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Table of Contents
Year : 2022  |  Volume : 15  |  Issue : 4  |  Page : 209-213

Health-related behaviours of urban school-going adolescents of a Metropolitan City of Eastern India

1 Department of Community Medicine, Medical College, Kolkata, West Bengal, India
2 Department of General Medicine, Medical College, Kolkata, West Bengal, India
3 Department of Community Medicine, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India

Date of Submission04-Jul-2022
Date of Decision20-Aug-2022
Date of Acceptance23-Sep-2022
Date of Web Publication22-Dec-2022

Correspondence Address:
Saikat Bhattacharya
Department of Community Medicine, Nil Ratan Sircar Medical College, Kolkata - 700 014, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hmj.hmj_57_22

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Background: Adolescence is the phase of attaining physical, mental and psychosocial maturity. Adolescents are susceptible to high-risk behaviours which affect both their physical and mental health. Aims and Objectives: This study aims to determine their sociodemographic profile, dietary preferences, physical activity, personal hygiene, substance abuse, interpersonal relationships, academic performance, etc., Materials and Methods: This cross-sectional study was undertaken amongst adolescents aged 16 to 19 years in two randomly selected schools. The youth Risk Behaviour Surveillance System questionnaire 2019 was used to find out different domains of adolescent behaviours. Their positive attributes fetched positive scores, whereas unhealthy attributes fetched negative scores. Bad scores (≤median) for each of the domains were computed, and logistic regression was done with sociodemographic and other variables. This was conducted in MS Excel and R 4.2.1. Results: Out of 145 adolescents interviewed, majorities (66.2%) were males, hailed from nuclear families (66.9%) and belonged to average financial status (53.8%). About 68.3% did not have any close friends. Dietary habits (71.0% had improper dietary habits) were worse amongst females (adjusted odd ratio [AOR] [95% confidence interval [CI] 1.58. 1.02–4.31) and amongst those coming from nuclear families (AOR [95% CI] 2.58 [1.57–7.47]). Health-related habit score was unsatisfactory at 28.9%. Substance abuse was noted in 16.6%; the presence of close friends (AOR [95% CI] 7.09 [3.24–26.71]) and either good (AOR [95% CI] 2.16 [1.22–53.39]) or poor (AOR [95% CI] 4.06 [1.54–57.73]) financial condition was the risk factors. Most (62.7%) had average school performance, and the majority wished to study in college. Poor school performance was associated with bad scores in health-related behaviour (AOR [95% CI] 7.43 [3.07–17.44]) and substance abuse (AOR [95% CI] 1.84 [1.02-12.35]). Conclusion: Regular assessment of various health-related risk factors must be done for the better physical and mental health of adolescents.

Keywords: Adolescents, mental and physical health, risk factors, school performance

How to cite this article:
Das A, Bhattacharyya K, Ansar M, Bhattacharya S. Health-related behaviours of urban school-going adolescents of a Metropolitan City of Eastern India. Hamdan Med J 2022;15:209-13

How to cite this URL:
Das A, Bhattacharyya K, Ansar M, Bhattacharya S. Health-related behaviours of urban school-going adolescents of a Metropolitan City of Eastern India. Hamdan Med J [serial online] 2022 [cited 2023 Feb 1];15:209-13. Available from: http://www.hamdanjournal.org/text.asp?2022/15/4/209/364690

  Introduction Top

According to the World Health Organization, adolescence refers to the age group of 10 to 19 years, which roughly corresponds to their puberty.[1] Adolescence may be defined as the stage of human life when individuals reach maturity. This is the critical time period when they experience a transition in their physical, social, psychological and emotional aspects of life.[2] Thus, activities, lifestyle and behaviour during this phase of life mould the future of the individual. While risk-free behaviours and healthy lifestyles carve the path for a healthy adulthood, high-risk behaviours along with stress, sedentary habits and unhealthy dietary practices increase proneness towards future health hazards and psychosocial morbidities. Some of the common high-risk behaviours which lead to adolescent health and development problems are unhealthy eating habits, substance abuse (including use of alcohol and tobacco), situations which increase the likelihood of violence and/or accident, negative peer relationships and affiliations and engaging in various unwanted and harmful circumstances. Since adolescents preferentially spend time with their peers rather than under their parent's supervision, adolescents' peer group culture possibly plays a significant role in the onset of lifestyle risk behaviour.[3] Schools are the cradle beds for the development of peer group culture. A lot depends on the school atmosphere and the nature of the peer group. Performance in the classroom can influence self-perceptions, as teacher-rated work and social patterns predict self-esteem, while grades in a particular subject can influence students' self-esteem relating to that given subject.[4] There is a growing recognition that the health and psychosocial well-being of students is of utmost importance, and the school settings can provide strategic means for improving health, self-esteem, life skills and behaviour. In India, there are nearly 207 million adolescents, comprising nearly 22% of the total population.[5] In the Indian context, school-based studies which focus on adolescents will be very crucial in developing future strategies towards better adolescent health. Keeping this in mind, the present study was undertaken on urban adolescents studying in schools in Eastern India with the following objectives: (1) to assess the dietary preferences, levels of physical activity and personal hygiene of the adolescents, (2) to find out various risk behaviours and substance abuse prevalent amongst the adolescents, (3) to demonstrate the nature of interpersonal relationships with peers and family members of the adolescents and (4) to assess the interrelationship between the above-mentioned parameters.

  Methods Top

This cross-sectional study was undertaken for a period of 3 months (October 2019 to December 2019) in two randomly selected schools out of a total of 10 schools located near a slum in Chetla, Kolkata, West Bengal, India. All adolescents in the age group of 16–19 years, studying in 11th and 12th standard and giving informed consent were included in the study. There were 184 students in total as per the attendance registers. The headmasters of both schools were approached with the proposal and questionnaire and were also explained the purpose of the study. Students were contacted during their periods of recess. A pre-designed and pre-tested questionnaire based on the Youth Risk Behaviour Surveillance System questionnaire 2019[6] keeping in mind the sociocultural and regional aspects of the study population, was administered to the students. Anonymity and confidentiality were assured. Unwilling candidates were excluded from the study. A scoring system was adapted for each of the following: (a) dietary habits, (b) health-related habits, (c) substance abuse and (d) interpersonal relationship. The positive attributes fetched positive scores, whereas unhealthy practices fetched negative scores. Scores less than the median were considered poor scores. Mean and standard deviation (SD) were used to describe the data. Logistic regression was applied for statistical analysis. 'P' < 0.05 was considered statistically significant. MS Excel and R 4.2.1 were used for statistical analysis. The study received clearance from the institutional ethics committee.

  Results Top

One hundred and forty-five students completed the full questionnaire making a response rate of 78.8%. The sociodemographic characteristics of the study population are shown in [Table 1]. Mean age was 17.03 (SD = 0.80) years. Majorities (96 [66.2%]) were males, hailed from nuclear families (97 [66.9%]) and belonged to average financial status (78 [53.8%]). Most of the adolescents consumed junk food daily and preferred not to take milk or fresh fruits and vegetables [Table 2]. Almost half of the respondents did not wear fresh and clean clothes daily. Only 21.4% engaged in physical activity/outdoor sports. Substance abuse was a monopoly of male students. [Table 2] Overall, poor dietary habit score was present in 103 (71.03%), poor hygiene and physical activity score in 42 (28.97%), poor substance abuse score in 24 (16.55%) and poor interpersonal relationship score in 66 (45.52%) adolescents. [Table 3] Dietary habits were found to be worse amongst females (adjusted odd ratio [AOR] [95% confidence interval [CI]] 1.58. 1.02–4.31) and those coming from nuclear families (AOR [95% CI] 2.58 [1.57–7.47]). The presence of close friends (AOR [95% CI] 7.09 [3.24–26.71]) and either good (AOR [95% CI] 2.16 [1.22–53.39]) or poor (AOR [95% CI] 4.06 [1.54–57.73]) financial condition was the risk factors for substance abuse. Nuclear family (AOR [95% CI] 2.02 [1.32–19.11]), the absence of siblings (AOR [95% CI] 1.36 [1.02–42.29]), the absence of grandparents (AOR [95% CI] 2.01 [1.13–17.24]) and the absence of close friends (AOR [95% CI] 2.38 [1.24–9.41]) were covariates of poor interpersonal relationships [Table 3].
Table 1: Sociodemographic characteristics of the study population (n=145)

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Table 2: Description of dietary habits, hygiene, physical activity, substance abuse and interpersonal relationships of the study population (n=145)

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Table 3: Relationship between sociodemographic parameters and the scores in different domains (n=145)

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  Discussion Top

The present study documented the presence of faulty dietary preferences, unhygienic habits, reduced physical activity, substance abuse and poor interpersonal relationships amongst urban adolescents of Eastern India. Excessive indulgence in junk food and a high-calorie diet coupled with avoidance of fruits, vegetables and milk were observed. Many were reluctant to wear fresh and clean clothes daily, and the majority did not exercise/play outdoor games regularly. Less than half of the respondents had satisfactory body weights according to themselves. Substance abuse was noted amongst male adolescents only. Many of the candidates fell prey to bullying, got involved in quarrels or fights and were scolded or punished by the teachers because of their behaviour in school.

There is growing concern regarding adolescent health and high-risk behaviour. The picture, in spite of some regional variations, is dismal throughout different parts of the world. Adolescence is the time when substance abuse and obesity tend to be established.[7],[8],[9] Obesity in childhood and adolescence is on the rise in developing countries.[10] Being overweight is a significant risk factor for chronic diseases such as arteriosclerosis, ischemic heart disease and diabetes.[11] A study from Pakistan documented obesity in about 18% of school-going adolescents.[12] In our study, we did not directly measure obesity; however, 25.5% of the subjects wanted to lose weight. The dietary patterns of adolescents are equally harmful and unhealthy. Galhotra et al. and Singh et al. both demonstrated a high intake of fast food along with lower consumption of nutritious food items.[13],[14] We also experienced overindulgence in fast food, junk food and high-calorie foods such as ice creams, sweets and chocolates which supposedly pre-dispose to obesity. A sedentary lifestyle is a known risk factor for cardiovascular diseases. Lack of physical exercise and disinterest in outdoor sports were prominent in the study by Galhotra et al.[13] Poor hygienic practices are also common, as evidenced by a study from Turkey.[15] However, Majumdar et al. reported a relatively low prevalence of unhygienic practices.[16] We found that about half of adolescents did not wear fresh clothes every day. Substance abuse amongst adolescents is a challenge to health personnel and policymakers. In developed countries such as Russia and United States, adolescent binge drinking and drunk driving are quite prevalent.[17],[18] The scenario is equally bad in developing countries, like Pakistan.[19] In Indian studies also, a significant proportion of adolescents indulged in substance abuse in some form, many out of sheer curiosity.[13],[14] Of particular importance is a study from West Bengal by Tsering et al., where authors found that substance abuse was prevalent in 15.1% of adolescents.[20] This percentage is similar to our study (16.55%). Sharma et al. and Munni and Malhi have found a high percentage of bullying, fighting, quarrelling and some form of violence amongst adolescent school-goers, similar to our study.[21],[22]


Apart from a relatively small sample size, a number of physical and mental health problems, sexual inclinations and behaviours and risk-taking tendencies could not be documented in our study, in view of the time constraint and to keep the questionnaire from becoming too lengthy. Some questions could not be included as they might have decreased the response rate significantly due to their sensitive nature in the Indian context. This study was conducted in the pre-COVID era. The COVID-19 pandemic has had a prolonged effect on the lives of school-going adolescents as after almost 2 years of closure impact of school education has changed a lot. Hence, a similar study is needed to be conducted in the post-COVID era to compare the results of these two.

  Conclusion Top

Health-related behaviour of adolescents is far from satisfactory in urban Eastern India. Health practitioners and policymakers should concentrate on the betterment of adolescent health by strategies like school-based health education.[23] Urgent steps are necessary to formulate a need-based health programme for the betterment of the current status of adolescent health in this part of the country.

Ethical clearance

The study was approved by Institutional Ethics Committee of Medical College Kolkata, reference number MC/KOL/IEC/NON-SPON/258/02-2019.

Declaration of participant consent

The authors certify that they have obtained all appropriate participant consent forms. In the form, the participants have given their consent for their information to be reported in the journal. The participants understand that their identity will not be disclosed voluntarily but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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Galhotra A, Abrol A, Agarwal N, Goel N, Gupta S. Lifestyle related risk factor for cardiovascular disease in Indian adolescents. Internet J Health 2009;9:2.  Back to cited text no. 13
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Majumdar R, Ganguly SK, Raje S. A study of adolescents in rural area. Health Popul Perspect Issues 2001;24:198-205.  Back to cited text no. 16
Stickley A, Koyanagi A, Koposov R, Razvodovsky Y, Ruchkin V. Adolescent binge drinking and risky health behaviours: Findings from Northern Russia. Drug Alcohol Depend 2013;133:838-44.  Back to cited text no. 17
Delcher C, Johnson R, Maldonado-Molina MM. Driving after drinking among young adults of different race/ethnicities in the United States: Unique risk factors in early adolescence? J Adolesc Health 2013;52:584-91.  Back to cited text no. 18
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  [Table 1], [Table 2], [Table 3]


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