Article Text

Download PDFPDF

Original article
Impact of health behaviours and deprivation on well-being in a national sample of English young people
  1. Aswathikutty Gireesh1,
  2. Shikta Das2,
  3. Russell M Viner1
  1. 1 Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2 MRC Unit for Lifelong Health and Ageing at UCL, UCL Institute of Cardiovascular Science, London, UK
  1. Correspondence to Mrs Aswathikutty Gireesh; a.aswathikutty-gireesh{at}


Objective To determine the modifiable factors influencing well-being in boys and girls by accounting for deprivation, ethnicity and clustering within local authorities.

Methods We used data from a very large nationally representative survey, the What About Youth study involving 120 115 adolescents aged 15 years. Our outcome measure of mental well-being was the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Potential explanatory factors included substance abuse, screen time, eating habits, reading, bullying, sleeping pattern, physical activity and area-level deprivation. We ran unadjusted and adjusted multilevel models for each explanatory factor, after adjusting for ethnicity, deprivation and including a random effect for the local authority.

Results Boys had a higher overall mean WEMWBS score than girls (p<0.0001). In the adjusted model, each of multiple risk behaviours, eating habits, sleep, bullying, physical activity, screen-time and reading were independently associated with mental well-being in both boy and girls (p<0.0001 for both). Sleep and eating behaviours had a stronger association in both sexes than bullying, physical activity and screen time. Young people from black ethnic groups had significantly higher well-being in both sexes. Deprivation was not associated with well-being among boys but was among girls.

Conclusion The largest contributors to adolescent well-being appear to be sleep, eating behaviours and bullying when considered in a multivariable framework. While adolescents from black ethnic groups had higher overall well-being scores, area deprivation did not affect male well-being but had a small effect on female well-being. Future longitudinal studies and health policies need to consider a range of behavioural factors to drive improvements in adolescent well-being.

  • adolescent health
  • sleep
  • nutrition

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from


  • Contributors AG and SD led the writing of the study and undertook the analyses. RV conceptualised the project, contributed to the ideas underlying the article, contributed to writing and revision of the article.

  • Funding This report is an independent research commissioned and funded by the National Institute for Health Research Policy Research Programme.

  • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health or its arm’s length bodies and other Government Departments.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The National Children’s Bureau carried out a detailed ethical review of the original study, but it was not required for this secondary data analysis.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at Preliminary findings of this paper were presented at the Adolescent Lives and Wellbeing 2017 Conference organised by University College London.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.