National-Level Wealth Inequality and Socioeconomic Inequality in Adolescent Mental Well-Being: A Time Series Analysis of 17 Countries

Abstract

Although previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level. Methods: Data were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n ¼ 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups. Results: Higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated IMPLICATIONS AND CONTRIBUTIONResearch has established the positive association between national income inequality and adolescent socioeconomic health inequalities, but little is known about national-level wealth inequalities (i.e., accumulated financial resources). This study linked national wealth and income inequality to socioeconomic inequalities in Conflicts of interest: B.D.C. is working for a financial company under supervision of the Financial Services and Markets Authority. The authors have no other conflicts of interest to disclose. Authors' contributions: B.D.C. and M.D. designed the study. M.D. had primary responsibility for writing and editing of the article and supervised the interpretation of the results. B.D.C. conceptualized and developed the wealth inequality indicator. D.W. and Y.Y.H. further improved the conceptualization of the wealth inequality indicator, collected reliable financial and economic data, and calculated the wealth inequality indicator. F.E. performed the analysis, and L.A. and N.L. interpreted the results. All authors critically reviewed the article. G.W.J.M.S. and C.C. made substantial and equal contributions to the writing of the whole article. All authors listed gave final approval for the article to be published. Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peerreviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder.

A bio-ecological framing of evidence on the determinants of adolescent mental health - A scoping review of the international Health Behaviour in School-Aged Children (HBSC) study 1983–2020

“… Dierckens et al (2020) examined country level and family level socioeconomic influences on life satisfaction and both psychological and somatic symptoms. They found that higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms.…”

“…At the macro-system level, we found that greater levels of inequality at the country level, whether socioeconomic or gender tend to be associated with poorer mental health in the adolescent population (for example, Zaborskis et al, 2019 ; de Looze et al, 2018 ). There were papers that looked at macro and micro/mesosystem level effects together and reported various combined effects on mental health (for example, Ottova et al, 2012; Dierckens et al, 2020 ; Kern et al, 2020 ).…”

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“…However, we find nearly no related studies that explore the above relationship from the role of income inequality. Income inequality can affect population health in the following ways: consumption capacity (38)(39)(40), psychological state (41)(42)(43), and social relations (44)(45)(46). Hence, income inequality may influence the effect of business cycles on health expenditure.…”

“…Many related studies have verified that income inequality can adversely affect population health (38)(39)(40)(41)(42)(43)(44)(45)(46). Economic booms can benefit population health by guaranteeing the residents more material goods and medical goods.…”

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