DEMOGRAPHIC PATTERN OF UNHEALTHY LIFESTYLES AND INTERVENTION STRATEGIES AMONG SECONDARY SCHOOL STUDENTS IN IMO STATE

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CHAPTER ONE

Introduction

Background of the Study

 It is often believed that a healthy lifestyle is a valuable resource for reducing the incidence and impact of health problems, enhancing recovery, coping with life stressors and improving quality of life. However, almost everybody exhibits unhealthy lifestyles in one form or the other (National Institutes of Health-NIH, 2006). It appears, however, that secondary school students indulge in unhealthy lifestyles more than their out-of-school counterparts. According to NIH (2006), in-school male students are more likely than out-of-school male students to indulge in unhealthy lifestyles. This may however be primarily because of their condition of life, which involves tension and environmental factors that expose them to most of these unhealthy lifestyles more than out-of-school students, (Fineran, 1996; Visser & Moleko, 1998; Daga & Daga, 2004; Ezedum, 2004). The International Union for Health Promotion and Education -IUHPE (1999) was of the opinion that a sizable proportion of the ten leading causes of death was due to potentially modifiable social and lifestyle factors. The IUHPE also condemned unhealthy lifestyles in whichever pattern it is practiced.

        Unhealthy lifestyles, according to Eaton, Kann, Kinchen, Ross, Harkins, Harris, Lowry, Memanus, Chyan and Shanklin (2006), are those risky behaviours that can have adverse effect on the overall development and well-being of the individual. Springer, Selwyn and Kelder (2006) perceived unhealthy lifestyles as a general term used to describe adverse health behaviours adopted by individuals and groups.

     Unhealthy lifestyle is a concept that denotes potential negative impact to an asset or some characteristics of value that may arise from present process or future event. Reber (1995) conceptualized unhealthy lifestyles as a set of actions that jeopardize something of value. The object that is threatened may be a physical object, a social or culturally valued psychological entity such as self-esteem. For example, when an individual involves himself or herself in an action that involves risk that results to unpleasant outcome, it is referred to as unhealthy lifestyle. According to Adam (2003), unhealthy lifestyles are situations where something unpleasant happens to someone. It also means doing something that one knows has dangerous or unpleasant result.

     Robyn and Lam (1999) opined that, there is no clear consensus in the literature about the definition or the key elements that are encompassed in the concept of unhealthy lifestyles. While it is generally agreed that such lifestyles are associated with increased risks of mortality, morbidity, and disability, there is uncertainty about whether specific lifestyles are associated with acute adverse outcomes.

       Trimpop (1994) defined unhealthy lifestyles in either or both of the following ways: Firstly, in terms of lifestyles that have been shown or are believed to be associated with increased chances of mortality, morbidity or disability. Secondly, in terms of propensity to take risks in general, rather than a focus on specifically defined lifestyles. In the context of this study, unhealthy lifestyles as suggested by Robert and Peter (1990) are open to variety of interpretations. While it certainly connotes the possibility of some negative outcome, views differ on whether these risky actions are necessarily deliberate. For some, the term implies deliberate choice of exposure to danger; others extend the meaning of unhealthy lifestyles to include all actions that can have negative consequences even when playing it safe in-school secondary school students.

          Unhealthy lifestyle is defined as volitional involvement in established patterns of lifestyles that threaten the well-being of secondary school students and limit their potential for achieving responsible adulthood (Lindberg, Boggess & Williams, 2000). These are also commonly referred to as problem behaviours (Elliott, 1993); (Jessor & Jessor, 1997). Springer, Selwyn and Kelder (2006) perceived unhealthy lifestyle as a general term used to describe adverse health behaviours adopted in adolescence. Lindberg et al., (2000) further distinguished unhealthy lifestyles from unhealthy lifestyle outcomes- the consequences of the behaviour. For example, unprotected sexual intercourse is an unhealthy lifestyle, while teenage pregnancy is an unhealthy lifestyle outcome and is not examined in the present study.

       Unhealthy lifestyle as viewed by Onuzulike (2007) is defined as a vehicle by which adolescents begin to make the transition to adulthood. Biologically based theories attribute unhealthy lifestyle to genetic predispositions and hormonal and psychosocial changes mediated through pubertal timing (Igra & Irwin, 1996; Blum, McNeely & Nonnemaker, 2001). In the context of the study, unhealthy lifestyle shall refer to sum total of health impairing behaviours or lifestyles practices, which initiated during secondary school days.

 Literature (Abanobi, 2005) revealed that secondary school students’ unhealthy lifestyles include smoking, drinking alcohol, eating food with too much calories and fats, and inactivity. National Institute of Health (2006), on the other hand, categorized unhealthy lifestyles into substance abuse, inadequate exercise, and poor dietary practices as they relate to being over-weight and intentional injuries. Similarly, Onuzulike (2007) classified unhealthy lifestyles into smoking, tobacco use, excessive consumption of alcohol, drug abuse, sex-work and unsafe sex, unhealthy diet, child abuse, family violence, lack of exercise, intentional injuries and suicidal behaviours. DeGuzman and Bosch (2007) stated that unhealthy lifestyles include self injuries behaviours (violence and suicide); substance use (alcohol abuse, tobacco and drug abuse); risky sexual behaviours (sex-work); behaviours related to obesity and unhealthy dieting (unhealthy diet) and inactivity or lack of exercise. 

In this study, unhealthy lifestyles refer to that way of living that has adverse effects on the overall development and well-being of youths and adults or attitudes that might prevent them from success and development.  This study focused essentially on unhealthy lifestyles which are classified into five categories namely; self injuries behaviours (violence, sexual harassment and suicide); substance use (alcohol abuse, tobacco and drug abuse); risky sexual behaviours (sex-work); behaviours related to obesity and unhealthy dieting (unhealthy diet) and inactivity or lack of exercise. DeGuzman and Bosch (2007) posited that unhealthy lifestyles are commonly seen among the secondary school students. The study focused on secondary school students because majority of them inclined to unhealthy lifestyles. This was based on the studies conducted by Fineran (1996), Visser and Moleko (1998), Daga and Daga (2004), who concluded in their various studies that unhealthy lifestyles existed among secondary school students.

        Unhealthy lifestyles, according to NIH (2006) are the primary preventable cause of death in the United States. The report further noted that the majority of American adult deaths result from cardiovascular disease and cancer, with many associated risk factors being initiated during secondary school days. Substance abuse and other unhealthy lifestyles carry an enormous price tag in terms of toll on life, quality of life and economic costs.

          Substance use is among the leading cause of accidents, homicides and suicides, the three leading causes of teenage deaths in Nigeria, as in most countries of the world (Abanobi, 2005). Cigarette / tobacco smoking is the primary preventable cause of death in the world today (World Health Organization, 1995). Kelder, Perry and Lytle (1994) reported that majority of the all the adult deaths results from cardiovascular disease and cancer, with many of the associated risk factors being initiated during adolescence. Substance misuse and abuse drastically reduce quality of life, and demands substantial economic costs to remedy such abnormalities on the part of the individual, family, and govement.

         Unrestrained sexual activity is another unhealthy lifestyle that has given rise to unwanted pregnancies, abandonment of babies, high mortality due to HIV and AIDS, high morbidity due to sexual transmitted infections, increasing cases of infertility as an aftermath of promiscuous behaviour as well as other social vices. It has also been shown that unhealthy lifestyles exposed the adolescent to conditions, which are likely to cause physical, mental, psychological distress and damage (Abanobi, 2005).     

Earlier, Salami (1997) identified peer group influence, quackery, dearth of qualified medical personnel and proliferation of patent medicine stores as factors responsible for secondary school students’ vulnerability to substance misuse and abuse. Given the acknowledged dangers inherent in substance misuse and abuse, and considering the fact that secondary school students of today will constitute the productive sector of the nation’s future economy sustainable solutions must be proffer to eradicate or minimize this threat to secondary school students’ health.

Physical inactivity or lack of exercise is another unhealthy lifestyle pattern that could be of treat to secondary school students. According to World Health Organization (2002), Physical inactivity is responsible for an estimated 1.9 million annual deaths worldwide. It was also reported that in 2000 alone in U.S.A. the inactivity health care costs was estimated to be US$75 billion. In its Health Report (2002), physical inactivity alone with tobacco use and unhealthy diet contributed significantly as a risk factor for non-communicable diseases (NCD) even though, it is preventable. It was reported that in 2001, NCDs accounted for 59 per cent of global deaths of which 77 per cent were in developing countries including Nigeria. Physically inactive secondary school students with low levels of cardiovascular fitness, high per cent of body fat, and large amounts of visceral adipose tissue have unfavourable cardiovascular risk profiles which increase their risks of developing cardiovascular diseases later in life (Healthy People 2010). Although physical activity can help prevent excessive weight gain, more than a third of all middle and high school students do not get the recommended 30 minutes of moderate physical activity on most days of the week. Regular exercise and participation in sports or physical education classes can have positive effects such as building and maintaining strong muscles and bones, controlling weight, and providing positive psychological benefits. Regrettably, studies of Kelder, Perry and Lytle (1994) and Healthy People (2010) revealed that physical activity declines during children’s transition from childhood through secondary school studentship.

          Some of the constituent elements of secondary school adolescents’ unhealthy lifestyles, according to Diclement, Prochasrkasand Gilbartim (1999), include tobacco use, cigarette smoking, substance abuse and misuse, alcohol misuse and abuse, suicidal behaviour and suicide ideation, intentional injury and violence. They further submitted that these unhealthy lifestyles are prevalent among adolescents regardless of age, gender, level of education, education zone, socio-economic status (SES) and cultural background. Resnick, Ireland and Borowky (2004) identified education zone (school environment) as one of the demographic factors that influenced perpetration of students’ unhealthy lifestyles. Such education zones could be seen in Imo State. They include Okigwe zone, Orlu zone and Owerri zone. 

      Demographic factors such as school environment and level of education have been identified among others as major factors predisposing secondary school students into unhealthy lifestyles. World Health Organization (2000) identified factors associated with unhealthy lifestyles. They include level of education and school environment or education zone. For example, WHO (2000) observed that junior secondary school students experienced more bullying from their fellow senior secondary school mates. The report further indicated that some school environment exposes the secondary school students to various unhealthy lifestyles ranging from substance abuse, poor dietary condition, victimization, bullying among school mates and unwanted prangnancy to illegal abortions and sexually transmitted infections (STI), including the most dreaded Acquired Immune Deficiency Syndrome (AIDS). Following from this, the study was focused essentially on demographic factors proven to be potent vehicles for perpetration of unhealthy lifestyles and behaviours among secondary school students.

         In addition, the study examined the influence of such demographic characteristics as age, level of education,  gender, education zone and school type on the students’ unhealthy lifestyles patterns. Study of Fekete, Voros, Osvath and Trixler (1997) had shown, for example, that considerable number of younger secondary school students than the older students experienced more bullying by their fellow school mates in the school. The report further showed that junior secondary school students experienced victimization, punishment and bullying by fellow school mates more than their senior secondary school counterparts. On the other hand, Fekete, Voros and Osvath (1997) asserted that gender has been shown to influence secondary school students’ unhealthy lifestyles patterns. A study (Onuzulike, 2007) of the reproductive behaviours of Nigerian adolescents indicated that boys experienced their sexual intercourse at slightly earlier ages than girls. The researcher further stated that male students exhibited most of the unhealthy lifestyles more than the female secondary school students.  Furthermore, a study conducted by Fekete, Voros, Osvath and Trixler (1997) showed that a significant relationship exists between age, gender and unhealthy lifestyles among adolescents. In conclusion, they also indicated that male students engaged in unhealthy lifestyles much early in lifetime than the female students who experienced theirs much later in life. This could be as a result of the labels of shyness for the girls and boldness for the boys. To the knowledge of the researcher, however, no study has ever examined the influence of school type on any pattern of unhealthy lifestyles in the locality of this study. These explain the present interest in examining the influence of the identified variables on the secondary school students’ unhealthy lifestyles patterns.            

         Cowie (1990) defined patterns as various forms in which something may occur. Hornby (2001) referred to patterns as the regular ways in which something happens or is done. In the present study, patterns shall refer to as regular ways in which unhealthy lifestyles occur, appear or happens. Pridemore, Andrew and Spivak (2003) classified patterns into three forms; namely: demographic, temporal and spatial.

DEMOGRAPHIC PATTERN OF UNHEALTHY LIFESTYLES AND INTERVENTION STRATEGIES AMONG SECONDARY SCHOOL STUDENTS IN IMO STATE