Many of the local non-communicable public health priorities are the same in children as in adults. In fact, many of these childhood conditions are a risk factor for these conditions in adulthood – for instance, 80% of obese children grow up to become obese adults. 11  More information about some of the risk factors underlying these conditions, and the subsequent health impacts, can be found in the ‘Lifestyle and behaviour’ and ‘Adult health and illness’ JSNA chapters. A summary description of causes and risk factors of particular relevance to children and young people is provided below:

Obesity

While the fundamental ‘cause’ of obesity may appear simple – i.e. the result of people consuming more energy than they expend – the factors that influence energy consumption and expenditure (i.e. physical activity) are highly complex. 12 13 Modern society creates an environment that encourages weight gain, with an abundance of cheap, energy-dense food and drink (such as hot food takeaways and sugar-sweetened beverages), alongside reduced physical activity associated with sedentary lifestyles and the ease and speed of motorised transport. This is commonly referred to as the ‘obesogenic environment’. While biological and medical factors do play a role, the social context has been shown to have a strong influence on the vulnerability of individuals to the obesogenic environment. In particular, obesity is associated with deprivation and low educational achievement, and is more common in certain ethnicity minority communities. 14 In turn, obesity is a risk factor for a range of other health and wellbeing issues in childhood, including stigmatisation, bullying and low self-esteem, as well as increased school absence, which may affect educational attainment. 15

Oral health

Individual risk factors for poor oral health include: poor diet/high sugar consumption; poor oral hygiene; tobacco and alcohol consumption; and injury from sports, violence and falls. 16 For information about the risk factors for poor diet, please see the ‘Lifestyle and behaviours’ JSNA chapter. Fluoride exposure through toothpaste and drinking water is a protective factor. 17  Broader risk factors for poor oral health include deprivation, and low access to information and services, with protective factors including oral health promotion in schools. 18

Poor oral health can have a significant impact on a child’s quality of life by causing dental caries, which may result in pain, affect appearance and necessitate fillings or tooth extractions. Dental caries may also occasionally result in sepsis. These factors may cause sickness absence from school and therefore affect education. 19

Smoking, alcohol and other substance misuse

While many of the factors that contribute to teenagers smoking, drinking alcohol or misusing other substances may be similar to those in adults, the relative importance of these factors could be different. A 2012 survey of adolescents in Hackney found that half (51%) of those whose parents smoke also smoke themselves, and a third (35%) of those whose siblings smoke also smoke themselves (compared with an average smoking prevalence rate of 10% among young people in this survey). The most common reasons given for trying smoking were ‘to see what it was like’ (60%), followed by because their ‘friends are smoking’ (35%).

Reproductive health

Reproductive health in this section covers teenage pregnancy and contraception use. Teenage pregnancy is defined and measured as the number of conceptions to women under 18 years old.

There are many risk factors for teenage pregnancy. The Centre for Analysis of Youth Transitions (CAYT) has listed eligibility for free school meals and persistently being absent from school as the two most strongly associated individual characteristics for teenage pregnancy – both because these young people are more likely to conceive and because they are more likely to continue with their pregnancy. Other individual-based risk factors listed in this same CAYT report include low prior educational attainment and deterioration in academic performance between Key Stages 2 and 3.B Area deprivation is also a risk factor, even after the individual characteristics of the girls themselves have been taken into account. Attending a higher performing school is both protective against conception, and associated with an increased rate of abortion in those who do conceive. 20

Notes

  1. Key Stage 2 covers ages 7-11 (Years 3 to 6); Key Stage 3 covers ages 11-14 (Years 7 to 9). For more information see https://www.gov.uk/national-curriculum/overview
  2. Key Stage 2 covers ages 7-11 (Years 3 to 6); Key Stage 3 covers ages 11-14 (Years 7 to 9). For more information see https://www.gov.uk/national-curriculum/overview

References

  1. Children and Young People’s Health Outcomes Forum, “Children and young people’s health outcomes annual report 2013 to 2014,” 2014
  2. “What causes overweight and obesity?,” US Department of Health & Human Services, [Online]. Available: http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes. [Accessed April 2016]
  3. “Tackling Obesities: future choices – project report,” Foresight, 2007
  4. “Health inequalities,” Public Health England, [Online]. Available: http://www.noo.org.uk/NOO_about_obesity/inequalities. [Accessed April 2016
  5. G. Kalra, A. D. Sousa, S. Sonavane and N. Shah, “Psychological issues in pediatric obesity,” Industrial Psychiatry Journal, vol. 21, no. 1, pp. 11-17, 2012
  6. Department of Health, “Choosing Better Oral Health: An oral health plan for England,” 2005
  7. Department of Health, “Choosing Better Oral Health: An oral health plan for England,” 2005
  8. National Institute of Dental and Craniofacial Research, “Chapter 10: Factors Affecting Oral Health over the Life Span,” [Online]. Available: http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/sgr/chap10.htm. [Accessed 30 September 2016]
  9. “Tackling poor oral health in children: local government’s public health role,” Local Government Association; Public Health England, 2016.
  10. C. Crawford, J. Cribb and E. Kelly, “Teenage Pregnancy in England,” Centre for Analysis of Youth Transitions; Department for Education, 2013
  11. Children and Young People’s Health Outcomes Forum, “Children and young people’s health outcomes annual report 2013 to 2014,” 2014
  12. “What causes overweight and obesity?,” US Department of Health & Human Services, [Online]. Available: http://www.nhlbi.nih.gov/health/health-topics/topics/obe/causes. [Accessed April 2016]
  13. “Tackling Obesities: future choices – project report,” Foresight, 2007
  14. “Health inequalities,” Public Health England, [Online]. Available: http://www.noo.org.uk/NOO_about_obesity/inequalities. [Accessed April 2016
  15. G. Kalra, A. D. Sousa, S. Sonavane and N. Shah, “Psychological issues in pediatric obesity,” Industrial Psychiatry Journal, vol. 21, no. 1, pp. 11-17, 2012
  16. Department of Health, “Choosing Better Oral Health: An oral health plan for England,” 2005
  17. Department of Health, “Choosing Better Oral Health: An oral health plan for England,” 2005
  18. National Institute of Dental and Craniofacial Research, “Chapter 10: Factors Affecting Oral Health over the Life Span,” [Online]. Available: http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/sgr/chap10.htm. [Accessed 30 September 2016]
  19. “Tackling poor oral health in children: local government’s public health role,” Local Government Association; Public Health England, 2016.
  20. C. Crawford, J. Cribb and E. Kelly, “Teenage Pregnancy in England,” Centre for Analysis of Youth Transitions; Department for Education, 2013