No longer a black and white question: Gender and ethnic differences in multiple health risk behaviours (MHRBS) and their associated risk and protective factors

Purpose: Research has long shown that incidence and type of risk behaviour differs by ethnicity. However, the majority of these studies have focussed on broad categories of ethnicities thereby ignoring other minority populations. Such categorization may conceal differences in health risk behaviours between racial groups giving the illusion of overall cultural similarity. The goal of the following study was to examine the prevalence of individual and multiple health risk behaviours (MHRB) amongst an ethnically diverse sample of adolescents. This study also sought to determine the effects of socioeconomic-status, gender, mental health, family and neighbourhood on ethnic variation in MHRB. Methods: This paper draws on a large quantitative dataset collected as part of the Research with East London Adolescents Community Health Survey, a school-based study of a representative sample of 2,789 adolescents aged 11-14 (2001), 2,675 aged 13-16 (2003) and 1,023 aged 15-16 (2005). Information on health risk behaviours, psychological well-being, physical health and social support was collected by a self-administered questionnaire. Four health risk behaviours were analysed; smoking, risky drinking, drug use, and risky sexual behaviour. A cumulative risk score ranging from 0 to 4 was constructed. Ordinal logistic regression models were conducted to explore the protective and risk factors associated with a cumulative risk score in year 9 and year 11. Predictor variables were measured at year 7. Data were weighted to provide national estimates. Results: Our results revealed a trend toward convergence between genders for several health risk behaviours. By year 11, more girls than boys were engaged in risky drinking and drug-use. There was a significant gender difference for concurrent use of cigarettes and alcohol X2(1) = 5.70, p <.05) as well as all three substances X2(1) = 6.59, p <.01). White United Kingdom/Other and Mixed adolescents reported the highest prevalence rates for substance use. Black Caribbean adolescents (13%) had higher rates of unprotected intercourse. Multivariate analyses revealed several risk and protective factors associated with a cumulative risk score. For year 9, risk factors included greater mental health difficulties (OR = 1.06, p <.05), regular cannabis use (OR = 9.76, p <.05), and stronger peer affiliation (OR = 2.42, p