Health risk behaviours such as tobacco smoking, excessive alcohol consumption, drug use, unhealthy diet and unprotected sexual intercourse contribute to the global burden of non‐communicable diseases and are often initiated in adolescence. An individualistic focus on ‘health risk behaviours’ has resulted in behaviour change strategies that are potentially ineffective and increase inequalities. We conducted a grounded theory study of 25 young adults to increase the limited qualitative evidence base surrounding young people, health risk behaviours and socioeconomic inequalities. We found that health risk behaviours were perceived as class markers, manifesting as class stigma, leading some participants from lower socioeconomic backgrounds to employ strategies to avoid such behaviours. Peers and family were core constructs for understanding the relationship between health risk behaviours and socioeconomic life trajectories. However, individualism and choice were consistently expressed as the overriding narrative for understanding health risk behaviour and socioeconomic position during the transition to adulthood. The use of ‘personal responsibility’ discourse by young adults, we argue, highlights the need for a public health focus on achieving structural changes as opposed to individualised approaches to avoid reinforcing neoliberal ideologies that serve to marginalise and maintain social inequalities.

中文翻译：

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了解青少年健康风险行为和社会经济地位：针对英国年轻人的扎根理论研究

吸烟、过量饮酒、吸毒、不健康饮食和无保护性行为等健康风险行为加重了全球非传染性疾病的负担，并且往往始于青春期。对“健康风险行为”的个人主义关注导致行为改变策略可能无效并加剧不平等。我们对 25 名年轻人进行了一项扎根理论研究，以增加有关年轻人、健康风险行为和社会经济不平等的有限定性证据基础。我们发现，健康风险行为被视为阶层标记，表现为阶层耻辱，导致一些社会经济背景较低的参与者采取策略来避免此类行为。同伴和家庭是理解健康风险行为与社会经济生活轨迹之间关系的核心结构。然而，个人主义和选择始终被视为理解成年过渡期间健康风险行为和社会经济地位的首要叙述。我们认为，年轻人使用“个人责任”话语强调了公共卫生重点需要实现结构性变革，而不是采取个性化方法，以避免强化导致边缘化和维持社会不平等的新自由主义意识形态。