understand the child development process, the issues related to the transitions to adolescence and adulthood and how to recognize and respond to cries for help. In addition to information, parents who are having difficulty with adolescents need hands-on support from service providers who can help. Accessessibilty to help is especially important in rural and isolated areas where families are isolated and often under-serviced.

  • Offer employee assistance programs (EAP) and counselling for troubled employees.

  • Have an occupational nurse on site who can provide advice on health concerns and carry out preventive programs.

  • Promote a working culture that is supportive of peer relationships and healthy lifestyle practices.

  • Provide incentives for health professionals to support self care practices such as quitting smoking and to support prevention activities.

Supportive learning, living and working environments

School, workplace and community level interventions that strengthen social networks can help to foster collective social support and prevent or alleviate these problems. (289)

In Canada, the nature of one’s living and working environment most often reflects one’s socioeconomic status. Crowded housing, neighbourhoods where there is a lot of drug dealing and unemployment, isolated living conditions with little to do, and unsafe workplaces all contribute to youth misuse of alcohol and tobacco and to feelings of alienation and depression.


Create healthy environments and make the healthy choices the easy choices.

  • Adopt and enforce policies of no smoking or use of alcohol or other drugs on school property.

  • Provide healthy food choices in school cafeterias and vending machines.

  • Provide opportunities for healthy, fun physical activity outside of the physical education curriculum.


Actively involve youth in decisions, policies and programs that affect their health; provide them with opportunities to develop leadership skills and take on leadership roles.

  • Encourage children and youth to define the issues that affect their health and work together to address these issues. A Dialogue with the Children and Youth of Ottawa-Carleton is an outstanding example of how a public health department took the lead in implementing a multisectoral dialogue with youth that led to a comprehensive collaborative plan for promoting adolescent health.

  • Encourage young people to show leadership in responding to health issues that concern them. Making A Difference For Youth in Antigonish, Nova Scotia has taken on a number of community initiatives and entrepreneurial projects related to health issues.

  • Encourage children and youth to lead activities during National Drug Awareness Week, National Nutrition Month, National Non-Smoking Week and other designated weeks and months.

  • Offer programs that are youth led in disadvantaged neighbourhoods. The Media Arts Program in Regent Park, Toronto is one example of a model program.

Cooperate with schools to adopt a comprehensive school health approach that compliments high quality health instruction with a healthy physical and social environment in the school, and collaboration with services and supports in the community.

  • Work with schools to develop integrated, holistic health promotion materials and programs that fit local needs.

  • Assist in training teachers.

  • Work with schools to provide complimentary services that respond to local needs. For example, studies have shown that school-based health clinics with a generic front can be effective in overcoming access barriers and in changing sexual behaviours. (270) Provide a range of services from information to support, counselling and rehabilitation.

  • Facilitate meetings of the school principal, school nurse, guidance counsellors, social workers, police liaison officers and parent representatives.

  • Provide schools with an up-to-date list of self-help groups and available health professionals and counsellors.

  • Provide prevention, treatment and counselling services for alcohol and drug use (including tobacco) and counselling for safe sex, Ssexually transmitted diseases, AIDS, sexual abuse, sexual assault and family planning.

Create healthy environments and make the healthy choices the easy choices.

  • Empower residents' committees to take charge and clean up unhealthy neighbourhoods. The Alexandra Park Resident’s Association is an excellent example of this.

  • Adopt and enforce policies of no smoking or use of alcohol or other drugs in public places where young people gather, and in all community programs that include children and young people.

  • Provide hassle-free healthy sexuality clinics and anonymous testing for sexually transmitted diseases and HIV.

  • Provide healthy food choices in public places and vending machines.

  • Provide ways for young people to make constructive use of their leisure time, for example through opportunities for enjoyable physical activities that stress fun and leadership development. This may be especially important in rural and isolated areas where young people have little to do in their leisure time and are often unemployed. The Town Youth Participation Strategy describes an effort in small towns in rural Ontario.

  • Create walking and cycling paths, ski trails, skating areas, swimming areas and other incentives for spontaneous physical activity.

  • Report merchants who sell tobacco or alcohol to underage youth.

  • Sponsor alcohol free dances and special events, for example, New Year’s Eve celebrations.

Provide support to young people in need, especially young pregnant women, young parents and street youth.




  • Provide a smoke-free workplace and enforce policies against drinking or drug use at work.

  • Offer healthy food choices in cafeterias and catered events.

  • Offer health promotion and health education programs to employees, for example, smoking cessation programs, so that young adults can adopt positive health practices.

  • Support local events such as health fairs, charity runs, etc.

  • Offer sport and active living programs to employees either on site or in collaboration with a community facility.

  • Support research and information dissemination on best practices of interventions that create environments which help young people make healthy lifestyle choices.

  • Implement mandatory health and physical education programs in all schools. Work with school administrators to ensure that high quality programming that meets local needs is carried out.

  • Support teaching of healthy sexuality in schools.

  • Support the training and use of specialist teachers in health and physical education.

  • Develop policies, programs and procedures to support a comprehensive school health approach, participatory needs assessments and needed services.

  • Adopt and enforce policies of no smoking or use of alcohol or other drugs in public places where children gather, and in all community programs that include children and young people.

  • Enforce the law. Monitor merchants and fine those who sell tobacco or alcohol to underage youth.


Media

Advertizing, movies, television programming and music bombard young people with seductive messages that glamorize smoking, drinking, drug use, violence, foods with little nutrition value and unhealthy sexual relationships.

  • Communicate your disapproval when media that youth are attracted to portray images and messages that glamorize unhealthy lifestyle choices. Praise media that shows positive lifestyle choices as attractive and fun.

  • Provide media literacy programs that teach young people to critically examine how advertisements for tobacco and other products are designed to encourage young people to buy and use their products, despite the known negative effects on their health.

  • Protest advertising of tobacco and alcohol near school properties.

  • Link health education activities with media awareness campaigns linked to special weeks and events, fro example, National Non-Smoking Week and Weedless Wednesday.

  • Work with the media to arrange for student assignments such as preparing a public service health message or writing an article about a health issue.

  • Advocate media coverage that portrays healthy young people involved in healthy lifestyle activities.

  • Protest media coverage that glamorizes drinking, smoking, drug use and unhealthy sexual behaviour.

  • Encourage media personalities to act as positive role models for young people.

  • Encourage media outlets to sponsor youth sports and activities and to provide coverage of young people’s events.

  • Encourage media outlets to provide programs and ads that provide young people with the information they need to make healthy lifestyle choices.

  • Encourage media outlets to work with schools and community groups to arrange for young people to prepare a health message, participate in a talk show about a health issue, etc.

  • Protest advertizing of tobacco or alcohol near school property or at events designed for young people and families.

  • Regulate the advertising of tobacco and alcohol.

  • Provide guidelines for programming directed at children and youth and encourage the development of self-regulating guidelines in the media industry.

  • Sponsor media campaigns and programs that portray youth and role models enjoying healthy lifestyles and choosing not to use alcohol, tobacco or drugs or to engage in inappropriate sexual behaviour.

  • Sponsor media campaigns and programs that provide young people with relevant information about healthy lifestyle choices in a way that appeals to them.

  • Provide an example in all government communications. Show children and young people making healthy lifestyle decisions such as wearing a bicycle helmet, engaging in physical activity and eating healthy foods.


Aware of any innovative programs, legislation or initiatives that are relevant to this positive outcome?
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We are always on the lookout for specific strategies proven to be successful (or showing promise), that illustrate work done in this area. After reading this section of the site, click on the icon below and share your ideas.



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