Improving the Health of Young Canadians
Positive relationships, opportunities competencies, values and self-perceptions help adolescents succeed....the more of these assets adolescents possess, the greater their likelihood of engaging in health-enhancing practices and the less likely they are to engage in practices potentially harmful to their health .
Canadian Population Health Initiative. (2005). Improving the Health of Young Canadians. Ottawa, Ontario: Canadian Institute for Health Information.
The Canadian Population Health Initiative (CPHI), a part of the Canadian Institute for Health Information (CIHI), was created in 1999. CPHI’s mission is twofold:
1. To foster a better understanding of factors that affect the health of individuals and communities; and
2. To contribute to the development of policies which reduce inequities and improve the health and well-being of Canadians.
This report focused on the health of youth aged 12 to 19 years. information was obtained from various published reports and surveys and is referenced accordingly (for example, Youth in Transition Survey, Adolescent Health Survey). In addition, this report features new analyses using data from the Canadian Community Health Survey (CCHS 2003) and the National Longitudinal Survey of Children and Youth (NLSCY Cycle 4, 2000/2001).
Adolescence is the life phase between childhood and adulthood and is marked by biological, intellectual and psychosocial development. It is a developmental phase that begins at different times for different people and progresses at varying rates. It marks a period during which adolescents move from relying on the judgement and authority of others to learning to make independent and responsible choices. Physical changes, including the remodelling of the brain’s basic structure in areas that affect logic, impulse control, intuition and language, also occur.
Adolescence is a time of changing social roles, relationships, experiences, and expectations. It is a time for developing skills for healthy adulthood and of experimentation in activities that may be beneficial or harmful to health. Lifelong behaviour patterns, which can become protective factors against or long-term risk factors for many chronic health conditions, may be established or strengthened.
Although adolescence is generally a time of good health, injury, depression, substance use, violence and risky sexual activities can present threats to the health and well-being of this age group. A broad range of factors and determinants of health may interact to affect health and well-being during this life phase. One such factor includes positive relationships, opportunities competencies, values and self-perceptions that help adolescents succeed.
Research from other countries has shown that the more of these assets adolescents possess, the greater their likelihood of engaging in health-enhancing practices and the less likely they are to engage in practices potentially harmful to their health .
Just the facts:
1. In 2003, 76% of 12- to 14-year-old males and 71% of 12- to 14-year old females were moderately active or active in leisure-time physical activity; among youth aged 15 to 19 years, rates decreased slightly for males to 74% and decreased significantly for females to 61%.
This research noted that community engagement and feelings of community belonging are facilitated through opportunities for youth to participate outside of school in clubs, sports, music, the arts, fundraising, volunteer activities and other community organizations and activities. Participation in extracurricular activities and community youth organizations is associated with better self-reported health, higher perceived self-esteem and feelings of control.
Current research indicates that children’s participation in organized activities is associated with family income level. Children in low-income families, in single-parent families and of caregivers with less than a high school education are less likely to have ever participated in organized activities.
Among Canadian youth aged 12 to 17 years, 73% engage in volunteer activities. Rates of volunteerism are higher among females (77%) than males (70%). Relative to the Canadian average (73%), volunteerism was highest among youth in Alberta (82%) and lowest among youth in Quebec (61%) in 2000/2001. Previous research shows an association between higher levels of community involvement and never having had sexual intercourse. Further to this, new CPHI analyses show that compared to nonvolunteers, youth who volunteer are less likely to report using tobacco and marijuana and more likely to report high self-worth and excellent or very good self-rated health (see Figure 4). Non-volunteers, on the other hand, report lower levels of anxiety. This finding is in line with current research that shows that while adolescents’ participation in physically active leisure, sports and activities increased from the early 1990s to the late 1990s, so did their reported levels of feeling rushed and time-stressed. In the CPHI analyses, adolescents’ use of alcohol and their contact with peers who engage in criminal behaviours were not associated with whether or not they volunteer.
Evidence also indicates that feeling a sense of belonging to one’s community is associated with higher levels of health status.
A recent study among First Nations youth in British Columbia found that Aboriginal control of key aspects of community and cultural life are strongly associated with lower youth suicide rates. The term ‘cultural continuity’ is used to describe efforts to preserve and promote cultural practices and to control and manage available resources. Markers used to create the cultural continuity index for the B.C. study include community self-government, control over a traditional land base, band-controlled schools, community control over health services, presence of cultural facilities and control over police and fire services. In communities without any of these markers, the rate of youth suicide was 138 per 100,000 population, compared to virtually no suicides in communities with all six markers. Among male and female youth aged 12 to 19 years across the 10 provinces, 17% report a very strong sense of belonging to their community and 55% a somewhat strong sense of belonging.
Across the three territories, 26% report a very strong sense of belonging and 52% report a somewhat strong sense of belonging.
Approaches that support healthy youth development
The study stated that while interventions that address risky behaviours can be effective, there is emerging evidence that suggests that youth may also benefit from approaches that focus on supporting healthy development. Healthy youth development initiatives, also known as positive youth development, view adolescence as a stage in which youth:
1. develop a sense of identity and competence;
2. make transitions from school to meaningful employment;
3. participate in their community; and prepare for personal relationships and family life.
Approaching adolescent health from a positive development perspective differs from problem-based programs (such as smoking cessation) by focusing on providing support for youth to experience:
1. a sense of belonging;
2. bonding and connections to caring, committed adults;
3. age-appropriate responsibility for decision-making, problem solving;
4. leadership roles and activities that are youth friendly and encourage youth ownership and participation.
Some research suggests that by creating supportive environments and opportunities, a positive youth development approach can provide both prevention and health promotion benefits.
Evidence from a review of outcome-evaluated positive youth development initiatives indicates that, effective programs which sought to build competence and strengthen bonding showed improvements in relationships with parents, school attachment and attendance, as well as a reduction in problem behaviours such as substance use. There is also some evidence that suggests that interventions that support youth to engage in employment and learning experiences and to develop healthy relationships, problem solving and coping skills may be linked to healthier transitions to adulthood. However, more research is needed to better understand the effectiveness of positive youth development approaches on long term outcomes.
The report shows that youth with higher levels of parental nurturance and school attachment report higher levels of health status. In addition, the association between assets and positive health behaviours and outcomes appear to be cumulative. Youth with more assets are less likely to engage in risky behaviours than youth with fewer assets and are more likely to report high levels of health status and self-worth.
| © 2005 Canadian Institute for Health Information The contents of this publication may be reproduced in whole or in part provided the intended use is for non-commercial purposes and full acknowledgement is given to the Canadian Institute for Health Information. Canadian Institute for Health Information 495 Richmond Road Suite 600 Ottawa, Ontario, Canada K2A 4H6 Telephone: (613) 241-7860 Fax: (613) 241-8120 www.cihi.ca ISBN 1-55392-680-3 (PDF)