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Abstract
Compared with the volume of research on school effects on educational outcomes, and in spite of growing interest in the health promoting school, there are very few studies that have investigated the way schools influence pupils' health behaviours. This paper reports the results of a longitudinal study of over 2000 young people in the West of Scotland who were followed from the end of primary school (age 11) to the end of statutory education (age 15), a design permitting investigation of school effects on smoking, drinking, drug use, and ‘unhealthy diet’ at two time‐points in secondary school (age 13 and 15). The results showed considerable variation in the rates of these health behaviours between 43 secondary schools. Using multi‐level modelling, and adjusting for prior (age 11) behaviour, sociodemographic characteristics, religion, family characteristics, disposable income, and parental health behaviours, the analyses showed that, with the exception of diet, school level variation (school effects) remained, meaning that pupil composition did not account for these differences. School effects were stronger for smoking and drinking than drugs, the effect remaining in a cross‐classification analysis of school and neighbourhood (as measured by postcode district). Using data from pupils about characteristics of their schools, together with three independent measures, higher levels of smoking, drinking, and drug use were found in schools containing more pupils who were disengaged from education and knew fewer teachers, and in larger schools independently rated as having a poorer ethos. These results raise several issues of interpretation, but are compatible with the attention given to school ethos in the health promoting school model.
Acknowledgements
The authors would particularly like to thank SPHSU colleagues, Jacki Gordon, Marion Henderson, Katrina Turner, and Robert Young, for their enthusiastic involvement in school effects research, and Paul Aveyard, Sally Macintyre, and Wolfgang Markham for their informed comments on earlier drafts of this paper. We would also like to thank Russell Ecob for his earlier involvement in the design and sampling procedures for the 11 to 16 study. Thanks, too, to the participants and the teachers, schools and nurse interviewers who made the study possible. Patrick West, Helen Sweeting, and Alastair Leyland are supported financially by the Medical Research Council of Great Britain.
Notes
* Corresponding author: Patrick West, MRC Social & Public Health Sciences Unit, 4, Lilybank Gardens, Glasgow G12 8RZ, Scotland. Email: [email protected]