Conceptualisation of health among young people: a systematic review and thematic synthesis of qualitative studies.

abstractIntroduction: Self-reported health is a widely used measure of general health in survey research. Qualitative studies that investigate young people's conceptualisation of health are hard to locate and use different measures of health and sample construction. This review aims to synthesise the findings of qualitative studies that investigate how young people conceptualise their health, including during self-assessments. Methods: We searched MEDLINE (Ovid), PsycINFO (APA PsycNet), ProQuest Sociology Collection (Applied Social Sciences Index & Abstracts/Sociological Abstracts/Sociology Database) and Web of Science Core Collection without date restrictions. Searches were last updated on 11 March 2025. We searched the reference lists of relevant studies and conducted backward and forward citation searching. Papers reporting qualitative primary studies that focused on the conceptualisation of health among 10-24-year olds were included. We used the Quality Framework for quality appraisal and the thematic synthesis strategy for data synthesis. Results: Twenty-one studies from 11 countries with a pooled sample of 1434 participants met the inclusion criteria. We developed two analytical themes: (1) 'dimensions of health' and (2) 'health in context' with eight subthemes. Factors from the physical dimension of health, such as symptoms, physical activity or diet, dominate in young people's conceptualisation of health; these factors are also considered when responding to self-assessed general health questions in the surveys. When the survey question uses the word 'feel', respondents discuss elements from physical, social and mental dimensions, and their interaction in the formation of health. In some studies, young people describe health in relation to context. Conclusions: This is the first systematic review of the conceptualisation of health among young people. Our findings indicate that self-reported general health questions in the surveys invite young people to focus on the physical aspects of health. Overall, young people hold a holistic conceptualisation of health. To improve the understanding of young people's health, future research needs to focus on conceptual clarity. Different wording captures different aspects of health that need to be balanced for optimal development of young people's health. PROSPERO registration number: CRD42022367519.