No abstract

Study objective-To assess the influences related to social mobility, particularly health related behaviours, as one potential explanation for the social class variation in health among adults. Design-The study is based on questionnaire data from the Adolescent Health and Lifestyle Surveys of 1985, 1987, and 1989. Setting-The whole of Finland. Participants-A representative sample of 8355 adolescents. The response rate was 79%. Measurement and main results-The relation between social mobility and health related behaviours among 16 and 18 year old young people was studied.The measure of social mobility was based on a combination of the social class of origin and achieved social position measured by the present educational status, educational attainment, and labour market position. Three mobility groups were constructed: the downwardly mobile, the upwardly mobile and the stable. Health related behaviours in an upwardly or downwardly mobile group were compared with a stable group from the same social class of origin by calculating relative risks (RR). RRs were assessed by calculating age and sex adjusted rate ratios approximating a Mantel-Haenszel estimate. In logistic regression analyses the independent effects of the social class of origin and the achieved social position were investigated. Most of the nine behaviours studied (smoking, alcohol use, heavy intoxication, coVee drinking, tooth brushing, consumption of sweets, lack of physical exercise, choice of bread spread, and consumption of milk) were related to the direction of mobility so that health compromising behaviours were more frequent among downwardly mobile and less frequent among upwardly mobile young people than their stable peers. Achieved social position proved to determine health related behaviours more strongly than class of origin, thus emphasising the way education facilitates both health values and behaviours as well as the future social position. Conclusions-The close relation between social mobility and health related behaviours is concluded to be a part of an explanation of social class diVerences in health observed among adults.

Measurements and main results-The outcome variable was the attained educational level at age 24 to 30. Predictive variables described health related lifestyle and health at the age of 16 and 18. Those whose educational level was low at follow up, had in adolescence, a more health compromising lifestyle than those who had reached higher levels. They had placed less emphasis on health promoting behaviours like not smoking, physical exercise, good diet, and dental hygiene. Smoking was the outstanding predictor of attained educational level. Among the health variables, only psychosomatic symptoms predicted high educational levels in girls, and both psychosomatic symptoms and height in boys. Conclusion-Those who reach a high level of education in adulthood, have had a health enhancing lifestyle already in adolescence, while those reaching only a low level, have had a health compromising lifestyle. Health plays only a small part in the prediction of adult educational level. The results suggest that a health compromising lifestyle, adopted already in adolescence, is an important mechanism from which educational health diVerences originate. (J Epidemiol Community Health 1998;52:794-801)

Health behaviors and educational tracks of an individual are here presumed to have a strengthening influence on each other during the developmental process, through which individuals gradually reach their adult health and social position. This longitudinal study of a Finnish nationally representative sample of 12 year olds born in 1970 (N = 1009) examined the associations of health behaviors at ages 12 and 14 with educational track at age 16. The dependent variable, educational track, classified the respondents into five successive categories, thought to predict their adult social position. Selection into different educational tracks according to health behaviors was obvious already at age 12, when frequency of tooth brushing, consumption of sweets, coffee drinking and level of participation in physical exercise predicted educational track independently of sociodemographic background. At age 14, the independent predictors were smoking, frequency of tooth brushing and coffee drinking. At both ages, sociodemographic factors had independent associations with educational track. It seems that certain health-related behaviors in early adolescence are indicators of a person's possibilities to benefit from a country's educational supply. Both sociodemographic background and health-related behaviors influence the process of selection into educational tracks leading to social position and health in adulthood.

The purpose of this study was to investigate if a secular trend towards an earlier age of menarche still existed in Finland in the 1980s and if social class and regional differences observed previously in the mean age of menarche had disappeared. Questionnaires were mailed to nationwide representative samples of 16- and 18-year-old girls every other year from 1979 to 1989. At the national level, the secular trend towards an earlier menarche was not observed in the 1980s but the trend was significant among girls living in the North-West and rural areas. Clearly observed regional and urban-rural differences in 1979 disappeared in the 1980s. Social class differences persisted: farmers' daughters had a higher mean age of menarche than those of other occupational groups. Adolescents in the 1980s displayed a more even distribution of health than the cohorts born before them. Improved welfare of the Finnish society and reorganization of the primary health care are probable explanations.