Clustering of Multiple Health Risk Behaviors Among Emerging Australian Adults and Associations with Mental Health Outcomes a Socio-Demographic Factors

Introduction: Six key risk behaviors (physical inactivity, diet, smoking, alcohol use, sedentary behavior and sleep) have been associated with risk of chronic disease, such as cardiovascular disease and cancers. These risk behaviors (“Big 6”) commonly co-occur and typically emerge in adolescence and early adulthood, a critical transitional period characterized by greater autonomy over lifestyle choices. An examination of the clustering of these behaviors is important for guiding the development of multiple health behavior interventions to prevent chronic disease. This study aimed to investigate the clustering of the “Big 6” among young adults in Australia, and examine how the clusters relate to mental health and socio-demographic factors.

Methods: A total of 350 participants (Mage=18.8 yrs, 68% male) completed an online self-report survey assessing the six behaviors (binge drinking and smoking in the past 6 months, moderate-to-vigorous physical activity/week, sitting time/day, fruit and vegetable intake/day and sleep duration/night). Engagement in each behavior was represented by a dichotomous variable reflecting adherence to national guidelines. Clusters were identified using latent class analysis and associations with psychological distress, anxiety, depression, gender, employment, and tertiary education were examined via chi-square analysis and ANOVAs.

Results: Three distinct classes emerged: ‘Poor diet, nonsmokers’ [nonsmokers, highly likely to meet sleep, physical activity and sedentary behavior guidelines, moderately likely to binge drink and not eat enough fruit and majority have poor vegetable intake; Class 1, 64%]; ‘Binge drinkers and smokers’ (majority binge drink, smoke and have poor vegetable intake, but highly likely to meet fruit, sleep, physical activity and sedentary behavior guidelines; Class 2, 24%) and ‘High risk’ (high rates of smoking and binge drinking, poor fruit and vegetable intake and comparatively high rates of sedentary behavior; Class 3, 12%). There were no significant socio-demographic differences between the classes, however there were significant differences in terms of psychological distress [F(2,347)=10.29, p=<.001], anxiety [F(2,347)=4.99, p=.01], and depression [F(2,347)=7.95, p=<.001]. Specifically, the ‘high risk’ class had significantly greater psychological distress (p<.000) and depression (p=.01) than the other classes, and higher anxiety (p=.01) than ‘poor diet, nonsmokers’.

Conclusions: These results indicate that health risk behaviors cluster in young Australian adults and covary with mental ill health. Findings reinforce the importance of delivering multiple health interventions to reduce later chronic disease risk and to improve current mental wellbeing.