Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Research Department of Primary Care and Population Health, University College London, London, UK.
BMC Public Health. 2021 Feb 26;21(1):412. doi: 10.1186/s12889-021-10229-6.
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.
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.
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.
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.
综合征理论强调健康问题可能会协同作用，从而加剧影响。未接受教育、就业或培训的年轻人（NEET）更有可能遭遇不利处境和较差的总体健康结果。然而，针对他们的性健康问题或该问题与精神和身体健康结果的关联程度，研究甚少。
对 2010-12 年间接受英国第三次全国性态度和生活方式调查（Natsal-3）的 16-24 岁年轻人（男性 1729 人，女性 2140 人）的数据进行分析。Natsal-3 是一项全国性的概率抽样调查，采用计算机辅助个人访谈和计算机辅助自我访谈。参与者被分为工人、学生或 NEET。我们使用多变量逻辑回归来研究相对于工人或学生，NEET 状态与身体、性和心理健康领域风险行为和结果之间的关联。然后，我们研究了风险行为和不良健康结果在各领域内和跨领域的聚集情况。
15%的男性和 20%的女性为 NEET；36%的男性和 32%的女性为工人；49%的男性和 48%的女性为学生。NEET 的年轻人比其他年轻人更有可能报告吸烟和吸毒（男性）。在性健康方面差异不大，但 NEET 更有可能报告无保护性行为，而 NEET 女性更有可能报告意外怀孕（过去一年）。对于 NEET 男性，风险行为在各领域内和跨领域内的聚集程度更高。在 NEET 女性中，不良健康结果在精神、身体和性健康领域内跨领域聚集。
对于 NEET，有害健康行为（男性）和不良健康结果（女性）更为集中。这表明 NEET 状态对整体健康不良可能存在综合征效应，特别是对女性而言。我们的论文新颖之处在于强调，风险增加不仅涉及精神和身体健康，还涉及性健康。
