Egan Lyra, Gardner Lauren A, Newton Nicola C, Champion Katrina E
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
Health Promot J Austr. 2025 Oct;36(4):e70079. doi: 10.1002/hpja.70079.
Recent Australian adolescent data on the prevalence of chronic disease risk behaviours among diverse sociodemographic groups is lacking. This study examined the prevalence of dietary intake (sugar-sweetened beverages (SSBs); discretionary foods; fruit; vegetables), and alcohol (standard drink; binge drinking), tobacco, and e-cigarette use, across adolescents of diverse socioeconomic status (SES) and geographical locations.
Cross-sectional data were analysed from 4445 adolescents across 71 schools in 2022 as part of the 36-month follow-up survey from the school-based cluster randomised controlled trial, Health4Life (M = 15.7 years, SD = 0.6; 47.0% female-identifying). Fourteen percent (n = 571) were categorised as low SES and 86% (n = 3518) as mid-to-high SES, relative to the study sample, with 9% (n = 399) from regional areas. Binary logistic regressions compared differences for each outcome across SES and geographical locations, controlling for gender, psychological distress, intervention status, and school clustering.
Low SES adolescents had a lower prevalence of excessive discretionary food intake (PR = 0.87, 95% CI = 0.77-0.99), standard drink consumption (PR = 0.78; 95% CI = 0.65-0.93) and binge drinking (PR = 0.68; 95% CI = 0.50-0.92) compared to mid-to-high SES adolescents. Regional adolescents had a higher prevalence of standard drink consumption (PR = 1.41; 95% CI = 1.00-1.97), binge drinking (PR = 1.77; 95% CI = 1.07-2.93), and tobacco smoking (PR = 2.06; 95% CI = 1.18-3.60) compared to adolescents in major cities. Excessive discretionary food intake was less prevalent among adolescents from disadvantaged backgrounds (PR = 0.84, 95% CI = 0.76-0.94) compared to more advantaged adolescents.
Chronic disease risk behaviours among adolescents differ across SES and geographical locations, with regional adolescents fairing considerably worse across alcohol and tobacco use outcomes. Prevention for diet-related behaviours should be improved for more advantaged adolescents, while tailored interventions to SES and geographical location separately may be required for alcohol-, tobacco-, and e-cigarette use. SO WHAT?: Public health policy and interventions targeting chronic disease risk behaviours must prioritise the needs of low SES and regional adolescents to reduce health inequities.
The Health4Life trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123).
澳大利亚近期缺乏关于不同社会人口群体中慢性病风险行为患病率的青少年数据。本研究调查了不同社会经济地位（SES）和地理位置的青少年在饮食摄入（含糖饮料（SSB）； discretionary食物；水果；蔬菜）、酒精（标准饮酒量；暴饮）、烟草和电子烟使用方面的患病率。
对2022年来自71所学校的4445名青少年的横断面数据进行分析，作为基于学校的整群随机对照试验Health4Life为期36个月的随访调查的一部分（M = 15.7岁，标准差 = 0.6；47.0%为自我认定的女性）。相对于研究样本，14%（n = 571）被归类为低SES，86%（n = 3518）为中高SES，9%（n = 399）来自地区。二元逻辑回归比较了SES和地理位置上各结果的差异，并控制了性别、心理困扰、干预状态和学校聚类。
与中高SES青少年相比，低SES青少年过量摄入discretionary食物（PR = 0.87，95% CI = 0.77 - 0.99）、标准饮酒量（PR = 0.78；95% CI = 0.65 - 0.93）和暴饮（PR = 0.68；95% CI = 0.50 - 0.92）的患病率较低。与大城市的青少年相比，地区青少年标准饮酒量（PR = 1.41；95% CI = 1.00 - 1.97）、暴饮（PR = 1.77；95% CI = 1.07 - 2.93）和吸烟（PR = 2.06；95% CI = 1.18 - 3.60）的患病率较高。与条件更优越的青少年相比，来自弱势背景的青少年过量摄入discretionary食物的情况较少见（PR = 0.84，95% CI = 0.76 - 0.94）。
青少年中的慢性病风险行为在SES和地理位置上存在差异，地区青少年在酒精和烟草使用结果方面情况要差得多。对于条件更优越的青少年，应改善与饮食相关行为的预防措施，而对于酒精、烟草和电子烟的使用，可能需要分别针对SES和地理位置进行量身定制的干预措施。那又如何？：针对慢性病风险行为的公共卫生政策和干预措施必须优先考虑低SES和地区青少年需求，以减少健康不平等。
Health4Life试验已在澳大利亚新西兰临床试验注册中心注册（ACTRN12619000431123）。
