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John Coleman
University of Oxford
Thinking a bit more broadly
The family
The school
The peer group
The digital world
The family
 The Cheltenham study of drug users
 Various studies of smoking in young people
 Sexual health
 International studies showing the more parents talk,
the less sexual risk-taking
 The FPA and Speakeasy
Where else might the family be
influential?
Exercise?
Eating behaviour?
Attendance at primary care?
Transition?
The school
 The health-promoting school
 Chris Bonell and others “Improving school ethos may
reduce substance abuse and teenage pregnancy”
 The Gatehouse project in Australia
 The Healthy Schools initiative in the UK
 Why schools can make a difference
The peer group
 It seems obvious, yet very little research has
highlighted the role of the peer group.
 One exception - studies of smoking
 We know from studies of anti-social behaviour that
there is a reciprocal influence between behaviour and
membership of a peer group
 But we know little about how this works where health
is concerned
 MORE RESEARCH!
The digital world
 The positives: access to information, staying in
touch with services, highlighting issues on social
media (e.g. prostitution)
 The negatives: pornography, internet addiction,
grooming, cyber-bullying.
 Where is the balance?
 As health professionals we have to become engaged
 But MORE RESEARCH!
Conclusion
 All four factors clearly impact on young people’s health
 Yet, to a large extent, these factors are not linked to
health outcomes and to the delivery of services
 An opportunity for some exciting new thinking
 Let’s expand the notion of social determinants of
health to include some of the things I have discussed
this morning.