The Happiest Kids on Earth. Gender Equality and Adolescent Life Satisfaction in Europe and North America

Gender differences in adolescents' life satisfaction: A replication study in Kazakhstan

INTRODUCTION

Whether adolescents' life satisfaction varies with gender is unclear. In a recently published study, Brisson et al. found unadjusted mean scores of life satisfaction to be higher in boys than in girls in Luxembourg, a country ranking high in gender-equality indexes. However, gender was no longer predictive of life satisfaction when well-identified predictors of life satisfaction were included in the model. The present work aimed to replicate Brisson et al.'s study in Kazakhstan, a less gender-equal country than Luxembourg, and test the gender-equality-paradox hypothesis.

METHODS

We used cross-sectional data from the Health-Behavior in School-aged Children study conducted in 2022 to mirror Brisson et al.'s study design. We relied on a nationally representative sample of 7369 school attendees in Kazakhstan (MAGE = 13.4; SDAGE = 1.7; 52.3% female). We performed general linear modeling analyses to achieve our research goals.

RESULTS AND CONCLUSIONS

In keeping with Brisson et al.'s study, we found unadjusted mean scores of life satisfaction to be higher in boys than in girls. The magnitude of the gender gap was lower in Kazakhstan than in Luxembourg. In contrast to Brisson et al.'s study, controlling for well-identified predictors of life satisfaction did not annul the gap in question but changed its sign. This result suggests that, ceteris paribus, girls were more satisfied with their life than boys. Overall, our replication study supports the gender-equality-paradox hypothesis. Future studies may investigate whether this paradox stems from gendered criteria of life satisfaction assessment and/or sociobiological differences in health profiles.

Statistical analysis of the effect of socio-political factors on individual life satisfaction

Life satisfaction refers to an individual's cognitive evaluation of the quality of their life. The aim of the present study is to develop the current understanding of how perceived corruption, attitudes toward migration, perceived security, and strength of national identity influence life satisfaction. Additionally, the study examines how demographic variables of relationship status, social class, sex, religious affiliation, and country impact life satisfaction in the provided cultural context. Ordinal logistic regression analysis, Confirmatory Factor Analysis, and Structural Equation Modeling are used to analyze data from the World Values Survey. Findings from the analyses indicate that perceived corruption, perceived security, and strength of national identity have a significant impact on life satisfaction, whereas migration has an indirect effect on life satisfaction through perceived security. The present research can develop our current understanding of life satisfaction from a socio-political perspective.

The influence of parents on children's consciousness of gender equality: a multi-group structural equation modeling approach

Objective

This study aimed to understand the consciousness of gender equality among school-aged children in China and its influencing factors using structural equation modeling to explore the pathways, intensity and group differences among these factors.

Methods

A cross-sectional survey was conducted using stratified random whole-group sampling of primary school students in grades 1-6 and their parents who met the inclusion and exclusion criteria. In this study, 1,312 valid questionnaires were collected from a total of 1,500 school-aged children in Hunan Province, China (effective response rate of 87.5%). Statistical analysis was conducted using SPSS 26.0 and AMOS 24.0 software. Statistical inference consisted of t-tests, analysis of variance, the LSD test, Pearson correlation analysis, multiple stepwise linear regression analysis and structural equation modeling.

Results

School-aged children had the lowest consciousness of gender equality in the area of occupation and relatively higher consciousness in the areas of family and school. Children's age, gender, gender role, parent-child relationship, teacher-student relationship and parents' gender equality consciousness had predictive effects on children's consciousness of gender equality. The structural equation model constructed in this study is applicable to school-aged children of different genders. There was a significant difference in the structural equation modeling for children in different study period groups.

Conclusion

In the education process, parents and teachers should attempt to improve their own consciousness of gender equality, integrate the concept of androgynous education, enhance close relationships with children, and adopt appropriate education methods according to the characteristics of different groups of children.

Direct and Indirect Effects of Youth Sports Participation on Emotional Intelligence, Self-Esteem, and Life Satisfaction

The present study investigated the mediating effects of emotional intelligence and self-esteem between youth sports participation and life satisfaction, as well as the comparative effects of different types of sports involvement (team, individual, and non-participation) on these selected variables. A sample of 1053 Portuguese adolescents (612 girls and 441 boys), aged between 12 and 18 years (M = 14.40; SD = 1.55), completed the following self-report measures: the Wong and Law Emotional Intelligence Scale, the Rosenberg Self-Esteem Scale, and the Satisfaction with Life Scale. The structural equation modeling results indicated a complete mediating role of two emotional intelligence dimensions (use of emotion and self-emotional appraisal) and self-esteem in the relationship between sports participation and adolescents' life satisfaction. Team sport participants reported higher emotional intelligence and self-esteem scores than their non-sport participant counterparts who revealed lower levels of emotion use than their individual sport participant peers. These findings provide novel insights into the potential emotional and psychological mechanisms underlying the association between youth sports participation and life satisfaction.

The Cantril Ladder as a Measure of Well-Being and Life Satisfaction Among Refugee Youth Experiencing Symptoms of Post-Traumatic Stress

Given the number of refugee youth whom require mental health support, there is a need to provide community-based interventions that can be easily scaled-up at a low cost. Yet, safety procedures associated with community-based intervention require careful consideration. The Cantril Ladder is a visual scale used to assess life satisfaction. It could be a useful tool to track the well-being of participants throughout an intervention. However, concerns have been raised about the validity of single-item life satisfaction measures and it is recommended they are tested when used in specific populations. This is particularly relevant to the refugee youth population who experience ongoing stress due to concern for family, friends, housing, and schooling and whose perceptions of life satisfaction may differ to the cohorts the Cantril Ladder has previously been tested with. The purpose of this study was to explore the validity of the Cantril Ladder as a measure of well-being and life satisfaction in refugee youth experiencing post-traumatic stress symptoms by exploring the relationship between how the youth scored on the Cantril Ladder with their scores on measures of depression and self-efficacy. Hierarchical multiple linear regression was applied to self-reported survey data in order to test how refugee youth experiencing post-traumatic stress symptoms (n = 51) score on the Cantril Ladder compared with Patient Health Questionnaire-9 (PHQ-9) and General Self Efficacy Scale (GSE) scores. The mean Cantril Ladder score in the present sample was 5.33 (SD = 2.77). The PHQ-9 and GSE total scores together explained 19.1% of the variability in the Cantril Ladder score. The Cantril Ladder showed moderate concurrent validity with validated measures of depression and self-efficacy. These findings have important implications for intervention programs designed to support refugee youth experiencing post-traumatic stress, as the Cantril Ladder offers a promising way to track well-being throughout the program as part of a wider safety protocol procedure. Additional research is required to not only confirm these findings, but also to test the face validity of the Cantril Ladder for a more complete validation of life satisfaction.

Exploring the role of country-level gender equality in the link between relationship status and perceived social support across 49 countries

Past studies have demonstrated that higher perceived social support among coupled individuals and greater gender equality foster a more supportive social context. Less is known about how the link between relationship status and perceived social support may vary across countries that differ in gender equality. Employing the data collected from the COVIDiSTRESS I (39 countries; N = 99,075) and COVIDiSTRESS II (23 countries; N = 8293) projects, we examined whether country-level gender equality moderates the link between relationship status and perceived social support. Multilevel regression analyses indicated that gender equality moderated the link between relationship status and perceived social support. Single people in countries with less gender equality reported less perceived social support than was reported by both coupled people and single people from countries with moderate and high levels of gender equality, however, the effect of the interaction between relationship status and gender equality on perceived social support was very low. The results suggest that gender equality fosters perceived social support, both for single people and for partnered people.

The Equality Paradox: Gender Equality Intensifies Male Advantages in Adolescent Subjective Well-Being

Individuals' subjective well-being (SWB) is an important marker of development and social progress. As psychological health issues often begin during adolescence, understanding the factors that enhance SWB among adolescents is critical to devising preventive interventions. However, little is known about how institutional contexts contribute to adolescent SWB. Using Programme for International Student Assessment (PISA) 2015 and 2018 data from 78 countries (N = 941,475), we find that gender gaps in adolescents' SWB (life satisfaction, positive and negative affect) are larger in more gender-equal countries. Results paradoxically indicated that gender equality enhances boys' but not girls' SWB, suggesting that greater gender equality may facilitate social comparisons across genders. This may lead to an increased awareness of discrimination against females and consequently lower girls' SWB, diluting the overall benefits of gender equality. These findings underscore the need for researchers and policy-makers to better understand macro-level factors, beyond objective gender equality, that support girls' SWB.

Transgender identity is associated with severe suicidal ideation among Finnish adolescents

OBJECTIVES

Emerging evidence reveals disparities in suicidal behaviour and ideation exist between transgender and cisgender youth. It has been hypothesized that certain gender minority specific risk factors, such as experiences of victimization, could partially explain the mental health disparities between transgender and cisgender youth. We set out to explore whether transgender identity is associated with severe suicidal ideation among Finnish adolescents and whether the possible association persist when a range of covariates is controlled for.

METHODS

The study included 1,425 pupils (mean age (SD) = 15.59 (0.41)) who participated in the study during a school lesson. Logistic regression was used to study associations between transgender identity and severe suicidal ideation.

RESULTS

Four models, each adding more covariates, were created. The final model revealed a statistically significant association between transgender identity and severe suicidal ideation, even though the association grew weaker as more covariates were added and controlled for.

CONCLUSIONS

The results indicate that transgender identity is associated with severe suicidal ideation even after prominent covariates or risk factors of suicidal behaviour and ideation have been taken into account.

Female political representation and the gender health gap: a cross-national analysis of 49 European countries

Background

Does increased female participation in the social and political life of a country improve health? Social participation may improve health because it ensures that the concerns of all people are heard by key decision-makers. More specifically, when women’s social participation increases this may lead to health gains because women are more likely to vote for leaders and lobby for policies that will enhance the health of everyone. This article tries to examine whether female participation is correlated with measures of health inequality.

Methods

We draw on data from the World Health Organization Health Equity Status Report initiative and the Varieties of Democracy project to assess whether health is better and health inequalities are smaller in countries where female political representation is greater.

Results

We find consistent evidence that greater female political representation is associated with lower geographical inequalities in infant mortality, smaller inequalities in self-reported health (for both women and men) and fewer disability-adjusted life-years lost for women and men. Finally, we find that greater female political representation is not only correlated with better health for men and women but is also correlated with a smaller gap between men and women because men seem to experience better health in such contexts.

Conclusions

Greater female political representation is associated with better health for everyone and smaller inequalities.

Structural gender inequality and gender differences in adolescent substance use: A multilevel study from 45 countries

-Societal gender inequality relates to gender differences in adolescent substance use.-The gender gap in adolescent substance use is larger in countries with higher levels of gender inequality.-Girls in these countries were less likely to get drunk, use alcohol or smoke cigarettes than boys.

The role of family support and conflict in cyberbullying and subjective well-being among Chilean Adolescents during the Covid-19 period

Introduction

Life satisfaction plays a crucial role in integral development and mental health during childhood and adolescence. Recently, it has been shown that cyberbullying has severe consequences for the mental health and wellbeing of victims such as increased anxiety, depressive symptoms and even suicide risk. Although the role of the family in life satisfaction and cyberbullying behaviors has been studied, there is limited information on its impacts during the current pandemic period.

Objective

The aim of this study is to determine the role of family variables regarding students’ levels of life satisfaction and cyberbullying victimization during the pandemic period.

Method

Structural equation modeling was done using data from a cross-sectional study (n = 287; age ranged 14–18) conducted in six schools in Santiago, Chile during 2020.

Results

The tested model has a good fit and parsimonious adjustment. It explained 25.9% of the life satisfaction and 9% of the variance of cyberbullying victimization. Family support was positively associated with life satisfaction (p < 0.001) and negatively associated with cyberbullying victimization (p < 0.05). Likewise, family conflict was positively associated with levels of cyberbullying victimization (p < 0.05) and negatively associated with life satisfaction levels (p < 0.001). Finally, family visits were only positively associated with life satisfaction (p < 0.01).

Conclusions

Generating interventions on several levels focused on positive family bonds has become essential and urgent. This is especially important considering their protective impacts on cyberbullying victimization in promotion of adolescent well-being and quality of life.

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Level of family support decreased cyberbullying victimization and increased life satisfaction during the Pandemic.

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Level of family conflict increased the risk of cyberbullying victimization and decreased levels of life satisfaction.

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Interventions and policies are urgently needed to promote positive family bonds and work-life balance.

Gender Differences Influence Gender Equality Awareness, Self-Esteem, and Subjective Well-Being Among School-Age Children in China

The objective of this study was to investigate and analyze the status and influential factors of gender equality awareness, self-esteem, and subjective well-being in school-age boys and girls. The results can help schools and teachers provide more effective gender equality and mental health education. In the study, 284 valid questionnaires were collected from a total of 323 school-age boys and girls in the Hunan Province, China (effective response rate of 87.93%). The questionnaire covered gender equality awareness, self-esteem, and subjective well-being, with the influencing factors analyzed through multiple linear regression. There was a significant correlation among children’s gender equality awareness in all areas examined (family, occupation, and school), with both boys and girls having the lowest awareness of gender equality in occupational fields. The children’s self-esteem and subjective well-being were significantly correlated as well. Gender equality awareness, self-esteem, and subjective well-being among boys and girls reflected different influential factors. Androgynous traits (neither feminine nor masculine) were conducive to the development of gender equality awareness and self-esteem among the children. Therefore, schools and teachers need to provide gender equality and mental health education according to the specific psychological characteristics of each boy and girl.

A sense of health and coherence in young rural schoolchildren in Sweden

Background: Little is known about how younger schoolchildren in a rural setting experience their sense of coherence (SOC), how they think and reason about health and what they perceive as important to achieve health goals. This study aimed to investigate children's SOC and their health perceptions.Method: In this mixed-method study 94 children (8-12 years) from three rural schools answered several questionnaires: The Child-SOC (CSOC), Positive Health Scale (PHS) and Cantril's ladder of life scale. Another 23 children (of 94) participated in four focus group interviews. Thematic analysis was used to identify themes from the interview transcripts.Results: High SOC was reported by 48% of the boys and 22% of the girls. However, no significant gender differences were found. Four themes were generated from the qualitative analysis: Understanding health, Managing health, Doing bodily health and Socialising health. Both younger and older children had a holistic view of health in which health was seen as an individual's living habits in which social contacts mattered.Conclusion: In a rural context children need to adapt to activities that exist in their immediate environment. Thus, activities during school hours can be an important complement in health promotion.

Perceived Social Support from Different Sources and Adolescent Life Satisfaction Across 42 Countries/Regions: The Moderating Role of National-Level Generalized Trust

Although previous research established a positive association between perceived social support and adolescent life satisfaction, little is known about the relative importance of different sources of support for adolescent life satisfaction and cross-country variations in this respect. Using large-scale representative samples from the 2017/18 Health Behaviour in School-aged Children (HBSC) study, this study examined to what extent the association between social support and life satisfaction in early adolescence varied across different social sources and countries. Also, it examined whether cross-country variations are explained by national-level generalized trust, a sociocultural factor that shapes adolescent socialization. National-level data were linked to data from 183,918 early adolescents (Mage = 13.56, SD = 1.63, 52% girls) from 42 European and North American countries/regions obtained from HBSC. Multilevel regression analyses yielded a positive association between support from different sources and life satisfaction. The strongest associations were found for support from families, followed by teachers and classmates, and weakest for support from friends. Associations varied across different countries/regions. National-level trust amplified the association between perceived classmate support and adolescent life satisfaction. The revealed cross-country differences open avenues for future cross-cultural research on explanations for cross-cultural differences in the association between social support from different sources and life satisfaction in early adolescence.

Psychosocial Working Conditions in School and Life Satisfaction among Adolescents in Sweden: A Cross-Sectional Study

Poor psychosocial working conditions in school have consistently been shown to be associated with adverse health among adolescents. However, the relationships between school demands, teacher support, and classmate support and positive aspects of health have not been explored to the same extent. The aim of this study was to examine differences in psychosocial working conditions in school and in life satisfaction by gender and by grade, and to investigate the association between psychosocial working conditions in school and life satisfaction among boys and girls, and among students in different grades. Data from the Swedish Health Behavior in School-Aged Children (HBSC) study of 2017/18 were used, consisting of 3614 students in Grades 5, 7, and 9 (~11, 13, and 15 years). Psychosocial working conditions in school were captured by indices of perceived school demands, teacher support, and classmate support. Life satisfaction was measured by the 11-step Cantril’s ladder (using cutoffs at >5 and >8, respectively). Whereas girls reported higher school demands than boys, higher levels of teacher and classmate support were reported by boys. Students in lower grades reported lower school demands but higher levels of teacher and classmate support compared with students in higher grades. Boys and students in lower grades were more likely to report high life satisfaction compared with girls and students in higher grades. Results from binary logistic regression analyzes showed that school demands were inversely associated with life satisfaction, and that higher levels of teacher support and classmate support were associated with high life satisfaction. These results were found for both boys and girls, and for students in all grades. The findings indicate that schools have the potential to promote positive health among students.

The gender gap in adolescent mental health: A cross-national investigation of 566,829 adolescents across 73 countries

Mental ill-health is a leading cause of disease burden worldwide. While women suffer from greater levels of mental health disorders, it remains unclear whether this gender gap differs systematically across regions and/or countries, or across the different dimensions of mental health. We analysed 2018 data from 566,829 adolescents across 73 countries for 4 mental health outcomes: psychological distress, life satisfaction, eudaemonia, and hedonia. We examine average gender differences and distributions for each of these outcomes as well as country-level associations between each outcome and purported determinants at the country level: wealth (GDP per capita), inequality (Gini index), and societal indicators of gender inequality (GII, GGGI, and GSNI). We report four main results: 1) The gender gap in mental health in adolescence is largely ubiquitous cross-culturally, with girls having worse average mental health; 2) There is considerable cross-national heterogeneity in the size of the gender gap, with the direction reversed in a minority of countries; 3) Higher GDP per capita is associated with worse average mental health and a larger gender gap across all mental health outcomes; and 4) more gender equal countries have larger gender gaps across all mental health outcomes. Taken together, our findings suggest that while the gender gap appears largely ubiquitous, its size differs considerably by region, country, and dimension of mental health. Findings point to the hitherto unrealised complex nature of gender disparities in mental health and possible incongruence between expectations and reality in high gender equal countries.

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Girls have worse average mental health than boys across 4 measures of mental health.

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There is large heterogeneity in the size of the mental health gender gap across countries.

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The gap is most pronounced for psychological distress and life satisfaction.

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More gender equal countries have larger gender gaps in mental health.

Social Networking Addiction Among Hong Kong University Students: Its Health Consequences and Relationships With Parenting Behaviors

The use of social networking sites (SNSs) has been growing at a staggering rate, especially among university students. The present study investigated the prevalence of social networking addiction (SNA), its health consequences, and its relationships with parents' Internet-specific parenting behaviors in a sample of Hong Kong university students (N = 390). Adopting the 9-item social media disorder scale, 21.5% of the participating students met the criteria for SNA. Students with SNA showed longer sleeping latency, more sleep disturbance, poorer academic performance, lower levels of life satisfaction, and higher levels of depression than did students without SNA. Parental reactive restriction and limiting online behaviors of the participants were associated with higher risk of SNA. The findings suggest the severity of SNA and its negative consequences among Hong Kong university students. While parental behaviors limiting children's use of SNSs were found to increase the occurrence rate of SNA among university students, longitudinal studies are needed to further examine this causal relationship.

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

This paper extracts, organises and summarises findings on adolescent mental health from a major international population study of young people using a scoping review methodology and applying a bio-ecological framework. Population data has been collected from more than 1.5 million adolescents over 37 years by the Health Behaviour in School-Aged Children: WHO Cross-National (HBSC) Study. The paper reviews the contribution that this long standing study has made to our understanding of the individual, developmental, social, economic, cultural determinants of adolescent mental health by organising the findings of 104 empirical papers that met inclusion criteria, into individual, microsystem, mesosystem and macrosystem levels of the framework. Of these selected papers, 68 were based on national data and the other 36 were based on international data, from varying numbers of countries. Each paper was allocated to a system level in the bio-ecological framework according to the level of its primary focus. The majority (51 papers) investigate individual level determinants. A further 28 concentrate primarily on the microsystem level, 6 on the mesosystem level, and 29 on the macrosystem level. The paper identifies where there is evidence on the determinants of mental health, summarises what we have learned, and highlights research gaps. Implications for the future development of this population health study are discussed in terms of how it may continue to illuminate our understanding of adolescent mental health in a changing world and where new directions are required.

Young people's sexual readiness: insights gained from comparing a researchers' and youth advisory group's interpretation

This study explored young people's understandings of sexual readiness and what influenced their decision to initiate first sex. Interviews conducted with 20 heterosexual young people aged 16-18 years, attending sexual health clinics in Northern Ireland, were analysed using a combined approach. This included comparing a researchers and youth advisory group's interpretations of the same data. Thematic analysis enabled comparison to draw out insights across both interpretations. Three themes emerged from each analysis that aligned closely with one another: Mental/Intimate Contact; People/Peer Influences; Self/Socio-Cultural Influences. One additional theme, Adult Control, emerged from the researchers' understanding alone. Results suggest that young people actively deliberate about sex as inevitable and find it difficult to resist the peer and social influences that regulate their lives, with many initiating sex 'to-get-it-over-with'. Gender ideologies and relationship status influenced expectations, motivations and the context surrounding first sex. Sexual readiness was informed by whether first sex was 'good', 'not so good' or 'bad', highlighting the gaps in young people's understanding. Health, law, and education sectors should co-produce interventions with young people to provide relevant and realistic information that explores the effects of gender equality in everyday life on related concepts such as respect, rights, responsibility and resilience.

Gender role orientation and body satisfaction during adolescence - Cross-sectional results of the 2017/18 HBSC study

During adolescence both sexes experience a loss of body satisfaction, whereby the effect is greater among girls. Coming to terms with gender roles is an important step in the development of a person's identity. Traditional gender roles tend to emphasise certain physical attributes: attractiveness in women, and strength and dominance in men. This article analyses associations between a traditional gender role orientation and body satisfaction during adolescence based on logistic regression models and using data taken from the 2017/18 Health Behaviour in School-aged Children (HBSC) study (n=1,912 girls, n=1,689 boys). The results show an overall high degree of body satisfaction, with girls scoring lower than boys. Role preconceptions were mostly not traditional, with boys being slightly more traditional than girls. In both sexes, a more traditional role orientation was accompanied by lower levels of body satisfaction; in boys, this effect was seen to decrease with age. The stereotypical features of role preconceptions are examined as a possible explanation for these differences. An alternative explanation posits that an egalitarian role orientation (i.e. one based on the principle of equality) creates a more tolerant environment with greater social support, which could foster a greater sense of self-acceptance. These results indicate that questioning traditional preconceptions of gender roles during adolescence may help prevent problems related to body image in both sexes.

Trends over Time in Adolescent Emotional Wellbeing in the Netherlands, 2005-2017: Links with Perceived Schoolwork Pressure, Parent-Adolescent Communication and Bullying Victimization

In some Scandinavian countries, the United Kingdom and the United States, there is evidence of a dramatic decline in adolescent emotional wellbeing, particularly among girls. It is not clear to what extent this decline can be generalised to other high-income countries. This study examines trends over time (2005-2009-2013-2017) in adolescent wellbeing in the Netherlands, a country where young people have consistently reported one of the highest levels of wellbeing across Europe. It also assesses parallel changes over time in perceived schoolwork pressure, parent-adolescent communication, and bullying victimization. Data were derived from four waves of the nationally representative, cross-sectional Dutch Health Behaviour in School-aged Children study (N = 21,901; 49% girls; M_age = 13.78, SD = 1.25). Trends in emotional wellbeing (i.e., emotional symptoms, psychosomatic complaints, life satisfaction) were assessed by means of multiple regression analyses with survey year as a predictor, controlling for background variables. Emotional wellbeing slightly declined among adolescent boys and girls between 2009 and 2013. A substantial increase in perceived schoolwork pressure was associated with this decline in emotional wellbeing. Improved parent-adolescent communication and a decline in bullying victimization may explain why emotional wellbeing remained stable between 2013 and 2017, in spite of a further increase in schoolwork pressure. Associations between emotional wellbeing on the one hand and perceived schoolwork pressure, parent-adolescent communication, and bullying victimization on the other were stronger for girls than for boys. Overall, although increasing schoolwork pressure may be one of the drivers of declining emotional wellbeing in adolescents, in the Netherlands this negative trend was buffered by increasing support by parents and peers. Cross-national research into this topic is warranted to examine the extent to which these findings can be generalised to other high-income countries.

Patterns of Health-Related Gender Inequalities-A Cluster Analysis of 45 Countries

PURPOSE

The paper explores gender inequalities between 45 countries across 10 health indicators among adolescents and whether those differences in health correlate with gender inequality in general.

METHODS

Data from 71,942 students aged 15 years from 45 countries who participated in the 2018 Health Behaviour in School-aged Children survey were analyzed. For this purpose, 10 indicators were selected, representing a broad spectrum of health outcomes. The gender differences in the countries were first presented using odds ratios. Countries with similar risk profiles were grouped together using cluster analyses. For each of the 10 indicators, the correlation with the Gender Inequality Index was examined.

RESULTS

The cluster analysis reveals systematic gender inequalities, as the countries can be divided into seven distinct groups with similar gender inequality patterns. For eight of the 10 health indicators, there is a negative correlation with the Gender Inequality Index: the greater the gender equality in a country, the higher the odds that girls feel fat, have low support from families, have low life satisfaction, have multiple health complaints, smoke, drink alcohol, feel school pressure, and are overweight compared with boys. Four indicators show a divergence: the higher the gender equality in a country in general, the larger the differences between boys and girls regarding life satisfaction, school pressure, multiple health complaints, and feeling fat.

CONCLUSIONS

Countries that are geographically and historically linked are similar in terms of the health risks for boys and girls. The results challenge the assumption that greater gender equality is always associated with greater health equality.

Intersectionality and Adolescent Mental Well-being: A Cross-Nationally Comparative Analysis of the Interplay Between Immigration Background, Socioeconomic Status and Gender

PURPOSE

Intersectionality theory highlights the importance of the interplay of multiple social group memberships in shaping individual mental well-being. This article investigates elements of adolescent mental well-being (life dissatisfaction and psychosomatic complaints) from an intersectional perspective. It tests mental well-being consequences of membership in combinations of multiple social groups and examines to what extent such intersectional effects depend on the national context (immigration and integration policies, national-level income, and gender equality).

METHODS

Using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy, we assessed the role of the national context in shaping the interplay between immigration background, socioeconomic status, and gender, using data from 33 countries from the 2017/2018 Health Behaviour in School-aged Children survey.

RESULTS

We found no uniform intersectionality effects across all countries. However, when allowing the interplay to vary by national context, results did point toward some intersectional effects. Some aggravated negative effects were found for members of multiple disadvantaged social groups in countries with low levels of income equality and restrictive migration policies, whereas enhanced positive effects were found for members of multiple advantaged groups in these countries. Similarly, mitigated negative effects of membership in multiple disadvantaged groups were shown in countries with higher levels of income equality and more inclusive migration policies, whereas mitigated positive effects were found for multiply advantaged individuals. Although for national-level gender equality results pointed in a similar direction, girls' scores were counterintuitive. High national-level gender equality disproportionately benefitted groups of disadvantaged boys, whereas advantaged girls were doing worse than expected, and reversed effects were found for countries with low gender equality.

CONCLUSIONS

To fully understand social inequalities in adolescent mental well-being, the interplay between individual-level and national-level indicators must be explored.

Cross-National Time Trends in Adolescent Mental Well-Being From 2002 to 2018 and the Explanatory Role of Schoolwork Pressure

PURPOSE

Previous research has shown inconsistent time trends in adolescent mental well-being, but potential underlying mechanisms for such trends are yet to be examined. This study investigates cross-national time trends in adolescent mental well-being (psychosomatic health complaints and life satisfaction) in mainly European countries and the extent to which time trends in schoolwork pressure explain these trends.

METHODS

Data from 915,054 adolescents from 36 countries (50.8% girls; mean_age = 13.54; standard deviation_age = 1.63) across five Health Behaviour in School-aged Children surveys (2002, 2006, 2010, 2014, and 2018) were included in the analyses. Hierarchical multilevel models estimated cross-national trends in adolescent mental well-being and schoolwork pressure. We also tested whether schoolwork pressure could explain these trends in mental well-being.

RESULTS

A small linear increase over time in psychosomatic complaints and schoolwork pressure was found. No change in life satisfaction emerged. Furthermore, there was large cross-country variation in the prevalence of, and trends over time in, adolescent mental well-being and schoolwork pressure. Overall, declines in well-being and increases in schoolwork pressure were apparent in the higher income countries. Across countries, the small increase in schoolwork pressure over time partly explained the decline in psychosomatic health complaints.

CONCLUSIONS

Our findings do not provide evidence for substantial declines in mental well-being among adolescents. Yet, the small declines in mental well-being and increases in schoolwork pressure appear to be quite consistent across high-income countries. This calls for the attention of public health professionals and policy-makers. Country differences in trends in both adolescent mental well-being outcomes and schoolwork pressure were considerable, which requires caution regarding the cross-national generalization of national trends.

Smoking beliefs across genders, a comparative analysis of seven European countries

BACKGROUND

Most European countries have seen a decrease in the prevalence of adolescent smoking. This decrease has, however, been patterned by gender. Girls' smoking rates have now overtaken boys' in many European countries. The two genders may not, however, share the same smoking beliefs and this could explain differences between the genders in smoking prevalence. We describe gender differences in smoking beliefs and investigate variations between countries, along with their gender context.

METHODS

In 2016, we conducted the SILNE R study (Smoking Inequalities Learning from Natural Experiments - Renew) in 55 schools located in seven European countries: Belgium, Italy, The Netherlands, Portugal, Finland, Ireland, and Germany. We surveyed 12,979 students aged 14-16 years (50% were girls). We classified smoking beliefs into four categories: positive individual, positive social, negative individual, and negative social beliefs. We expected girls to score higher on the last three of those categories and we hypothesized that countries with a more gender-equal culture would have less gender difference in beliefs about smoking.

RESULTS

One out of two smoking beliefs differed significantly between genders. Negative social beliefs were more common in girls, while beliefs about the dating-related aspects of smoking were more common in boys. We identified Germany and Belgium as the only countries with no gender differences in any of the belief scales. No correlation was found, however, between these scales and the Gender Inequality Index.

CONCLUSIONS

In some countries, gender-specific interventions might be implemented; however, two opposing strategies might be used, depending on whether such programs are aimed at boys or girls.

Gender inequality and adolescent suicide ideation across Africa, Asia, the South Pacific and Latin America - a cross-sectional study based on the Global School Health Survey (GSHS)

Background: Suicide ideation is a health issue affecting adolescents worldwide. There are significant variations in suicide ideation between countries and genders, which have not been fully explained. Research is especially lacking in countries outside Europe and North America. Gender equality has been shown to matter in other aspects of adolescent mental health, such as life satisfaction, but has not been researched in relation to suicide ideation at national level.

Objective: To investigate how national gender inequality is related to self-reported suicide ideation among adolescents, and whether this association differs between boys and girls.

Methods: This is a cross-national, cross-sectional study using individual survey data from the Global School-based Student Health Survey, a survey in Africa, Asia, Latin America and the South Pacific, developed and supported by among others the WHO and the CDC; connecting this to national data: the gender inequality index from the UNDP; controlling for GDP per capita and secondary school enrolment. The data was analysed using a multilevel logistic regression method and included 149,306 students from 37 countries.

Results: Higher national gender inequality, as measured by the gender inequality index, was significantly associated with a higher likelihood of suicide ideation in both girls and boys (odds ratio: 1.38 p-value: 0.015), but for girls and both sexes this was only after adjusting for selection bias due to secondary school enrolment (as well as GDP/capita). Interaction models showed that this association was stronger in boys than in girls.

Conclusions: National gender inequality seems to be associated with higher levels of suicide ideation among adolescents in mainly low- and middle-income countries, especially among boys.