3.4 Health and children
So far, all the studies we have discussed have been based on adults. Health viewed through children's eyes is receiving attention, mainly in order to be able to target health promotion messages. Bendelow and Pridmore (1998) interviewed 100 nine and 10-year-olds in three primary schools in urban and rural areas of south-west England. As well as having discussions with the children, they asked the children to draw pictures to convey their views. Their results are quoted in Box 2.
All the children wrote or drew at least two items in response to the requests to indicate factors responsible for health and ill health; most described between two and four, and some covered the whole page. On the whole, boys tended to draw more pictures per page than girls, but girls wrote more. Exercise and healthy eating were acknowledged by the children to be the most important factors in keeping healthy, whereas smoking and bad diet were cited most often as representing unhealthy behaviours. However, especially in terms of unhealthy behaviours, other items were mentioned which included both environmental as well as ‘individualistic’ factors. For example, inner-city children were more likely to mention violence and pollution.
What makes you healthy?: The major categories of response identified [were] diet/healthy food, fruit, vegetables, exercise, sport, hygiene, not smoking and sleep … The majority of responses centred on food and exercise. General indications of a healthy diet included fish, cheese, eggs, soup, cereals, ‘not eating meat’, milk, mineral water, milkshakes, vitamins and iron, and fruit is constantly mentioned so is listed separately, as is the case with vegetables. The category of hygiene includes cleaning teeth, washing and bathing.
What makes you unhealthy?: In similar fashion, on the next blank page the children were asked to do the following: ‘Please write or draw anything you think makes you unhealthy.’ Again, the answers were organised into categories – smoking, diet, environment/pollution, violence, hygiene, alcohol, illness. Factors mentioned ranged from personal behaviour and lifestyles to more environmental issues. The category of diet includes the following responses: ‘being fat’, fatty meat, sugar, salt, pop/fizzy drinks, burgers/fast food, chips, crisps, fatty food, cakes, meat, chocolate, sugary food, red meat, ‘too much food’, ‘unhealthy food’, school dinners, beans, ‘weetabix and lemon custard’, ‘fish salad’, rape seed oil, dieting, no food and anorexia. Environment and pollution includes ‘smelly odours’, smog, pollution, petrol, bad gases, car fumes, fumes, acid, factories, ozone layer, motorway, cars, running in road, microwaves, cutting down the rainforest, toxic waste, swimming in chlorine, bad waters, dustbins, sun, heat, fire, lack of fresh air, computers, litter and poison. Violence includes cuts, mugging, stabbing, knives, fighting,‘dangerous drunks’, guns, nuclear arms, bombs, wars and tanks. Hygiene includes ‘dirty clothes’, not washing, not brushing teeth, not cleaning teeth. Illness includes asthma, germs and infection. Environmental and pollution factors were more frequently mentioned by children in the inner-city schools, and boys were more likely than girls to mention both violence and hygiene.
A Health Education Authority (HEA) survey (Brannen and Storey, 1996) of just over 500 11 to 12-year-olds in three west London state schools found similar responses to the ones expressed in Box 2. The children in the HEA study linked their health very much to eating habits, and there was a tendency for boys to define their health more in terms of physical fitness. But there was no mention of health as a mental or emotional state or of a link to wellbeing. In fact the survey concludes that the children seem to have absorbed the messages of health educators.