This supplement to the Journal of Adolescent Health highlights research from the latest Health Behaviour in School-aged Children (HBSC) 2017–2018 survey, which includes data from 45 countries across Europe and North America. The articles in the supplement, cover the social determinants of health, social media, mentalhealth, and other aspects of adolescent well-being…


Jason M. Nagata


Nagata, J., 2020. New Findings From the Health Behaviour in School-aged Children (HBSC) Survey: Social Media, Social Determinants, and Mental Health. Journal of Adolescent Health, 66(6), pp.S1-S2.

Journal of Adolescent Health
Release date

New Findings From the Health Behaviour in School-aged Children (HBSC) Survey: Social Media, Social Determinants, and Mental Health

Research editorial

The editorial introduces the Journal of Adolescent Health Special Supplement on the HSBC Study. The special supplement has the topic:

“Understanding Adolescent Health and Wellbeing in Context: Cross-National Findings from the Health Behaviour in School-aged Children Study”

Editorial summary


The HBSC is a school-based survey with data collected through self-completion questionnaires administered in the classroom. This cross national survey collects data every 4 years on social environments, health behaviors, and well-being. These data allow cross national comparisons to be made, and with successive surveys, trend data analyses are possible.

This survey focuses on early adolescence (ages 11, 13, and 15 years) when health-related behaviors develop concurrent with physical development and increasing autonomy. The HBSC dates back to 1982, and the World Health Organization Regional Office for Europe adopted the HBSC as a collaborative study in 1983. Further details about the background, theoretical approach, and survey methods are summarized in a commentary in this supplement by Inchleyet al. Youth participation and engagement are core tenets of the HBSC and are further outlined in a second commentary that highlights the core tenets of youth engagement

The 10 research articles can be grouped into three broad areas: Social Determinants of Health, Mental Health and Well-Being, and Social Media and Health .

The final commentary by Budisavljevicet al. demonstrates the critical importance of how data can drive policy and encourage investment in the early adolescence phase of life course development.

Social Determinants of Health

The first set of articles investigate structural drivers of adolescent health, from wealth, income, and gender inequality to social disadvantage. Kern et al. demonstrate that adolescents belonging to multiple disadvantaged social groups may particularly benefit from policies promoting inclusivity and equality. Dierckens et al. show that both national wealth and income inequality are associated with socioeconomic inequalities in adolescent mental health and well-being. Heinz et al. delve into adolescent gender inequalities and health, challenging the assumption that gender equality is necessarily associated with greater health equality.

Mental Health and Well-Being

From the broad structural drivers of adolescent health, the next set of articles examines the mental health and well-being of adolescents in the HBSC study. Walsh et al. examine clusters of risk, including low social support, bullying, insufficient nutrition, sugary foods and drinks, substance use and early sex, physical health risk, and problematic social media use. Cosma et al. show small declines in mental well-being and increases in school work pressure among adolescents, particularly in higher income countries. Löfstedt et al. find that over the 2002 – 2018 period, school satisfaction increased among boys, but school pressure increased among girls. Few students felt highly satisfied and not pressured in 2017-2018.

Articles in this supplement also examine specific issues related to mental health and well-being such as weight reduction behaviors and sleep patterns. Dzielska et al. examine weight reduction behaviors among European adolescents in the 2001-2002 and 2017-2018 HBSC surveys. Gariepy et al.  examine sleep patterns of adolescents and find insufficient sleep on school days to be a cross-national phenomenon.

Social Media and Health

Two articles in this supplement focus exclusively on social media use. Boer et al. find that more than one third of youth across 29 countries report intense social media use, defined as use almost all the time throughout the day. Furthermore, more than 7% of youth have problematic social media use, indicated by symptoms of addiction to social media. Craig et al. explore social media and cyber-bullying, finding that social media use, intense use, problematic use, and frequent online contact with strangers in adolescence are all independently associated with cyber bullying.


This supplement issue highlights novel findings from the latest HBSC 2017-2018 survey, using data from 45 countries across Europe and North America. These findings have important policy implications spanning socioeconomic and gender inequalities, social media, and mental health and well-being and highlight the importance of investment in the adolescent years.

Other key articles of the special supplement

Table of Contents:

Understanding Adolescent Health and Wellbeing in Context: Cross-National Findings from the Health Behaviour in School-aged Children Study


Enhancing Understanding of Adolescent Health and Well-Being: The Health Behaviour in School-aged Children Study” by Joanna C. Inchley, Gonneke W.J. M. Stevens, Oddrun Samdal, Dorothy B. Currie  

Original Article:

National-Level Wealth Inequality and Socioeconomic Inequality in Adolescent Mental Well-Being: A Time Series Analysis of 17 Countries” by Maxim Dierckens, Dominic Weinberg, Yanyan Huang, Frank Elgar, Irene Moor, Lilly Augustine, Nelli Lyyra, Benedicte Deforche, Bart De Clercq, Gonneke W.J.M. Stevens, Candace Currie

Original Article:

Clusters of Contemporary Risk and Their Relationship to Mental Well-Being Among 15-Year-Old Adolescents Across 37 Countries” by Sophie D. Walsh, Tal Sela, Margaretha De Looze, Wendy Craig, Alina Cosma, Yossi Harel-Fisch, Meyran Boniel-Nissim, Marta Malinowska-Cieślik, Alessio Vieno, Michal Molcho, Kwok Ng, William Pickett

Original Article:

Cross-National Time Trends in Adolescent Mental Well-Being From 2002 to 2018 and the Explanatory Role of Schoolwork Pressure” by Alina Cosma, Gonneke Stevens, Gina Martin, Elisa L. Duinhof, Sophie D. Walsh, Irene Garcia-Moya, András Költő, Inese Gobina, Natale Canale, Carolina Catunda, Jo Inchley, Margaretha de Looze

Source Website: Journal of Adolescent Health