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U.S. Teens in Our World

Understanding the Health of U.S. Youth in Comparison to Youth in Other Countries

Table of Contents | Executive Summary | Introduction | Chapter 1 | Chapter 2 | Chapter 3 | Chapter 4 | Chapter 5 | Chapter 6 | What Was Left Out | Summary

CHAPTER FOUR: SCHOOL ENVIRONMENT


In this chapter:
School Environment | What Didn't We Know | References

SCHOOL ENVIRONMENT

School is an important and pervasive influence on children's education, health, well-being, and development.1,2 During U.S. students' twelve years of compulsory education, schools provide structured learning activities, establish norms for personal and social behavior, and offer opportunities for civic, social, and co-curricular activities and experiences. Schools expose children to adult role models in the form of teachers and administrators, whose job it is to impart both knowledge and understanding of subject matter as well as motivation to achieve. Also, many other school programs, including school food services, counseling services, and formal health and physical education instruction, directly affect health and well-being.3 School programs foster the identification of health-related issues and address developmental, learning, health, and social problems. Hence, there is increasing interest in how schools are organized, the effectiveness of school programs and policies, and how students perceive their schools.4,5

Recent research has emphasized the link between students' perceptions of school and their motivation, achievement, and behavior. Students who like and feel connected with school may be more motivated to achieve academically6,7 and less motivated to engage in anti-social behavior than children who feel disconnected from it.

Societal expectations for school are substantial. Primarily, Americans want schools to produce students who achieve academically and behave respectfully. However, an over-emphasis on academic achievement and discipline, without concern for students' positive affiliation with school, can undermine student morale and motivation.4 Social development9 and social 'bonding' theories10 argue that commitment to social institutions, including family and school, provide important protection against anti-social behavior and encourage academic effort and self-control. The typical school environment, characterized by an emphasis on rules, control, and discipline, may conflict with the adolescent's developmental needs for increased autonomy, opportunities to demonstrate competence, exposure to caring and support from adults, developmentally appropriate supervision, and acceptance by peers, and can undermine positive affiliation with school and academic engagement.6,7,11

An extensive review of research on adolescence emphasized the importance of a positive school environment in preventing problem behavior.12 The U.S. National Longitudinal Study of Adolescent Health (AddHealth) found that students who reported being more connected with school were less likely to use cigarettes, alcohol, or illegal drugs, engage in aggressive and violent behavior, and get pregnant.13,14,15 An analysis of AddHealth concluded that connectedness, the feeling that one belongs and is cared for at school, is a crucial requirement for student health and well-being.14 However, according to Blum et al.,15 the potential of schools to promote positive health behavior is largely untapped.

School connectedness, it appears, is one good way of characterizing the relationship between children and their schools. However, connectedness may be best understood within a broader view of children's "developmental assets." The developmental assets approach provides a way of thinking about the wide range of possible personal and socio-environmental assets that can help young people grow up to be healthy, caring and responsible. Scales16 recently noted the potential of schools to foster many of the forty developmental assets identified by providing a caring school climate, safe environment, high expectations for achievement and comportment, and commitment to learning, including achievement motivation, school engagement, and school connectedness and bonding.

By adolescence, a student has acquired many health-related attributes through assets gained and exposure to risks from family, peers and community, including their earlier school experiences.16 Schools in the U.S. and Western Europe also provide experience in programs specifically tailored to improve health-related attitudes, behaviors, and student well-being.16,17,18 Many of these behaviors and attitudes have consequences affecting not only the adolescent progression to adulthood and adult health but occurrence of health attributes during each developmental stage.

Results of an analysis of all countries participating in the HBSC study indicate that students appear to be satisfied with their school setting if they take part in establishing school rules, get needed support from teachers or other students, and perceive high expectations from teachers and parents.1 This international analysis found results similar to the AddHealth study for behaviors such as smoking13 and for physical activity, but also found associations with student reports of a lower quality of life if school satisfaction is low. Students report feeling healthier when they are satisfied with their school and feel supported by teachers and by other students.

The HBSC study provides an excellent opportunity to examine the teens' perceptions of school and to explore their implications for school policies, programs, and practices. This chapter presents selected findings from the HBSC survey on students' school-related perceptions and attitudes and compares these findings with those from other HBSC study countries.

Factors Associated with Student's Perception of School

 

11-year-olds

13-year-olds

15-year-olds

Boys

Girls

Boys

Girls

Boys

Girls

Students are satisfied with their school when:

They take part in setting rules at school

***

***

***

***

***

***

They get support from teachers when needed

***

***

***

***

***

***

They feel supported by other students

***

***

**

***

***

***

Expectations by teachers and parents are high

*

*

**

**

**

**

Students feel healthier when:

They are satisfied with their school

*

**

*

**

*

**

They are involved in setting rules at school

*

*

*

*

*

*

They feel supported by teachers

*

*

*

**

*

*

They feel supported by other students

**

**

**

**

**

*

Expectations by parents and teachers are low

*

*

*

*

*

*

Students smoke more when:

They are not satistified with their school

*

*

**

**

**

**

They are not involved in setting rules at school

*

*

*

**

*

**

They do not feel supported by teachers

*

*

*

*

*

*

They do not feel supported by other students

*

*

*

*

*

*

Expectations by parents and teachers are high

*

*

*

*

*

**

Students report a lower quality of life when:

They are not satisfied with their school

**

***

***

***

**

**

They are not involved in setting rules at school

**

**

*

*

*

*

They do not feel supported by teachers

**

**

**

***

**

**

They do not feel supported by other students

***

***

***

***

**

**

Expectations by parents and teachers are high

*

*

*

**

*

**

Strength of association (Pearson Correlation)

None (<0.15) = *

Medium (0.15-0.25) = **

Strong (>0.25) = ***

U.S. students rank among the top third of countries, with 19 percent of girls and 17 percent of boys, liking school a lot. The response choices were: like it a lot, like it a little, don't like it very much, or don't like it at all. The proportion saying that they don't like it a lot means that about 80 percent of U.S. students don't enjoy school very much. Students liking school a lot ranged from 40 percent of girls in Latvia to 5 percent or less in the Czech Republic and Finland. Liking school a lot tends to decrease with age across all countries. More girls than boys liked school in most countries.

In their assessment of parental expectations, U.S. students rank in the middle, with 36 percent of girls and 41 percent of boys feeling that their parents expect too much of them at school, compared to nearly three-quarters of students in Greece and one-fifth of students in Finland. Overall, boys complain more of excessive pressure than girls, indicating that boys may feel more challenged or that some parents treat boys and girls differently.

  Graph: "How Do You Feel About School At Present?"[d]   Graph: "My Parents Expect Too Much Of Me At School"[d]

U.S. students are about equally likely to feel high expectations on the part of parents and teachers, with similar rankings among all countries. However, the differences between boys and girls on teacher expectations are not as pronounced as for parental expectations in many countries.

U.S. students rank second highest in the percent of students who felt pressured by their school work, with 31 percent of girls and 27 percent of boys feeling pressured a lot. Few countries have rankings of school stress this high, with most countries reporting between 10-13 percent. Stress from schoolwork increases with age in most countries.

  Graph: "My Teachers Expect Too Much Of Me At School"[d]   Graph: "How Pressured Do You Feel By The School Work You Have To Do?"[d]

U.S. students rank among the bottom five countries for students who report that they take part in making school rules, with only 18 percent of girls and 21 percent of boys agreeing with this statement, an improvement from the lowest in rank at age 11 and third lowest at age 13 (data not shown).1 However, the percentages for U.S. students across age are not significantly different. Countries vary widely in the percent of students participating in the making of school rules, ranging from 8 percent (Finnish girls) to 67 percent (boys in Switzerland). Among other countries, student reports show a general decrease in the sense of participation, sometimes by as much as half between ages 11 and 15.

U.S. students rank near the top third (10th) among all students who feel that rules are not fair, with 27 percent of girls and 35 percent of boys. The U.S. ranking at age 15 is an improvement compared to ages 11 and 13 years, at sixth and fourth place respectively (data not shown).

  Graph: "'In Our School, The Students Take Part In Making Rules'"[d]   Graph: "'The Students Are Treated Too Severely/Strictly In This School'"[d]

Across countries, there is wide variation in the percentage of students who feel this way (8 to 54 percent), although boys outnumber girls in all countries.

U.S. students are among the least likely to agree that their fellow students are kind and helpful (only 39 percent of girls and 35 percent of boys), followed only by Lithuania and the Czech Republic. Across countries there were no marked differences by age or gender in perception of classmates' kindness and help to those in need.

Graph: "'Most Of The Students In My Classes Are Kind And Helpful'"[d]

What Didn't We Know?

The HBSC revealed a number of perceptions and attitudes about the school environment that are common among all countries, particularly by gender and age. Across countries, girls tended to like school and consider rules to be fair more often than boys. Boys are more likely to feel that parents expect too much of students at school, although this gender difference tends to disappear for teacher expectations. For both genders, enthusiasm and a sense of participation tends to decrease as students age, just as pressure from school work increases as they grow older.

Comparisons of U.S. student reports on their school environment indicate that the proportion of U.S. 15-year-old students who are enthusiastic about school (like it a lot) is among the best of countries - even though about four out of five U.S. students like school only a little, not very much, or not at all. U.S. students are among the least likely to feel that they participate in making rules at school or that rules are fair. This sense of lack of participation in rule making and unfairness gets worse as students grow older. U.S. students of all ages also are among the least likely to feel that their classmates are kind and helpful. The research citing a link between student perceptions of school and motivation, academic achievement, and behaviors stresses the importance of feeling connected to school.6,7,8,12

The low proportion of U.S. students who feel that they participate in rule-making or that rules are fair, along with the lack of support they perceive from other students, raises concern for the prospect that students will see themselves as future members of a participatory democratic society. Not only are students who feel unconnected more likely to abuse substances, engage in violence, and become pregnant,13,14,15 but they may be less likely to acquire developmental assets and to experience opportunities to demonstrate competence through increasing autonomy appropriate to their developmental stage.6,7,8,11,16

The HBSC did not measure actual student academic achievement, although students were asked how they thought their class teacher(s) would rate their school performance compared to classmates.1 Comparisons in the HBSC international report show that U.S. students ranked perceptions of their own performance as very high compared to other students in their class. The proportion in the U.S. who thought they were very good at school ranks fourth highest among all countries at each age (data not shown). No HBSC analysis has been completed comparing perceived academic achievement to environmental factors such as parent and teacher expectations, pressure from school work, assessment of fairness of rules and involvement in rule-making, and relationships with overall health, fitness, quality of life or health behaviors.

However, other studies have found associations between academic performance and related factors in U.S. middle school students.6,7 Two other international studies, the Third International Mathematics and Science Study and Program for International Student Assessment,19,20 include U.S. students to compare academic performance, although the other countries are not necessarily the same as those in the HBSC. However, these studies do not include the contextual factors of family, peers, and school environment, so the influence of these factors cannot be assessed.

For school factors and other assessments, even nationally representative school-based studies may include a biased sample based on the characteristics of those most likely to complete the questionnaires, as discussed in the chapter on “What’s left out.” Therefore, students who are struggling in the school environment may be represented in school-based surveys in lower proportions than actually occur in the school's population. In addition, students who have dropped out of school or cannot attend due to severe illness or disability are excluded. Based on these sources of sampling bias, the associations shown from the HBSC and other school-based study analyses may underestimate the significance of the school environment, connectedness, and school failure.

The AddHealth study analysis by McNeely et al. emphasizes that feeling that one belongs and is cared for at school is a crucial requirement for student health and well-being.14 The HBSC international analysis demonstrated that negative health behaviors, feeling unhealthy, decreased physical activity and low quality of life increase when school satisfaction is low. This finding may have implications for U.S. student reports of relatively high levels of health symptoms and feeling low.1

Some of the associations of school environment with overall health and well-being, fitness, family and peer relations, substance use, and violence found in the HBSC and other studies should be examined further in special populations. For example, the U.S. is more racially and ethnically diverse than most of the other countries included in the HBSC.21 As noted in the chapter on family and peer relations, acculturation also interacts in the school setting.22 Adolescents who usually speak a language other than English at home face a greater risk for psychosocial and school risk factors with less parental support in the school setting regardless of race or ethnicity. In these analyses, students who primarily speak a language other than English at home are more likely to have difficulty making new friends, be involved in bullying (as either a victim, a bully, or both), not feel accepted by other students, not feel as though they belong at school, and have difficulty talking to either parent about things that bothered them. They feel that their parents are less supportive and less willing to help with school problems or talk with teachers. The HBSC international report did not compare students' perceptions of their parents' willingness to talk to teachers or whether they were ready to help when the student had problems at school, although the survey included these questions. Lack of parental support at school may be associated with the language and cultural barriers faced by immigrant parents in other countries as well as the U.S.

Another analysis of U.S. HBSC data shows differences in psychosocial factors associated with being a victim of bullying, including those students who are both a bully and a victim.23 These factors include feelings of isolation in the school environment, lack of parental support, loneliness, and the lack of support from other students. Violence among U.S. youth is a primary concern for the public and officials in the school, public health and law enforcement sectors.24 A recent AddHealth study by Moody shows that teens are more likely to choose friends within their own racial group in moderately racially mixed schools, with the likelihood greatest in schools where diversity is moderately high.25 However, the analysis also found that in schools with the highest levels of diversity, the likelihood of choosing friends from one's own racial group decreases, and students are more likely to form friendships with people in other groups. Since U.S. students in the HBSC study are among the least likely to feel that other students are kind and helpful, we should investigate both the social and structural aspects of school and community life in the U.S. that detract from a supportive school environment.

While schools are required to provide a solid education while managing many of the social and physical attributes that students bring from their larger family and community environments, the opportunity to build better school connectedness and support for health and well-being exists. Formal and informal instruction exists to directly address physical health and well-being through programs such as school health guidelines on areas related to healthy eating, injury and violence, physical activity, tobacco use, and AIDS.26,27

A report based on the AddHealth study results suggests that current efforts to improve school connectedness are being applied in some venues.15 The American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health has issued a policy statement affirming their commitment to prevention, early detection, and management of behavioral, developmental, and social problems as a focus in pediatric practice.28 In addition, they address the need to advocate for children's mental health needs and become familiar with mental health referral processes and community resources to ensure access and continuity of services. In particular, they emphasize the physician's need to address psychosocial issues involved in diagnosing and treating school-related disorders and other problems that have been better identified through recent research: learning disabilities and attention difficulties, child and adolescent mood and anxiety disorders, adolescent suicide and homicide, firearms in the home and school violence, drug and alcohol abuse, human immuno-deficiency virus and acquired immunodeficiency syndrome, and the effects of media on violence, obesity, and sexual activity. Recommendations from research on findings that strong school and family ties protect teens from violence, substance use, suicide and early sex may also be found in a briefing paper prepared by NICHD's Demographic and Behavioral Sciences Branch.29 The following chapters describe findings related to substance use and violence across countries.

REFERENCES

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  1. Samdal O, Dur W. The school environment and health of adolescents. In: Currie C, Hurrelman K, Settertobulte W, Smith R, Todd J, Health and Health Behaviour among Young People. WHO Policy Series: Health Policy for Children and Adolescents Issue 1. Copenhagen, Denmark: World Health Organization Regional Office for Europe, 2000.
  2. Masten AS, Coatsworth JD. The development of competence in favorable and unfavorable environments: Lessons from research on successful children. American Psych 1998;53:205-220.
  3. Kolbe LJ. Developing a plan of action to institutionalize comprehensive school health education programs in the United States. Journal of School Health 1993;63:12-13.
  4. Anderman EM, Maehr ML, Medgley C. Declining motivation after the transition to middle school: Schools can make a difference. Journal of Research and Development in Education 1999;32:131-147.
  5. Eccles JS, Midgefield C, Wigfield A. Development during adolescence: The impact of stage-environment fit on young adolescents' experiences in schools and families. American Psychologist 1993;48:90-101.
  6. Roeser R, Eccles JS. Adolescents' perceptions of middle school: Relation to longitudinal changes in academic and psychological adjustment. Journal of Research on Adolescence 1998; 8:123-158.
  7. Eccles JS, Wigfield A, Midgley C, Reuman D, MacIver D, Feldlaufer H. Negative effects of traditional middle schools on students' motivation. Elementary School Journal 1993;93:553-574.
  8. Simons-Morton BG, Crump AD, Haynie DL, Saylor KE. Student-school bonding and adolescent problem behavior. Health Education Research 2001;14:99-107.
  9. Hawkins JD, Weis JG. The social development model: An integrated approach to delinquency prevention. Journal of Primary Prevention 1985;6:73-97.
  10. Gottfredson MR, Hirschi T. A general theory of adolescent problem behavior: Problems and prospects. In: R.D. Ketterlinus and ME Lamb (Eds.) Adolescent Problem Behaviors: Issues and Research. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1994;pages 41-56.
  11. Eccles JS, Early D, Frasier K, Belansky E, McCarthy K. The relation of connection, regulation, and support for autonomy to adolescents' functioning. Journal of Adolescent Research 1997;12:263-286.
  12. Kipke MD. Risks and Opportunities: Synthesis of Studies on Adolescence. Washington, DC: National Academy Press, 1999.
  13. Resnick MD, Bearman PS, Blum RW, et al. Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997;278:823-832.
  14. McNeely CA, Nonnemaker JM, Blum RW. Promoting school connectedness: Evidence from the National Longitudinal Study of Adolescent Health. Journal of School Health 2002;72:138-146.
  15. Blum RW, McNeely CA, Rinehart PM. Improving the odds: The untapped power of schools to improve the health of teens. Minneapolis, MN: Center for Adolescent Health and Development, University of Minnesota, 2002.
  16. Scales PC. Reducing risks and building developmental assets: Essential actions for promoting adolescent adolescent health. Journal of School Health 1999;69:113-119.
  17. Centers for Disease Control and Prevention. School Health Program Guidelines. (Available at: http://www.cdc.gov/chronicdisease/resources/publications/aag/dash.htm.)
  18. European Network of Health Promoting Schools Program.
  19. National Center for Educational Statistics. Third International Mathematics and Science Study. Washington, DC: U.S. Dept. of Education. (Description and Reports available at: http://www.nces.ed.gov; last accessed on
    September 2002.)
  20. National Center for Educational Statistics. Outcomes of Learning: Results from the 2000 Program for International Student Assessment of 15-year-olds in Reading, Mathematics, and Science Literacy (PISA). Washington, DC: U.S. Dept of Education Pub. No. NCES 2002-115, 2001. (Also available at http://www.nces.ed.gov; last accessed on September 2002.)
  21. Hernandez DJ, Charney E. (eds.) From Generation to Generation: The health and well-being of children in immigrant families. Washington, DC: National Academy Press, 1998.
  22. Yu SM, Huang ZJ, Schwalberg R, Overpeck MD, Kogan MD. Acculturation and the health and well-being of U.S. immigrant adolescents. J Adolescent Health (in press).
  23. Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton BG. Bullying behaviors among the U.S. youth: Prevalence and association with psychosocial adjustment. JAMA 2001;285(16):2094-2100.
  24. U.S. Department of Health and Human Services. Youth violence: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, 2001.
  25. Moody J. Race, school integration, and friendship segregation in America. American Journal of Sociology 2001;107(3):679-716.
  26. Kann L, Collins JL, Patemena BC, Small ML, Russ JG, Kolbe LJ. The school health policies and programs study (SHPPS): Rationale for a nation-wide status report on school health program. Journal of School Health 1995;22:291-293.
  27. National Center for Chronic Disease Prevention and Health Promotion. Adolescent and School Health: School Health Program Guidelines. (Available at http://www.cdc.gov/healthyyouth/; last access on September, 2002.)
  28. American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. The new morbidity revisited: A renewed commitment to the psychosocial aspects of pediatric care. Pediatrics 2001;108:1227-1230.
  29. Demographic and Behavioral Sciences Branch. Research on Today's Issues: Strong school, family ties protect teens from violence, drugs, suicide and early sex. Briefing Papers, Issue No 1. Bethesda, MD: National Institute of Child Health and Human Development, 1998.

* Note: If you used a link in the text to reach these footnotes, please use the "Back" button on your browser to return to the text you were reading.

 

Table of Contents | Executive Summary | Introduction | Chapter 1 | Chapter 2 | Chapter 3 | Chapter 4 | Chapter 5 | Chapter 6 | What Was Left Out | Summary

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