Section 7: Healthy settings for young people in Canada – Emotional health and well-being
7 Emotional Health and Well-being
by John Freeman
The importance of emotional health
Young people’s emotional health reflects their awareness of their own emotions or feelings, their thinking or psychology, and how these influence their overall health, attitudes, and well-being.
Canadians should be concerned about emotional health. Research has shown that many adolescents who experience mental health problems continue to have these problems in adulthood; as a result, early recognition of the signs of emotional health difficulties is critical.Footnote 1
People with poor emotional health may suffer multiple personal costs, including limited employment opportunities, reduced access to housing, and strained family relationships.Footnote 2 If poor emotional health develops into more severe mental illness, personal costs can lead to poverty, homelessness, and social exclusion, which may ultimately be life-threatening.
Research can help to identify those school-aged young people most likely to have poor emotional health. The HBSC study plays a valuable role in gathering such information about young Canadians.
Emotional health is measured in four different ways on the HBSC survey. We categorize these as direct and indirect measures of emotional health (including physical aspects) at specific and global levels of the person (Table 7.1).
|Indirect||Psychosomatic symptoms||Perceived health|
|Direct||Emotional well-being||Life satisfaction|
The eight psychosomatic symptoms assessed in the HBSC study represent indirect, but specific indicators of emotional health. The symptoms include headache, stomach ache, backache, feeling low (depressed), irritability or bad temper, feeling nervous, difficulties in getting to sleep, and feeling dizzy. For each of the symptoms, young people were asked to indicate how often it occurred in the past six months, with possible responses being about every day, more than once a week, about every week, about every month, or rarely/never.
Nine emotional well-being questions were used as more direct, specific indicators of young people’s emotional health. The emotional well-being questions include asking them about having self-confidence, wishing they were someone else, feeling helpless, having trouble making decisions, being sorry for the things they do, changing how they look, feeling left out of things, feeling lonely, and having a hard time saying no. Students could choose from a set of five responses to the questions, including strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree.
One question explored global emotional health indirectly by asking students to assess their general health as excellent, good, fair, or poor.
A final question represented a more direct, global indicator of emotional health. Students were asked to indicate their level of life satisfaction from 0 (worst possible life) to 10 (best possible life).
The eight psychosomatic symptoms and nine emotional well-being questions can be examined separately or combined to form two scales: psychosomatic symptoms and emotional well-being. The scale for psychosomatic symptoms consists of three categories: none, 1 to 3 symptoms, and 4 or more symptoms. On the other hand, the emotional well-being scale is divided into three categories of equal sizes: low, medium, and high. Frequencies are presented for three separate psychosomatic symptoms experienced by students in the past six months, namely backaches (as experienced at least once a month), low or depressed feeling (as experienced at least once a week), and bad temper or irritability (as experienced more than once a week).
We then focus on three of the nine questions related to students’ emotional well-being, specifically self-confidence, wishing they were someone else, and feelings of helplessness. We also provide the results of students’ assessments of general health and their selfreports on life satisfaction. The relationship between life satisfaction and the two full scales (psychosomatic symptoms and emotional well-being) is also explored.
All four contextual variables – living with both parents, school experience (academic achievement and attitude towards school), peer relationships (communication with friends and pro-social attitudes of friends), and socio-economic status (family affluence) – are reported in relation to the psychosomatic symptoms and emotional well-being scales.
Figure 7.2 shows the percentage of students who report having a backache at least once a month in the past six months. Proportions of young people who have backaches increase for both boys and girls over the grades, starting at 36% for boys and 31% for girls in Grade 6 and growing to 53% and 60% in Grade 10, respectively. The increase is steeper for girls between Grades 6 and 8 than it is for boys. In upper grades, the proportion of girls who have backaches is 7% higher than that for boys.
Although gender differences in reported backaches were not pronounced in the three previous survey years (with the exception of Grade 10 students in 1994 and 1998), they are greater in 2006, such that more Grade 6 boys experience regular backaches than Grade 6 girls, with the reverse being true in Grades 8 and 10 (Figure 7.3).
Figure 7.4 gives a picture of the percentage of students who feel depressed or low at least once a week in the past six months. For boys, the number is highest in Grade 6 at 26%, drops to 21% in Grade 7, and stays at that level in the three subsequent grades. In contrast, for girls, the number is lowest in Grade 6 (24%), increases sharply in Grade 7 to 32%, and peaks in Grade 10 at 38%. Thus, while the proportion of boys feeling depressed or low slightly exceeds that of girls (by 2%) in Grade 6, the gap between boys and girls in Grade 10 is more extreme.
As shown in Figure 7.5, the 2006 numbers for feeling depressed are relatively consistent with the previous three surveys, although the gender gap is wider in both Grade 8 and Grade 10 than in previous years.
Similar to the other two psychosomatic symptoms reported, the pattern for being bad tempered or irritable more than once a week in the past six months shows gender differences (Figure 7.6). The percentage of boys being in a bad mood/irritable remains constant across the grades, whereas percentage of girls increases by grade, with the biggest jump between Grade 6 and Grade 7. Thus, while boys and girls have almost the same rate of being bad tempered/ irritable in Grade 6, 17% and 16% respectively, there is a gender gap in all the other grades, with girls reporting more bad mood/irritability in each grade.
Gender differences in bad temper and irritability are consistent across survey years (Figure 7.7). While this symptom declined across grade and gender from 1994 to 1998, there was little change from 1998 to 2002, and virtually no change from 2002 to 2006.
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