title: Distinct patterns of health engagement among adolescents and young adults in England: implications for health services.
abstract: OBJECTIVE
  To compare levels of health engagement between adolescents, young adults and older adults and to investigate the association between health engagement and key health outcomes at different ages.
  
  
  METHODS
  Using the Healthy Foundations study (2008), the responses to three previously validated questions on health engagement were analysed by age group; adolescents (12-15 years; N=452), young adults (16-24 years; N=785) and older adults (25-74 years; N=4136). Logistic regression was used to calculate the odds ratio of poor health outcomes among participants with low versus high health engagement.
  
  
  RESULTS
  Feeling in control of one's own health decreased from adolescence (mean score 79.3 (95% CI 77.6,81.0)), through young adulthood (74.6 (73.1,76.1)) into older adulthood (72.2 (71.5,72.9)). In contrast, perceived involvement in health showed a U-shaped trajectory: (adolescents 72.0 (70.2,73.7), young adults 68.6 (67.1,70.1), older adults 73.8(73.1,74.5)), as did perceived importance of health (adolescents 75.0 (73.1,76.9), young adults 62.9 (61.0,64.8), older adults 77.1 (76.4,77.8)). Not feeling involved in health was more strongly associated with poor general health among adolescents (OR 1.81 (1.41,2.32)) than older adults (OR 1.19 (1.11,1.28)). Not feeling in control of health was only associated with poorer general health among young adults (OR 2.33 (1.93,2.83)) and older adults (OR 2.26 (2.10,2.44)). In contrast, lack of control over health was most strongly associated with physical inactivity among adolescents (OR 1.99 (1.49,2.66)) but this was also significant in young adults (OR 1.25 (1.06,1.48)) and older adults (OR 1.11 (1.04,1.19)).
  
  
  CONCLUSIONS
  Young adults feel less involved in their health and rate health a less important priority than adolescents and older adults. Involvement is more strongly linked to key health behaviours among under 25s than older adults.
authors: University College Hospital, London, UK.
authors: Dougal S
authors: DS
authors: Hargreaves
authors: David
authors: D
authors: James
authors: Anne-Lise
authors: AL
authors: Goddings
authors: Dominic
authors: D
authors: McVey
authors: Russell M
authors: RM
authors: Viner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001837:Body Weights and Measures; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D055815:Young Adult
keywords: adolescent; health engagement; health involvement; young adult