Supplemental Analysis of Children's Diet, Exercise, and Safety: Self-Reported Results from the Health Care Survey of DoD Beneficiaries (HCSDB): - Issue BriefObjective: A special study using data collected from the 2005 HCSDB to assess special clinical needs and conditions of MHS children between the ages of 1-17.
Results: The 2005 HCSDB measures key health risk behaviors among children of military families, including physical activity, watching television and playing videogames, eating fast food, using seat belts, and wearing a helmet when biking and rollerblading. Results from the survey show that, for children served by the MHS, unhealthy behaviors of all sorts are more common among adolescents than among younger children. They also show that children of active duty are more likely than are children of retirees and Prime enrollees are more likely than children in other enrollment groups to take important safety measures. EXERCISE: The proportion of children with no exercise rises from 4 percent of children aged 6 to 12 to 13 percent of teenagers. Similarly, the proportion exercising at least 3 days per week falls from 84 percent of children aged 6 to 12 to 70 percent in the teenage group. Age differences in exercise are evident in both active duty and retired families, while the family’s beneficiary category is not itself significantly related to exercise frequency. Eighty-five percent of children with an active duty parent in the younger age group exercise at least 3 times per week compared to 83 percent of retirees’ children, while in the teenage group, 72 percent of children with an active duty parent exercise compared to 70 percent of retirees’ children. Leisure Activities and Eating Habits Leisure activities and eating habits that may promote obesity increase with age. Watching television 3 or more hours per day increases with age, from 24 percent of children aged 6 to 12, to 32 percent of teenagers. Video game use increases still more. The proportion playing three or more hours per day increases from 8 percent among children aged 6 to 12 to 20 percent of children 13 to 17. Teenagers also eat more often in fast food restaurants than do younger children. Twenty percent of teenagers compared to 10 percent of children aged 6 to 12 eat 3 times per week or more in fast food restaurants. By contrast with exercise and leisure activities, the number of fast food meals varies by beneficiary category. Though exercise and television watching and video game playing do not vary significantly with beneficiary group , children of retirees in both age groups are more likely to eat fast food than are children in active duty families. Nine percent of children aged 6 to 12 with an active duty parent eat at fast food restaurants 3 or more times per week compared to 12 percent of children in that age group with a retired parent. Among teenagers, 22 percent with a retired parent eat 3 or more fast food meals per week while 18 percent with an active duty parent eat fast food as often. Safety Habits Children’s behavior gets riskier with age. Safety belt use is almost universal and changes little with age. Ninety-nine percent of both teenagers and younger children usually or always wear safety belts according to their parents. However, teenagers use helmets when biking or rollerblading less often than younger children. The proportion of children usually or always wearing a helmet when bicycling falls from 75 percent among younger children to 58 percent of teenagers, while the proportion that usually or always wears a helmet when rollerblading falls from 74 percent to 54 percent. In both age groups, reported use of bicycle helmets is greater among children with an active duty parent than among children with a retired parent. Among children aged 6 to 12, 78 percent with an active duty parent usually or always wear a bicycle helmet, compared to 69 percent with a retired parent. Among teenagers, 64 percent with an active duty parent use helmets, compared to 53 percent with a retired parent. Children in active duty families are also more likely to wear a helmet when rollerblading than are retirees’ children. These survey results show that unhealthy behavior increases with age among children in the MHS population as in the civilian population, and that this relation persists across beneficiary categories and health plans. Older children may require more creative interventions to encourage healthy habits, such as safety measures, exercise and healthy eating. In addition, the results suggest that Prime enrollees and children from active duty families are more likely to take safety measures than are other enrollment groups and children of retirees. If parents’ reports are correct, this finding suggests that it is possible to influence health-related behaviors and that Prime, or the active duty environment promote child safety. By understanding how they promote safety, we may be able to develop strategies that encourage other healthy behaviors.