The clustering of risk behaviours in adolescence and health consequences in middle age

Abstract

There is increasing interest in the clustering of risk behaviours in adolescence. However, few studies have examined what clusters of risk behaviours exist among adolescents, their earlylife predictors, and their associations with later health. MethodsWe analysed data derived from 8754 participants (women 53.3%) in the 1970 British Cohort Study. Latent class analysis was used to identify clusters of risk behaviours at age 16.Regression modelling was then used to examine predictors of clusters and their consequences of risk behaviours and health outcomes at age 42. ResultsWe identified two latent classes: a risky-behaviour (men: 20.0%, women: 23.6%) and less-riskybehaviour class. Among men, those in the risky-behaviour class were more likely to report smoking, multiple binge drinking, sexual debut before 16, involvement in fights and delinquency than were women. Membership in risky-behaviour class was mainly predicted by sociodemographic and parental risk behaviours and monitoring. The risky-behaviour class at age 16 was associated with the following outcome age 42: smoking status (more strongly among women), excessive alcohol consumption (more strongly among men), worse self-rated health (more strongly among men), and psychological distress (only among women). ConclusionsEngagement in multiple risk behaviours in adolescence is an important driver of health inequalities later in life. Early life intervention, for example via school-based interventions, may be warranted for favourable lifelong health.

Is Mental Health Competence in Childhood Associated With Health Risk Behaviors in Adolescence? Findings From the UK Millennium Cohort Study

“…Our research shows that MHC at the end of elementary school is associated with a number of health risk behaviors at age 14 years, particularly for those with the lowest levels of MHC. Although health risk behaviors may reflect normative adolescent development, behaviors such as smoking, illegal drug use, binge drinking, antisocial behavior, and sexual risk taking are important predictors of later health risk behaviors and/or may have adverse consequences for later health (including greater likelihood of cardiovascular disease and cancer) and social well-being [ [1] , [2] , [3] , [4] , [37] , [38] , [39] ]. Research has also suggested that health risk behaviors in adolescence are likely to cluster and covary and may influence the development of more extreme or new behaviors over time [ 2 ].…”

“…Research has also suggested that health risk behaviors in adolescence are likely to cluster and covary and may influence the development of more extreme or new behaviors over time [ 2 ]. It has also been found that early onset of smoking and sexual intercourse compared with peers is associated with greater involvement in risky behaviors in early adulthood [ 2 , 4 ]. School-based life skills and positive youth development programs may help reduce the likelihood of certain health risk behaviors, such as alcohol and drug consumption in young adolescents [ 2 , 38 , [40] , [41] , [42] ].…”

“…A number of behaviors such as cigarette smoking, substance abuse, and engaging in risky sexual behaviors are associated with increased risks to health and well-being [ 1 , 2 ]. Although the tendency to explore different behaviors and identities may be driven by normative adolescent developmental processes, many such “health risk behaviors” are initiated during adolescence and may cluster and track into adulthood, affecting health and social outcomes such as education and employment [ [2] , [3] , [4] ]. Although the United Kingdom has made progress in reducing the prevalence of particular health risk behaviors in adolescents since the turn of the century, these remain a concern in health research and policy [ 3 , 5 , 6 ].…”

Effects of a Whole-School Health Intervention on Clustered Adolescent Health Risks: Latent Transition Analysis of Data from the INCLUSIVE Trial

“…Adolescence is a time typically characterised by good physical health but the emergence of risk behaviours, including bullying and aggression, as well as common mental health problems, with important consequences for individuals' current as well as adult mental and physical health. Such risks and problems tend to cluster within individuals (Meader et al, 2016), with clustering of multiple risks being associated with particularly poor health in adulthood (Akasaki et al, 2020). Whole-school interventions are a promising approach to preventing bullying and aggression while also promoting broader health (Smith et al, 2004;Vreeman & Carroll, 2007).…”

Measuring Health Behavior Problems in Chinese Adolescents: Scale Development and Preliminary Validation

“…Other studies have con rmed that the improvement of risk behaviors in adolescence is an important way to prevent chronic diseases at an older age [10]. Health behavior in the early stages of life has an impact on health consequences in later life [11,12]. Adolescence is a critical transitional period within the life course during which rapid physical, emotional, cognitive, and social development occurs [9,13].…”