Health for young is defined holistically, which places solid emphasis on their relationships and emotions and how they feel. Health is not just about being physically well or being ill. The environment, too, is viewed as crucial through its impact on opportunities for healthy lifestyles and its effects on emotional well-being. Children and young people have a good understanding of what is considered healthy and unhealthy, nevertheless infer that the environment, and their way of life, do not always favour healthy alternatives and choices.
Health Evidently, health is not viewed by young people as purely being in good health or being ill in a physical or mental sense. It is seen as a manifestation and a “mirror image” of their lifestyle and well-being which places strong emphasis on their feelings. Their health in this sense is strongly influenced by their relationships and friendships, and is also affected by the environment – the local neighbourhood, as well as schools and other settings – in which they live.
There have been several researches asking children for their insights and comprehension of health (Emerson et al, 2000; Chapman et al, 2000; Stockdale and Katz, 2002; Stansfeld et al, 2003), and apparently even fairly young children are well able to provide diverse standpoints. Many of the studies imply a close association between healthy living and perceptions of health. For instance, in one study, 11 to 24 year olds stated that a balanced diet, taking exercise, and not smoking or drinking, are important to their health (Chapman, et al, 2000).
They also seem well able to articulate the dominant Western health messages (Burrows and Wright, 2004). What comes through particularly strongl from young people is a holistic view of health. Young researchers examining fellow pupils’ experiences of ‘health’ services demonstrated, how young people thought that ‘health’ should be regarded as everything to do with keeping well and not just about being ill (Cant et al, 1999). The participants saw positive actions to make their lives healthier as important as visits to the doctor or hospital.
These included providing a balanced diet at school as well as good advice, directed at young people, on how to achieve healthy lifestyles. Findings from a r research project inquiring on the different comprehensions and insights on health (Percy-Smith et al, 2003) provide further illustration. This study had two significant components — youth peer research involving 11 peer researchers from different communities who ran seven peer research projects in different settings, and a Knowledge Cafe event involving 62 young people and 31 professionals.
Young people did not provide direct descriptions of health and instead depicted how various elements in their lives were interconnected and significant. In its entirety, they highlighted on relationships and emphasized that health was about how young people feel about themselves, their relationships with others, their ability to survive in the world and their coping mechanisms, and the quality of their neighbourhood. Body image and the pressure to have cosmetic surgery, and a lack of facilities and places to go, were also included as important contributing factors.
It was then deduced that a wide range of young people’s health needs are rooted in the context of their everyday lives, experiences and relationships, and are not being understood as a necessary foundation for constructing effective local health policies. Marks et al (2004) likewise inferred that notions of health and well-being incorporate more than satisfaction, and that a second dimension of ‘personal development’ is relevant too.
Questionnaires were completed by a thousand children and young people from 7 to 19 years in Nottingham: just over half the respondents scored well on both life satisfaction and personal development scales, while one in eight scored poorly on both. Well-being in this sense appeared to decrease as young people get older. Researchers then have proposed that the ability to cope flexibly and creatively with life’s challenges is related to long-term health outcomes, and that personal development is a major contributing component.
The lack of a straightforward relationship between health and well-being has emerged from studies of selected groups of children. Monaghan and Broad (2003) reported semi-organised interviews and group sessions with 102 young people aged between 16 and 25 years and attached to three projects for young people facing social exclusion. Over half of these young people had spent some time in the care of the local authority, the majority were on low incomes, most had difficult family relationships, about half had left school before the legal minimum age, and almost all lived alone and/or in despicable situations.
When asked about their health, two-thirds said it was ‘good’ or ‘ok’, and the rest said ‘not good’, ‘poor’ or ‘bad’. However, when asked if they felt healthy, half said no. About one in four of the young people in the survey said that smoking affected their health, and others said that a lack of money, stress, or living in a hostel, have something to do with it. It was then suggested that this showed the significance the young people being attached to their feelings and emotions in defining their personal well-being.
Anderson et al (2004a) looked at the perceptions of health among 6 to 12 year-olds in foster care. Despite their young age, the children were broadly aware of what constitutes and promotes good health. In contrast they gave a range of definitions of mental illness. Not surprisingly, younger children may be less inclined than teenagers and other young people to define health in such overtly holistic terms. For example, in a study involving five to eleven year-olds (Chapman et al, 2000), mainly defined health in terms of a good diet, enough exercise and rest, and good hygiene (including dental hygiene).
Some, however, also included terms relating to emotions and mental health – like ‘feelings’, ‘sad’ – in their general definitions. Nevertheless, proof from the Children’s Rights Director’s consultation with children aged up to 12 on the five outcomes in the government’s Every Child Matters agenda, suggests that when asked what things are important to children, even younger children tend to think holistically: family, friends, fun, respect, and being happy were among the most common suggestions (Morgan, 2005).
In general, there is less consistency in young people’s descriptions of mental health than in their descriptions of physical health – even if there is a link between the two. In the evidence reviewed by Morgan, for instance, important health issues included stress – for example, young people feeling at breaking point, or having no-one to turn to, when confronted with serious problems such as child abuse. Monaghan and Broad (2003) also reported that the young people in their study defined mental health problems in a range of different ways.