Highlights

Eating behaviours and oral health

  • 48% of adolescents eat neither fruit nor vegetables daily (52% boys, 44% girls).
  • 1 in 4 adolescents eat sweets every day (27% girls, 23% boys).
  • 1 in 6 adolescents drink sugary soft drinks every day (18% boys, 14% girls).
  • Only 2/3 adolescents brush their teeth twice a day (73% girls, 57% boys).

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Physical activity

  • Fewer than one in five adolescents (19%) achieve the global recommendation for 60 minutes of MVPA every day (23% boys, 16% girls).
  • Levels of MVPA have declined in around a third of countries/regions since 2014.
  • At all ages and in almost all countries boys are more likely than girls to be physically active.
  • Older adolescents and those from poorer families were less likely to be physically active.

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Overweight, underweight and body image

  • Levels of overweight and obesity have risen since 2014.
  • One in five adolescents (21%) were found to be overweight or obese (25% boys, 16% girls)
  • More than one in four (27%) adolescents perceived themselves as too fat, especially girls (31% girls, 22% boys).
  • There was a significant decline since 2014 in perceptions of being too fat, especially among girls and 15-year-olds.
  • Strong social inequalities were observed with adolescents from less affluence families more likely to be overweight or obese.
  • One in 20 (5%) adolescents are underweight.

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Online communication

  • Over a third (35%) of adolescents communicate with their friends online almost all the time throughout the day. The prevalence is higher among girls than boys.
  • 7% of adolescents report problematic social media use which is characterized by addiction-like symptoms.
  • Over 1 in 10 adolescents prefer to communicate with friends online rather than face-to-face (13% of boys, 12% of girls).
  • One in 10 adolescents (10%) reported intensive online communication with people they got to know through the Internet and did not know before.
  • When talking about their feelings, concerns and secrets, most adolescents (86%) preferred face-to-face communication with friends over online communication. However, 14% said they strongly preferred online communication compared to face-to-face communication.

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Mental well-being

  • Adolescents from high-affluence families report higher levels of life satisfaction and excellent health, and lower levels of multiple health complaints.
  • At age 11, almost half (45%) of boys and 41% of girls said they had excellent health, but at age 15, slightly fewer boys (39%) and substantially fewer girls (25%) reported excellent health.
  • Most adolescents felt satisfied with their lives, with an overall score of 7.8 out of 10. Countries/regions with the highest overall estimates of life satisfaction also had the smallest gender differences.
  • Mean life satisfaction across all countries/regions decreased with age, from 8.3 at age 11 to 7.4 at age 15. This decline by age was stronger in girls.
  • One in four adolescents report feeling nervous, feeling irritable or experiencing sleep difficulties every week.
  • Girls experienced individual health complaints more often than boys. The largest gender differences were observed for irritability, nervousness and feeling low (an average difference of 10 percentage points between girls and boys).
  • Girls were more likely than boys to report multiple health complaints and this gender difference increased with age.

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Sexual health

  • At age 15, one in four boys (24%) and one in seven girls (14%) report having had sexual intercourse.
  • Less than two thirds (61%) of sexually active adolescents used a condom at last intercourse, a small decline since 2014 (down from 63%).
  • Around one in four 15-year-olds (25%) across the HBSC countries/regions who have had sex did not use either of the most effective contraceptive methods (condom or pill) at last intercourse.

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Alcohol, tobacco and cannabis use

  • At age 15, almost three in five young people have drunk alcohol in their lifetime, compared with almost one in four for smoking and around one in seven for cannabis use.
  • One in five 15-year-olds (20%) have been drunk twice or more in their lifetime, and almost one in seven (15%) had been drunk in the last 30 days.
  • The prevalence of lifetime alcohol use and cigarette-smoking has declined since 2014.
  • More than one in 20 (7%) girls and boys had smoked a cigarette or used cannabis in the last 30 days.
  • Higher family affluence is associated with higher alcohol consumption, but smoking and cannabis use are less socially patterned.

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Bullying and violence

  • Boys are more likely than girls to bully and cyberbully others.
  • While the proportion of boys and girls who are victims of traditional bullying is similar, girls are more likely to be cyberbullied.
  • There has been a decline in bullying perpetration since 2014, but the proportion of adolescents being bullied has remained the same.
  • 8% boys and 5% of girls had bullied others at least 2-3 times in the past couple of months
  • Over 1 in 10 adolescents had been cyberbullied at least once in the past couple of months (14% girls, 12% boys)
  • Girls were less likely than boys to cyberbully others but more likely to be the victim of cyberbullying.
  • Prevalence of bullying others was highest among boys at age 15 and girls at age 13.
  • Younger adolescents are particularly at risk of being bullied.
  • Boys were more likely than girls to be involved in physical fighting (15% boys, 5% girls).

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Injuries

  • The prevalence of medically attended injuries was higher for boys than girls (48% boys, 39% girls).
  • Younger adolescents were more likely to have received medical treatment for injuries in the last 12 months.
  • More affluent boys and girls are more likely to report medically attended injuries.

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Social well-being

  • Most adolescents reported easy communication with their mothers (87% boys, 84% girls) but fewer with their fathers (79% boys, 66% girls).
  • Only 57% of 15-year-old girls find it easy to talk to their father about things that bother them.
  • Since 2014, communication with fathers has improved, particularly for girls.
  • Adolescents from more affluent families have higher levels of family support, better communication with their parents and are more likely to report high levels of peer support (64% versus 56%).
  • Boys were more likely to report high family support (73% boys, 71% girls), whereas girls were more likely to report high support from their friends (55% boys, 66% girls).
  • Peer support has declined since 2014 (63% down to 60%), especially for girls.

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School experience

  • Just over a quarter of adolescents (28%) reported liking school a lot.
  • School experience worsens with age in most countries/regions; school satisfaction and perceived teacher support decline, while schoolwork pressure increases.
  • More than half of adolescents report high levels of support from their fellow students (59%) and their teachers (56%), but only around a quarter like school a lot (28%).
  • More girls than boys reported liking school at age 11 (43% and 35%, respectively) but there was no gender difference among 15-year-olds (22% and 21%, respectively).
  • Schoolwork pressure increased with age, from 26% of 11-year-olds to 44% of 15-year-olds.
  • School satisfaction has declined since 2014 in around a third of countries/regions.
  • Over a third of adolescents (36%) reported high levels of pressure from schoolwork and levels were particularly high among older girls.
  • Overall, more than half of adolescents reported high levels of support from their teachers and classmates but there was wide variation across countries.
  • Young people from poorer families were less likely to feel supported by their classmates but experienced lower levels of pressure from schoolwork.

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Family context

  • Most adolescents live with both their mother and father (73%) but one in six (17%) live in a single-parent family.
  • Most single-parent families are headed by a mother, with rates of single-father families being 5% or less in all countries/regions.
  • One in 20 adolescents live with at least one parent who is unemployed and looking for work. Adolescents were more likely to live with an unemployed mother (3%) than father (1%).
  • Over a fifth of adolescents had an immigrant background in almost half of countries and regions.

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Conclusions

  • “Social and emotional well-being decreases as adolescents get older, especially among girls.”
  • “Adolescents from less well-off families experience poorer health and well-being.”
  • “Investing in adolescence yields triple benefits, bringing health, social and economic gains to today’s adolescents, tomorrow’s adults and future generations.”
  • “Poverty can make it hard to create supportive relationships – adolescents from poorer backgrounds experience less social support from family, friends and classmates.”
  • “Technology can have positive benefits but can also amplify vulnerabilities and introduce new threats such as cyberbullying, which disproportionately affect girls.”
  • “Improving the health of adolescents requires action across all sectors and at all levels of society.”

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