The clustering of risk behaviours in adolescence and health consequences in middle age

Introduction: There is increasing interest in the clustering of risk behaviours in adolescence. However, few studies have examined what clusters of risk behaviours exist among adolescents, their early-life predictors, and their associations with later health. Methods: We analysed data derived from 8754 participants (women 53.3%) in the 1970 British Cohort Study. Latent class analysis was used to identify clusters of risk behaviours at age 16. Regression modelling was then used to examine predictors of clusters and their consequences of risk behaviours and health outcomes at age 42. Results: We identified two latent classes: a risky-behaviour (men: 20.0%, women: 23.6%) and less-risky-behaviour class. Among men, those in the risky-behaviour class were more likely to report smoking, multiple binge drinking, sexual debut before 16, involvement in fights and delinquency than were women. Membership in risky-behaviour class was mainly predicted by sociodemographic and parental risk behaviours and monitoring. The risky-behaviour class at age 16 was associated with the following outcome age 42: smoking status (more strongly among women), excessive alcohol consumption (more strongly among men), worse self-rated health (more strongly among men), and psychological distress (only among women). Conclusions: Engagement in multiple risk behaviours in adolescence is an important driver of health inequalities later in life. Early life intervention, for example via school-based interventions, may be warranted for favourable lifelong health.