摘要：Objectives. This study sought to identify, among youths, factors associated with characteristics such as poor health status, substance use, and suicide risk and to explore the extent to which the risk and protective factors identified cut across health-compromising behaviors. Methods. A survey was administered to representative samples of young people from 9 Caribbean countries. Results. Physical/sexual abuse and having a friend or relative who had attempted suicide were associated with an increased prevalence of health-compromising behaviors. Connectedness with parents and school and attendance at religious services were associated with fewer health risk behaviors. Conclusions. When the identified risk and protective factors were compared with those seen among young people in the United States, similarities as well as important differences were found. Until recently, we have known relatively little about the health status of youths residing in the Caribbean. Isolated reports, often in unpublished manuscripts, give glimpses of reproductive health concerns in one country or of substance abuse issues in another. From these snapshots, there is a cause for concern. In a study of a clinical population of young people in Jamaica, Smikle et al. 1 found that the mean age at onset of sexual intercourse among males was 12.5 years; 4% of sexually active males reported using condoms consistently, and 60% reported marijuana use. Soyibo and Lee 2, 3 reported, among a general population of Jamaican school-attending adolescents, rates of marijuana, cocaine, and heroin use of 10.2%, 2.2%, and 1.13%, respectively; the alcohol use rate was 50.2%, and the tobacco use rate was 16.6%. In addition, violence is on the rise among youths throughout the Caribbean. 4 Soyibo and Lee, in another study involving their sample of Jamaican youths, found that 78.5% of these young people had witnessed violence in their communities; 60.8%, in their schools; and 44.7%, in their homes. 5 Also, 29% reported that they had injured someone else. Suicide appears to be of increasing concern in the Caribbean as well; for example, Hutchinson and Simeon 6 reported a 319% increase in the male suicide rate in Trinidad and Tobago between 1978 and 1992 (4.96 to 20.76 per 100 000). The data just described present a very limited portrait of youth health in the Caribbean, and none of these studies have provided an understanding of the factors that protect Caribbean youths and those that predispose them to poor health and health risk behaviors. We focused on these issues in the present study.
