University of Oulu

Heikkala, E., Remes, J., Paananen, M. et al. Accumulation of lifestyle and psychosocial problems and persistence of adverse lifestyle over two-year follow-up among Finnish adolescents. BMC Public Health 14, 542 (2014).

Accumulation of lifestyle and psychosocial problems and persistence of adverse lifestyle over two-year follow-up among Finnish adolescents

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Author: Heikkala, Eveliina1; Remes, Jouko2; Paananen, Markus1;
Organizations: 1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Aapistie 1, 90220, Oulu, Finland
2Finnish Institute of Occupational Health, Statistics and Health Economics, Aapistie 1, 90220, Oulu, Finland
3Department of Public Health, University of Helsinki, Helsinki, Finland
4Institute of Health Sciences, University of Oulu, Aapistie 5 B, 90220, Oulu, Finland
5Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Aapistie 1, 90220, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: Springer Nature, 2014
Publish Date: 2020-05-08


Background: Adolescents’ psychosocial problems associate with unhealthy behaviors, but data on co-occurring patterns is sparse. We investigated 1) whether adolescents could be categorized into meaningful subgroups with respect to psychosocial and lifestyle factors, 2) whether the prevalence of physical inactivity, overweight and smoking vary within the subgroups and 3) whether these unhealthy behaviors persist in a two-year follow-up.

Methods: The study was based on a subgroup of the 1986 Northern Finland Birth Cohort, which consisted of adolescents who replied to a postal questionnaire at 16 years (n = 6792) and a subgroup of this sample at 18 years (n = 1552). Latent class analysis (LCA) was performed to establish clusters at 16 years.

Results: Smoking co-existed with emotional and behavioral problems in both genders. Boys with the most inactive lifestyle slept poorly, whereas multiple problems co-occurred among girls. Those with a high body mass index (BMI) separated as groups of their own. Different combinations of adverse lifestyle and emotional and behavioral problems were relatively common in both sexes as only 51% of boys and 67% of girls belonged to the reference cluster with low probability for these findings. Physical inactivity, high BMI and smoking tended to persist over the two-year follow-up.

Conclusions: It seems that lifestyle and psychosocial factors divide adolescents into distinct subgroups in which unhealthy lifestyle patterns remain between the ages of 16 and 18. This may indicate problems in other life areas and expose them to an increased risk of future health problems.

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Series: BMC public health
ISSN: 1471-2458
ISSN-E: 1471-2458
ISSN-L: 1471-2458
Volume: 14
Article number: 542
DOI: 10.1186/1471-2458-14-542
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Funding: This work was supported by grants from the Academy of Finland (Dr. Karppinen; grants 121620 and 129504, SALVE) and the Yrjö Jahnsson Foundation (Dr. Karppinen).
Academy of Finland Grant Number: 121620
Detailed Information: 121620 (Academy of Finland Funding decision)
129504 (Academy of Finland Funding decision)
Copyright information: © 2014 Heikkala et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.