Global School-based Student Health Survey, 2003-2008

Background: Health risk behaviors that occur or are established during adolescence are among the leading causes of morbidity and mortality among youth and adults worldwide. Purpose: The Global School-based Student Health Survey (GSHS) was developed to obtain systematic information on risk behaviors and protective factors among students globally. Significance: Economic development in many countries is dependent on having healthy, well-educated adolescents who will be productive adults. Methodology: From 2003-2008, the GSHS was conducted among students aged 13-15 in 56 national or sub-national sites in 44 countries. The questionnaire collected information about alcohol and other drug use; dietary behaviors (including self-reported height and weight); hygiene; mental health; physical activity; protective factors; sexual risk behaviors; tobacco use; violence; and unintentional injuries. Findings/Results: A number of risk behaviors were common globally. For example, in all but five sites, <30% of students were physically active for ≥60 minutes/day on ≥5 of the previous 7 days. The percentage who usually did sitting activities ≥3 hours/day was >50% in eight sites and >20% in all but two. In every site, >60% of students who ever tried a cigarette and >50% of students who ever had sex first did so before age 14. Conclusions/Recommendations: Interventions to prevent behaviors associated with chronic diseases, HIV or other sexually transmitted infections, unintended pregnancy, and injuries are needed worldwide. The GSHS can be used to monitor risk behavior prevalence and guide the development of school and youth health programs and policies.