Slovak Partners Study Effects of Stress on Family

By Julia Ross

Residents of the rural town of Turcianske Teplice, Slovakia have watched cautiously as their nation's political transformation has created new social and economic challenges to the stability of family life in the 1990s; many parents are working longer and harder to keep afloat in a competitive, market-oriented economy, while others face unemployment.

In an effort to gauge how such stressors are affecting adult and child health within the family unit, town officials and partners at The MetroHealth System in Cleveland, Ohio are conducting a two-part "family stress" survey of Turcianske Teplice's children and adults. The study's first part surveyed nearly 1,700 local schoolchildren, ages 10 to 18, on topics such as alcohol and drug use, self-esteem, diet, teen-parent relationships and academic performance. US survey director Elaine Borawski, PhD, assistant professor of epidemiology and biostatistics at Cleveland's Case Western Reserve University, and Slovak survey director Alexander Chvojka, chief of the Turcianske Teplice Department of the Environment, reported preliminary results in August.

According to Borawski, researchers used a questionnaire designed by Johns Hopkins University, which measures six areas of health: satisfaction, discomfort, resilience, risks, disorders and achievement. This methodology also allowed for US-Slovak comparison, since it has been conducted on thousands of adolescents in the US and abroad.

Among the child health survey findings:

• Forty percent of Slovak respondents reported having smoked cigarettes, and 50 percent reported drinking alcohol within the past month--compared to a 35 percent rate in a similar US sample. Less than 5 percent said they had tried marijuana, a rate much lower than that of US teens.
• Seventy-four percent of children came from homes where both parents work full-time. Thirteen percent said their fathers were "underemployed or unemployed," while 18 percent said their mothers fell into this category.
• When asked to compare life today with life prior to 1993 (Slovak independence), 16 percent of respondents assessed life as worse, while 24 percent said life was better. Thirty-eight percent said life would be better in ten years due to the political change.
• Fifty-nine percent said there was "no chance" they would drop out of school.
• Twenty percent reported having sexual intercourse, as compared to over twice that rate in the US sample.
• Nearly a quarter of respondents had thought about suicide.
• Well over half the sample reported watching three or more hours of television a day.

Children of unemployed or underemployed parents, however, reported consistently negative patterns: more health problems, less satisfaction with life, less family involvement and lower academic performances.

Overall, in comparison to a similar US sample of adolescents, Slovak teens were less involved in risky health behaviors and in acts of juvenile delinquency, such as stealing or vandalism, Borawski said. But they also reported lower levels of self-esteem, physical activity and family involvement than their US counterparts.

The survey findings counterbalanced another 1997 study by the Petrzalka, Slovakia-Kansas City, Missouri healthy communities partnership, which measured drug and alcohol use among teens living in an economically depressed, urban district of Bratislava. That survey found higher rates of tobacco, drug and alcohol use among the inner-city adolescents: for example, 61 percent of 12 to 18-year-olds said they had smoked cigarettes, and 12 percent said they had tried marijuana (see Spring 1997 CommonHealth).

Partners from Cleveland will travel to Turcianske Teplice in November to discuss the child health survey results and identify related community interventions that might influence teen behavior. The second half of the study will assess healthy behaviors and stressors affecting the town's adults; results should be tabulated this winter.

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