Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: a scoping review

Abstract

ObjectivesTo synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies.DesignScoping review. We included studies examining the role of at least one school or class characteristic on students’ health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities.ResultsOf 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes.ConclusionsSchool characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.

Factors associated with mental health and mental disorders in childhood: Ecosocial and ecological models for public health policies

“…13 Although childhood is characterized by the presence of good health, there may be health inequities and other factors that cause the onset of a mental disorder at this stage. 14 The epidemiological overview of mental disorders in this sector of the population before the pandemic derived from COVID-19 reflected that one in five children or adolescents in the world presented the necessary criteria to be diagnosed with a mental disorder, and it was estimated that symptoms usually began before 14 years of age, due to exposure to life adversities and the interaction of another individual, family, social and cultural factors, in addition to the fact that specialized care is usually provided until symptoms are moderate or severe, or even in adulthood. 2,9,15 The COVID-19 pandemic showed the need for attention to mental health problems because during the confinement, a large part of the population manifested symptoms of mental disorders, and in other groups, they worsened.…”

“…22 Concerning children, this interaction usually occurs in the primary contexts where they develop, the family and the school, both of which determine physical, cognitive, psychological, and social development. 14,23 Individual factors such as genetics, lifestyles, and psychological characteristics interact with different family, school, and social environments, in which factors such as parenting styles, social support, social belonging, socioeconomic status, and culture influence mental health (Figure 1). 14,23 Figure…”

“…14,23 Individual factors such as genetics, lifestyles, and psychological characteristics interact with different family, school, and social environments, in which factors such as parenting styles, social support, social belonging, socioeconomic status, and culture influence mental health (Figure 1). 14,23 Figure…”

The influence of institutional characteristics on implementing school-based universal addiction prevention: a Hungarian mixed-methods nationwide study on the state of implementation, barriers, and facilitators

“…The implementation of prevention programs within the school environment can serve to bolster individual protective factors while mitigating the influence of risk factors associated with school and family. Furthermore, this contributes to the reduction of health disparities (Pulimeno et al, 2020;Herke et al, 2022). Both the European Union (EU) and the United States have adopted a comprehensive strategy for health promotion in schools to address substance and behavioral addictions (European Monitoring Centre for Drugs and Drug Addiction, 2019; Centers for Disease Control and Prevention, n.d.).…”

“…Nonetheless, the implementation of the aforementioned interventions can be influenced by various school characteristics including teacher competencies, school and class size, institutional resources, and organizational structures (Herke et al, 2022). Drawing from Domitrovich's Multi-Level Model, it becomes evident that these contextual factors play a significant role in influencing the implementation quality of school-based interventions (Domitrovich et al, 2008).…”