Actual problems of modern youth in the context of health-oriented behavior

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"Institute for Children and Adolescents Health Care at the National Academy of Medical Sciences of Ukraine"

Karazin Kharkiv National University

Actual problems of modern youth in the context of health-oriented behavior

Peresypkina T.V. phD, chief of department of Science organization of medical care for children and adolescents State Institution

Merculova T.V. phD, chief of department of Hygiene of children and adolescents State Institution

Merculov V.V. Assistant of department Hygiene and Social medicine of medical faculty, V. N.

Peresypkina A.M. Assistant of department Hygiene and Social medicine of medical faculty

Summary

Discussed medical and social determinants of health - oriented behavioral modem youth and way to changing situation. The most significant changes of prevalence of diseases occur among school-age children, and especially among adolescents (for the period 2001 - 2017 this indicator increased by 46,6 % among adolescents). Widespread negative social determinants that are characteristic of modern teens: spending free time in front of a computer, have irregular meals, less level of physical activity, present tense situation in the family and in school, feel dissatisfied with the material situation, a lot of adolescents never spend time together with the family, parents only sometimes control condition of their health. All this factors lead to disorders of health. The consequences of the negative tendencies in the health of young people are the reduction of the part of the ablebodied population and the reduction of the country's labor potential. Currently, youth need immediately implement preventive measure and programs for develop and strengthening of their health-oriented behavior.

Key word: youth, medical and social determinants of health, health-oriented behavioral

The health of young people is emphasized as the highest value of any state, and all political decisions must take into account interests of children, because they are a new generations of state. The state of health of children and adolescents in Ukraine has had a negative change for many years: the health level is decreasing, the prevalence of diseases is increasing, and the high mortality rate remains for reasons that can be prevented.

The most significant changes of prevalence of diseases occur among school-age children, and especially among adolescents. Thus, for the period 2001 - 2017 this indicator increased by 46,6 % (from 1485,7 to 2177,7 %o), which requires to take immediate measures to prevent development of diseases and to strengthen health through the strengthening of preventive measures. World experience shows that preventive measures are most effective in their application in accordance with the specific needs of the target audience.

The problem of preserving the health of the younger generation and preventing the development of chronic non-infectious diseases, reducing the impact of negative behavioral risk factors for develop of disease is a priority area of research of the European Regional Office of WHO. Many preventive strategies are based on the study of social determinants of health and are reflected in numerous publications.

Therefore, the purpose of the work is detected all of determinants of the formation of health among modern youth with the aim to propose and implement corrective and preventive programs, which can prevent development of deviations in health and the progression of chronic pathology, ensuring the realization of all opportunities of children during their life.

Materials and methods. As part of research work, a questionnaire among school-age children regarding health and social determinants of health was carried out. Appraisal and analysis of health status and physical development among school-age children was based on medical preventive examinations. Data processing was performed using MS Excell software package and SPSS-17.

Results and discussion. According to the results of a study conducted by the specialists of State Institution "Institute for Children and Adolescents Health Care at the National Academy of Medical Sciences of Ukraine" in 2018 among about 3300 schoolchildren of the Kharkiv region, 57.1% of children in all age groups have harmonious physical development. And this indicator is almost unchanging during the all period of schooling. The reason for this among other things is low level of physical activity of schoolchildren, which tends to decrease during the school period. Thus, according to polls, if 47.9% of sixth graders indicated daily morning exercise and physical activity, then the same levels of physical activity are observed only in 33% of the students of nine graders.

Violations of the harmony of physical development of schoolchildren were observed mainly due to excess body mass (25%) and insufficient (12%) body weight. The main predictors of this are a violation of the diet and eating behavior. Thus, according to the survey, the mismanagement of eating behavior and the lack of "proper" eating habits in the families of schoolchildren leads to irrational nutrition of children due to their inadequate take of the necessary nutrients and an increase in the daily ration of unhealthy foods (such as smoked sausages, sausages, sweets, fast food, chips, crackers, sweet sparkling drinks, etc.). Today, only 45-54.7% of schoolchildren point everyday consumption of meet; only 38-43% persons of middle and upper grades take milk and dairy products every day; and about 60-72% - eat of fresh vegetables and fruits. About 4.5 to 6% say they use "fast food" and other "rubbish food" daily from of students in grades 69 classes.

The leading causes of negative changes in health are behavioral risk factors and aggressive advertising of harmful food products, tobacco, alcoholic beverages, etc. on the background of society; the lack of attention of parents, teachers and society as a whole to the need for the active formation of healthy lifestyles and conscious decision-makers in adolescents attitude towards own health. Preventive failure of the system of medical preventive measure for schoolchildren is confirmed by the increasing prevalence of harmful habits during the study in school, mass failure to observe the school daily regime, lack of health-oriented behavior, low level of knowledge about healthpreserving behavior, lack of intersectoral interaction for improving the health of children by system of health promotion.

According to own researches, only 50.4% of adolescents believe that they lead a healthy lifestyle, and among reasons that prevent sufficiently healthy lifestyles, adolescents indicate "lack of time" - 49.3% and "laziness" - 32.2 % and 24.4% of adolescents are not in a position to accurately determine the cause. At the same time, 63.9% of schoolchildren consider it necessary to change something in their behavior and habits fo improve their health, which is a positive sign. Besides, among adolescents there is a rather high prevalence of behavioral risk factors such as: violations of the day regime (13-40%) by of the various components (diet, rest, training activities, etc.), the formation of a smoking habit (6%) and alcohol use (5 - 8%) at least once a month.

Almost 45% of adolescents have not formed a value attitude to health and health-oriented behavior: there are no examples, authorities, school children are not defined in their relation to bad habits. About 1015% of schoolchildren did not think at all or have no personal opinion about the impact of life style on health.

Widespread negative social determinants that are characteristic of modern teens: spending free time in front of a computer (28.6% of schoolchildren); do not feel comfortable at school 30.0% of schoolchildren; about 13% of children eat only 1-2 times a day and as many have irregular meals; 14.0% of respondents indicate that they have a tense situation in the family, feel dissatisfied with the material situation, family relationships are not trustworthy, roughly the same part of adolescents never spend time together with the family, parents only sometimes control condition of their health.

All this indicates at the low effectiveness of existing prevention programs, the weak health-saving component of the educational process, the lack of effective means of interaction between educational institutions and parents against the background of aggressive "anti advertising" of a healthy lifestyle through the media and Internet space.

The state of health of children also has an impact on the future economic state of the country. Thus, the deterioration of the physical, mental and social health of children is at increased risk of being transformed over time into serious health impairments that often limit the ability of a full-fledged life or profession, cause dependence on drugs and medical services, and often becomes life-long and greatly aggravates further adult life and worsens its quality of life.

The consequences of the negative tendencies in the health of young people are the reduction of the part of the able-bodied population and the reduction of the country's labor potential. At present, almost 80% of 911 grade pupils are restricted in choosing professions due to chronic illness in 65% of cases. As result, 2025% of adolescents get not suitable for the profession and only 30-40% continue to work in the chosen profession. According to our research, young people are not well-informed (only 49.9% of adolescents) regarding their own health, or medical indications and contraindications when choosing their professional activities. At the same time, the level of organization of counseling of students for professional orientation among specialists is not enough - 79.3% of adolescents did not receive advice on the choice of profession.

In a multi-sectoral economy, a graduate of a school does not imagine the needs of production in the personnel of certain professions, the real possibilities of employment or continuing education, the specifics of different professions. There are more than 40 thousand professions at present: Higher education institutions train specialists in 800, vocational schools - in 1100 professions, more than 500 new professions are born annually. In recent years, general education institutions have focused their graduates mainly on admission to higher education institutions. On the other hand, vocational and technical institutions, while in the process of reform, prepare graduates without taking into account of staff needs of the region. This led to a shortage of many labor specialties in the labor market and, at the same time, an increase in the number of young people who, having an education can not be employment in their chosen profession.

In this regard, an important aspect is the redistribution of the priorities of state programs to the disease prevention and promotion of health in the first place among the students of the youth. Children and adolescents are contingents with the highest rate of effectiveness of prevention programs, and their health is the fundamental basis for the formation of public health. The processes of growth and development a child are subject of certain biological laws, but at the same time determined by the factors of the environment. Among the causes of unfavorable changes in the health of children is the social factors, which have a significant negative impact. Problems are exacerbating during school years, when inappropriate educational load and unsatisfactory sanitary and hygienic conditions of education, the lack of a systematic approach to physical and hygienic education take place. And it all leads to maladaptation and illness, disharmonious development, neuropsychiatric overload, social and psychological.

At the same time, according to the European Regional Office of the World Health Organization (WHO), schools are an influential environment that can form and maintain health. Understanding the health issues of young people should be significantly enhanced by the content and providing official health- oriented training programs. The physical environment of an educational institution can be used to implement concrete actions for the protection and enhancement of the health of the younger generation. The school affects the perceptions, attitudes, activities and behavior of not only students, but also teachers, health workers, parents and society in general. Therefore, an irreplaceable and practically the only one (after a family) facility that can systematically and long-term period influence to the health of children and adolescents is an educational institution.

Promotion of health in educational institutions should aim at: defining the main determinants of children's health with the further development and adoption of new preventive programs and health-saving technologies at the state level; development of technologies for the early detection of health disorders, their prevention and adherence to rehabilitation; strengthening students' health by influencing to their determinants; information and explanatory activity and subject-oriented technologies of preserving the health of adolescents; introduction of a policy of preserving and strengthening the health by all participants in the educational process at the educational institution; communication, social mobilization of stakeholders for prioritizing and conducting co-operative activities in the interests of preserving the health of the younger generation.

In today's realities of reforming the healthcare system and almost eliminated school medicine, providing medical care for school age children only by primary care physicians is not effective. At this stage, the most appropriate distribution of functions and competencies of healthcare in an educational institution between the three links following: a public health specialist, a health worker (nurses or doctors) and a practical psychologist.

The main health promotion functions should be delegated to a public health specialist. health behavioral working

A public health specialist, acting directly to the management of an educational institution, may become the coordinator of health care work of the institution. It is expedient to include the following in his competencies:

analysis of medical data of the health status of children in the institution as a whole and in separate classes in the dynamics of the school year and at different stages of study identification of social, school and other factors that have a direct impact to the formation of health, the search for ways to manage them;

selection, justification and organization of the implementation of the necessary prevention measures for non-communicable diseases with making further evaluation of their effectiveness;

organization of targeted educational activities among schoolchildren and their parents in order to create value orientations for a healthy lifestyle;

social mobilization and organization of cooperative work of teachers, parents, medical institutions, and other public organizations in the interests of schoolchildren 's health using modern methods of reporting information on health and safety issues.

The main sections of work of the psychological service of an educational institution should include following aspects:

preservation of psychological comfort of students at stages of adaptation to education, during transition to secondary and high school;

co-operative work with teachers on creating a comfortable psychological climate in small educational groups;

Accompanying inclusive education;

psychological support for the introduction of new educational programs;

psychological support of the process of professional self-determination.

Work on this issue should begin with junior high school and have a continuous systematic character with the conduct of psycho-diagnostic tests, counseling according to the age of students with a single professional self-determination card for each student.

The functioning of an educational institution without a staff member of a medical worker in the current realities of the organization of medical care is not possible. The decision to assign appropriate responsibilities to a doctor or a other health care worker with secondary education remains open for discussion.

However, there are competences of a purely medical nature, which can not be performed by any specialist without special medical education, namely:

providing first medical qualified assistance in cases of emergencies, injuries, rapid manifestation of an infectious disease, etc .;

hygienic measures for the prevention of outbreaks of infectious diseases, including the control of the sanitary and hygienic regime of the food unit;

control over the passing of periodic medical examinations, preventive vaccinations;

medical support of dispensary groups;

professional medical counseling for students and parents at all stages of professional self-determination.

The training of any personnel in the field of child health should take into account the knowledge of the main determinants of childhood health, important mechanisms, measures and technologies for managing them in educational settings. In this regard, the scientific and practical activities of the State Institution "Institute for Children and Adolescents Health Care at the National Academy of Medical Sciences of Ukraine" are indisputable grounds for the establishment of a center for the fulfillment of important functions and training of qualified public health personnel, especially in that part that concerns the contingent of the children's population.

Conclusion

Detect all medical and social factors which affect to health of modern youth, develop and implement preventive programs for forming health- oriented behavior of youth, competency justification for persons, who provide medical care for children and adolescents today is very important for Medical and other facilities as well as parents and teachers. The main role in this process should belong to scientific institutions.

Literature

1. Center of Medical Statistic of Ministry of Health of Ukraine.

2. Extending life: Progress and achievements in 2017 of the WHO European Office for the Prevention and Control of Noncommunicable Diseases (2017).

3. European health report 2018.

4. Transforming noncommunicable disease in

5. Europe 2014-2016: Building the capacity to achieve the noncommunicable disease goals by 2030 (2018).

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