Prevalence and clustering of unhealthy behaviours in young people: an analysis of health and wellbeing surveys in Southeast England

Background: Most chronic diseases are strongly associated with four modifiable behaviours: smoking, alcohol consumption, low fruit and vegetable consumption and physical inactivity. When established early in life, these lifestyle factors could persist in adulthood and predict the incidence of chronic diseases. The objective of this study was to determine the prevalence of these behaviours and association between sociodemographic/personal characteristics and clustering of multiple unhealthy behaviours in young people. Methods: Data from the Brighton and Hove Safe and Well at School Surveys (2010-2014) were analysed to examine the prevalence and clustering of these behaviours in Year 10 and 11 pupils (n=10,099; aged 14-16 year). Results: Of the 10,099 pupils aged 14-16 years, the vast majority (97%) were engaged in either one or more unhealthy behaviours: about 58% were engaged in 1-2 and 39% were engaged in 3-4 unhealthy behaviours, respectively. Multiple regression analysis showed that a number of factors were significantly associated with the clustering of 3-4 unhealthy behaviours in young people. These included: being in Year 10 (OR=2.0, 95% CI, 1.8-2.2), family problems (1.8, 1.6-2.0), being female (1.7, 1.5-1.9), not enjoying school (1.6, 1.4-1.8), and rarely/never feeling happy (1.3, 1.0-1.6). Conclusions: These findings highlight the need for modifications in community-based and in-school health and wellbeing programmes to increase awareness about health impacts of smoking and alcohol consumption and beneficial effects of healthy diet and exercise to decrease the prevalence and clustering of unhealthy behaviours in young people.