Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

Holstein, Bjørn Evald; Currie, Candace; Boyce, William; Damsgaard, Mogens Trab; Gobiņa, Inese; Kökönyei, Gyöngyi; Hetland, Jørn; Looze, Margaretha de; Richter, Michael; Due, Pernille

doi:10.1007/s00038-009-5418-4

Cited by 118 publications

(132 citation statements)

References 73 publications

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“…Our finding that older age in males and females was associated with both latent variables also confirms earlier studies [5][6][7]9,20,21,33], and might, among other things, be explained by a growing self-awareness among older adolescents, which might increase the perception and reporting of health complaints (see [6]) or by increasing school-related stress, which seems to be associated with health complaints [34].…”

Section: Other Predictorssupporting

confidence: 90%

“…Hence, no points about period effects in externalizing symptoms can be made. Lastly, we did not include other covariates in the MIMIC model that might have been related to psychological and somatic health complaints, such as socio-economic status (see for instance [33]), because no reliable or valid measure of this variable was available for all survey years.…”

Section: Limitationsmentioning

confidence: 99%

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Cross-sectional time trends in psychological and somatic health complaints among adolescents: a structural equation modelling analysis of ‘Health Behaviour in School-aged Children’ data from Switzerland

Dey

Jorm

Mackinnon

2015

Soc Psychiatry Psychiatr Epidemiol

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2 ABSTRACTPurpose: This study examined cross-sectional time trends in health complaints among adolescents living in Switzerland, including differences between population subgroups and sources of differential response to items.Methods: Swiss data were analysed from the Health Behavior in School-aged Children (HBSC; including 11-to 15-years old) from 1994 (n=7008), 1998 (n=8296), 2002 (n=9066) and 2006 (n=9255). Structural equation modelling was used to assess 1) the structure of the HBSC Symptom Checklist (HBSC-SCL; questionnaire, which asks about the frequency of eight health complaints) and 2) associations between the HBSC-SCL with year of data collection and demographic characteristics of the participants. Results:Two correlated factors fitted the data better than a single factor. The psychological factor included the items 'feeling low', 'irritability and bad temper', 'nervousness' and 'difficulties in getting to sleep', and the somatic factor the items 'headache', 'backache', 'stomach ache' and 'dizziness'. Relative to 1994, lower levels of psychological health complaints were experienced in 1998, 2002 and 2006. However, the changes were only minor. In contrast, somatic health complaints increased monotonically over the years of the survey. Experiencing psychological and somatic health complaints was more pronounced with age among females relative to males and was associated with living in particular language regions of Switzerland.Conclusions: Different cross-sectional time trends were identified for the psychological and somatic latent variables, indicating that both factors should be investigated when studying period effects.

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Section: Other Predictorssupporting

confidence: 90%

Section: Limitationsmentioning

confidence: 99%

Cross-sectional time trends in psychological and somatic health complaints among adolescents: a structural equation modelling analysis of ‘Health Behaviour in School-aged Children’ data from Switzerland

Dey

Jorm

Mackinnon

2015

Soc Psychiatry Psychiatr Epidemiol

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“…Social gradients in symptom load among adolescents have been demonstrated in most countries and studies, confirming a pattern of socially differential exposure (A) [11][12][13]. A wide range of adolescent symptoms have important implications for adult health, e.g.…”

Section: Physical Healthmentioning

confidence: 61%

Pathways and mechanisms in adolescence contribute to adult health inequalities

Due

Krølner

Rasmussen

et al. 2011

Scand J Public Health

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179

152

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Aims: This paper presents a model that encompasses pathways and mechanisms working over adolescence that contribute to adult health inequalities. We review evidence on the four mechanisms: socially differential exposure, tracking, socially differential tracking, and socially differential vulnerability. Methods: We conducted literature searches in English-language peer-reviewed journals using PubMed (from 1966 to May 2009) and PsycINFO, and combined these with hand-searches of reference lists, journals, and authors of particular relevance. Results: Most health indicators are socially patterned in adolescence and track into adulthood, with higher risks of adverse outcomes among individuals from lower socioeconomic positions. Adolescent health behaviours track into adulthood. Smoking, physical activity, and especially fruit and vegetable intake are socially patterned, while evidence for social patterning of alcohol use is less consistent. Relational dimensions like lone parenthood and bullying are socially patterned and track over time, and there are indications of a socially differential vulnerability to the effects of these types of relational strain. Very little research has investigated the social patterning of the above indicators over time or studied social vulnerability of these indicators from adolescence to adulthood. However, all four mechanisms seem to be active in establishing social differences in adult educational attainment. Conclusions: We find the Adolescent Pathway Model useful for providing an overview of what elements and mechanisms in adolescence may be of special importance for adult health inequalities. There is a lack of knowledge of how social patterns of health, health behaviours, and social relations in adolescence transfer into adulthood and to what extent they reflect themselves in adult health.

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“…Holstein et al 129 point out that the Family Affluence Scale measures family consumption rather than occupation, education and income, which are usually considered to constitute a more accurate measure of socioeconomic status. However, the scale has been developed for use in HBSC surveys because younger children had difficulty in answering questions about parents' occupations and because it measures more than one dimension of socioeconomic status.…”

Section: Demographic Informationmentioning

confidence: 99%

Preventing alcohol misuse in young people: an exploratory cluster randomised controlled trial of the Kids, Adults Together (KAT) programme

et al. 2015

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BackgroundInvolvement of parents/carers may increase the effectiveness of primary school-based alcohol-misuse prevention projects. However, few interventions have been designed for pre-adolescent children, or specifically involve parents/carers. The Kids, Adults Together (KAT) programme in primary schools aimed to reduce alcohol misuse through such an approach.ObjectiveTo determine the value and feasibility of conducting an effectiveness trial of KAT.DesignParallel-group cluster randomised exploratory trial with an embedded process evaluation. Schools were the unit of randomisation.SettingPrimary schools (n = 9) in south Wales, UK.ParticipantsPupils in Year 5/6 (aged 9–11 years) and their parents/carers; school staff.InterventionThe Kids, Adults Together programme consisted of (1) classwork addressing the effects of alcohol; (2) a family event for children and parents/carers; and (3) a ‘goody bag’ containing fun items, including a digital versatile disc (DVD) for families to watch together. The intervention comprised KAT plus existing alcohol-related activities and lessons. Control-group schools continued with existing alcohol-related lessons and activities.Main outcome measuresKey outcomes related to the progression criteria for a potential future effectiveness trial. These included the acceptability, participation equity, feasibility and implementation of KAT; the recruitment and retention of research participants; and the acceptability and feasibility of research processes, including data collection methods and outcome measures.ResultsNine schools (free school meal entitlement ranging from 1% to 37.2%) participated. Two of five intervention schools withdrew but all four control schools were retained, and these seven schools facilitated all research data collections. Programme acceptability and participation rates were high in all three intervention schools (parent/carer participation rates ranged from 45.1% to 65.7%), although implementation quality varied. At baseline, approximately 75% of eligible children (n = 418) provided data, of whom 257 also provided data at follow-up. Only 27 parents/carers (estimated response rate 6.5%) completed interviews. Most children were willing to complete questionnaires but measures were not appropriate for this age group. Measures of alcohol consumption produced inconsistent responses. Intermediate outcomes on family communication showed no evidence of intervention effectiveness.ConclusionsIn the three schools that received the KAT intervention, it was found to be acceptable to schools and pupils and there were good levels of participation from parents/carers from across a range of socioeconomic groups. However, two intervention schools withdrew from the trial. Findings from intermediate outcomes on family communication did not support programme theory. In addition, the study highlighted challenges in identifying suitable outcome measures for children aged 9–11 years and the feasibility of long-term follow-up via secondary schools.Future workIt would not be appropriate to proceed to an effectiveness trial of KAT. There are doubts/uncertainties about the potential effects of KAT; suitability of measures; the large number of schools which would be required for an effectiveness trial of KAT, and the cost of this; feasibility of follow-up in secondary schools; and programme implementation and theory. There is a need to develop and validate measures for children aged 9–11 years; to test the feasibility of follow-up data collection methods in secondary schools; and to further consider sample size requirements and feasibility.Trial registrationCurrent Controlled Trials ISRCTN80672127.FundingThe exploratory trial of this project was funded by the National Institute for Health Research Public Health Research programme and the process evaluation was funded by the Economic and Social Research Council. The work was undertaken with the support of The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Joint funding (MR/KO232331/1) from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, the Welsh Government and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This project will be published in full inPublic Health Research; Vol. 3, No. 15. See the NIHR Journals Library website for further project information.

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Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

Abstract: There was a significant association between low FAS and high level of health complaints in 30 of 37 countries. Health complaints increased significantly by increasing income inequality in the country.

Cited by 118 publications

References 73 publications

Cross-sectional time trends in psychological and somatic health complaints among adolescents: a structural equation modelling analysis of ‘Health Behaviour in School-aged Children’ data from Switzerland

Cross-sectional time trends in psychological and somatic health complaints among adolescents: a structural equation modelling analysis of ‘Health Behaviour in School-aged Children’ data from Switzerland

Pathways and mechanisms in adolescence contribute to adult health inequalities

Preventing alcohol misuse in young people: an exploratory cluster randomised controlled trial of the Kids, Adults Together (KAT) programme

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