Lifestyle and health status of children and youth

Transcription

1 Surmach Probl Hig M, Epidemiol Piecewicz-Szczęsna 2011, 92(4): H Lifestyle and health status of children and youth 753 Lifestyle and health status of children and youth Styl życia i stan zdrowia dzieci i młodzieży Marina Surmach 1/, Halina Piecewicz-Szczęsna 2/ 1/ Chair of Public Health and Public Health Care, Grodno State Medical University, Belarus 2/ Chair and Department of Epidemiology, Medical University of Lublin, Poland Cel i metody badań. Celem pracy jest przedstawienie stanu zdrowia i stylu życia dzieci i młodzieży na Białorusi na podstawie analizy danych statystycznych, wyników badań własnych i dostępnej literatury. Wyniki. Liczba i procentowy udział dzieci i młodzieży na Białorusi zaczęły gwałtownie się zmniejszać od połowy lat 90. XX w. Odnotowuje się również wzrost zachorowalności dzieci. Porównanie rokrocznych kohort nastolatków pokazuje, że co roku obniża się potencjał ich zdrowia. Styl życia wpływa znacząco na stan zdrowia młodzieży. Potwierdzają ten fakt wyniki wywiadu 300 uczniów koledżów w Grodnie. Tylko 37,3% badanych unikają spożywania produktów złej jakości. Co dziesiąty ogranicza siebie w spożywaniu pokarmów, część ankietowanych oszczędza czas na jedzeniu. Co trzeci uczeń pali. Średni wiek rozpoczęcia palenia to 14,5±0,22, chociaż są osoby, które zaczęli palić w wieku 7 lat. Co czwarty twierdzi, że często pije piwo. Co dziesiąty zna w swoim otoczeniu kogoś, kto zażywa narkotyki. Mimo tego, że w koledżach są realizowane lekcji wychowania fizycznego, tylko 41,7% respondentów ćwiczy często lub codziennie. Około 40% nastolatków nie korzysta z żadnych środków antykoncepcji przy kontaktach seksualnych. Jednocześnie osoby badane uważają, że zdrowie jest bardzo ważnym czynnikiem w osiąganiu sukcesu życiowego. Wnioski. Pozytywny stosunek do zdrowia, który jest kształtowany u dzieci i młodzieży w ramach działań profilaktycznych, nie przekłada się jednak na styl życia młodzieży, o czym świadczą zachowania zdrowotne negatywnie wpływające na ich stan zdrowia. W związku z tym szczególnie ważnym zadaniem staje się praca z rodziną, w której są kształtowane postawy dotyczące stylu życia dzieci. Słowa kluczowe: zdrowie, styl życia, zachowania zdrowotne Aim & methods. The paper presents the Belarusian teenagers health status and lifestyle, based on the analysis of official data, own research and published sources. Results. The number and proportion of children in Belarus have started to decrease sharply from the middle of 1990 s. The growth of disease incidence has been observed. Each subsequent cohort of teenagers has a lower health potential than the previous one. Lifestyle considerably influences the teenagers health decrease. It has been confirmed with the results of 300 students of the Grodno colleges questionnaire. Only 37.3% of the interrogated avoid poor-quality products. Every tenth limits the food intake, a part of teenagers save eating time. Every third smokes. An average age to begin smoking was 14.5±0.22 years of age, however there are answers about early beginning of smoking (7 years of age). Every fourth realizes they drink beer too frequently. Every tenth college student has acquaintances who use drugs. Despite physical training lessons, only 41.7% of the interrogated are engaged in physical activity daily. About 40% of the teenagers having intimate relations do not use contraceptives. At the same time, according to the answers, health takes the leading place in the structure of factors promoting life success for youth. Conclusions. A positive attitude to health, formed under public preventive measures, does not lead to adequate behavior, which is evident in negative norms of lifestyle standards of youth. Therefore it is important to work with a family as the basis of formation of proper lifestyle attitudes of children and youth. Key words: health, lifestyle, health-forming behavior Probl Hig Epidemiol 2011, 92(4): Nadesłano: Zakwalifikowano do druku: Adres do korespondencji / Address for correspondence Prof. Marina Surmach Chair of Public Health and Public Healht Care, Grodno State Medical University, Gorkogo st., 80, Grodno , Belarus marina_surmach@mail.ru Introduction The statistical data testify that the total number of children s population and the proportion of children in the Republic of Belarus have started to decrease sharply from the middle of the 1990 s. The proportion of children s population at the age of 0-15 years made % in According to the population census of 2009, the share of persons younger than able-bodied age (under 16 years) fluctuated from 14.3% in the city of Minsk to 18% in villages of the Brest area. Such considerable decrease in children and teenagers in the population structure, obviously, aggravates an urgency of research in the field of their health. The purpose, materials & methods The work purpose was to establish peculiarities of Belarusian teenagers health status and lifestyle. According to the official medical statistics, on the basis of our own research of the teenage lifestyle and the review of published sources we carried out the analysis of health status and lifestyle of teenagers, the conditionality of their behavior in the health sphere.

2 754 Probl Hig Epidemiol 2011, 92(4): Results & discussion The dynamics of children s morbidity parameters in Belarus, according to the statistical reporting for the last 15 years (a full change of a cohort of children) was the following. The indicators of prevalence have made cases in 10 thousand of the children s population, cases in 10 thousand of the adult population in There was a growth of morbidity in all age groups in later 14 years. The morbidity (prevalence rate) in the children s population has made cases of diseases in 10 thousand (rate of a gain of +26.4%), the adult cases in 10 thousand of the population (rate of gain of +23.0%) in For 14 years the indicators of prevalence and incidence have significantly grown for the following classes of illnesses: mental disorders, cardiovascular diseases, diseases of urinogenital system, separate conditions arising in the perinatal period (in times the prevalence and in times the incidence has increased); cancer, illnesses of muscularskeletal system, congenital anomalies, symptoms and signs (prevalence and incidence has grown more than twice). The total pure gain for the account of the listed groups of classes has made cases in of the children s population in relation to the level of Hence, simultaneously with the decrease in proportion of children in the population structure, the growth of children s morbidity (mainly caused by new cases) has been observed [1]. The analysis of dynamics of year-old children s (teenagers ) health status, executed for by Antipova S.I. and Savina I.I., has shown that morbidity both in young men, and in girls has considerably increased during the last 5 years. The mid-annual rate of gain for incidence has made 8.8% in young men, 8.2% in girls; for prevalence 5.8% in young men and 5.5% in girls [2]. The authors notice that young men of 2005 were more healthy in comparison with young men of 2009 the general prevalence rates across Belarus became over 24.4% (from 5.1% in Vitebsk to 48.3% in the Gomel area). Higher indicators of morbidity were registered in 2009 in the following classes of illnesses: cancer; cardiovascular diseases; illnesses of endocrine system; nervous system, vision, hearing; of pulmonary system; congenital developmental anomalies; symptoms, signs and inexactly designated conditions; external influences. It is characteristic that the frequency of congenital developmental anomalies both in girls, and in young men in 2009 in comparison with teenagers of 2005 has increased as a whole across Belarus by 1.4 times. The proportion of practically healthy teenagers (I group of health) in 2009 in Belarus has made about a quarter 26.3% of young men and 24.7% of girls. This indicator is the lowest in Minsk (8% of young men and 7.7% of girls). The fact of high frequency of cases of suicides among teenagers is especially disturbing. From 2 to 11 (in 2006) cases of murders of teenagers are annually registered, besides, 5-7 cases of their deaths from injuries with uncertain intentions [2]. It has been proved that the raised risk of death rate from external reasons is directly connected with alcohol abuse [3]. The growth of alcohol sale level on 1 litre per capita in Belarus is accompanied by growth of crude death rate level by 2.8%, of death rate from external reasons by 5.8%, of level of suicides by 5.9%. It is characteristic that the connection between the alcohol sale level and crude death rate in Belarus is stronger than in Russia. This fact says indirectly that the alcohol sale level in Belarus reflects the level of its consumption more precisely [4]. Growth of death rate from external reasons in teenagers, increase in suicides, has an obvious correlation with the prevalence of alcohol use in the youth environment. It is necessary to note the considerable increase of morbidity in deeper retrospective (from 1991 to 2009): the incidence has grown 2.5 times (from to ), the prevalence has grown 2.2 times (with to ) [2]. The infringement of menstrual cycle at teenage girls was 3 times more frequent in 1997 than in 1991; inflammatory diseases of reproductive system 5.7 times more frequent [5]. Thus, each subsequent cohort of teenagers has a lower potential of health than the previous one. The comparison of prevalence rates among teenagers of Belarus and the nearest regions of Russia (Bryansk, Smolensk, Leningrad areas) shows that morbidity of year-old children in Russia is much lower than in regions of Belarus [6]. At the same time, the growth of morbidity of children aged under 14 years reached 13.1% and of teenagers 15% in the last 5 years [7]; and the death rate of teenagers in Russia almost twice the above than that of their contemporaries in Belarus [8]. According to inspections of an invocatory contingent in the Kirov area, only about one third of young men (33.4% in 2005) suitable for military service admit at initial statement on the military account [9]. Health of an invocatory contingent is the sphere of attention in Belarus. According to Rednenko V.V., Litvjakova A.M., essential means are spent annually for carrying out military-medical examination of recruits. The analysis of cases of hospitalization in therapeutic branches of the Vitebsk regional clinical hospital shows that recruits make about one sixth of all patients, in cardiological branch about 26% of the patients [10]. The deterioration of health of children is partly caused by the academic workload which has increased in the last decades. It creates obstacles for the realization of biological requirements of the child

3 Surmach M, Piecewicz-Szczęsna H. Lifestyle and health status of children and youth 755 for night sleep, impellent activity, outdoor walks. According to a questionnaire of Russian schoolboys, insufficient duration of night sleep is observed at 90% children of school age; 5% feel chronic weariness [11]. The results of research of lifestyle connected with training at school of elementary grade schoolboys of Gomel (852 children), have shown that, contrary to sanitary rules and norms, 46.3% of first-graders spend for 2 hours in preparation for lessons, 14.8% more than 2 hours. Almost 29.6% of first-graders and 49.7% of second-grade pupils sleep less than 10 hours a day. Hence, norms of physiological sleep duration are not maintained in one third of children. In spite of the fact that duration of outdoor stay should make not less than 3.5 hours per day at the age of 6-10 years, 63% of elementary grade pupils spend outdoors less than 3 hours per day. The diet also is not observed in the majority of pupils: 55.6% of first-graders have breakfast. Only 69.4% of children never tried alcohol in the fourth grade [12]. College students are teenagers that need special attention. As a rule, it is a contingent of young men whose families have lower social status in comparison with students of universities. At the same time, vocational training promotes more independent behavior interfaced with risk for college students, in comparison with the schoolboys. We had interrogated 300 students of Grodno colleges in 2009 (100 students in medical and technical colleges, and also in a college of arts). The questionnaire was developed on the basis of the Questionnaire of the Russian Society of sociologists «Health of students». It was necessary for students to answer questions which concerned aspects of diet, bad habits, physical activity, peculiarities of psychoemotional background, sexual life. An average age of the interrogated was 17.4 years. Young men made 33.3%, girls 66.7%. To the question «Which restrictions do you make in your diet?» the majority of the questioned (39.7%) answered that they did not have any limits. Approximately 36% among them were the technical college students, 33% medical and 31% college of arts. 37.3% of the interrogated students avoided use of poor-quality products. 19.7% of the teenagers tried not to eat late at night. 11% limited themselves in the quantity of meal (mostly girls and students of the college of arts). Smaller proportions of the questioned resorted to other restrictions in their diet: avoid farinaceous food (7,3%), sweets (6%), a spicy foods (5.3%). There were also original answers: «I am guided by the prices», «I avoid products with preservatives», «I try to use more vegetables», «I save meal money». 62% of the college students paid attention to shelf lives (expiry dates) of foodstuffs often, 28% never, 9.7% rarely, 0.3% did not know anything about it. Among those who paid attention to safety terms often 753% were girls, 39.2% were students of medical college. Among those who never paid attention to safety terms of a foodstuff, 58.6% were students of technical college, 65.5% were young men. 26.3% of the students paid attention to unsafe additives (preservatives, dyes) at a purchase of a foodstuff often, 44.7% rarely, 26% never; 3% did not know anything about it (the future physicians among the given group were absent). Among those who paid attention often, 40.5% were students of medical college. Among those who never paid attention to the presence of unsafe additives in a foodstuff, 41% were students of technical college. Only 21.7% of the students used water-purifying filters always, 12.7% frequently, 27.3% sometimes, 38.3% never (proportions of students of the three colleges were distributed fifty-fifty in the last group). 31% of the interrogated students smoke at present, 38% tried smoking. The proportion of smokers among young men reached 44%, among girls 24.5%. At the comparative analysis between colleges it was established that 17% of students smoked in the college of arts, 23% in medical college, 53% in technical college. 75.3% of the smoking students smoked up to 10 cigarettes in day, 24.7% from 10 to 20 cigarettes in day. An average age of smoking initiation was 14.5±0,22 years (M±m). 4.3% of the students used dry wines, champagne often, 73.3% rarely, 14% do not drink at all; 8.3% of the students were at a loss to answer. Cognac, vodka were used often by 2.7%, seldom by 29%, 57.3% do not drink at all; 11% of the interrogated were at a loss to answer. Beer is used often by 23.3%, rarely by 51%, 19.7% do not drink it at all, 6% of the college students were at a loss to answer. Only 3.3% of Grodno college students positively answered the question «Have you ever tried drugs?». 10% among them medical college students, 20% students of technical college, 70% students of college of arts; 40% girls. Only one girl from the medical college admitted at the moment of the questionnaire to the use of narcotic substances. 10.6% of the students positively answered the question «Do any of your friends and acquaintances use drugs?». Only 13% revealed physical activity daily, 28.7% sometimes, 53% never, 5.3% of students frequently (table I). Table I. Influence of future specialty on frequency of physical activity of college students Frequency of physical activity College Total (100% Technical Of arts Medical on each line) Daily 56,4% 41% 2,6% 39 persons Often 27,9% 37,2% 34,9% 86 persons Sometimes 30,8% 27,1% 42,1% 159 persons Never 31,3% 56,2% 12,5% 16 persons

4 756 Probl Hig Epidemiol 2011, 92(4): Students have answered Daily (5,7%) to the question «How often do you have conflicts with associates?», 14.7% Frequently, 73.3% Sometimes, 12% Never. Approximately 8% of the students have negative emotions daily, 5.7% frequently, 22.3% sometimes, 64% never. At the same time, 28% of the students have positive emotions daily, 19% never, 2% frequently, and 51% sometimes. Only 1.7% experience bad mood daily, 0.3% frequently, 19.7% sometimes, 78.3% never. In contrast, 22.3% are daily in a good mood. More than a half (53.7%) of the students of colleges positively answered the question «Have you ever had sexual relations?» (71% of young men and 45% of girls). Among those who had sexual relations, 41.6% are students of technical college, 33.6% of medical college, 24.8% is the share of the college of arts. Only 60% of the interrogated who had sexual relations used contraceptives. Among the students who use contraceptives, the overwhelming majority use condoms. The reasons of those who did not use contraceptives were the following: 32% because they did not want to, 25.4% because they were sure it will not result in pregnancy, 8% because of a desire to conceive a child, 5.3% because of absence of contraceptives during the necessary moment, 2.7% because of having a constant sexual partner, 1.3% forgot, 1.3% did not consider it necessary. Almost a quarter (24%) of the students were at a loss to explain the reason. The behavior of students of colleges in relation to dietary intake is not safe. Only 37.3% of the questioned avoid the use of poor-quality products (though two thirds of the interrogated answered that they paid attention to the safety terms of a foodstuff often), every fifth tries not to eat late at night. Only about the quarter of the students pays attention to unsafe additives at a purchase of a foodstuff, about 62% on the safety terms of a product. About one third of the students use the water-purifying filter. The most part (39.7% of the interrogated, mostly students of technical college) do not resort to any restrictions in a diet. On the other hand, every tenth student limits the quantity of meal (more often girls, students of college of arts), a part of the interrogated specified that they save the food money for other purposes. One third of students of colleges smoke. The proportion of smoking young men almost twice exceeds a share of smoking girls. The part of smokers from among trained in the technical college 2 times exceeds the number of the future physicians, and 3 times the number of the students of college of arts. The majority of the interrogated positively answered the question on smoking, and smoke up to 10 cigarettes a day. Smoking is also at its maximum in the technical college here the share of smokers of more than 10 cigarettes a day is the highest (32.1%). The average age of the smoking initiation was 14.5±0.22 years (M±m), however this figure was affected by individual answers about the early beginning of smoking (7 years of age). The majority of smokers (45.6%) started to smoke between years of age. The students self-estimation of the frequency of alcoholic drinks has shown that 4.3% use dry wines, champagne often; 2.7% often use cognac, vodka; 23.3% beer. Every fourth student realizes that they use beer too frequently. Some of the interrogated admitted that they tried narcotic substances. At the same time, every tenth student of Grodno colleges has acquaintances using drugs. Despite the lessons of physical training in colleges, only 41.7% of the interrogated are engaged in physical activity daily or often, and the share of young men almost 3 times exceeds the share of girls, the share of students of technical college is maximum, medical minimum. The psycho-emotional background of the majority of students is positive. Nevertheless, every fifth student of Grodno college even at teen age had conflicts with associates daily or often, more than 30% of the interrogated revealed negative emotions daily or often; every fifth seldom experienced positive emotions. More than a half of the students have experience of sexual relations. The share of young men and students in technical college with experience of sexual life was the greatest. About 40%, having intimate relations do not use contraceptives. The reasons are unwillingness, self-trust; about a quarter of the students who have intimate relations and do not use contraceptives, were at a loss to give any explanation of risky sexual behavior. As it has appeared, features of the future professional specialty are reflected in separate aspects of lifestyle: for example, future physicians make more rigid demands as to the quality of food products and their safety; the share of smokers and smoking are maximum in technical college, but the highest physical activity is noted among students of technical college. Girls are more inclined to watch the food quality, they manifest fewer incorrect nutritional habits, however they are characterized by lower physical activity. As a whole, the lifestyles of Grodno college students are not adequate for the preservation and health strengthening in all considered aspects, among which is food, risk of bad habits (smoking, alcohol, availability of drugs), psycho-emotional background, sexual life.

5 Surmach M, Piecewicz-Szczęsna H. Lifestyle and health status of children and youth 757 As Reshetnikov A.V. remarks, both external circumstances and internal values are important in the formation of personal behavior: the system of external circumstances refracts through the system of internal conditions generated by the individual (valuable orientations, peculiarities of objectives, generalized modes of behavior, psycho-dynamic peculiarities of self-control). However the basic factor of behavior is the orientation of the person, the system of values defining motives [13]. The peculiarity of health as value from the sociocultural point of view, as I.V.Zhuravlyova specifies, consists of the fact that public health invariably is tool value, i.e. means of achievement of higher social purposes. An individual value of health can be both fundamental, and a tool, depending on a psychosomatic and psychological condition of the individual. For a healthy person health is the possibility of a high-grade life, i.e. tool value. Health can become the fundamental value for a sick person [14, p. 59]. With the purpose to establish peculiarities of the structure of factors estimated by studying youth as «factors of vital success», we had analyzed the results of 350 students of Grodno State Medical University and Yanka Kupala Grodno State University questionnaire, and also of 300 students of Grodno colleges (medical, technical colleges, college of arts). It was necessary to choose no more than three variants for the answer to a question «As you consider, which are the most important factors to promote achievement of vital success?». The analysis of answers of studying youth has shown that health, force of character, ability and talent, occupy leading places among the most important factors promoting achievement of vital success (table II). Surprisingly, students of universities, unlike college students, have given more value to such factors as good luck and favorable circumstances (students of colleges to education and money). The structure of vital values of studying youth had some gender Table II. Most important factors promoting achievement of vital success The factor promoting achievement of vital success The rang place Pupils of colleges University students Health 1 1 Force of character 2 1 Abilities, talent 2 2 The good luck, favorable 4 2 circumstances Education 2 3 Money 3 4 Support of relatives or acquaintances 4 5 Any success is the gift of destiny and is independent of the person s activities 5 6 distinctions. 50.5% of girls against 44% of young men (p=0.02) specified the importance of the factor health. The analysis of the structure of factors of vital success depending on the future specialty peculiarities has shown, that young men whose specialty concerns natural-scientific knowledge consider health as the most important vital value more often. So, for colleges: the proportion of medical college students was maximum among those who chose the alternative health (39%, significantly more in comparison with technical college and college of arts, χ²=5.81, p=0.016); for universities: the proportion of future doctors who marked alternative health was significantly more than proportions of students from classic university (54.5%, in comparison with students of humane and technical profiles χ²=16.4, p=0.0001). The students of college of arts and students of technical university, unlike the future physicians, gave great value to such factors as force of character and ability, talent. It is known that the important factor promoting realization of behavioral intentions, is the public approval of prospective actions. It is possible to establish the fact of positive attitude to health among studying youth. The factor health takes the leading place in the structure of factors most crucial for promoting achievement of vital success (by the opinion of studying youth). The role of health in value judgment of the future physicians is especially high. A conductor at formation of the child, the teenager of values of the first and second level (terminal and tool) is, certainly, the family. Thus the role of mother is especially important in families where the child is brought up in her presence. It has been proved that parents can influence children s behavior in the sphere of alcohol and nicotine use by social rules and norms operating in this area. It has been established that Russian parents manifest a considerably higher (by 5 times) approval of alcohol consumption by the children in comparison with American parents (2.8% vs. 0.5% for children of years of age and 24.7% vs. 4.9% for teenagers of years of age) [15]. According to the official data, 42% of the population smoked in 2005 in Belarus [16]. The highest indicators of smoking are marked among persons of years of age almost a half of the population of this age group will become smokers [17]. According to the data about initiation and continuation of smoking among students of universities of Minsk (830 persons), it was revealed that in those students who had begun smoking at preschool and younger school age the initiative of initiation to tobacco in three of five cases belonged to smoking parents. At the teen age, according to

6 758 Probl Hig Epidemiol 2011, 92(4): value judgment of the reasons of the beginning of smoking, the motives included the desire to test new sensations, to confirm own importance in a circle of contemporaries, to relieve loneliness and boredom, and also inability to organize leisure [17]. Zhuravlyova I.V. remarks: «The schemes of behavior depending on the conscious motivation are less steady than those that are a natural consequence of social norms and the representations accepted in a society» [18, p. 21]. As Reshetnikov A.V. specifies, socialization mastering of cultural norms and development of social roles proceeds throughout life, but this process in children and youth is most intensive. The socialization of adults is directed towards mastering skills and abilities, of children towards motivation of their behavior. Adults can estimate norms, children perceive all directly, through an ideal [13]. Conclusions The data of official medical-demographic statistics reveal the decrease in proportion of children s population in the population structure, the growth of disease incidence in children is observed. Each subsequent cohort of teenagers has a lower health potential than the previous one. The role of bad habits (alcohol, smoking) and stress factors connected with an increasing school workload is considerable in the decrease in health potential of children. It has been confirmed with the results of 300 students of the Grodno colleges questionnaire. The lifestyles of Grodno college students are not adequate for the preservation and health strengthening in all considered aspects, among which is food, risk of bad habits (smoking, alcohol, availability of drugs), psycho-emotional background, sexual life. At the same time, the attitude to health as a vital value among the studying youth testifies to the positive tendency. According to the results of our questionnaire, the factor health takes the leading place in the structure of factors most crucial for promoting achievement of vital success by the opinion of the studying youth. The role of health is especially high in value judgment of the future physicians. Possibly, a positive attitude to health, formed under the influence of public preventive maintenance in many respects, does not lead to health-oriented behavior, as it co-operates with the negative norms of behavior standard in relation to health in the society. We should say that the norms and vital values achieved in childhood are consolidated at the unconscious level. Health behavior of the teenagers defines their health status in the subsequent future. Even if the value of health is high, the behavior of teenagers of Belarus does not promote preservation and increase of potential of their health. Therefore the work with a family is vitally important after all, the bases of lifestyle, remaining for long years and transferred through generations, are formed there. Piśmiennictwo / References 1. Глинская, Т.Н. Динамика показателей заболеваемости детей в Республике Беларусь /Т.Н. Глинская, М.В. Щавелева // Современные подходы к продвижению здоровья: Материалы III Международной научнопрактической конференции, Гомель, 21 октября 2010 г./ ред. совет: А.Н.Лызиков [и др.]. Гомель: ГомГМУ, 2010: Антипова, С.И. Анализ заболеваемости и смертности подростков Республики Беларусь в гг. / С.И. Антипова. И.И. Савина // Вопросы организации и информатизации здравоохранения. 2010, 4: Смертность от болезней, ассоциированных с алкогольной интоксикацией, как косвенный индикатор общественного здоровья / М.А. Метельская, В.В. Антипов, Л.Н. Гришенкова, Ю.И. Рогов // Вопросы организации и информатизации здравоохранения. 2010, 4: Разводовский, Ю.Е. Продажа алкоголя и смертность в России и Беларуси: сравнительный анализ трендов /Ю.Е. Разводовский // Вопросы организации и информатизации здравоохранения. 2009, 2: Иокша, О.В. Формирование валеологической культуры школьников /О.В. Иокша // Здаровы лад жыцця. 2002, 3: Дети в России. 2009: Стат. сб. / ЮНИСЕФ, Росстат. М.: ИИЦ «Статистика России», 2009, 121. [Электронный ресурс] Режим доступа: Дата доступа: Огрызко-Вевюровский, Г. Версии вопроса при исследовании общественного мнения /Г. Огрызко- Вевюровский // Социологические исследования. 2003, 6: Здоровье подростков как общественная ценность // ADOLESMED.RU Портал для специалистов, работающих в сфере подросткового здоровья и медицины. - [Электронный ресурс] Режим доступа: html. Дата доступа: Петров, М.В. Медицинское освидетельствование юношей летнего возраста при первоначальной постановке на воинский учёт /М.В. Петров, А.В. Завалин // Проблемы социальной гигиены, здравоохранения и истории медицины. 2009, 5: Редненко, В. В. Органи зационная и клиникоэкономическая характеристика системы обследования призывного контингента в стационаре /В.В. Редненко, А.М. Литвяков // Медицинские новости. 2006, 2:

7 Surmach M, Piecewicz-Szczęsna H. Lifestyle and health status of children and youth Кучма, В.Р. О проблемах сохранения здоровья школьников /В.Р. Кучма // НИИ гигиены и охраны здоровья детей и подростков Научного центра здоровья детей РАМН [эл. ресурс] Режим доступа: iew&id=11194&itemid=3. Дата доступа Соболева, Л.Г. Детерминанты здоровья школьников начальных классов г.гомеля /Л.Г. Соболева // Современные подходы к продвижению здоровья: Материалы III Международной научно-практической конференции, Гомель, 21 октября 2010 г./ ред. совет: А.Н.Лызиков [и др.]. Гомель: ГомГМУ, 2010: Решетников, А.В. Социологическая теория формирования личности в обществе / А.В. Решетников // Социология медицины. 2004, 2: Журавлёва, И.В. Отношение к здоровью индивида и общества / И.В. Журавлёва; Ин-т социологии РАН. М.: Наука, 2006, Williams CL, Grechanaia N, Romanova O, Komro K, Perry C, Farbakhsh K. Russian-American partners, alcohol use prevention. Adaptation of a school-based parent-child programme for alcohol use prevention. Eur J Public Health 2003, 1(3): Постоялко, Л.А. Некоторые проблемы здравоохранения Беларуси и расширение его социальной базы /Л.А. Постоялко, А.К.Цыбин, И.В.Малахова, А.А.Гракович // Вопросы органи зации и информати зации здравоохранения. 2005, 3: Дюбкова, Т.П. Частота курения табака среди студенческой молодёжи и мотивации продолжения курения в период обучения в вузе /Т.П. Дюбкова, С.В. Альшевская // Вопросы организации и информатизации здравоохранения. 2009, 2: Журавлёва, И.В. Здоровье подростков: социологический анализ / И.В. Журавлёва. М.: Издательство Института социологии РАН, 2002, 240.