Abstract Number: 872
ABSTRACT: The School Environment And Health-Risk Behaviors In High School Students InOkinawa, JapanAuthor: Dr Minoru Takakura, School Of Health Sciences, University Of The Ryukyus
Introduction
In Japan, it is compulsory for all children from ages 6 to 15 years to attend
elementary and junior high school. Most of them (97%) go on to senior high school. Asstudents spend their time in the school setting almost all day, the school environment
has a significant impact on not only academic performance but also health outcomes ofthe students. In the West, many studies have indicated that students who had positive
perceptions of their school environment were significantly less likely to report somatic
complaints and to engage in health-risk behaviors. However, it is not clear about how
Japanese students’ perceptions of the school environment are associated with theirhealth outcomes.
This study aims to examine the relationships between the school environment andtheir health-risk behaviors among high school students in Okinawa, Japan.
Methods
A self-administered anonymous questionnaire survey was conducted in a classroom
setting from November to December 2002. The study sample consisted of 2,852 students
in grades 10 through 12 (ages 15-18) at 25 public senior high schools throughout
Okinawa. Schools were chosen from 17 general high schools and 8 vocational highschools. Health-risk behaviors studied included nonuse of seatbelts, suicide ideation,
cigarette smoking, alcohol drinking, sexual intercourse, and physical inactivity. Theschool environment variables, which were adapted from the questionnaire used in theWHO Health Behaviour in School-aged Children Study (HBSC), contained students’
perceptions of autonomy and control, unrealistic expectation, support from teacher, andsupport from classmates.
Results
Among high school students, 43.9% rarely or never wore a seatbelt, 7.7% seriously
considered attempting suicide, 17.4% smoked cigarettes, 40.8% drank alcohol, 23.5%
had sexual intercourse, and 46.1% reported physical inactivity.

In the logistic regression model, controlled for sociodemographic variables, students
who perceived a high level of autonomy and control were significantly less likely toengage in all health-risk behaviors except for physical inactivity. Students who had
unrealistic expectations were more likely to engage in suicide ideation and alcohol
drinking, but less likely to engage in nonuse of seatbelts and physical inactivity.
Students with high classmate support were less likely to consider attempting suicide
and to report physical inactivity, but more likely to drink alcohol. Teacher support was
not significantly associated with most of the health-risk behaviors.
Discussion
The school environment variables examined were found to have independent effects
on the prevalence of health-risk behaviors in Japanese high school students. As
students’ perceptions of autonomy and control were negatively related to engaging inmost health-risk behaviors, it is reasonable that reinforcing their perceptions ofautonomy and control may be an important strategy to protect against health-riskbehaviors. Interestingly, high-level classmate support was positively associated with theprevalence of alcohol drinking. It is possible that alcohol consumption may occur as aresult of peer pressure.
Recently, the Japanese government has been developing a health policy based on theidea of health promotion. The findings suggest that interventions which improve thepsychosocial school environment are needed in order to create a health-promoting
school.