Differences in health and health behaviors between urban and rural school children aged 11 13 years in Turkey: findings from the health behavior in school aged children study 2006 Original Article

Abstract

Summary Aim: The aim of the study was to determine the differences between rural and urban adolescents rsquo; health and health behaviors Material and Method: The data presented in this study were a part of the Turkish data nbsp; collected for the cross sectional and international nbsp; ldquo;Health Behavior in School aged Children 2005 2006 study rdquo; which aimed to evaluate adolescents rsquo; health and health behavior around Europe and North nbsp; America Data were collected from 3884 11 to 13 years of age nbsp; 1946 males 1938 females students who attended nbsp; 180 classes of 82 primary schools in nbsp; 23 cities Statistical analyses were made by using chi square nbsp; test Results: Both female and male students who lived in rural areas were more likely to go to bed hungry more often to feel dizzy more often to eat nbsp; fruits less often to brush teeth less often to exercise less often and to use computers less often than their peers living in urban areas Besides in rural areas nbsp; male students were more likely to be violent and female students were more likely to feel unhealthy to be unsatisfied with their lives and to be injured more often than their urban peers Both female and male students who lived in urban areas were more likely to eat or drink more energy dense and low nutritional value foods and drinks than their peers living in rural areas Males who lived in urban areas were more likely to be on a diet not to be satisfied with their body and to be obese than their peers living in rural areas nbsp; Conclusions: The results of this study showed that there are several health inequities between rural and urban female and male adolescents These differences should be taken into account when prepering adolescent health promotion programs Turk Arch Ped 2010; 45: 96 104 Key words: Adolescent health health behavior rural urban differencest

Keywords

• -

Kırsal ve kentsel alanlarda yaşayan 11 ve 13 yaşlarındaki öğrencilerin sağlık durumları ve sağlık davranışları arasındaki farklılıklar: Türkiye sağlık davranışları araştırması 2006 sonuçları Özgün Araştırma

Öz

Özet Amaç: Bu araştırmanın amacı Türkiye rsquo;de kentsel ve kırsal alanlarda yaşayan 11 ve 13 yaşındaki öğrencilerin sağlık durumları ve sağlıkla ilgili davranışları arasındaki farklılıkları saptamaktı Gereç ve Yöntem: Bu çalışmada gençlerin sağlık durumları ve sağlık davranışlarını saptamayı hedefleyen kesitsel tanımlayıcı ve çok uluslu ldquo;Health Behavior in School Aged Children 2006 HBSC rdquo; araştırmasının Türkiye ayağına katılan 11ve 13 yaşındaki nbsp; çocukların verilerinden yararlanıldı Bu çalışma için veri çözümlemeleri 23 ildeki 82 ilkokulun 180 dersliğinde 11 ve 13 yaşlarındaki 3884 1946 erkek 1938 kız öğrenci üzerinden yapıldı Gruplar arasındaki oran farklılıkları ki kare testi ile değerlendirildi Bulgular: Kırsal alanda yaşayan hem kızların hem de erkeklerin kentlerde yaşayan akranlarından daha sık yatağa aç girdikleri daha sık baş dönmesinden yakındıkları daha az meyve yedikleri daha nadir diş fırçaladıkları daha az egzersiz yaptıkları saptandı Kırsal alanda yaşayan öğrenciler kentlerde yaşayanlara göre daha az bilgisayar kullanıyorlardı Ayrıca kırsal alanda yaşayan erkeklerin daha sık şiddet davranışları gösterdikleri ve kızların ise kendilerini daha sağlıksız hissettikleri yaşamlarından daha az memnun oldukları ve daha sık yaralandıkları saptandı Kentlerde yaşayan nbsp; kız ve erkek öğrenciler kırsal alanda yaşayan akranlarından daha sık olarak besin değeri düşük ve enerji içeriği yüksek yiyecek ve içecekleri tükettiklerini bildirdiler Kentsel alanda yaşayan erkekler arasında diyette olma bedeninden hoşnut olmama ve şişmanlık kırsal alanda yaşayanlara göre daha sıktı Çıkarımlar: Araştırmamız ülkemizde kentsel ve kırsal alanda yaşayan 11 ve 13 yaşındaki kızlar ve erkekler arasında sağlık açısından eşitsizlikler olduğunu ve kırsal alanda yaşayan hem kızların hem de erkeklerin daha fazla risk altında olduğunu göstermektedir Ergenler için sağlığı geliştirme programları hazırlanırken yerleşim yeri nedeni ile ortaya çıkan bu farklılıkların göz önüne alınması gerektiğini düşünmekteyiz nbsp; Türk Ped Arş 2010; 45: 96 104 Anahtar sözcükler: Ergen kırsal kentsel farklılıklar sağlık sağlık davranışları

Anahtar Kelimeler

• Ergen, kırsal kentsel farklılıklar, sağlık, sağlık davranışları

References

1. Ottawa Charter for Health Promotion. Copenhagen, WHO Regional Office for Europe, 1986 (http://www.euro.who. int/AboutWHO/Policy/20010827_2) (erişim 24.05.2009).
2. Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fatness among children. JAMA 1998; 279: 938-42. (Abstract) / (Full Text) / (PDF)
3. Maddah M. Risk factors for overweight in urban and rural school girls in Iran: skipping breakfeast and early menarche. Int J Cardiol 2009; 136: 235-8. (Abstract) / (Full Text) / (PDF)
4. Soyer MT, Ergin I, Gürsoy ST. Effects of social determinants on food choice and skipping meals among Turkish adolescents. Asia Pac J Clin Nutr 2008; 17: 208-15. (Abstract)
5. Yannakoulia M, Karayiannis D, Terzidou M, Kokkevi A, Sidossis LS. Nutrition-related habits of Grek adolescents. Eur J Clin Nutr 2004; 58: 580-6. (Abstract) / (Full Text) / (PDF)
6. Molcho M, Gabhainn SN, Kelly C, Friel S, Kelleher C. Food poverty and health among school children in Ireland: findings from the Health Behaviour in School-aged Children (HBSC) study. Public Health Nutr 2007; 10: 364-70. (Abstract) / (Full Text) / PDF)
7. Vereecken CA, Toda J, Robetrs C, Mulvihill C, Maes L. Television viewing behaviour and associations with food habits in different countries. Public Health Nutr 2006; 9: 244-50.
8. Lien L, Green K, Welander-Vatn A, Bjertness E. Mental and somatic health complaints associated with school bullying between 10th and 12th grade students; results from cross sec- tional studies in Oslo, Norway. Clin Pract Epidemol Ment Health 2009; 5: 6. (Abstract) / (Full Text) / (PDF)

9. Bakoula C, Kapi Aikaterini, Veltsista A, Kavadias G, Kolaitis G. Prevalence of recurrent complaints of pain among Greek schoolchildren and associated factors: a population-based study. Acta Paediatr 2006; 95: 947-51. (Abstract) / (Full Text) / (PDF)
10. Currie C, Gabhainn SN, Godeau E, et al. Inequalities in young people’s health. HBSC Internatıonal Report From The 2005/2006 survey. WHO, Health Policy Children and Adolescents No:5.
11. Alikaşifoğlu M, Erginöz E, Ercan O, Uysal Ö, Albayrak-Kaymak D, İlter Ö. Cigarette among Turkish high school students. J Adolesc Health 2002; 30: 7-8. (Abstract) / (PDF)
12. Alikasifoglu M, Erginoz E, Ercan O, Uysal Ö, Albayrak-Kaymak D, Ilter Ö. Alcohol drinking behaviors among Turkish high school students. Turk J Pediatr 2004; 46: 44-53. (Abstract) / (Full Text) / (PDF)
13. Alikaşifoğlu M, Erginöz E, Ercan O, Uysal Ö, Albayrak-Kaymak D, İlter Ö. Violent behaviors among Turkish high school students and correlates of physical fighting. Eur J Public Health 2004: 14; 173-7. (Abstract) / (PDF)
14. Alikasifoglu M, Erginoz E, Ercan O, Uysal O, Albayrak-Kaymak D. Bullying behaviours and psychosocial health: results from a cross-sectional survey among high school students in Istanbul, Turkey. Eur J Pediatr 2007; 166: 1253-60. (Abstract) / (Full Text) / (PDF)
15. Jones- Matre RR, Welk GJ, Calabro MA, Russell DW, Nicklay E, Hensley D. Rural-urban differences in physical activity, physical fitness, and overweight prevalence of children. J Rural Health 2008; 24: 49-54. (Abstract) / (Full Text) / (PDF)
16. Swaim RC, Henry KL, Kelly K. Predictors of aggressive behav- iors among rural middle school youth. J Prim Prev 2006; 27: 229-43. (Abstract) / (Full Text PDF)
17. Martens MK, van Assema P, Brug J. Why do adolescents eat what they eat? Personal and social environmental predictors of fruit, snack and breakfast consumption among 12- 14 year-old Dutch students. Public Healt Nutr 2005; 8: 1258-65. (Abstract) / (Full Text) / (PDF)
18. Larson NI, Story M, Wall M, Neumark-Sztainer D. Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns. J Am Diet Assoc 2006; 106: 1816- 24. (Abstract) / (Full Text) / (PDF)
19. Jiang X, Li D, Boyve W, Pickett W. Variations in injury among Canadian adolescents by urban-rural geographic status. Chronic Dis Can 2007; 28: 56-62. (Abstract) / (PDF)
20. Karademas EC, Peppa N, Fotiou A, Kokkevi A. Family, school and health in children and adolescents. Finding from the 2006 HBSC study in Greece. J Health Psychol 2008; 13: 1012-20. (Abstract) / (PDF)
21. Due P, Lynch J, Holstein B, Modvig J. Socieconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations. J Epidemiol Community Health 2003; 57: 692-8. (Abstract) / (Full Text) / (PDF)
22. Youngblade LM, Theokas C, Schulenberg J, Curry L, Huang IC, Novak M. Risk and promotive factors in families, schools, and communities: A contextual model of positive youth development in adolescence. Pediatrics 2007; 119: 547-53. (Abstract) / (Full Text) / (PDF)
23. Erginöz E, Alikaşifoğlu M, Ercan O, et al. Perceived health sta- tus in a Turkish adolescent sample: risk and protective factors. Eur J Pediatr 2004; 163: 485-94. (Abstract) / (Full Text) / (PDF)
24. Burt MR. Reasons to invest in adolescents. J Adolesc Health 2002; 31: 136-52. (Abstract) / (Full Text) / (PDF)
25. Bernat DH, Resnick MD. Healthy youth development. Science and strategies. J Public Health Manag Pract 2006; Suppl: 10-6. (Abstract) / (Full Text) / (PDF)
26. Davis AM, Boles RE, James RL, et al. Health behaviors and weight status among urban and rural children. Rural Remote Health 2008; 8: 810. (Full Text)
27. Kelishadi R, Ardalan G, Gheiratmand R, et al. Thinness, over- weight and obesity in a national sample of Iranian children and adolescents: CASPIAN Study. Child Care, Health Dev 2008; 34: 44-54. (Abstract) / (Full Text) / (PDF)
28. Liu J, Bennett KJ, Harun N, Probst JC. Urban-rural differences in overweight status and physical inactivity among US children aged 10-17 years. J Rural Health 2008; 24: 407-15. (Abstract) / (Full Text) / (PDF)
29. Aounallah-Skhiri H, Romdhane HB, Traissac P, et al. Nutritional status of Tunisian adolescents: associated gender, environ- mental and socio-economic factors. Public Health Nutr 2008; 11: 1306-17. (Abstract) / (Full Text) / (PDF)
30. Monge-Rojas R, Campos H, Fernandez Rojas X. Saturated and cis-and trans-unsaturated fatty acids intake in rural and urban Costa Rican adolescents. J Am Coll Nutr 2005; 24: 286-93. (Abstract) / (Full Text) / (PDF)
31. Coben JH, Tiesman HM, Bossarte RM, Furbee PM. Rural-urban differencesw in injury hospitalizations in the US, 2004. Am J Prev Med 2009; 36: 49-55. (Abstract) / (PDF)
32. Boland M, Staines A, Fitzpatrick P, Scallan E. Urban-rural variation in mortality and hospital admission rates for uninten- tional injury in Ireland. Inj Prev 2005; 11: 38-42. (Abstract) / (Full Text) / (PDF)
33. Türkiye İstatistik Yıllığı 2004. TC Başbakanlık Devlet İstatistik Enstitüsü, Türkiye İstatistik Kurumu yayınları, Ankara: 2004.
34. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a stan- dard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1-6. (Abstract) / (Full Text) / (PDF)
35. Piko BF, Kovasc E, Fitzpatrick KM. What makes a difference? Understanding the role of protective factors in Hungarian ado- lescents’ depressive symptomatology. Eur Child Adolesc Psychiatry 2009; 10: 617-24. (Abstract) / (PDF)
36. Koivusilta LK, Rimpela AH, Kautiainen SM. Health inequality in adolescence. Does stratification occur by familial social back- ground, family affluence, or personal social position? BMC Public Health 2006; 6: 110. (Abstract) / (Full Text) / (PDF)
37. Roth-Isigkeit A, Thyen U, Stöven H, Schwarzenberger J, Schmucker P. Pain among children and adolescents: Restrictions in daily living and triggering factors. Pediatrics 2005; 115: 152-62. (Abstract) / (Full Text) / (PDF)
38. Maddah M, Rashidi A, Mohammadpour B, Vafa R, Karandish M. In-school snacking, breakfast consumption, and sleeping pat- terns of normal and overweight Iranian high school girls: a study in urban and rural areas in Guilan, Iran. J Nutr Educ Behav 2009; 41: 27-31. (Abstract) / (Full Text) / (PDF)
39. Keski-Rahkonen a; Kaprio J, Rissanen A, Virkkunen M, Rose RJ. Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr 2003; 57: 842-53. (Abstract) / (Full Text) / (PDF)
40. Rampersaud GC, Pereira MA, Girard BL, Adams J, Metzl JD. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. J Am Diet Assoc 2005; 105: 743-60. (Abstract) / (Full Text) / (PDF)
41. Utter J, Scragg R, Mhurchu CN, Schaaf D. At-home breakfast consumption among New Zealend children: Associations with body mass index and related nutrition behaviors. J Am Diet Assoc 2007; 107: 570-6. (Abstract) / (Full Text) / (PDF)
42. Haug E, Rasmussen M, Samdal O, et al. Overweight in school- aged children and its relationship with demographic and lifestyle factors: results from the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) Study. Int J Public Health 2009; 54: 167-79. (Abstract) / (PDF)
43. Weinreb L, Wehler C, Perloff J, et al. Hunger: Impact on chil- dren’s health and mental health. Pediatrics 2002; 110: 41.
44. Abstract) / (Full Text) / (PDF)
45. Monge-Rojas R, Nunez HP, Garita C, Chen-Mok M. Psychosocial aspects of Costa Rican adolescents’ eating and physical activity patterns. J Adolesc Health 2002; 31: 212-19.
46. Shi Z, Lien N, Kumar BN, Holmboe-Ottesen G. Socio-demo- graphic differences in food habits and preferences of school adolescents in Jangsu-Province, China. Eur J Clin Nutr 2005; 59: 1439-48. (Abstract) / (Full Text) / (PDF)
47. Ying-Xiu Z, Shu-Rong W. Distribution of body mass index and the prevalence changes of overweight and obesity among ado- lescents in Shandang, China from 1985 to 2005. Ann Hum Biology 2008; 35: 547-55. (Abstract) / (Full Text) / (PDF)
48. Özdirenç M, Özcan A, Akın F, Gelecek N. Physical fitness in rural children compared with urban children in Turkey. Pediatr Int 2005; 47: 26-31. (Abstract) / (Full Text) / (PDF)
49. Bruner MW, Lawson J, Pickett W, Boyce W, Janssen I. Rural Canadian adolescents are more likely to be obese compared with urban adolescents. Int J Pediatr Obes 2008; 3: 205-11. (Abstract) / (Full Text) / (PDF)
50. WHO Regional Office for Europe. Obesity in Europe. http://www.euro.who.int/obesity (erişim: 24.05.2009)
51. Sjolie AN, Thuen F. School journeys and leisure activities in rural and urban adolescents in Norway. Health Promot Int 2002; 17: 21-30. (Abstract) / (Full Text) / (PDF)
52. Springer AE, Hoelscher DM, Castrucci B, Perez A, Kelder SH. Prevalence of physical activity and sedentary behaviors by metro- politan status in 4th-, 8th, and 11th-grade students in Texas, 2004- 2005. Prev Chronic Dis 2009; 6: A21. (Abstract) / (Full Text) / (PDF)
53. Loucaides CA, Chedzoy SM, Bennett N. Differences in physical activity levels between urban and rural school children in Cyprus. Health Educ Res 2004; 19: 138-47. (Abstract) / (Full Text) / (PDF)
54. Bathrellou E, Lazarou C, Panagiotakos DB, Sidossis LS. Physical activity patterns and sedentary behaviors of children from urban and rural areas of Cyprus. Cent Eur J Public Health 2007; 15: 66-70. (Abstract Full Text)
55. Xu F, Ji J, Ware RS, Owen N. Associations of television viewing time with excess body weight among urban and rural high- school students in regional mainland China. Public Health Nutr 2007; 11: 891-6. (Abstract) / (Full Text) / (PDF)
56. Chen MY, Liou YM, Wu JY. The relationship between TV/comput- er time and adolescents’ health-promoting behavior: A secondary data analysis. J Nurs Res 2008; 16: 75-85. (Abstract) / (Full Text)
57. Feldman S, Eisenberg ME, Neumark-Sztainer D, Story M. Associations between watching TV during family meals and dietery intake among adolescents. J Nutr Educ Behav 2007; 39: 257-63. (Abstract) / (Full Text) / (PDF)
58. Giammattei J, Blix G, Marshak HH, Wollitzer AO, Pettitt DJ. Television watching and soft drink consumption. Arch Pediatr Adolesc Med 2003; 157: 882-6. (Abstract) / (Full Text) / (PDF)
59. Marshall SJ, Biddle SJH, Gorely T, Cameron N, Murdey I. Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. International J Obesity 2004; 28: 1238-46. (Abstract) / (Full Text) / (PDF)
60. Lam LT. Hospitalization due to sports-related injuries among children and adolescents in New South Wales, Australia: an analysis on socioeconomic and geographic differences. J Sci Med Sport 2005; 8: 433-40. (Abstract) / (PDF)
61. Atav S, Spencer GA. Health risk behaviors among adolescents attending rural, suburban, and urban schools: a comparative study. Fam Community Health. 2002; 25: 53-64. (Abstract)
62. Johnson AO, Mink MD, Harun N, Moore CG, Martin AB, Bennett KJ. Violence and drug use in rural teens: national prevalence estimates from the 2003. J Sch Health 2008; 78: 554-61. (Abstract) / (Full Text) / (PDF)