080212P - TOWARDS DEVELOPING A YOUTH HEALTH INDEX

Discussion paper prepared by Professor Omar Hasan Kasule Sr. February 12^th 2008

ABSTRACT

This paper is a health input into the development of a national youth health index suitable for Brunei.

INTRODUCTION

Governments have an interest in generating an index to be used in monitoring the development of the youths. Malaysia formulated such a composite index for its youths (15-40 years) covering 8 domains one of which was health. The health domain however covered 8 disease conditions [1]. Only 2 conditions (obesity and HIV/AIDS) are common in this age group. Six conditions are more common in the middle ages (high blood pressure, diabetes, cancer, heart problems, and kidney problems). Asthma can occur at any age but is mostly a childhood disease. The youth are generally in good physical health. They however have problems of mental health and unhealthy lifestyles and behavior that eventually manifest as poor health in middle age.

The youth period can be divided into 2 stages: adolescence 15-19 years and young adults 20-40. Adolescence has more health and behavioral problems than young adulthood. Adolescence is a period of rapid growth, psychological adjustment, emotional upsets, cognitive change from concrete to abstract thought and youth idealism, as well as social maturation leading to an independent life style. Adolescents do not seek primary health care due to communication difficulties and mistrust of doctors. Adolescent problems include high risk behaviors and life styles like addiction to alcohol and drugs, aggressive behavior, delinquency, anti-social behavior, conflict with parents, running away from home/drifting, sexual promiscuity leading to pregnancy and STD, school difficulties, eating problems, depression/anxiety, withdrawal from relationships and being lonely, risk behavior with motorbikes and motorcycles, anorexia and other eating disorders, drug overdose, attempted suicide. Common medical complaints of adolescents are delayed puberty, atypical puberty, menstrual disorders, sexually transmitted disease, teen pregnancy, skin diseases especially acne.

This paper proposes indicators of youth health that involve physical health, mental health, as well as lifestyle and behavior. It also proposes separating adolescents (15-19) from young adults (20-40).

METHODS

Studies of birth cohorts (2-8) were studied to obtain health information collected from youths. The following health domains were initially selected for adolescents: morbidity, behavior, lifestyle, anthropometry, vision, development, puberty, and health KAP.  The following domains were initially selected for young adults: morbidity, vision, psychology, anthropometry, smoking, alcohol, physical exercise, education, work, fertility, contraception, sexual practice, and health KAP. After review of local health statistics and personal observations it was decided to compile all the domains into one list: anthropometry (height and weight), vision (short, long-sighted, astigmatism), growth and development (retardation, precocity), morbidity (physical and mental), life style (smoking, alcohol, drugs), sexual behavior (abstinence, partners, contraception), diet (fruits, vegetables, meats, fiber), health seeking behavior (vaccinations, annual physical examination, physical exercise), and social relations (marriage, friends). Then local data was used to develop specific numerical indicators that were incorporated in a questionnaire with 15-20 items. The questionnaire was pretested and was then administered to a national stratified random sample of 1000 youths. An optimal level was determined for each indicator. Each youth would be assigned a score as a percent of the optimum. An total health score for each youth will be computed using weights based on the prevalence of that indicator in the local youth population. Then a national score would be computed as an average of individual scores. Computations will be carried out separately for years 15-19 and 20-40.

RESULTS

REFERENCES

1.     Anonymous. Malaysian Youth Index 2006. Malaysian Institute for Research in Youth Development.

2.     Power C and Elliot J. Cohort profile: 1958 British birth cohort (National child development study). Int J Epidemiol 2006; 35(1):34-41

3.     Wadsworth M, Kuh D, Richards M et al. Cohort Profile: The 1946 National birth cohort (MRC national survey of health and development). Int J Epidemiol 2006; 35(1):49-54

4.     Osler M, Lund R, Kriegbaum M et al. Cohort Profile: The Metropolit 1953 Danish male birth cohort. Int J Epidemiol 2006; 35(3): 541-545

5.     Victoria CG and Barros FC. Cohort Profile: The 1982 Pelotas (Brazil) birth cohort study Int J Epidemiol 2006; 35(2): 237-242.

6.     Stenberg S-A and Vagero D. Cohort Profile: The Stockholm birth cohort of 1953. Int J Epidemiol 2006; 35(3):546-548.

7.     Leon DA, Lawlor DA, Clark H et al. Cohort profile: the Aberdeen children of the 1950s study. Int J Epidemiol 2006; 35(3):549-552.

8.     Elliott J and Shepherd P. Cohort Profile: 1970 British birth cohort (BCS70). Int J Epidemiol 2006; 35(4):836-843.