Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective

Abstract

BackgroundSocioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.MethodCross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.ResultsSubjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).ConclusionsThe level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries.

Direct and Indirect Influences of Objective Socioeconomic Position on Adolescent Health: The Mediating Roles of Subjective Socioeconomic Status and Lifestyles

“…With respect to health, SSS showed a significant effect even when controlling for the effect of IOSEP and health, congruent with previous research [21,22]. However, our results differ from other studies [24,25] in which SSS is reported to have a higher impact on health than objective indicators. Moreover, when comparing the models of objective and subjective SEP indicators (both individually and combined), our results show SSS to mediate the relationships between objective SEP and health.…”

“…In addition, previous findings have reported certain consequences on adolescent health of perceiving oneself as having a low SEP in comparison to others, even after controlling the effect of objective indicators [21,22,23]. Moreover, a study conducted by Ahlborg et al [24] demonstrated that controlling either the objective or subjective factors might affect the others impact on health. For example, the effect of FAS on multiple health complaints diminished or even reverted when SSS was controlled.…”

The Effects of Gender and Family Wealth on Sexual Abuse of Adolescents

“…This three-category framework was designed as a proxy for young people’s perceptions of their family’s socioeconomic circumstances and implicates a subjective socioeconomic status. It is used frequently in similar studies and has previously been shown to reliably predict health inequalities [16,28,29,30]. It seems that subjective measures of socioeconomic status combine absolute and relative deprivation of current and past social circumstances along with future prospects [31,32].…”

A Pilot Study for Socioeconomic Inequalities in Health among Jordanian Adolescents

“…(3) Socioeconomic indicators include social and economic circumstances, level of education, occupation, gender, family income (affluence), and family sizeboth objective and subjective measurements. (4) While several studies have justified the associations between socioeconomic status (SES) and health across the life course, health inequalities are not consistent through different age groups. (5) Some previous studies support the relative lack of social inequalities (that is a certain level of equalization) in adolescents' health (e.g.…”