Clare Tanton1, Lorraine McDonagh2, Melissa Cabecinha3, Soazig Clifton3, Rebecca Geary4, Greta Rait2,5, John Saunders3,5, Jackie Cassell5,6, Chris Bonell4, Kirstin R Mitchell7, Catherine H Mercer3,5. 1. Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. clare.tanton@lshtm.ac.uk. 2. Research Department of Primary Care and Population Health, University College London, London, UK. 3. Institute for Global Health, University College London, London, UK. 4. Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. 5. National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with Public Health England (PHE), in collaboration with London School of Hygiene & Tropical Medicine, London, UK. 6. Department of Primary Care and Public Health Medicine, Brighton and Sussex Medical School, University of Brighton, Brighton, UK. 7. MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
Abstract
BACKGROUND: Syndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Young adults not in education, employment or training (NEET) are more likely to experience disadvantage and poorer general health outcomes. However, there is little research on their sexual health, or the extent to which this clusters with mental and physical health outcomes. METHODS: Analysis of data from 16 to 24 year olds (1729 men, 2140 women) interviewed 2010-12 for Britain's third National Survey of Sexual Attitudes and Lifestyles. Natsal-3 is a national probability sample survey using computer-assisted personal interviewing with computer-assisted self-interviewing. Participants were classified as workers, students or NEET. We used multivariable logistic regression to examine associations between being NEET (relative to worker or student) and risk behaviours and outcomes in physical, sexual and mental health domains. We then examined how risk behaviours and poor health outcomes cluster within and across domains. RESULTS: 15% men and 20% women were NEET; 36% men and 32% women were workers; and 49% men and 48% women were students. Young people who were NEET were more likely to report smoking and drug use (men) than other young people. There were few differences in sexual health, although NEETs were more likely to report condomless sex, and NEET women, unplanned pregnancy (past year). Risk behaviours clustered more within and across domains for NEET men. Among NEET women, poor health outcomes clustered across mental, physical and sexual health domains. CONCLUSIONS: Harmful health behaviours (men) and poor health outcomes (women) clustered more in those who are NEET. This points to a possible syndemic effect of NEET status on general ill health, especially for women. Our paper is novel in highlighting that elevated risk pertains to sexual as well as mental and physical health.
BACKGROUND: Syndemic theory highlights the potential for health problems to interact synergistically, compounding impact. Young adults not in education, employment or training (NEET) are more likely to experience disadvantage and poorer general health outcomes. However, there is little research on their sexual health, or the extent to which this clusters with mental and physical health outcomes. METHODS: Analysis of data from 16 to 24 year olds (1729 men, 2140 women) interviewed 2010-12 for Britain's third National Survey of Sexual Attitudes and Lifestyles. Natsal-3 is a national probability sample survey using computer-assisted personal interviewing with computer-assisted self-interviewing. Participants were classified as workers, students or NEET. We used multivariable logistic regression to examine associations between being NEET (relative to worker or student) and risk behaviours and outcomes in physical, sexual and mental health domains. We then examined how risk behaviours and poor health outcomes cluster within and across domains. RESULTS: 15% men and 20% women were NEET; 36% men and 32% women were workers; and 49% men and 48% women were students. Young people who were NEET were more likely to report smoking and drug use (men) than other young people. There were few differences in sexual health, although NEETs were more likely to report condomless sex, and NEET women, unplanned pregnancy (past year). Risk behaviours clustered more within and across domains for NEET men. Among NEET women, poor health outcomes clustered across mental, physical and sexual health domains. CONCLUSIONS: Harmful health behaviours (men) and poor health outcomes (women) clustered more in those who are NEET. This points to a possible syndemic effect of NEET status on general ill health, especially for women. Our paper is novel in highlighting that elevated risk pertains to sexual as well as mental and physical health.
Entities:
Keywords:
Clustering; Cross-sectional survey; Not in education, employment or training (NEET); Sexual health
Authors: George C Patton; Susan M Sawyer; John S Santelli; David A Ross; Rima Afifi; Nicholas B Allen; Monika Arora; Peter Azzopardi; Wendy Baldwin; Christopher Bonell; Ritsuko Kakuma; Elissa Kennedy; Jaqueline Mahon; Terry McGovern; Ali H Mokdad; Vikram Patel; Suzanne Petroni; Nicola Reavley; Kikelomo Taiwo; Jane Waldfogel; Dakshitha Wickremarathne; Carmen Barroso; Zulfiqar Bhutta; Adesegun O Fatusi; Amitabh Mattoo; Judith Diers; Jing Fang; Jane Ferguson; Frederick Ssewamala; Russell M Viner Journal: Lancet Date: 2016-05-09 Impact factor: 79.321
Authors: Nigel Field; Philip Prah; Catherine H Mercer; Greta Rait; Michael King; Jackie A Cassell; Clare Tanton; Laura Heath; Kirstin R Mitchell; Soazig Clifton; Jessica Datta; Kaye Wellings; Anne M Johnson; Pam Sonnenberg Journal: BMJ Open Date: 2016-03-23 Impact factor: 2.692