Child and adolescent health and wellbeing: evidence review
Maps available national data on child health and wellbeing against the SHANNARI domains, to produce a full and detailed picture of ‘where we are now’ on child health and wellbeing in Scotland.
6. Active
6.1 Elements within the Active domain
The Active domain is defined as 'Having opportunities to take part in activities such as play, recreation and sport, which contribute to healthy growth and development, at home, in school and in the community'. The key indicators identified here are around area factors such as greenspace, active travel, physical activity and sedentary behaviour.
Area factors
As noted in the Safe chapter, one important link between neighbourhood environment and health outcomes is the availability of play areas and greenspace, which provide opportunities to be physically active, often without cost. As well as the availability of these facilities, it is also important whether they are used by young people. Likelihood of use is partly driven by an individual's lifestyle and preferences, as well as wider social norms within an area, which in turn are driven by perceptions of the quality and safety of play areas and green spaces ( liv). Young people themselves have indicated that open spaces for leisure are a prerequisite for health and wellbeing ( lv).
Physical activity and exercise
Regular physical activity can improve physical and psychological health and quality of life. Participation in physical activity and sport amongst children and adolescents has been linked to multiple positive health outcomes. There is widespread consensus around the health, economic and social benefits of physical activity, with strong scientific evidence that sufficient, regular physical activity is beneficial for the health of body and mind. Physical activity improves the health of the heart, skeletal muscles, bones, blood, immune system and nervous system. Physical activity also improves psychological wellbeing; self-perception and self-esteem; and mood and sleep quality ( lvi). Adolescence is a crucial time to establish an active lifestyle that will continue into adulthood.
Physical activity guidelines recommend 60 minutes of moderate to vigorous activity a day. One way of meeting this recommendation is through active travel to and from school. Further along the activity spectrum, measures include exercise and participation in sport. These can have the additional benefits of increasing resilience, feelings of achievement and belonging to a group and may prevent young people from participating in risky behaviours. Participation in sport was also found to be the most important childhood resilience factor after the presence of a trusted adult in research with people with four or more ACEs ( lvii).
It is worth noting that the physical activity measure for children aged 2 to 15 from the Scottish Health Survey included here is largely based on parental report, which generally results in a higher level of adherence than child self-report studies or objective measurement through accelerometers.
Sedentary behaviour
Sedentary behaviour refers to participation in low energy activities requiring minimal physical movement. Contrary to what might be expected, levels of sedentary behaviour are not strongly correlated with how active a young person is, and time spent being sedentary ( e.g. watching television or playing computer games) does not necessarily displace time spent engaging in physical activity ( lviii). Sedentary behaviours, independently of lack of participation in physical activity, are associated with higher levels of obesity ( lix), as well as negative dietary behaviours such as consumption of sugary drinks ( lx) and energy-dense snacks ( lxi). They are also associated with poorer mental health ( lxii).
6.2 Current position
| Indicator |
Headline figure |
Date |
Data source |
Next data |
Time trend |
Key inequalities |
International comparisons |
|---|---|---|---|---|---|---|---|
| Area factors |
|||||||
| Percentage of households with children aged 6 to 12 where children have access to at least one play area in their neighbourhood |
92% |
2016 |
SHS [3] |
/ |
No change over time |
* SIMD No difference * Urban/rural No difference |
/ |
| Percentage of 13 and 15 year olds who use local greenspace weekly during summertime |
64% |
2014 |
HBSC |
2018 |
The percentage decreased from 71% in 2010 |
* Age Weekly use declined with age. 68% of 13-year olds and 61% of 15-year olds used greenspace weekly * Gender At 15, the percentage was higher among boys than girls (65% vs 56%). There was no gender difference at 13 |
Scotland only question |
| Percentage of 13 and 15 year olds who used greenspace at least 2 hours a week in the summertime |
54% |
2014 |
HBSC |
2018 |
The percentage decreased slightly from 58% in 2010 |
* Age The percentage declined with age, particularly among girls (59% to 46%) * Gender At 15, the percentage was lower among girls than boys (46% vs 56%). There was no gender difference at 13 |
Scotland only question |
| Active travel |
|||||||
| Percentage of primary and secondary school children normally travelling to school in an active way (walking, cycling, and using a scooter, skateboard or inline/roller skates). |
48.8% |
2017 |
Hands up Scotland |
2018 |
The percentage travelling to school in an active way has remained relatively steady since 2008 |
* Age The percentage was higher among primary school pupils (53.1%) than secondary school pupils (42.7%) * School sector State school pupils were more likely to travel actively (49.2%) than independent school pupils (17%) |
/ |
| Physical activity/exercise |
|||||||
| Percentage of children aged 2-15 who meet physical activities guidelines (including activities at school) |
76% |
2016 |
SHeS |
2017 |
There has been an increasing trend since 2012 (70%). The percentage among girls has increased from 64% in 2008, while the percentage among boys has fluctuated. |
* Age younger children were more likely than older children to meet the guidelines. The percentage was highest for those aged 5-7 (82%), then declined steadily with increased age, to 61% for those aged 13-15 * Gender Boys were more likely to meet the guidelines (79%) than girls (72%). The difference in activity levels between boys and girls was largely explained by differences in the older age groups. At ages 5-7 and 8-10 the gender gap was 1-2 percentage points. This rose to 20 percentage points at 11-12 and 23 percentage points at 13-15 * SIMD There was no clear pattern by area deprivation |
/ |
| Percentage of 11,13 and 15 year olds who take part in vigorous physical activity at least 4 times a week |
49% |
2014 |
HBSC |
2018 |
The percentage has increased from 37% in 2002, although it has fluctuated substantially. |
* Gender Participation in vigorous physical activity was higher among boys (56%) than girls (42%) * Age Frequency of vigorous activity was highest at age 11 (65% of boys and 56% of girls) |
Scotland performed better than average at age 11, reporting the 4 th highest proportions of pupils exercising 4+ times per week across all HBSC countries (61% Scotland; 42% HBSC average). At age 13, boys and girls report rates were only a little higher than the HBSC average (47% Scotland, 43% HBSC average). By age 15, Scotland performed average in international comparison. |
| Percentage of S2 and S4 pupils who do sport at least once a week outside of school |
66% |
2015 |
SALSUS |
2018 |
/ |
* Gender Boys were substantially more likely to do sport (75%) than girls (57%) * Age the percentage decreased with age (71% to 61%) |
/ |
| Percentage of S2 and S4 pupils who participated in sports clubs, gyms, exercise or dance groups in the last 12 months |
62% |
2015 |
SALSUS |
2018 |
Percentage increased between 2008 (54%) and 2013 (62%). There was no further change between 2013 and 2015 among S2 pupils and S4 girls and a small decrease in participation among S4 boys (64% to 61%). |
* Age The percentage increased with age (66% S2; 58% S4) * Gender Participation was higher among boys than girls, and the gap widened between S2 (67% vs 61%) and S4 (69% vs 59%) |
/ |
| Children aged 2-15 had participated in sport outside of school in the week prior to interview |
68% |
2016 |
SHeS |
2017 |
There has been relatively little change since 2010 (ranging between 70% and 66%) following a drop from 73% in 2009. |
* Gender Sport participation rates in 2016 were similar for boys and girls (70% and 67%) and followed a similar time trend |
/ |
| Sedentary behaviour |
|||||||
| Percentage of 11,13 and 15 year olds who watch television for two or more hours every day during the school week |
64% |
2014 |
HBSC |
2018 |
The percentage has decreased since 2002 (75%) |
* Age The percentage was greater at ages 13 and 15 (both 68%) than at age 11 (57%) * Gender The percentage was greater for boys in all three age groups (62% vs 51% at 11; 71% vs 65% at 13; 72% vs 64% at 15) |
With the exception of 15 year old girls, all the other groups have reported significantly higher levels compared with the HBSC average: * 51% Scotland, 47% HBSC average for girls aged 11; * 60% Scotland, 53% HBSC average for boys aged 11 * 65% Scotland, 61% HBSC average for girls aged 13; * 71% Scotland, 62% HBSC average for boys aged 13 * 72% Scotland, 65% HBSC average for boys aged 15 |
| Percentage of 11, 13 and 15 year olds who play computer games for two or more hours every day during the school week |
55% |
2014 |
HBSC |
2018 |
There was an increase in girls playing computer games between 2010 and 2014 (29% to 46%) but no change among boys |
* Gender The percentage was greater for boys (65%) than girls (46%) * Age The percentage was higher at age 13 (61%) than 11 (52%) and 15 (53%) |
Scotland performed significantly worse than the HBSC average: * 42% Scotland, 28% HBSC average for girls aged 11 * 61% Scotland, 46% HBSC average for boys aged 11 * 52% Scotland, 35% HBSC average for girls aged 13 * 70% Scotland, 56% HBSC average for boys aged 13 * 44% Scotland, 30% HBSC average for girls aged 15 * 64% Scotland, 54% HBSC average for boys aged 15 In all age/gender groups, the percentage in Scotland was among the highest of all HBSC countries |
6.3 Key points
- Physical activity is a key driver of both physical and mental health. Around three quarters of children aged 2-15 met the physical activity guidelines of at least 60 minutes of moderate physical activity a day, leaving around a quarter who did not. Physical activity may include active travel, playing outside or participation in sports.
- Physical activity declined substantially with age. Among 13-15 year olds, only six in ten met the physical activity guidelines, compared with 82% of those aged 5-7. Primary school children were also more likely to travel to school in an active way, and younger teenagers were more likely to use greenspace and participate in sport (including through sports clubs) than older teenagers.
- Girls were less likely to meet the physical activity guidelines and were substantially less likely to take part in sports than boys. The gender difference was greater at older ages.
- Sedentary behaviour is a separate measure from physical activity, with independent negative health and wellbeing effects. The majority of young people participated in sedentary behaviour. There has been a shift between types of sedentary behaviour as the percentage of young people watching television for two hours a day decreased, while the percentage playing computer games for two hours increased.
- Boys were also more likely to engage in sedentary behaviour.
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