KWDI Korean Women’s Development Institute

As unhealthy behaviors and mental health occurring during adolescence, such as cigarette smoking, alcohol drinking, obesity, depression and suicide thoughts, have not only hovered at high levels but increased steadily during the last decade, their health quality has also become an important policy issue in Korea. Nonetheless, since teens experience rapid gains in growth and weight in combination with the development of secondary sexual characteristics during adolescence, national adolescent health policies seem to be more focused on a biological perspective, not on a gender perspective. The latter view, however, is much more im- portant for health equality than the former view because of economic and social differences between men and women. In particular, health policies can impact on men and women’s healthy lives in one way or another, so adolescent health policies from a gender perspective should be developed and performed.

To find out a gender approach to adolescent health improvement and health equality between boys and girls, this study was to 1) examine the recent changes of health behaviors and health conditions (e.g., cigarette smoking, alcohol drinking, drug intake, physical activity, sleep satisfaction, skipping breakfast, unhealthy weight control behaviors, sexual behaviors, stress, depressed mood, and suicidal thoughts) of both genders during the period 2006-2011, 2) test the gender difference in mediating effect of body weight perception (BWP) between body mass index (BMI) and suicidal thoughts, even adjustment for confounding factors and 3) parse out whether a gender perspective on the operation types of school physical and health education performed by teachers is associated with physical strength, health condition, interest in physical and sport activity, and sex- ual consciousness, attitude and knowledge between boys and girls. Some of the key findings in the study are as follows: First, except for some health indexes, such as cigarette smoking, sex- ual relationship and obesity showing no change, but stress perception and body weight distortion showing an increasing trend over six years, most of health indexes seem to be positively improved in both genders. However, the gender inequality in all health indexes has still been existed. Particularly, girls are more likely than boys to report unhealthy weight control behaviors, body weight distortion and suicidal thoughts, which are usually affected by sociocultural environment. Second, this study found that BMI is related to BWP, BMI is related to suicidal thoughts, and BWP is related to suicidal thoughts, respectively. After adjustment for individual characteristics (e.g., gender, age, school type, school record, family structure, family socioeconomic status, and parents' educational attainment) and covariates (e.g., cigarette smoking, alcohol drinking, physical activity, drug intake, unhealthy weight control behaviors, and depressed mood), BWP plays a mediator for the association between BMI and suicidal thoughts. This phenomenon is also existed in both genders, but the mediating effect on the two relationship is different. For Boys, the significant relationship between over- weight-obese and suicidal thoughts is disappeared, but the significant relationship between underweight and suicidal thoughts still remains when BWP is added, which indicates that BWP partially mediates the relationship between BMI and suicidal thoughts. For girls, in contrast, even the significant relationship between underweight and suicidal thoughts is dis- appeared when BWP is included, indicating that BWP perfectly mediates the association between BMI and suicidal thoughts. Third, physical education teachers who works at coeducational schools mostly operate their classes with a gender perspective, such as adopting to different learning level, evaluation standard, and active type between boys and girls with consideration to their different bodily powers, physical size, and interest in physical activity. Nevertheless, over 80% of physical education teachers agreed that gender perspective on the current physical education must be needed for not only increasing the physical education class attendance of girls, but also improving boys and girls' bodily powers and sexual consciousness. Regarding health education, about 80% of schools do not organize a regular health education program. As the result, health education including sexual education is formally performed by arranging outside lecturers after gathering all students in a gymnasium and/or putting some information related to health and sex on school boards. Health education teachers also agreed that a gender approach to health and sexual education should be re- quired for not only increasing sexual awareness but preventing sexual violence during adolescence.

Lastly, for the questions on current different contents, evaluation standards and exam items of physical education at the interview, girls are more likely to positively agree than boys. Particularly, girls who said that they are placed at a disadvantage position form different contents, evaluation standards and exam items of physical education compared to boys seem to have lower levels of physical powers, health promotion, and interest in physical activity. Meanwhile, both levels of sexual knowl- edge and attitudes are lower in boys than in girls. Indeed, in both gen- ders, this study also found the significant associations of sexual knowl- edge and attitudes with sexual awareness, even with health promotion and interest in physical activity. From the findings of this study, we found that both gender differences and gender inequality can give rise to inequities between boys and girls in health status, even bodily powers and sexual awareness. Therefore, Korean government should pay attention to adolescent health policies by taking a gender perspective.