Study reports on the health of adolescents in Germany

Most students in German schools rate their health as good. However, almost all of them get too little physical activity and their health situation is heavily dependent on wealth, age and gender. These are some of the findings of the current HBSC study (Health Behavior in School-aged Children). This nationwide survey involved 6,500 students.

The HBSC study is a cross-national survey with 51 countries currently participating. The survey was developed in collaboration with the World Health Organization (WHO). Representative surveys are carried out in schools every four years. A research consortium led by the Technical University of Munich (TUM) and the University Medicine Halle collected the current data for Germany.

The researchers investigated issues relating to physical activity, bullying and cyberbullying, mental well-being, health literacy and health inequalities. The most recent survey in 2022 involved 6,475 students aged 11 to 15 from all over Germany. The results are published in the Journal of Health Monitoring.

Exercise and sport

• Only around one in ten girls, one in five boys and one in eight of gender-diverse adolescents met the WHO recommendation for at least 60 minutes of daily exercise.
• The older the respondents were, the less they exercised. While around 15% of eleven-year-old girls met the WHO's physical activity recommendation, the figure for fifteen-year-old female students was just under 7%.
• While physical activity remained relatively stable among boys between 2009 and 2022, it decreased slightly among girls.

Subjective health and psychosomatic complaints

• 84% of children and adolescents reported a good state of health and 87% reported a high level of life satisfaction, both based on self-assessment. Although this has worsened compared to the 2017-18 survey, life satisfaction has increased compared to the 2009-10 and 2013-14 surveys.
• A continuous increase in various psychosomatic complaints, such as stomach aches or headaches, problems falling asleep or irritability, was observed between 2010 and 2022.
• Girls, gender diverse adolescents and older adolescents reported poor health, low life satisfaction or multiple psychosomatic complaints more frequently than younger students and male adolescents.

Bullying and cyberbullying

• The frequency of bullying at school has changed very little since 2017. Compared to 2009 and 2013, fewer students reported bullying. The proportion of students affected by cyberbullying, however, has risen from 4% to 7% compared to 2017.
• Over 8% of students reported being bullied at school. Around 3% of all students—an average of one per class—reported actively bullying others. Gender diverse students are particularly affected: Almost one in three reported bullying experiences.

Health literacy: The ability to use health information

• A low level of health literacy can be deduced for around a quarter of students.
• Health literacy depends heavily on individual circumstances such as gender, age, type of school and family wealth.
• Health literacy hardly changed between 2017-18 and 2022.

Health inequality: Connection between health and wealth or gender

• In low affluent families, 24% of female adolescents report low life satisfaction. This is twice as common as among female students from high affluent families. Among male adolescents with low family affluence, 17% report low life satisfaction. This is three times as common as among students with a high family affluence.
• Compared to 2018, the proportion of students reporting low life satisfaction has risen slightly.
• The high level of health inequalities between students with different socio-economic status did not worsen between 2017-18 and 2022, but remains at a high level.

"The foundation for health in adulthood is laid in childhood and adolescence," says Matthias Richter, Professor of Social Determinants of Health at TUM and head of the study. "Unfortunately, our figures show that we as a society do not always do this well. Even if adolescents today are mostly satisfied with their lives: The continuous increase of psychosomatic complaints and the low numbers for daily exercise hint at future problems. We must develop programs that actually reach young people and help them to stay healthy."

"The results underline once again that not all children and young people have the same health opportunities. In order to reduce bullying, health inequalities and the frequency of psychosomatic complaints, target group-specific measures are needed that take particular account of school type, migration background, socio-economic status, gender and age, for example. Girls, older and gender diverse adolescents are particularly affected in many areas," explains Dr. Irene Moor from the University Medicine Halle. As deputy head of the study, she is coordinating the project at the Institute of Medical Sociology in Halle.