Country
Work Package 1
12) Health Behaviour in School-Aged Children (HBSC)
The Health Behaviour in School-Aged Children (HBSC) study is a cross-national, school-based survey conducted in collaboration with the WHO Regional Office for Europe and coordinated by the University of Bergen. It collects comparable data every four years on adolescent health behaviours, wellbeing, social environments, and health outcomes using a standardised international protocol across participating countries.
HBSC is an international study involving approximately 50 countries and regions across Europe, Central Asia, and North America.
Type of Study
A repeated cross-sectional, school-based survey conducted every four years since its first wave in 1983/84.
Data Collection
The target population consists of school-attending adolescents aged 11, 13, and 15 years. Data are collected through self-administered questionnaires completed in classroom settings, either on paper or electronically. Fieldwork typically takes place between October and May, although timing may vary slightly by country and survey cycle (e.g. October 2021 to June 2022 in the 2021/22 wave, with some adjustments due to the COVID-19 pandemic). The international questionnaire includes a mandatory core set of items to ensure comparability, alongside optional modules that can be adapted at the national level.
Sample Size
National samples typically include approximately 1,500 respondents per age group, corresponding to around 4,500 participants per country. The 2017/18 international dataset included approximately 227,441 adolescents from 45 countries, while the 2021/22 dataset includes nearly 280,000 adolescents across approximately 47 countries and regions.
Sample Size Characteristics
Samples are designed to be nationally representative of school-attending adolescents aged 11, 13, and 15 years. The data include detailed demographic and contextual information, such as age, sex, family affluence, and social background, as well as indicators related to family, peer, and school environments and a wide range of health-related behaviours and outcomes.
Measurement of Mental Health
HBSC includes a broad set of validated and widely used indicators of mental health and wellbeing. Core measures include life satisfaction (assessed using the Cantril ladder), self-rated health, and psychosomatic health complaints (e.g. feeling low, nervousness, headaches). The survey also captures aspects of the social environment relevant to mental health, such as perceived family and peer support and school climate. In more recent cycles (e.g. 2021/22), additional measures such as loneliness and general self-efficacy have been introduced. While the survey provides robust population-level indicators, it does not include full clinical diagnostic assessments.
Cohort Profile Available
No. HBSC is based on repeated cross-sectional samples rather than longitudinal follow-up of individuals. However, extensive international and national reports provide detailed descriptions of methodology, sampling, and fieldwork procedures.
Key Publications
- Cosma A et al. Cross-National Time Trends in Adolescent Mental Well-Being From 2002 to 2018 and the Explanatory Role of Schoolwork Pressure. J Adolesc Health, Volume 66, Issue 6S, 50-58, Jun 2020. doi:10.1016/j.jadohealth.2020.02.010.
- Cosma, A et al. A focus on adolescent mental health and wellbeing in Europe, Central Asia and Canada: Health Behaviour in School-aged Children (HBSC) international report from the 2021/2022 survey. Copenhagen: WHO Regional Office for Europe; 2023.
Open Access
HBSC data from the 2001/02 to 2017/18 survey cycles are available for research purposes through the HBSC Data Management Centre at the University of Bergen, typically after an initial embargo period of approximately three years. The 2021/22 dataset remains under embargo until October 2026; currently, only summary statistics and interactive data visualisations are publicly available.
Contact For Collaboration and Possible Access
- HBSC Data Management Centre (University of Bergen): email data@hbsc.org for data access enquiries (e.g. Prof. Oddrun Samdal).
- International Coordinating Centre (University of Glasgow / MRC Unit): email info@hbsc.org (e.g. Dr. Joanna Inchley) for general enquiries or collaboration.
- Danish national team (Skolebørnsundersøgelsen, University of Southern Denmark): info@hbsc.dk