StudentsStudents’’ Health Health Survey 2006Survey 2006

Highlights Of Highlights Of Findings Among Findings Among

Secondary StudentsSecondary Students

Health Promotion Board, Singapore

www.hpb.gov.sg

Objectives of StudyObjectives of Study

• To assess the following health behaviours and health risk among Sec 1-4 students:

– Cigarette smoking

– Nutrition

– Physical activity

– Sexual practices

– Mental health

• To explore determinants of health risk behaviours

MethodologyMethodology

• Study cleared by HPB Ethics Committee

• Random selection of 3844 students from Sec 1-4 across 51 secondary schools selected by MOE

• 1907 students in Sec 3-4 answered questions with regard to sexual behaviour

MethodologyMethodology

• Letters were sent to parents

of selected students who

were given a choice to opt

their children out of the

study

• Self-administered

questionnaire conducted at

the schools

Outline of PresentationOutline of Presentation

• Profile of students

• Prevalence of health behaviours/risks

– Smoking

– Sexual practices

– Dietary practices

– Physical activity

– Mental health

• Comparisons

– Gender

– Academic level

– Relevant determinants (social influences, perception of health behaviours etc)

Distribution of participantsDistribution of participants-- By gender & ethnicityBy gender & ethnicity

52.7%47.3%

Male

Female1.8%

22.4%68.1%

7.7%

Chinese

Malay

Indian Others

SmokingSmokingSmoking

26%

11%

2%

19%

9%

2%

0%

5%

10%

15%

20%

25%

30%

Ever tried smoking Smoke at least one day

in the past 30 days

Smoke everyday in the

past 30 days

GYTS SHS

Cigarette Smoking rates Cigarette Smoking rates

((GYTS 2000 and SHS 2006)GYTS 2000 and SHS 2006)

GYTS: Global Youth Tobacco Survey (2000)

SHS: Student Health Survey (2006)

17%

6%

1%

22%

11%

2%

0%

5%

10%

15%

20%

25%

Ever tried smoking* Smoke at least one day in

the past 30 days*

Smoke everyday in the

past 30 days*

Female Male

Student Health Survey Student Health Survey (SHS)(SHS)

Cigarette Smoking Cigarette Smoking By genderBy gender

*p<0.001

26%

12%

3%

13%

5%

1%

0%

5%

10%

15%

20%

25%

30%

Ever tried smoking* Smoke at least one day in

the past 30 days*

Smoke everyday in the past

30 days*

Upper Secondary Lower Secondary

Cigarette SmokingCigarette SmokingBy academic levelBy academic level

Lower Secondary students: Secondary 1 to 2, Upper Secondary students: Secondary 3 to 4

*p<0.001

Cigarette SmokingCigarette SmokingAge of initiationAge of initiation

12 yearsCurrent Smokers

(Smoke at least one day in

the past 30 days)

Median age of initiation

Social Influence on Smoking StatusSocial Influence on Smoking Status

95%

59%

44%42%

34%

11%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Close friends are

smokers*

At least one parent is

a smoker*

Siblings are smokers*

Current smokers Non-current smokers

Current Smokers: Those who smoked at least 1 day in the past 30 days

*p<0.001

Perception of SmokingPerception of SmokingBy smoking statusBy smoking status

71%

19% 17%

53%

86%*

69%*

6%*

65%*

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

"I can stop

smoking anytime I

want to"

"Smoking is not

harmful to my

health"

"Smoking is a very

wrong behaviour

for someone my

age"

"Parents think that

smoking is a very

wrong behaviour"

Non-current smokers Current smokers

Current smokers: Those who smoked at least 1 day in the past 30 days

*p<0.001

Sexual BehaviourSexual Sexual BehaviourBehaviour

Sexual Sexual behaviourbehaviourAmong Sec 3Among Sec 3--4 students4 students

15 yearsMedian age of initiation

4%Prevalence of sexual intercourse

- No gender differences in sexual intercourse

11%

15% 15%

9%

13% 13%

24%

0%

5%

10%

15%

20%

25%

30%

0 1 2 3 4 5 More

than 5Number of times

Frequency of sexual intercourse in the past Frequency of sexual intercourse in the past

12 months12 months Among Sec 3 Among Sec 3 -- 4 students4 students

*p<0.001

Top 3 Top 3 rreasons for Engaging in Sexual Intercourseeasons for Engaging in Sexual IntercourseAmong Sec 3Among Sec 3--4 Students4 Students

62%

57%

49%

0%

10%

20%

30%

40%

50%

60%

70%

It just happened It felt good I was curious

Main reasons for Not Engaging in Sexual Main reasons for Not Engaging in Sexual BehaviourBehaviourAmong Sec 3Among Sec 3--4 Students4 Students

73%

69%

64%

63% 63%

58%

60%

62%

64%

66%

68%

70%

72%

74%

I want to avoid

sexually

transmitted

diseases (STDs)

or AIDs

I want to avoid

unwanted

pregnancies

I am too young for

sexual activities

I do not want to

upset my family

I do not want to

engage in any

sexual activity

before marriage

NutritionNutritionNutrition

Important Food GroupsImportant Food Groups

Comparison of Knowledge and intake of Fruit and Comparison of Knowledge and intake of Fruit and

VegetablesVegetablesSec 1Sec 1--4 Students (SHS) 4 Students (SHS) vsvs Adult SingaporeansAdult Singaporeans

70%

44%*

19%^24%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Students Health Survey Comparison with adult Singaporeans

Aware of recommended intake of 2 servings of fruit and 2 servings of vegetables daily

Eat 2 servings of fruit and 2 servings of vegetables daily

*Evaluation of National Healthy Lifestyle Campaign 2004, 30-70 yrs old

^National Nutrition Survey 2004; 18-29 yrs

77%80%

77% 79%

68%71%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Male Female*

Aware that a person should consume at least 2 servings of fruit a day

Aware that a person should consume at least 2 servings of vegetables a day

Aware that a person should consume at least 2 servings of fruit and 2 servings ofvegetables a day

Awareness of the Healthy Pyramid Guidelines for Fruit Awareness of the Healthy Pyramid Guidelines for Fruit

and Vegetables Consumption and Vegetables Consumption By Gender (Student Health Survey)By Gender (Student Health Survey)

*p<0.001

SelfSelf--reported Consumption of Recommended Amounts reported Consumption of Recommended Amounts

of Fruit and Vegetables of Fruit and Vegetables By GenderBy Gender

41%39%

48%44%

26%23%

0%

10%

20%

30%

40%

50%

60%

Male Female*

Eat at least 2 servings of fruit a day

Eat at least 2 servings of vegetables a day

Eat at least 2 servings of fruit and 2 servings of vegetables a day

*p<0.001

Meet the 2 +2 Fruits and Meet the 2 +2 Fruits and VegsVegs

Guideline Guideline By academic levelBy academic level

27%

22%24%

0%

5%

10%

15%

20%

25%

30%

Lower secondary Upper secondary All

*p<0.001

Consumption of the Recommended Amounts of Fruit Consumption of the Recommended Amounts of Fruit

and Vegetables and Vegetables By Awareness of the Recommended Intake GuidelinesBy Awareness of the Recommended Intake Guidelines

11%

30%

0%

5%

10%

15%

20%

25%

30%

35%

Not aware of recommended servings Aware of recommended servings*

Eats at least 2 servings of fruit and 2 servings of vegetables a day

*p<0.001

Consumption of Sweetened DrinksConsumption of Sweetened DrinksMore than once a dayMore than once a day

31%

26%

29%

28%

23%

24%

25%

26%

27%

28%

29%

30%

31%

Male Female* All students Adults NNS (18-

29 yrs)

NNS National Nutrition Survey (2004)

*p<0.001

Consumption of Milk / Milk ProductsConsumption of Milk / Milk ProductsAt least once a dayAt least once a day

43%

39%

41%

37%

38%

39%

40%

41%

42%

43%

Male Female* All students

*p<0.001

Consumption of Deep Fried FoodConsumption of Deep Fried FoodMore than twice a weekMore than twice a week

57%

47%

52%52%

0%

10%

20%

30%

40%

50%

60%

Male Female* All students Adults NNS (18-

29yrs)

*p<0.001

NNS National Nutrition Survey 2004

Physical ActivityPhysical ActivityPhysical Activity

Physical Activity Level Physical Activity Level Vigorous Physical ActivityVigorous Physical Activity

• † Vigorous physical activity is defined as any activity

that take hard physical effort and make a person

breathe much harder than normal.

• Examples of vigorous physical activities listed in this

questionnaire include heavy lifting, aerobics,

running, fast bicycling, taekwondo, judo, football,

basketball, squash, skipping, moving and pushing

heavy furniture.

Physical Activity Level Physical Activity Level Moderate Physical ActivityModerate Physical Activity

• †† Moderate physical activity is defined as activities those that take moderate physical effort and make a person breathe somewhat harder than normal.

• Examples of moderate physical activities include carrying light loads, bicycling at a regular pace, doubles tennis, gymnastics, badminton, table tennis, skateboarding, inline skating at a leisure pace, and moving light furniture.

Question adapted from the US Youth Risk Behavioural Surveillance Survey

Physical Activity Level Physical Activity Level By genderBy gender

18%

6%

12%13%

7%

10%

26%

11%

19%

0%

5%

10%

15%

20%

25%

30%

Male Female* All students

Engage in †vigorous activity for at least 30 mins/day for 5 or more days per week

Engage in ††moderate activity for at least 30 mins/day for 5 or more days per week

Engage in †vigorous or ††moderate activity for 30 mins/ day for 5 or more days per week

*p<0.001

Physical Activity Level Physical Activity Level By academic levelBy academic level

13%

11%12%

10%11%

10%

20%

18%19%

0%

5%

10%

15%

20%

25%

Lower secondary Upper secondary* All students

Engage in †vigorous activity for 30 mins each, 5 or more days per week

Engage in ††moderate activity for 30 mins each, 5 or more days per week

Engage in †vigorous or ††moderate activity for 30 mins each, 5 or more days per week

*p<0.001

47%

41%37%

67%

56%

31%

51%

44%

36%

0%

10%

20%

30%

40%

50%

60%

70%

80%

I am usually pretty good at

sports

My close friends exercise

regularly

It is often too hot to exercise

in Singapore

Did not engage in moderate† or vigorous†† activity for 30 minutes each, 5 or more days per week

Engaged in moderate† or vigorous†† activity for 30 minutes each, 5 or more days per week*

All Students

Factors associated with Engaging in Factors associated with Engaging in

Physical ActivityPhysical Activity

*p<0.001

Comparison of proportion of students engaging in Comparison of proportion of students engaging in

Physical Activity Physical Activity Sec 1Sec 1--4 Students (SHS) 4 Students (SHS) vsvs Adult Singaporeans Adult Singaporeans

19.0%

34.0%

29.7%

8.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

Students Health Survey Comparison with adult Singaporeans ^

Physically active Physically inactive

^National Health Survey 2004;18-69 yrs

Mental HealthMental HealthMental Health

71%

56%

51%

42% 41%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Listen to

music

Watch TV Play

computer

games

Surf

internet

Talk to

someone

about it

Coping Strategies with StressCoping Strategies with Stress

SummarySummary

• Importance of social influences and

misconceptions in smoking

behaviour

• Teaching lifeskills with regard to

sexual practices

• Translation of awareness of healthy

diet (eg 2+2 fruits and vegs etc) into

consumption behaviour

• Building skills in physical activity and

promoting a supportive environment

for physical activity