# Who Reports Greater Chronic Disease Risk Behaviours? A Closer Look at Sociodemographic Differences Among Australian Adolescents: A Cross‐Sectional Analysis

## TL;DR

This study explores how chronic disease risk behaviors, like unhealthy eating and substance use, vary among Australian adolescents based on their socioeconomic status and where they live.

## Contribution

The study provides new insights into sociodemographic differences in chronic disease risk behaviors among Australian adolescents using recent cross-sectional data.

## Key findings

- Low SES adolescents had lower rates of excessive discretionary food intake, alcohol consumption, and binge drinking compared to mid-to-high SES adolescents.
- Regional adolescents showed higher rates of alcohol and tobacco use compared to those in major cities.
- Tailored interventions may be needed for alcohol, tobacco, and e-cigarette use based on socioeconomic and geographic factors.

## Abstract

Recent Australian adolescent data on the prevalence of chronic disease risk behaviours among diverse sociodemographic groups is lacking. This study examined the prevalence of dietary intake (sugar‐sweetened beverages (SSBs); discretionary foods; fruit; vegetables), and alcohol (standard drink; binge drinking), tobacco, and e‐cigarette use, across adolescents of diverse socioeconomic status (SES) and geographical locations.

Cross‐sectional data were analysed from 4445 adolescents across 71 schools in 2022 as part of the 36‐month follow‐up survey from the school‐based cluster randomised controlled trial, Health4Life (Mage = 15.7 years, SD = 0.6; 47.0% female‐identifying). Fourteen percent (n = 571) were categorised as low SES and 86% (n = 3518) as mid‐to‐high SES, relative to the study sample, with 9% (n = 399) from regional areas. Binary logistic regressions compared differences for each outcome across SES and geographical locations, controlling for gender, psychological distress, intervention status, and school clustering.

Low SES adolescents had a lower prevalence of excessive discretionary food intake (PR = 0.87, 95% CI = 0.77–0.99), standard drink consumption (PR = 0.78; 95% CI = 0.65–0.93) and binge drinking (PR = 0.68; 95% CI = 0.50–0.92) compared to mid‐to‐high SES adolescents. Regional adolescents had a higher prevalence of standard drink consumption (PR = 1.41; 95% CI = 1.00–1.97), binge drinking (PR = 1.77; 95% CI = 1.07–2.93), and tobacco smoking (PR = 2.06; 95% CI = 1.18–3.60) compared to adolescents in major cities. Excessive discretionary food intake was less prevalent among adolescents from disadvantaged backgrounds (PR = 0.84, 95% CI = 0.76–0.94) compared to more advantaged adolescents.

Chronic disease risk behaviours among adolescents differ across SES and geographical locations, with regional adolescents fairing considerably worse across alcohol and tobacco use outcomes. Prevention for diet‐related behaviours should be improved for more advantaged adolescents, while tailored interventions to SES and geographical location separately may be required for alcohol‐, tobacco‐, and e‐cigarette use.

Public health policy and interventions targeting chronic disease risk behaviours must prioritise the needs of low SES and regional adolescents to reduce health inequities.

The Health4Life trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123)