Youth health status

The current core feature of my country's adolescent health is that "physiological development indicators have been improving for 20 consecutive years, but mental health and behavioral health problems have increased much faster than expected. "The body is strong but the heart is blocked, and habits hide hidden worries" is the overall situation that requires the most vigilance."

A while ago, I went to middle schools in seven urban areas to conduct student health screenings, and I flipped through the just-released 2023 National Student Physical and Health Survey Bulletin. The data is really eye-catching: the average height of boys aged 13-15 is 2.3 centimeters higher than 10 years ago, and the malnutrition rate has dropped to 8.7%. Even the prevalence of anemia among students, which was previously high, has dropped by 3 percentage points. That day, I tested the vital capacity of the second grade class. Half of the boys could blow more than 4000ml, which was higher than the passing mark of my college physical test. I stood on the playground and watched the children running between classes. They all had long legs and arms, and they looked really energetic.

But when I turned to another set of monitoring data, I couldn’t stop laughing: In the same survey, the detection rate of depressive tendencies among teenagers aged 14-18 was 17.5%, and almost 1 in 5 high school students had obvious emotional problems. The case I received last week was a 14-year-old girl who was in the top 15 of a key middle school grade. There was half a box of dismantled utility knife blades in the side pocket of her schoolbag. She had three or four old and new scratches on her arms. She kept her head down during the consultation and had to look at her mother's face before even taking a sip of water. Her mother held her hand and muttered to me: "We gave her everything good, and she didn't even need to wash her socks. Why is she so ignorant? ”

Interestingly, the academic community has not reached a unified conclusion on the reasons for the high incidence of psychological problems among adolescents. There is a group of scholars who pay close attention to academic pressure and say that the anxiety of being diverted from high school entrance exams has now reached the fourth grade of elementary school. Children starting from the third grade are scheduled to have cram schools on weekends, and they don’t even have time to daze. It would be strange if there are no problems. ； The other group believes that Juan is not entirely to blame. They say that the post-90s generation was under a lot of pressure to go to school when they were young. But at that time, the alleys were full of children after school. They would lose their temper after running around for an hour. Nowadays, children close the door after school. They rely on WeChat to chat with their classmates. There are few opportunities to complain face to face. The social support network is as thin as a piece of paper. ； There are also studies pointing to the fragmented media environment. It is said that children can receive more than a dozen "other people's perfect lives" by watching short videos in half an hour. Compared with the three test papers piled on their desks, it is easy to feel a sense of gap.

In addition to emotions, there are many small problems hidden in the details that are turning into big problems. Last year, I helped three schools conduct scoliosis screening. Among the 450 first-year students, 62 had a Cobb angle of more than 10 degrees, meeting the standard for clinical diagnosis of mild scoliosis. Most of them were slumped on the table while doing homework, or sunk into the sofa for two or three hours while scrolling through their mobile phones. There is also myopia. The overall myopia rate among children and adolescents nationwide in 2022 is 53.6%, and it is more than 80% in high school. The last time I had my eyesight tested in the third class of junior high school, the boy in the last row leaned in front of the eye chart and could only see the fourth line clearly. He took off his glasses and squinted and told me, "Yesterday, I finished the questions until 12 o'clock, and my eyes were a little blurry."

Solutions to these problems are even more controversial. Some people say that we need to reduce the overall workload, cut the workload in half, and ensure one hour of outdoor activities every day. However, when a school actually tried to implement a "no homework day on Wednesdays", the parent group exploded first, saying, "If the school doesn't assign homework, others are making up for it, won't my children fall behind?" ”I turned around and signed up my child for a cram school on Wednesday night, but instead the child didn’t even have time to rest. ； Some people say that the weight of sleep and physical fitness tests should be added to the high school entrance examination, and some parents object, saying, "Children are already tired enough from studying, but they also have to spend time practicing physical education. Wouldn't it be more difficult?" ”Some parents even told me bluntly, "What's wrong with my myopia? Just wear glasses and a little correction of scoliosis will be fine. If I can't get into a good university, all these will be useless."

I've seen a few good attempts. There is a suburban middle school that stipulates that children are not allowed to stay in the classroom for 10 minutes between classes, and teachers are not allowed to drag the class with them. They can run freely on the playground in front of the door. After half a year of trial, the myopia rate of students dropped by 2.1 percentage points. ； There is also a school that hired a full-time psychological social worker to stay on campus and hold a "casual chat" class every week. There is no need to take notes and no exams. You can say whatever you want. After one semester, the number of students actively seeking help from the psychology teacher tripled. On the contrary, the detection rate of depressive tendencies dropped by 4 percentage points. Of course, there are resistances to these attempts. For example, the latter was complained several times by parents, saying, "It is a waste of time to learn useless things. It is better to do two more sets of simulation papers."

To be honest, when it comes to adolescent health, there is never a standard answer once and for all. I have seen too many children who have excellent scores on their physical examination forms, but who will hide at home for half a month when they fail in the exam and refuse to go out. I have also seen children who have average grades, but play basketball for an hour after school every day, and happily talk to their parents about anything they encounter. In the final analysis, health is never a cold number. It is a body that can run and jump. It is the confidence to speak out when encountering difficulties. It is the energy to get up and move forward even if you fall down. This is the most important thing we should give to our children.