Social Health Among Adolescents in the Global School-Based Student Health Survey (GSHS)

Background: Social health is a function of the quantity and quality of relationships, including with family members and peers. Adolescents who report being lonely or having no close friends have a low quantity of relationships, and those who feel that their peers are unkind and their parents are not understanding have low quality relationships. We examined whether poor social health is associated with violent behavior. Methods: We analyzed data from the Global School-based Student Health Survey (GSHS), which employs a standardized two-stage cluster sampling method and a validated questionnaire to explore health and risk behaviors among nationally representative samples of secondary school students ages 13 to 17 years in more than 80 participating countries. We examined the associations among relationship quantity (loneliness and/or friendlessness), relationship quality (perceptions that classmates are unkind and/or parents are uncaring), and violence (ones related to bullying, interpersonal violence, injuries, and mental health). Findings: About 20% of students reported low relationship quantity and over 50% of students reported low relationship quality; these averages were similar for boys and girls. About 30% of students reported experiencing peer violence (being in a physical fight and/or attacked), with higher rates among boys than girls. Social isolation was associated with violent exposures. Interpretation: Achieving physical, mental, and social adolescent health will require greater investment in school- and community-based interventions that promote healthy relationships and reduce exposure to violence. Source of Funding: This research project was funded by the Academic Year Undergraduate Research Initiative (AYURI) and Summer Undergraduate Research Program (SURP) from Pepperdine University.