ABSTRACT

Health behaviours, sometimes referred to as (health) risk behaviours, theoretically refer to any practices, habits or actions which, either in the short or long term, have an effect on health, either positively or negatively. In medicine generally, and life-course epidemiology specifically, they are often conceptualized as components of an individual’s lifestyle, or even as lifestyles themselves. By virtue of human agency, or at least the potential for agency, they are distinguished from social structure (e.g. social class) which is typically understood as an external (material and/or cultural) constraint. In most studies, they are usually represented by four behaviours; diet, physical activity, smoking and alcohol consumption, and (increasingly) in the case of young people illicit drug use. Sexual behaviour is also referred to, but as the subject of another chapter, is not included here. From a sociological perspective, these behaviours are not so easily reducible to lifestyle

variables, nor are they necessarily dis-embedded from social structure. Each is imbued with social meaning, both in the way they are socially constructed through, for example, advertising and the media and in the way they are consumed, and displayed by individuals. For young people, they are especially strong signifiers of identity since they are so closely connected with the youth-adult transition, minimum ages for the legal purchase of tobacco and alcohol marking stages in the achievement of adult status in most developed countries. They are also remarkably precise signifiers of youth identities, group membership and subcultures, as indicated by the way particular young people engage in physical activity (and which activities), whether they smoke or drink (and which brands they consume) or use illicit drugs (and which drugs). The extent to which such health behaviours continue to be shaped by social structures such as social class, and the extent to which they are lifestyle choices, is an important indicator of where any society is positioned in late modernity. This chapter begins with a brief overview of the social epidemiology of diet, physical

activity, smoking, drinking and drug use among youth in developed societies, focusing on health consequences, prevalence issues, and age, gender and cross-national variations. A review of ethnic group and religious differences is beyond the scope of the chapter

though they are clearly important (e.g. for diet and alcohol). Developing from this, against the background of the structure/agency debate (Furlong and Cartmel 2007), and representing the former by young people’s social class of origin, the latter by various lifestyles, an assessment is made of the relative importance of each for health behaviours in contemporary society. The chapter concludes with a closer look at the social contexts within which young people’s health behaviours are developed, and the social processes involved. It is within these particular contexts, notably the school and the peer group, that the meaning of health behaviours for identity, group membership and lifestyles can best be understood. Because most research has been undertaken on young people of school-age, the focus is primarily on ‘early youth’ though the implications extend beyond school.