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.
8. Responsible
8.1 Elements within the Responsible domain
The Responsible domain is defined as 'having opportunities and encouragement to play active and responsible roles at home, in school and in the community, and where necessary, having appropriate guidance and supervision, and being involved in decisions that affect them'. The key indicators identified here are around participation in positive activities, risky behaviours and violence/offending.
Positive activities
Being responsible is often conceptualised in terms of the absence of 'irresponsible' behaviours. However, there has recently been a shift towards celebrating participation in positive activities, whether membership of clubs and groups, or volunteering. Such participation can have positive benefits for young people such as new experiences, improved peer relationships, exposure to role models and a feeling of belonging to a community ( lxix). Participation in positive activities has been shown to improve psychological wellbeing; self-perception and self-esteem; and skills development ( lxx). Volunteering in particular also has wider benefits, strengthening community cohesion and public services ( lxxi), which in turn act as protective factors for young people's health and wellbeing.
A particular type of volunteering is unpaid caring for a relative, friend or neighbour. This provides a crucial benefit to both the people being cared for and wider society, but the mental and physical health and wellbeing of carers can be negatively affected by the caring demands placed upon them ( lxxii).
Substance use and sexual behaviour
Another broad area under the Responsible domain refers to risk behaviours such as smoking, alcohol and drug use, and unsafe sexual behaviours. As well as the negative physical health impacts of these, they are associated with increased injuries ( lxxiii), increased sexual risk behaviour ( lxxiv) and emotional and mental health problems ( lxxv), as well as lower academic achievement ( lxxvi). Smoking, alcohol and drug use are often viewed as separate issues, but research has shown that these are often interrelated, with one leading to another ( lxxvii). Adolescent substance use has also been shown to carry over into adulthood and can lead to problems of dependence ( lxxviii). Early sexual activity has been strongly linked to adverse health outcomes such as sexually-transmitted infections ( lxxix), unplanned pregnancies ( lxxx), poor mental health and reduced academic performance ( lxxxi). In addition, high numbers of sexual partners and inconsistent contraception can be health risk factors for young people ( lxxxii), (lxxxiii).
Another area under the Responsible domain is young people becoming involved in damaging behaviour towards others, from bullying others, to committing offences, and, in the most serious cases, going to prison. Young people committing offenses often has long term negative impacts on their life outcomes.
8.2 Current position
| Indicator |
Headline figure |
Date |
Data source |
Next data |
Time trend |
Key inequalities |
International comparisons |
|---|---|---|---|---|---|---|---|
| Volunteering |
|||||||
| Percentage of people aged 16 to 24 providing unpaid help to organisations or groups in the last 12 months |
29% |
2017 |
SHS |
2018 |
Rates have fluctuated, with no consistent trend over time |
* Gender Volunteering was higher among girls (33%) than boys (24%) * SIMD The rate was highest in SIMD (39%) and lowest in SIMD2 (21%) and SIMD1 (24%) |
/ |
| Percentage of people aged 16 to 24 who provide unpaid help to organisations or groups who volunteer once a week or more |
44% |
2016 |
SHS |
2018 |
Evidence of some increase between 2007 (29%) and 2014 (51%) |
There was no meaningful difference by SIMD or gender |
/ |
| Caring responsibilities |
|||||||
| Percentage of S2 and S4 pupils who have caring responsibilities |
10% |
2015 |
SALSUS |
2018 |
/ |
* Age/Gender S2 boys were slightly more likely to report caring responsibilities (13%) than the other age/gender groups (9-10%) |
/ |
| Positive activities |
|||||||
| Percentage of S2 and S4 pupils who participated in a group, club or organisation in the last 12 months |
79%; |
2015 |
SALSUS |
2018 |
Participation increased between 2006 (75%) and 2008 (78%) and has stayed stable since |
* Age Participation was higher among S2 pupils (84%) than S4 pupils (74%) * Gender There was no gender difference at S2, but at S4 pupils participation was higher among boys (76%) than girls (72%) |
/ |
| Percentage of households with children ages 8 to 12 where children regularly take part in at least one leisure activity outside of school |
76% |
2016 |
SHS [4] |
/ |
/ |
* Urban/rural Participation was higher in rural areas (82%) than urban areas (74%) * SIMD Participation was lower in SIMD1 urban areas (68%) than other urban areas (77%) |
/ |
| Smoking |
|||||||
| Percentage of S4 pupils who usually smoke one cigarette or more a week |
7% |
2015 |
SALSUS |
2018 |
Smoking prevalence has dropped markedly from 29% in 1996 |
* Gender there was no gender difference, although over the previous three decades rates tended to be somewhat higher among girls |
/ |
| Percentage of S2 pupils who usually smoke one cigarette or more a week ('regular smokers') |
2% |
2015 |
SALSUS |
2018 |
Smoking prevalence has dropped since 2002- 2004 (10% girls, 8% boys) |
* Gender there was no gender difference, although over the previous three decades rates tended to be somewhat higher among girls |
/ |
| Median number of cigarettes smoked in the last week by S4 pupils who smoke at least one cigarette a week |
25 |
2015 |
SALSUS |
2018 |
The median number dropped from 34 in 2013 |
* Gender There was no gender difference |
/ |
| Percentage of 11, 13 and 15 year olds who have ever smoked tobacco |
12% |
2014 |
HBSC |
2018 |
The percentage among 15 year olds has decreased from a peak in 1998 (68% girls; 59% boys). |
* Age The percentage increased with age from 1% at 11, 8% at 13 and 28% at 15 * Gender At 13 and 15, the percentage was higher among girls than boys (11% vs 6%; 30% vs 26%). There was no difference at age 11 |
/ |
| Alcohol |
|||||||
| Percentage of S4 pupils who have ever drunk alcohol |
66% |
2015 |
SALSUS |
2018 |
The percentage has steadily decreasing since 2004 (86% girls; 83% boys) |
* Gender Girls were slightly more likely than boys to have drunk alcohol (68% vs 63%) |
/ |
| Percentage of S2 pupils who have ever drunk alcohol |
28% |
2015 |
SALSUS |
2018 |
The percentage has steadily decreased since 2004 (69% girls; 67% boys) |
* Gender Boys were slightly more likely than girls to have drunk alcohol (29% vs 26%) |
/ |
| Percentage of S4 pupils who have drunk alcohol in the last week |
17% |
2015 |
SALSUS |
2018 |
After a large decrease in prevalence between 2010 (34%) and 2013 (18%), and little change between 2013 and 2015 |
* Gender Girls were slightly more likely than boys to have drunk alcohol in the last week (19% vs 16%) |
/ |
| Percentage of S2 pupils who have drunk alcohol in the last week |
4% |
2015 |
SALSUS |
2018 |
After a large decrease in prevalence between 2010 (14%) and 2013 (4%), drinking in the last week has remained unchanged between 2013 and 2015 |
* Gender There was no gender difference |
/ |
| Percentage of S2 and S4 pupils who have ever drunk alcohol who have been drunk |
62% |
2015 |
SALSUS |
2018 |
There has been a small decline in the percentage between 2002 and 2015 |
*Age Higher among older pupils (S2 45%; S4 68%) * Gender Girls were more likely than boys to have been drunk at least once (64% vs 59%) |
/ |
| Percentage of S2 and S4 pupils who have ever drunk alcohol who experienced a negative effect as a result |
55% |
2015 |
SALSUS |
2018 |
Among S2 girls, the percentage increased from 44% in 2013 to 48% in 2015. There was no change among S2 boys and S4 pupils |
*Age Higher among older pupils (S2 45%; S4 59%) * Gender Girls were more likely than boys to experience at least one negative effect (60% vs 50%). Girls were more likely than boys to have an argument due to drinking alcohol (34% vs 24%); boys were more likely to have gone to hospital or seen a doctor (11% vs 7%) |
/ |
| Percentage 15 year olds who drink weekly |
14% |
2014 |
HBSC |
2018 |
Rates have declined since 1998 (45% of girls and 44% of boys). |
* Gender boys were more likely to drink weekly than girls (17% vs 11%) |
Scotland performed around average in international comparison |
| Drugs |
|||||||
| Percentage of S4 pupils who have used drugs in the last month |
11% |
2015 |
SALSUS |
2018 |
The percentage has decreased gradually since 2002 (20% boys, 23% girls). |
* Gender boys were more likely than girls to have used drugs (13% vs 9%) |
/ |
| Percentage of S2 pupils who have used drugs in the last month |
3% |
2015 |
SALSUS |
2018 |
Drug use has decreased since 2002 (6% girls, 10% boys), although between 2013 and 2015, the percentage of 15 year old boys increased slightly from 11% to 13% in 2015. Drug use among 13 year olds and 15 year old girls remained stable. |
* Gender No gender difference |
/ |
| Percentage of S2 and S4 pupils who have ever used drugs who experienced a negative effect as a result |
41% |
2015 |
SALSUS |
2018 |
There was no change in the percentage over time. |
*Age Higher among older pupils (S2 35%; S4 43%) * Gender There was little gender difference in the percentage experiencing any negative effects (39% boys, 43% girls), although there were differences by gender in the effects experienced. Boys were more likely than girls to have had a fight (13% vs 8%) or have been in trouble with the police (13% vs 9%). Girls were more likely to have been sick (21% vs 17%), sent a text/email that they wish they hadn't (13% vs 10%) and to have done something they later regretted (19% vs 16%) |
/ |
| Percentage of 13 and 15 year olds who have used cannabis at least once |
18% at 15; 4% at 13 |
2014 |
HBSC |
2018 |
Among 15 year olds, there was a decrease between 2002 (35 boys, 39% girls) and 2010, with no change since. |
* Gender There was no gender difference |
Scotland performed around international average |
| Percentage 15 year olds who have used cannabis within the last month |
10% |
2014 |
HBSC |
2018 |
There has been little change among boys since 2002, but there has been a slight decrease among girls from 12% in 2002 to 8% in 2014 |
* Gender The percentage was higher among boys than girls (13% vs 8%) |
Scotland performed worse than the average in international comparison for boys aged 15 (14% Scotland, 9% HBSC average). Scotland performed average for girls aged 15. |
| Sexual health |
|||||||
| Percentage of 15 year olds who have ever had sex |
26% |
2014 |
HBSC |
2018 |
The percentage decreased between 1994 (38%) and 2010 (31%), and then decreased markedly by 2014. This was mianly driven by a decline among girls between 2010 and 2014 (from 35% to 27%). |
* Gender The percentage was slightly higher among girls (27%) than boys (24%) |
Scotland performed worse than the average for girls (27% Scotland, 17% HBSC average). Scotland performed around average in international comparison for boys |
| Percentage of 15 year olds who have had sex, who report having had sex at 13 or younger |
24% |
2014 |
HBSC |
2018 |
The percentage had not changed in a consistent way |
* Gender The percentage was higher among boys than girls (34% vs 16%) |
/ |
| Percentage of 15 year olds who have had sex, who have used neither a condom nor the contraceptive pill at the last occasion |
29% |
2014 |
HBSC |
2018 |
There was an increase in the percentage from 19% in 2010 |
* Gender The percentage was higher among boys than girls (31% vs 27%) |
/ |
| Percentage of 15 year olds who have had sex, who have used a form of contraception at the last occasion |
71%; 42% condom only, 13% pill only, 16% condom and pill |
2014 |
HBSC |
2018 |
The percentage using a condom declined from 2010 (63%), while the percentage using both condom and pill , as well as pill only (both 9%) increased slightly |
* Gender Girls more likely than boys to have used the contraceptive pill (33% vs 24%). No gender difference for condom use |
For condom use, Scotland performed worse than average in international comparisons for boys (57% Scotland, 68% HBSC average), and about average for girls. For pill, Scotland performed about average in international comparisons for boys and girls. |
| Bullying |
|||||||
| Percentage of 11, 13 and 15 year olds who report bullying others at least twice a month |
4% |
2014 |
HBSC |
2018 |
The prevalence of bullying others has changed very little since 2002 |
* Gender The percentage was higher among boys than girls at 15 years (8% vs 1%). No difference at other ages |
Scotland performed better than the average in international comparison at all age/gender groups: * 2% Scotland, 6% HBSC average among girls aged 13 * 3% Scotland, 11% HBSC average among boys aged 13 * 1% Scotland, 6% HBSC average among girls aged 15 * 8% Scotland, 12% HBSC average among boys aged 15 |
| Offending |
|||||||
| Children referred to the SCRA for offence reasons; crude rate per 1,000 children aged 8-15 years |
6.7 |
2016/17 |
SCRA |
2017/18 |
The number has fallen substantially from a peak in 2005/06 (34.9) to 2013/14, and stayed stable since. |
* Gender Large majority are boys (77% of referrals) |
/ |
| Young people aged 16-25 years in prison crude rate per 100,000 population |
300.2 |
2012-2014 |
Scottish Prison service |
No reporting due to technical issues |
Fall over time - 19% fall in rate between 2009-11 and 2012-14 |
* SIMD 17 times as many young people from SIMD1 as SIMD5 |
/ |
| Average daily prison population under 21 |
416 |
2016-17 |
Scottish Prison Service |
2017-18 |
There has been a downward trend over time. There was a break in the data between 2013/14 and 2014/15 which means data can't be compared, but a downward trend is evident both before and after the break |
* Gender No data available by gender for this age group, but overall, large majority of prison population is male |
/ |
8.3 Key Points
- Around three quarters of children and young people in Scotland participated in positive activities such as clubs and organisations.
- The prevalence of substance use has decreased in Scotland over the last two decades.
- The decrease has been most marked in smoking. For example, the percentage of S4 pupils who usually smoke at least one cigarette a week dropped 22 percentage points to 7% between 1996 and 2015. The median number of cigarettes smoked by these pupils also dropped.
- The percentage of S4 pupils who have drunk alcohol in the previous week halved from between 2010 and 2015, to 17%.
- The percentage of S4 pupils who have used drugs in the last month also halved between 2002 and 2015, to 11%.
- Looking at sexual behaviours, just over a quarter of 15 year old girls, and just under a quarter of 15 year old boys reported having had sex. This was higher than the international average for girls.
- The percentage of 15 year olds who had had sex who used no contraception increased substantially from 19% in 2010, to 29% in 2014.
- In terms of offending, there has been a substantial drop in young people referred to the Scottish Children's Reporter Administration on offense grounds, and in the prison population aged 16-25. A large majority of offenders were boys.
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