Childhood risky behaviors always result in adverse health outcomes. These behaviors are greatly affected by social environment and individual factors. However, few studies explored the social determinants of schoolchildren＇s health behaviors. In this cross-sectional study, the social determinants of health behaviors were examined among both migrant and resident students in Beijing, China. Data of 967 children from six urban and suburban primary schools were analyzed using multiple linear regression analysis. The results showed that less than 60% of children performed some healthy behaviors, although their health knowledge was generally good. Children＇s health behavior scores were greatly determined by school characteristics, health knowledge, demographic characteristics, and family context. Therefore, improving health education and conditions in primary schools is the priority to promote children＇s healthy behaviors, especially for disadvantaged children.
Background：Studies in developed countries reveal that poor lifestyle choices triggering diseases typically cluster among children.However,there is insufficient evidence on the clustering of risk behaviors among children in developing countries.This study aimed to determine the clustering of risk behaviors and their social determinants among 4th-and 5th-grade learners in Beijing,China.Methods：The sample comprised of 967 learners from six primary schools enrolled migrant and resident learners by two-stage stratified cluster sampling.Prevalence denoted the risk behaviors and their clustering.A log-linear model was used to explore the clustering patterns.Ordinal logistic regression determined the influence of demographic characteristics,school environment,and family context on behavioral clustering.Results：The prevalence of none,one,two,and three or more risk factors was 61.2%,20.0%,10.8%,and 8.1% for infectious diseases and 46.0%,30.6%,15.4%,and 8.0% for chronic diseases,respectively.Some behaviors appeared dependent and were more likely to be observed together.The three most influential factors for infectious diseases were school type （odds ratio [OR] =4.47,95% confidence interval [CI] 3.00-6.66）,school located in an inner suburb （OR =0.27,95% CI 0.18-0.38）,and gender （OR =0.56,95% CI 0.42-0.74）.Regarding risk behaviors for chronic diseases,clustering was not associated with household registration status and number of appliances,but was significantly associated with school type （OR =5.36,95% CI 3.72-7.73）,school located in an inner suburb （OR =0.59,95% CI 0.43-0.81）,and gender （OR =0.61,95% CI 0.47-0.78）.School environment variables were the most significant contributor to the number of risk behaviors.Conclusions：The characteristics of schools enrolling migrants and residents influenced the number of risk behaviors.Therefore,improved school conditions and integrated behavioral interventions are particularly recommended for health promotion.
