Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey

Abstract

Objectives: This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents.

Methods: We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs).

Results: Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status.

Conclusions: The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.

Keywords: Adolescent; Alcohol consumption; COVID-19; Diet; Exercise; Financial stress.

Figure. 1.

The adjusted prevalence odds ratios (PORs) of the increased breakfast skipping, decreased physical activity, and increased alcohol drinking among combined coronavirus disease 2019 (COVID-19)-related family economic hardship and subjective family economic status categories for Korean adolescents. (A) Adjusted POR of increased breakfast skipping: adjusted POR for grades, residential area, co-residence with parents, subjective health status, depression status, the time difference between weekday and weekend wake-ups, subjective family economic status, COVID-19-related family economic hardship. (B) Adjusted POR of decreased physical activity: adjusted POR for grades, residential area, co-residence with parents, subjective health status, depression status, average smartphone usage time per day, average time spent sitting down per day, subjective family economic status, COVID-19-related family economic hardship. (C) Adjusted POR of increased alcohol drinking: adjusted POR for grades, residential area, co-residence with parents, subjective health status, depression status, smoking status, subjective family economic status, COVID-19-related family economic hardship. *p<0.05: from reference category (No COVID-19-related family economic hardship and high subjective family economic status).