Selected determinants of health behaviour in school children from rural environment

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1 Sygit Probl K, Hig et Epidemiol al. Selected 2014, determinants 95(4): of health behaviour in school children from rural environment 889 Selected determinants of health behaviour in school children from rural environment Wybrane uwarunkowania zachowań zdrowotnych młodzieży szkolnej ze środowiska wiejskiego Katarzyna Sygit 1/, Marian Sygit 1/, Ewa Pielichowska 2/ 1/ Chair of Pro-Health Upbringing, Faculty of Physical Education and Health Promotion, Szczecin University 2/ Department of Nursing Anesthesiology and Intensive Care, Medical University of Wroclaw Wstęp. Niezbyt korzystne warunki życia ludności, w tym w szczególności w środowisku wiejskim i stosunkowo niski poziom kultury zdrowotnej, nie sprzyjają zachowaniu zdrowia ludności. Stan zdrowia ludności kraju, w tym także młodzieży, oceniany jest jako wysoce niezadowalający. Cel badań. Poznanie niektórych wybranych uwarunkowań zachowań zdrowotnych młodzieży od 15 do 19 roku życia ze środowiska wiejskiego. Materiał i metoda. Badaniami objęto młodzież wiejską w wieku od 15 do 19 roku życia. Przebadano ogółem 984 osób oraz ich rodziców. Badania miały charakter badań reprezentacyjnych. W badaniach zastosowano autorskie kwestionariusze badań. Wyniki. Z rodzin pełnych pochodziło 85,87% badanych a niepełnych 11,45%. Przeważały gospodarstwa nierolnicze, z których pochodziła badana młodzież (52,98%). Sytuacja mieszkaniowa badanych gospodarstw domowych, wg 69,61% była dobra, zła natomiast u 14,5%. Odnotowano zależność spożycia I śniadania od płci badanej młodzieży, od wykształcenia rodziców, sytuacji finansowej gospodarstwa domowego, stwierdzono brak zależności od dochodu. Stwierdzono zależność spożycia podstawowych produktów odżywczych od sytuacji finansowej gospodarstwa oraz od dochodu w gospodarstwie domowym. Odnotowano również, zależność palenia tytoniu od płci badanych, wykształcenia rodziców, ale nie stwierdzono zależności od dochodów. Stwierdzono zależność od płci badanych, wykształcenia ich rodziców, sytuacji finansowej gospodarstwa domowego oraz dochodu. Wnioski. Stwierdzono: znaczną przewagę zachowań antyzdrowotnych nad zachowaniami prozdrowotnymi oraz złą sytuacje socjobytową rodzin badanych. Stwierdzono również zależności zachowań zdrowotnych młodzież od ich płci, wykształcenia rodziców, ich sytuacji bytowej oraz sytuacji finansowej gospodarstwa domowego. Słowa kluczowe: młodzież, środowisko wiejskie, żywienie, używki Probl Hig Epidemiol 2014, 95(4): Nadesłano: Zakwalifikowano do druku: Introduction. Poor living conditions of the population, particularly in the rural environment, and relatively low level of health culture are not conducive to the health of the population. The health condition of the population, young people included, is assessed as highly unsatisfactory. Aim. To investigate some selected determinants of health behaviour in young people aged between 15 and 19 years from the rural environment. Material & Method. The study covered rural youth aged between 15 and 19 years. We examined a total of 984 people and their parents in sample surveys. The study used authors questionnaires. Results % of the respondents came from a full family and 11.45% from a one-parent family. Non-agricultural farms dominated as the origin of the young people under study (52.98%). The residential situation of the households surveyed was good according to 69.61% and bad for 14.5%. A relationship between breakfast consumption and gender of the young people was found out, along with the education of parents, and the financial situation of the household. No correlation with income was found. A correlation between the consumption of basic nutritional products and the financial situation of the farm and the household income was ascertained. Another relation between smoking and both the gender of respondents and the parents education was also noted, but no relation with income. A correlation with the gender of respondents, their parents education and the household financial situation and income was noted. Conclusions. Unhealthy behaviour prevailed over pro-health conduct and the surveyed families lived in bad conditions. It was also revealed there was a relation between the pro-health behaviour of the young people and their gender, parents education, living conditions and financial situation of the household. Key words: youth, rural environment, nutrition, stimulants Adres do korespondencji / Address for correspondence Associate Professor Katarzyna Sygit Zakład Promocji Zdrowia, Wydział Kultury Fizycznej i Promocji Zdrowia Uniwersytet Szczeciński Al. Piastów 40 B, bl. 6, Szczecin tel , fax , ksygit@poczta.onet.pl Introduction The deteriorating health situation of the population as well as numerous health risks and health problems force to seek ways for improvement. Health should be protected at every stage of life. People should be aware of their own health status, behave accordingly and try to improve it starting from school age. When early habits and customs are established, they should include health protection, healthy lifestyles and health education [1-4]. Reports of the subject literature seem to indicate that this sphere of life and education is somewhat neglected, probably very differentiated, conditioned by the influence of various factors, both environmental and individual [5-8].

2 890 Probl Hig Epidemiol 2014, 95(4): Therefore, identifying the hazards, finding their determinants, diagnosing the situation, particularly among young people from the rural environment, is especially needed and expected. The programs of health promotion and prevention in adolescents from the rural environment must be based on a fully reliable, documented and monitored diagnosis of their social situation [9-11]. Poor living conditions of the population, particularly in rural areas, along with a relatively low level of health culture defined by improper diet, insufficient physical activity, alcohol abuse, smoking, are not conducive to maintaining good health condition of the population. The health condition of the Polish population, young people included, has been assessed as highly unsatisfactory [12-14 ]. Concrete measures to promote health at school and at home are necessary, along with the use of the existing knowledge to analyse and explore the determinants of young people health behaviour [11, 12]. Material and survey methodology The survey carried out under the grant of the State Committee for the Scientific Research KBN 1/ covered rural youth aged from 15 to 19 years. A total of 984 young people and their parents were surveyed. This study focused on rural youth selected for the research from 7 districts of Western Pomerania. Sample surveys were carried out. The authors questionnaires were used for the survey. The information collected was analysed statistically with the application of Chi-square test, Cramer s V, R Spearman rank statistical analyses. This study presents only the selected determinants of rural youth health behaviour. Study results Living and residential conditions of rural families of the youth over 15 years of age 85.87% of the respondents came from full families and 11.45% from one-parent families. Non-agricultural farms dominated as the place of origin of the young people under study (52.98%), 16.7% of those under study came from agricultural farms (tab. I). The residential situation of households surveyed was good according to 69.61% and bad for 14.5%. (and very bad for 1.76%) (tab. II). The household had enough money to afford anything (without saving) only according to 6.7% of the respondents. Most respondents (35.52%) reported that they avoided undue costs and had trouble with larger purchases % had enough money for the cheapest food, but nothing left for clothes (tab. III). 1/ The main contractor in the project: Associate Professor Katarzyna Sygit The highest household income per one person per month was 200 PLN (acc. to 40.37%), from 201 to 299 PLN (acc.to 18.6%) and from PLN (acc. to 14.27%). The main sources of household income were: agricultural produce only 14.41%, agricultural pension (6%), while other sources, as much as 68.9% of incomes (tab. IV). Some selected determinants of young people s health behaviours in rural areas Breakfast had: always: 54.47%, often 18.6%, rarely15.45%, 10.37%. There has been a correlation between having breakfast and the gender of young people (tab. V), the parents education (tab. VI), the financial situation of the household (tab. VII), but no correlation with income (tab. VIII). Table I. Type of household Type of household N % Agricultural Agricultural and productional Non-agricultural other Table II. Residential situation of households Residential situation of households N % Very good Good Bad Very bad Table III. Economic situation of households Can the household afford N % Anything without saving? Anything, avoiding undue costs? Larger purchases, avoiding undue costs? The cheapest food and clothes? The cheapest food but no clothes? Neither the cheapest food nor clothes? Table IV. Household sources of income Household main sources of income N % From agricultural produce From pension Other source No source of income Table V. Breakfast, depending on gender Gender Always Often Rarely Never Girls % 21.21% 17.37% 11.88% Boys % 15.73% 13.38% 8.69% Pearson s χ df=3 P= Cramer s V 0.13 R Spearman rank t= P=.00017

3 Sygit K, et al. Selected determinants of health behaviour in school children from rural environment 891 Table VI. Breakfast of rural young people, depending on parents education Education of the respondent always often rarely total Primary school % 14.44% 18.89% 10.00% General high school % 17.39% 10.63% 12.08% Vocational high school % 21.22% 16.73% 10.41% University % 15.71% 14.29% 7.14% Pearson s χ df=9 p= Cramer s V 0.07 R Spearman rank 0.01 t= p= Table VII. Breakfast of rural young people, depending on household financial situation Is there enough money for everything in the household without saving? We live modestly and have enough money always often rarely total % 20.55% 9.59% 9.59% % 20.80% 13.87% 10.95% We avoid undue costs but have problems with bigger 57.39% 17.33% 13.64% 11.65% purchases We have enough money for cheapest food and clothes 42.57% 25.74% 23.76% 7.92% We have enough money for cheapest food but not for 60.38% 15.09% 16.04% 8.49% clothes We have not enough money for cheapest food and clothes % 9.43% 26.42% 11.32% total Pearson s χ df=15 p= R Spearman rank 0.03 t= p= Table VIII. Breakfast of rural young people, depending on household income Average monthly income per one person in the household amounts always often rarely total Up to PLN % 13.88% 16.20% 10.28% % 22.73% 16.67% 11.62% % 24.66% 12.33% 11.64% % 23.16% 17.89% 5.26% % 20.69% 13.79% 13.79% 600 and more % 17.86% 12.50% 16.07% Pearson s χ df=15 p= R Spearman rank 0.04 t= p= Consumption of basic nutritional products. A correlation was found between the consumption of basic nutritional products and household financial situation (tab. IX) and its income (tab. X). Table IX. Consumption of basic food products, depending on household financial situation Is there enough money in the household For everything without need to economize We live modestly and have enough money We avoid undue costs but have problems with bigger purchases We have enough money for cheapest food and clothes We have enough money for cheapest food but not for clothes We have not enough money for cheapest food and clothes Can you say that in the recent month you have been having /meat, vegetables, fruit, salads, sweets, potatoes, bread, milk/ fewer than 10 no milk % 20.34% 10.17% 11.86% % 29.09% 14.09% 12.27% % 22.82% 13.42% 14.43% % 22.09% 17.44% 17.44% % 31.33% 14.46% 10.84% % 25.53% 23.40% 17.02% Pearson s df=15 p= Cramer s V 0.08 R Spearman rank 0.06 t= p= Table X. Consumption of basic food products, depending on household income Average monthly income per one person in the household amounts to Can you say that in the recent month you have been having /meat, vegetables, fruit, salads, sweets, potatoes, bread, milk/ fewer than 10 No milk Up to 200 PLN % 25.55% 16.51% 14.02% % 21.34% 17.68% 12.80% % 24.00% 10.40% 18.40% % 34.88% 9.30% 5.81% % 18.60% 18.60% 25.58% 600 and more % 23.26% 9.30% 13.95% Pearson s χ df=15 p= Cramer s V 0.10 R Spearman rank t= p=.37045

4 892 Probl Hig Epidemiol 2014, 95(4): Risky behaviours of young people cigarette smoking by the young people under study. A correlation between smoking and the gender of respondents (tab. XI), the parents education (tab. XII) was found, but there was no correlation with income (tab. XIII). Table XI. Correlation between smoking and respondents gender Gender I have smoked I used to smoke Do you smoke? I smoke I also smoke in fasting conditions Girls % 20.88% 10.62% 3.30% Boys % 23.00% 15.96% 2.82% Pearson s χ df=3 P= R Spearman rank 0.07 t= P= Table XII. Correlation between smoking and parents education Education of the respondent I have smoked I used to smoke Do you smoke? I smoke I also smoke in fasting conditions Primary School % 19.55% 12.29% 5.03% General High School Vocational High School % 19.32% 15.46% 2.42% % 24.54% 12.07% 2.86% University % 22.22% 11.11% 2.78% Pearson s χ df=9 p= Cramer s V 0.05 R Spearman rank 0.00 t= p= Table XIII. Correlation between smoking and household income Average monthly income per one person in the household amounts to I have smoked I used to smoke Do you smoke? I smoke I also smoke in fasting conditions Up to PLN % 21.19% 14.21% 3.88% % 24.00% 11.50% 2.50% % 20.14% 18.75% 2.08% % 25.26% 8.42% 0.00% % 19.30% 10.53% 1.75% 600 and more % 24.14% 6.90% 6.90% Pearson s χ df=15 p= Cramer s V 0.08 R Spearman rank t= p= alcohol drinking The correlation between drinking and the gender of respondents (tab. XIV), the education of their parents (tab. XV), and the financial situation of the household (tab. XVI) as well as income (tab. XVII) was found. Table XIV Correlation between alcohol drinking and respondents gender Gender Do you drink alcohol? I drink I drink occasionally Girls % 59.12% 0.00% Boys % 56.81% 2.58% Pearson s χ df=2 P= Cramer s V 0.12 R Spearman rank 0.02 t= p= Table XV. Correlation between alcohol drinking and parents education Your parents education Do you drink alcohol? I drink I drink occasionally University education (both) % 67.35% 4.08% General high school (both) % 64.06% 1.56% Vocational high school (both) % 58.60% 0.90% Primary school (both) % 55.37% 2.48% 1 university, not the other % 70.18% 0.00% 1 high school not the other % 52.91% 0.45% Pearson s χ df=10 p= R Spearman rank t= P= Table XVI. Correlation between alcohol drinking and household financial situation Is there enough money in the household for everything without economizing We avoid undue costs and have enough money We avoid undue costs and have problems with larger purchases We have enough money for cheapest food and clothes We have enough money for cheapest food but not for clothes We cannot afford cheapest food nor clothes Do you drink alcohol? I drink I drink occasionally % 61.33% 5.33% % 61.48% 0.74% % 58.29% 0.29% % 58.42% 2.97% % 50.94% 0.00% % 52.83% 1.89% Pearson s χ df=10 P= Cramer s V 0.11 R Spearman rank t= P=

5 Sygit K, et al. Selected determinants of health behaviour in school children from rural environment 893 Table XVII. Correlation between alcohol drinking and income Average monthly income per Do you drink alcohol? one person in the household I drink amounts I drink occasionally Up to PLN % 51.82% 2.08% % 59.60% 0.51% % 63.70% 0.68% % 63.83% 0.00% % 62.07% 0.00% 600 and more % 67.24% 1.72% Pearson s χ df=10 p= R Spearman rank 0.09 t= P= Discussion In adolescent life there are situations directly related to the preservation of health (eg. vaccinations or a visit to the doctor) and other definitely more numerous indirectly referring to health (various lifestyle elements: resting, nutrition, physical activity) [5, 15]. These situations are accompanied by certain behaviour directly or indirectly affecting health. The program of students health education should therefore address these situations and behaviour [1, 16, 17]. The dietary habits of the population leave a lot to be desired and those of rural youth manifest numerous irregularities [2, 18, 19]. According to B. Woynarowska [8] 18% do not eat breakfast every day and 21% do not have a sandwich at school. That undoubtedly adversely affects the physical and mental state and the disposition to learn at school. According to L. Szponar, nutritional problems are inadequately discussed in schools [13]. In the present study the correlation was shown between the consumption of basic nutritional products and the financial situation of the farm and the household income. Currently 16.5% of rural youth have smoked cigarettes for at least one year (between 10 and 20 pcs per day); 16.3% used to smoke; only 66.3% have smoked [20]. Mental and social determinants of smoking are given by A. Jakubik [21]. In B. Woynarowska s clinical study, this problem refers already to 43% of children aged between 11 and 15 years, and rapidly increases with age % of the surveyed rural youth drink alcohol [8]. In other studies [11, 14] 40 to 76% of rural youth aged years have tried alcoholic beverages (90% of 15-yearolds) once a week. The study showed a relationship between smoking and the gender of respondents, parents education, but it was not dependent on income. The alcohol consumption depends on the gender of the respondents, their parents education, household financial situation and income. B. Woynarowska [8] and other researchers [6, 11, 14, 18, 21] have come to similar conclusions. The strengthening of risky health behaviour habits with age in the group of students may contribute to excessive morbidity and mortality in the future (the excess male mortality included). The education system offers a huge opportunity to have an impact on the health of young people. Of course, we must not forget that in the process of socialization the family is of dominant importance for a child, as the family patterns may either enhance the transmission or be in conflict with the standards of healthy lifestyle [3, 9, 16, 22-24]. The school is a place of health education and health promotion: the school is a place where health is formed. It can exert an impact in preserving and improving health also because it runs health education. the school, as a widespread organization, facilitates systematic health education of young people (indirectly) and of their parents. From early childhood, the health behaviour is shaped in the socialization process, under the influence of a variety of factors: first of all at home, then in kindergarten, school, peer groups whose sources are mass media, patterns of human behaviour from the immediate surroundings. Particularly important is the second decade of life, especially adolescence, when a very strong need for the relationship with the current, immediate environment occurs in young people. Studying the importance of health behaviour of young people and their conditions is the basis for the health education program and various health promotion projects aimed at shaping lifestyles conducive to health [1, 3, 5]. Conclusions 1. A significant prevalence of unhealthy behaviours was found: a. nutritional deficiencies, b. the use of stimulants (high degree of smoking, alcohol drinking risk). 2. A correlation was found between health behaviours of the young people under study and their gender, parents education, living conditions and financial situation of their household.

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