Schools can have a major influence on health behaviours in young people, according to new research by the Economic and Social Research Institute (ESRI). The study found school policies and facilities had little impact on health behaviours, whilst school climate and negative relationships with teachers predicted drinking and smoking behaviour.

The research analyses how four different key risk factors for disease – smoking, alcohol consumption, physical activity, and diet – vary among groups of adolescents.

Data from nearly 5,000 17-year-olds in Ireland was examined for the study. The study found that students could be categorised into clusters based on three discrete health behaviours: 43% belonged to the “healthy” group, who did not smoke, drank rarely, had the best dietary quality, and engaged in regular physical activity. 36% belonged to the “unhealthy diet and physical activity” group, who did not smoke, drank rarely, but had the poorest dietary quality and the worst level of physical activity. 21% belonged to the “unhealthy smokers and drinkers” group, who were daily or occasional smokers, had the highest level of alcohol consumption, moderate to low levels of physical activity and poor to moderate dietary quality.

Within these groups, researchers found that a number of factors were associated with a particular cluster membership. Young women were more likely to fall into the unhealthy diet and activity groups, as well as the unhealthy smoker and drinker groups. Young people from working class backgrounds were more likely to smoke and drink. Parental health behaviour also made a difference, with higher rates of drinking and smoking among young people whose parents are occasional or regular smokers.

Young people’s health behaviours were found to be majorly influenced by the secondary school attended, and to a lesser extent, the primary school attended.

The measures of school policy, examined generally, had insignificant impact on which cluster students belonged to. Healthy eating policies and physical education in schools was found to have little effect – instead, the socioeconomic composition of students and school climate arose as the most dominant influences on health behaviour. Smoking and alcohol consumption was also less evident where students were given a greater say in school life.

Negative interaction with teachers and disaffection from school was also correlated with higher levels of drinking and smoking in students. Students with poor dietary quality and physical activity showed signs of being more socially isolated, having greater peer problems and having less interaction with teachers.

The research was funded by HSE Health and Wellbeing as part of their work to promote health under the Healthy Ireland Framework.

Speaking to the Irish Examiner, Anne Nolan, an author of the report, suggested that a “multi-faceted approach is needed to promote positive health behaviours”.

“The research findings show that measures to promote both school engagement and a more positive school climate … are likely to have positive spill-overs for other aspects of young people’s lives, including health behaviours”, she commented.

Helen Deely, Interim Programme Lead for HSE Health and Wellbeing, told the Irish Examiner that “patterns of health behaviour that can lead to chronic illness can be formed at a young age. This research is telling us that a positive school environment … makes it less likely that young people will turn to risky health behaviours, such as using tobacco and alcohol or engaging in unhealthy eating patterns to cope with their feelings of isolation and disconnection.”

Speaking to The College Tribune, Patricia Fitzpatrick, Professor of Epidemiology & Biomedical Statistics and Chair of the Healthy UCD Steering Committee, commented on the study: “This ESRI study reflects the lifestyle choices also seen in Healthy Ireland annual surveys, but also highlights [two] important points; the clustering of lifestyle choices and the importance of the educational setting, working with parents, in establishing lifestyle choice of young adults. We unfortunately see these clusters of unhealthy choices in all ages in society. The university setting is the next educational setting which has an impact on young adults’ lifestyle choices.”


Nessa Collins – Reporter