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Olsen HW, Sjúrðarson T, Danielsen BB, Krustrup P, Larsen MN, Skoradal MB, Mohr M. A 10-week implementation of the FIT FIRST FOR ALL school-based physical activity concept effectively improves cardiorespiratory fitness and body composition in 7-16-year-old schoolchildren. Front Public Health 2024; 12:1419824. [PMID: 39086810 PMCID: PMC11288947 DOI: 10.3389/fpubh.2024.1419824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/21/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction The purpose of the present study was to investigate the impact of the FIT FIRST FOR ALL school-based physical activity program on health-related physical fitness in Faroese schoolchildren. The program aimed to add three weekly sessions of organized high-intensity physical activity to the standard weekly physical education sessions for all pupils across the entire school. Methods A non-randomized controlled design was used to evaluate the effects of the program. Two schools participated, including one intervention school (INT; n =179) and one control school (CON; n =181), with pupils aged 7-16 years (grades 1-9). The FIT FIRST FOR ALL program consisted of three weekly 40-minute sessions of age-adjusted high-intensity physical activity over 10 weeks for the INT school, while the CON school continued their normal school program. Pre- and post-intervention assessments included cardiorespiratory fitness (Yo-Yo IR1C test), agility (Arrowhead Agility test), postural balance (Stork Stand), standing long jump performance, body composition, blood pressure, and resting heart rate. Results A significant time × group effect (p < 0.001) was observed for cardiorespiratory fitness, which increased by 31% [23;39] in INT (p < 0.001) and remained unaltered in CON (7% [-2;16], p = 0.13). In addition, a time × group effect (p < 0.001) was observed for agility, which improved by 2.1% [1.0;3.2] in INT (p < 0.001) and regressed by 3.3% [2.3;4.4] in CON (p < 0.001). No significant between-group effects were found for standing long jump and balance. A time × group effect (p < 0.001) was observed for changes in total muscle mass, which increased by 1.4 kg [1.2;1.5] in INT (p < 0.001) and by 0.4 kg [0.3;0.6] in CON (p < 0.05). Furthermore, a time × group effect (p < 0.001) was observed for total fat percentage, which decreased by -2.3% [-2.8;-1.9] in INT (p < 0.001) and remained unchanged in CON (-0.3% [-0.7;0.1], p = 0.16). No significant time × group effects were found for blood pressure and resting heart rate. Discussion The FIT FIRST FOR ALL program significantly improved cardiorespiratory fitness and agility, and it led to favorable changes in body composition in the intervention school. These findings suggest that the program is highly effective in enhancing physical fitness and health status across all investigated age groups when implemented at a school-wide level.
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Affiliation(s)
- Helgi Winther Olsen
- Faculty of Education, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Tórur Sjúrðarson
- Center of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
| | - Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - May-Britt Skoradal
- Center of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Magni Mohr
- Center of Health Science, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Martínez-Jiménez M, Hollingsworth B, Zucchelli E. Socioeconomic deprivation, health and healthcare utilisation among millennials. Soc Sci Med 2024; 351:116961. [PMID: 38761457 DOI: 10.1016/j.socscimed.2024.116961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/15/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Abstract
This study estimates and decomposes components of different measures of inequality in health and healthcare use among millennial adolescents, a sizeable cohort of individuals at a critical stage of life. Administrative data from the UK Hospital Episode Statistics are linked to Next Steps, a survey collecting information about millennials born between 1989 and 1990, providing a uniquely comprehensive source of health and socioeconomic variables. Socioeconomic inequalities in psychological distress, long-term illness and the use of emergency and outpatient hospital care are measured using a corrected concentration index. Shapley-Shorrocks decomposition techniques are employed to measure the relative contributions of childhood socioeconomic circumstances to adolescents' health and healthcare inequality of opportunity. Results show that income-related deprivation contributes to significant inequalities in mental and physical health among adolescents aged between 15 and 17 years old. There are also pro-rich inequalities in the use of specific outpatient hospital services (e.g., orthodontic and mental healthcare), while pro-poor disparities are found in the use of emergency care services. Regional and parental circumstances are leading factors in influencing inequality of opportunity in the use of hospital care among adolescents. These findings shed light on the main drivers of health inequalities during an important stage of human development and have potentially important implications on human capital formation across the life-cycle.
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Affiliation(s)
- Mario Martínez-Jiménez
- Department of Economics and Public Policy, Imperial College Business School, Imperial College London, London, UK; Centre for Health Economics and Policy Innovation, Imperial College Business School, Imperial College London, London, UK.
| | | | - Eugenio Zucchelli
- Division of Health Research, Lancaster University, Lancaster, UK; Madrid Institute for Advanced Study (MIAS) and Department of Economic Analysis, Universidad Autónoma de Madrid (UAM), Madrid, Spain; IZA, Bonn, Germany
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Klocke A, Stadtmüller S. Two generations later: New evidence on health equalisation in youth. Soc Sci Med 2024; 342:116522. [PMID: 38183934 DOI: 10.1016/j.socscimed.2023.116522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 01/08/2024]
Abstract
In the 1990s, Patrick West argued that, in contrast to childhood and adulthood, youth was characterised by relative social equality in health. This equalisation hypothesis has since been empirically tested several times, but with inconclusive results. The objective of the present study was to provide an up-to-date contribution to the question of health equalisation in youth by drawing on data from the German longitudinal study Health Behaviour and Injuries at School Age (GUS). The target population of GUS comprised students who were in 5th grade at German public secondary schools in the school year 2014/15. Over 10,000 students from randomly selected schools participated in the initial survey wave and were followed up in annual surveys until 10th grade. As GUS included a variety of health-related variables as well as indicators for family affluence, we could examine how social inequalities affected the health and health behaviour of young people with increasing age. Our study goes beyond previous research in two ways. First, from a youth and health sociology perspective, we present reasons why we expect an increase in socially determined health inequalities in the present youth generation. Second, we fully exploit the potential of our panel data, and thus arrive at very reliable results. For self-rated general health, as well as for numerous mental health and health behaviour items, our data show that health inequalities emerged or increased during the observation period (ages 10-16 years). Despite some indications of equalisation, especially for the consumption of unhealthy food and beverages, most of our results contradict West's equalisation hypothesis and suggest that social inequalities play an increasing role in health disparities among youth in the process of growing up.
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Affiliation(s)
- Andreas Klocke
- Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318 Frankfurt (Main), Germany.
| | - Sven Stadtmüller
- Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318 Frankfurt (Main), Germany.
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Tsiros MD, Vincent HK, Getchell N, Shultz SP. Helping Children with Obesity "Move Well" To Move More: An Applied Clinical Review. Curr Sports Med Rep 2021; 20:374-383. [PMID: 34234093 DOI: 10.1249/jsr.0000000000000861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Children with obesity experience musculoskeletal pain and reduced physical function and well-being, which collectively impact their fitness, strength, motor skills, and even their ability to undertake simple tasks, like walking and climbing stairs. Disrupting obesity-related disability may be critical to increasing children's physical activity. Thus, barriers to movement should be considered by health practitioners to improve the efficacy of prescribed physical activity. This applied clinical review highlights key subjective and objective findings from a hypothetical case scenario, linking those findings to the research evidence, before exploring strategies to enhance movement and increase physical activity.
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Affiliation(s)
- Margarita D Tsiros
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, Adelaide, SA, AUSTRALIA
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, Division of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL
| | - Nancy Getchell
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
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Minh A, Bültmann U, Reijneveld SA, van Zon SKR, McLeod CB. Childhood Socioeconomic Status and Depressive Symptom Trajectories in the Transition to Adulthood in the United States and Canada. J Adolesc Health 2021; 68:161-168. [PMID: 32680802 DOI: 10.1016/j.jadohealth.2020.05.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE We examined whether young people in the U.S. and Canada exhibit similar depressive symptom trajectories in the transition to adulthood and compared the effect of childhood socioeconomic status on trajectory membership. METHODS We used the American National Longitudinal Survey of Youth 1979 Child/Young Adult (n = 6,315) and the Canadian National Longitudinal Survey of Children and Youth (n = 3,666). Depressive symptoms were measured using five items from the Center for Epidemiological Studies on Depression scale. Latent trajectories of depressive symptoms from ages 16-25 years were identified using growth mixture models. We estimated the effect of childhood family income, parental education, and parental unemployment on trajectory membership using multivariable Poisson regression models with robust variances. RESULTS We identified four similar trajectories in the two countries: (1) low stable; (2) mid-peak; (3) increasing; and (4) decreasing. Relatively more Americans were in the low-stable trajectory group than Canadians (77.6% vs. 64.9%), and fewer Americans were in the decreasing group (7.1% vs. 19.1%). In the U.S., childhood family income in the bottom two quartiles was related to higher rates of increasing trajectory membership compared with income in the top quartile (incidence rate ratios: 1.59-1.79, p < .05), but not in Canada. In the U.S., parental education at a high school level was associated with higher rates of decreasing trajectory membership compared with higher education (incidence rate ratio = 1.45, confidence interval: 1.10-1.91; p = .01), but not in Canada. CONCLUSIONS Depressive symptoms may take a similar course in the transition to adulthood within these two countries. Country differences may modify the degree to which childhood socioeconomic status determines trajectory membership.
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Affiliation(s)
- Anita Minh
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Ute Bültmann
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christopher B McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Institute for Work & Health, Toronto, Ontario, Canada
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O'Neil A, Russell JD, Thompson K, Martinson ML, Peters SAE. The impact of socioeconomic position (SEP) on women's health over the lifetime. Maturitas 2020; 140:1-7. [PMID: 32972629 PMCID: PMC7273147 DOI: 10.1016/j.maturitas.2020.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022]
Abstract
The "social gradient of health" refers to the steep inverse associations between socioeconomic position (SEP) and the risk of premature mortality and morbidity. In many societies, due to cultural and structural factors, women and girls have reduced access to the socioeconomic resources that ensure good health and wellbeing when compared with their male counterparts. Thus, the objective of this paper is to review how SEP - a construct at the heart of the Social Determinants of Health (SDoH) theory - shapes the health and longevity of women and girls at all stages of the lifespan. Using literature identified from PubMed, Cochrane, CINAHL and EMBASE databases, we first describe the SDoH theory. We then use examples from each stage of the life course to demonstrate how SEP can differentially shape girls' and women's health outcomes compared with boys' and men's, as well as between sub-groups of girls and women when other axes of inequalities are considered, including ethnicity, race and residential setting. We also explore the key consideration of whether conventional SEP markers are appropriate for understanding the social determinants of women's health. We conclude by making key recommendations in the context of clinical, research and policy development.
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Affiliation(s)
- Adrienne O'Neil
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia.
| | - Josephine D Russell
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia
| | - Kelly Thompson
- Global Women's Health, The George Institute for Global Health, University of New South Wales, Australia
| | | | - Sanne A E Peters
- The George Institute for Global Health, University of Oxford, Oxford, UK; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Miething A, Almquist YB. Childhood peer status and circulatory disease in adulthood: a prospective cohort study in Stockholm, Sweden. BMJ Open 2020; 10:e036095. [PMID: 32933959 PMCID: PMC7493119 DOI: 10.1136/bmjopen-2019-036095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Childhood conditions have been recognised as important predictors of short-term and long-term health outcomes, but few studies have considered status position in the peer group as a possible determinant of adult health. Lower peer status, which often reflects experiences of marginalisation and rejection by peers, may impose inequality experiences and leave long-lasting imprints on health. The present study aimed to examine whether peer status is associated with the risk for circulatory disease in adulthood. DESIGN Prospective cohort study based on the Stockholm Birth Cohort Multigenerational Study(SBC Multigen). SETTING Stockholm metropolitan area. PARTICIPANTS All individuals who were born in 1953 and resident in the greater metropolitan area of Stockholm in 1963 (n=14 608). The analytical sample consisted of 5410 males and 5990 females. Peer status was sociometrically assessed in cohort members at age 13. The survey material was linked to inpatient care registers that contained information about circulatory diseases (n=1668) across ages 20-63. Cox proportional hazard models were used for the analysis. OUTCOME MEASURE Circulatory disease. RESULTS Peer marginalisation at age 13 resulted in significantly higher risks of circulatory disease in adulthood among males (HR 1.34; 95% CI 1.09 to 1.64) and females (HR 1.33; 95% CI 1.04 to 1.70) alike. A graded relationship between peer status and circulatory diseases was detected in females (p=0.023). Among males there was a threshold effect, showing that only those in the lowest status position had significantly increased risks of circulatory disease. The associations remained significant after adjusting for various conditions in childhood and adulthood. CONCLUSIONS This study shows that circulatory diseases in adulthood may be traceable to low peer status and marginalisation in childhood. It is suggested that peer status in late childhood may precede social integration in adolescence and adulthood, acting as a long-term stressor that contributes to circulatory disease through biological, behavioural and psychosocial pathways.
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Affiliation(s)
- Alexander Miething
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Russell MA, Odgers CL. Adolescents' Subjective Social Status Predicts Day-to-Day Mental Health and Future Substance Use. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30 Suppl 2:532-544. [PMID: 30938467 DOI: 10.1111/jora.12496] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adolescents' subjective social status (SSS) is associated with mental and behavioral health outcomes, independent of socioeconomic status (SES). Many previous findings, however, come from cross-sectional studies. We report results from a longitudinal study with 151 adolescents identified as at risk for early substance use and behavioral problems sampled from low-SES neighborhoods. We examined whether adolescent's SSS predicted mental health (depression, anxiety, and inattention/impulsivity) measured over 30 days via ecological momentary assessment and risk for substance use at an 18-month follow-up. Results showed that with each perceived step "up" the SSS ladder, adolescents experienced fewer mental health symptoms in daily life and lower future substance use risk after adjusting for objective SES and previous psychopathology. Implications of these findings are discussed.
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Rahal D, Chiang JJ, Bower JE, Irwin MR, Venkatraman J, Fuligni AJ. Subjective social status and stress responsivity in late adolescence. Stress 2020; 23:50-59. [PMID: 31204553 PMCID: PMC6917998 DOI: 10.1080/10253890.2019.1626369] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 05/25/2019] [Indexed: 12/27/2022] Open
Abstract
Subjective social status (SSS) reflects one's perception of one's standing within society. SSS has been linked with health outcomes, over and above socioeconomic status, and is thought to influence health in part by shaping stress responsivity. To test this, the present study examined the links between SSS and psychological, hypothalamic-pituitary-adrenal (HPA) axis, and cardiovascular responsivity in a sample of 87 ethnically diverse late adolescents (Mage = 18.39 years). Participants rated their family's SSS while either in high school (n = 50) or 1 year afterward (n = 37). Participants completed the Trier Social Stress Task (TSST) and reported their fear during baseline and after task completion, provided six saliva samples throughout the task, and had their heart rate monitored continuously throughout the task. Multilevel models, with time points nested within participants, were conducted to assess reactivity and recovery for each outcome. Results indicated that lower SSS was associated with greater fear reactivity and faster rates of HPA axis reactivity and recovery to baseline. Regarding cardiovascular responses, no differences were observed with respect to heart rate. Lower SSS predicted increased respiratory sinus arrhythmia during the stress task only among participants who rated their SSS while in high school; no association was observed for those who rated SSS after high school. Results suggest that perceptions of one's family's standing in society can shape responses to stress and potentially broader health.HighlightsSubjective social status (SSS) was linked with differences in stress responsivity. Specifically, lower SSS was associated with greater increases in fear following an acute stressor and faster rates of cortisol reactivity and recovery. Adolescents with lower SSS in high school showed less cardiovascular reactivity and recovery with respect to respiratory sinus arrhythmia, a marker of parasympathetic nervous system activity.
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Affiliation(s)
- Danny Rahal
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA
| | - Jessica J. Chiang
- Northwestern University, Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA
| | - Julienne E. Bower
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
- University of California, Los Angeles, Cousins Center of Psychoneuroimmunology, Los Angeles, CA 90095, USA
| | - Michael R. Irwin
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
- University of California, Los Angeles, Cousins Center of Psychoneuroimmunology, Los Angeles, CA 90095, USA
| | - Jaahnavee Venkatraman
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA
| | - Andrew J. Fuligni
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
- University of California, Los Angeles, Cousins Center of Psychoneuroimmunology, Los Angeles, CA 90095, USA
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Gorabi AM, Heshmat R, Farid M, Motamed-Gorji N, Motlagh ME, Zavareh NHT, Djalalinia S, Sheidaei A, Asayesh H, Madadi Z, Qorbani M, Kelishadi R. Economic Inequality in Life Satisfaction and Self-perceived Health in Iranian Children and Adolescents: The CASPIAN IV Study. Int J Prev Med 2019; 10:70. [PMID: 31198505 PMCID: PMC6547786 DOI: 10.4103/ijpvm.ijpvm_508_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/18/2017] [Indexed: 11/15/2022] Open
Abstract
Background: The purpose of this study was to assess socioeconomic status (SES) inequality in life satisfaction (LS) and good self-perceived health (SPH) in Iranian children and adolescents. Methods: This nationwide study was conducted as part of a fourth national school-based surveillance program performed on 14880 students aged 6–18 years who were living in urban and rural areas of 30 provinces of Iran between 2011 and 2012. Using principle component analysis, the SES of participants was constructed as single variable. SES inequality in LS and good SPH across the SES quintiles was assessed using the concentration index (C) and slope index of inequality (SII). The determinants of this inequality are investigated by the Oaxaca Blinder decomposition method. Results: Frequency of LS along with the SES quintiles shifted significantly from 73.28% (95% CI: 71.49, 75.08) in the lowest quintile to 86.57% (95% CI:85.20, 87.93) in the highest SES quintile. Frequency of favorable SPH linearly increased from lowest SES quintile (76.18% (95% CI: 74.45, 77.92)) to highest SES quintile (83.39% (95% CI: 81.89, 84.89)). C index for LS and good SPH was negative, which suggests inequality was in favor of high SES group. SII for LS and SPH was 15.73 (95% CI: 12.10, 19.35) and 8.21 (95% CI: 5.46, 10.96)]. Living area and passive smoking were the most contributed factors in SES inequality of LS. Also passive smoking and physical activity were the most contributed factors in SES inequality of SPH. Conclusions: SES inequality in LS and good SPH was in favor of high SES group. These findings are useful for health policies, better programming and future complementary analyses.
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Affiliation(s)
- Armita Mahdavi Gorabi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Malihe Farid
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nazgol Motamed-Gorji
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Neda Hani-Tabaei Zavareh
- Department of Public Health, Master Candidate in Public Health, Massachusetts College of Pharmacy and Health Sciences, Boston, USA
| | - Shirin Djalalinia
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Madadi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Department of Epidemiology, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Diseases, Isfahan University of Medical Sciences, Isfahan, Iran
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Fajardo-Bullón F, Rasskin-Gutman I, León-Del Barco B, Ribeiro Dos Santos EJ, Iglesias Gallego D. International and Spanish Findings in Scientific Literature about Minors' Mental Health: Predictive Factors Using the Strengths and Difficulties Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1603. [PMID: 31071907 PMCID: PMC6539595 DOI: 10.3390/ijerph16091603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 04/30/2019] [Accepted: 05/05/2019] [Indexed: 11/24/2022]
Abstract
Minors' mental health is a subject of high global concern. Understanding the factors that influence their mental health is essential to improving the health of future generations. In this study, an analysis of the Strengths and Difficulties Questionnaire's usefulness is carried out, as a validated tool, recognized in Spain and internationally, for the measurement of minors' mental health. In turn, the influence of the variables of gender, age, and physical health, along with the occupational social class of parents on Spanish minors' mental health, has been analyzed. Spanish minors with good physical health and of parents with middle and higher education, as well as in an occupational social class, are less likely to suffer mental health problems. On the other hand, it seems that internalizing symptoms are more likely in girls, and externalizing symptoms are more likely in boys. However, when a global measure of mental health is made without specific subscales, the effects of gender and age diverge greatly, according to the studies. Although there are examples of current research using the same measurement tool, there is still a need for many more international studies that are coordinated using the same methodology. This study identifies the factors which the international and Spanish scientific literature has revealed as being determinants in minors' mental health. Finally, it is essential that the influence of these factors be assessed in the areas of primary care and mental health to facilitate better detection, intervention, or prevention of mental health problems in today's children, as well as the children of future generations.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain.
| | - Irina Rasskin-Gutman
- Department of Psychology, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
| | - Benito León-Del Barco
- Department of Psychology, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
| | - Eduardo João Ribeiro Dos Santos
- Scientific Coordinator R&D Unit Institute of Cognitive Psychology (IPCDHS/FPCE), University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Damián Iglesias Gallego
- Department of Didactics of Music, Plastic and Body Expression, Teacher Training College, University of Extremadura, 10003 Cáceres, Spain.
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Zhu Y, Chen X, Zhao H, Chen M, Tian Y, Liu C, Han ZR, Lin X, Qiu J, Xue G, Shu H, Qin S. Socioeconomic status disparities affect children's anxiety and stress-sensitive cortisol awakening response through parental anxiety. Psychoneuroendocrinology 2019; 103:96-103. [PMID: 30665044 DOI: 10.1016/j.psyneuen.2019.01.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/08/2018] [Accepted: 01/09/2019] [Indexed: 01/07/2023]
Abstract
Socioeconomic status (SES) disparities have profound impacts on child development and health, which are linked to negative emotions and alterations in the integrity of stress-sensitive hypothalamus-pituitary-adrenal (HPA)-axis system. However, its underlying psychophysiological mechanisms remain poorly understood. Here we investigate how family SES, in concert with parental anxiety, affects children's anxiety and their integrity of HPA-axis system in two studies involving a total of 1318 children and their parents. In Study 1 with a cohort of 1088 children and their parents, we found that low-SES children relative to high-SES ones experienced a higher level of anxiety mediated by increasing parental anxiety. In Study 2 with an independent cohort of 230 children and their parents, we found that low-SES children exhibited an increase in pre-bedtime basal cortisol but a decrease in cortisol awakening response (CAR). Structural equation modeling (SEM) further revealed that the association between low SES and children's reduced CAR was mediated by increased parental and child anxiety. Our findings suggest that low-SES children are more vulnerable to anxiety and altered HPA-axis integrity, most likely mediated through increased parental anxiety.
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Affiliation(s)
- Yannan Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Xu Chen
- Faculty of Psychology at Southwest University, Chongqing, China
| | - Hui Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Menglu Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Yanqiu Tian
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Chao Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Zhuo Rachel Han
- Faculty of Psychology at Beijing Normal University, Beijing, China
| | - Xiuyun Lin
- Faculty of Psychology at Beijing Normal University, Beijing, China
| | - Jiang Qiu
- Faculty of Psychology at Southwest University, Chongqing, China
| | - Gui Xue
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Hua Shu
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning & McGovern Institute for Brain Research at Beijing Normal University, Beijing, China.
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Khazaie H, Behrouz B, Chehri A, Gerber M, Holsboer-Trachsler E, Sadeghi Bahmani D, Brand S. Among adolescents, addiction susceptibility and sleep-related dysfunction have a common cognitive-emotional base and predict poor sleep quantity. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1588405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrouz Behrouz
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azita Chehri
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran
| | - Markus Gerber
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
| | - Dena Sadeghi Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, Basel, Switzerland
- Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, University of Basel, Basel, Switzerland
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Waldhauer J, Kuntz B, Mauz E, Lampert T. Intergenerational Educational Pathways and Self-Rated Health in Adolescence and Young Adulthood: Results of the German KiGGS Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E684. [PMID: 30813568 PMCID: PMC6427741 DOI: 10.3390/ijerph16050684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Abstract
Health differences in social mobility are often analysed by income differences or different occupational positions. However, in early adulthood many young people still have very diffuse income situations and are not always fully integrated into the labour market despite many having finished school. This article focusses on the link between intergenerational educational pathways and self-rated health (SRH) among young adults considering their SRH in adolescence. The data source used is the German KiGGS cohort study. The analysis sample comprises 2175 young people at baseline (t0: 2003⁻2006 age 14⁻17) and first follow-up (t1: 2009⁻2012 age 19⁻24). Combining parent's and young people's highest school degree, the data can trace patterns of intergenerational educational pathways (constant high level of education, upward mobility, downward mobility, constant low level of education). Young people's SRH was recorded at t0 and t1. During adolescence and young adulthood, participants were less likely to report poor SRH if they had a constant high intergenerational education or if they were upwardly mobile. The differences were particularly striking among young adults: average marginal effects (AME) for poor SRH showed much higher risk among downwardly mobile compared to peers with an intergenerational constant high education (AME: 0.175 [0.099; 0.251]), while the upwardly mobile had a significantly lower risk for less than good SRH than peers with an intergenerational constant low level of education (AME: -0.058 [-0.113; -0.004]). In the context of great societal demands and personal developmental needs, educational differences in health tend to increase in young adulthood. Public Health should pay more attention to educational and health inequalities in young adulthood.
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Affiliation(s)
- Julia Waldhauer
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Benjamin Kuntz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Elvira Mauz
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
| | - Thomas Lampert
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany.
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15
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Silva LCOSTAE, Teles J, Fragoso I. Youth sports injuries according to health-related quality of life and parental instruction. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03749-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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León-Del-Barco B, Fajardo-Bullón F, Mendo-Lázaro S, Rasskin-Gutman I, Iglesias-Gallego D. Impact of the Familiar Environment in 11⁻14-Year-Old Minors' Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1314. [PMID: 29937491 PMCID: PMC6069230 DOI: 10.3390/ijerph15071314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/09/2018] [Accepted: 06/20/2018] [Indexed: 12/22/2022]
Abstract
The analysis of the mental health in children under 14 years has become a research topic of global interest where the family can be a key factor for protection or risk against mental health problems. With this work, we intend to determine, employing binary logistic regression analysis, whether parental acceptance-rejection perceived by boys and girls can predict their mental health. Seven hundred sixty-two students participated, the average age was 12.23 years; 53.8% (n = 410) girls and 46.2% (n = 352) boys. We have used the Strengths and Difficulties Questionnaire (SDQ), self-reported version and the Affection Scale children version (EA-H) for parental acceptance-rejection to assess mental health. The odds ratio (OR) of the logistic models reports that there is a greater probability of having mental health problems in boys and girls when they perceive that they are highly criticized and rejected by their parents. With our work, we highlight the importance of the environment and family affection on mental health. The perception of the children about the rejection, aversion, and criticism of their parents constitutes a risk factor in the manifestation of mental health problems.
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Affiliation(s)
- Benito León-Del-Barco
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, 06006 Badajoz, Spain.
| | - Santiago Mendo-Lázaro
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Irina Rasskin-Gutman
- Department of Psychology, Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
| | - Damián Iglesias-Gallego
- Department of Didactics of Music, Plastic and Body Expression. Teacher Training College, University of Extremadura, 10071 Cáceres, Spain.
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Glozah FN, Oppong Asante K, Kugbey N. Parental involvement could mitigate the effects of physical activity and dietary habits on mental distress in Ghanaian youth. PLoS One 2018; 13:e0197551. [PMID: 29771990 PMCID: PMC5957333 DOI: 10.1371/journal.pone.0197551] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 05/05/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Parental involvement in physical activity and dietary habits have been found to play a substantial role in the mental health of young people. However, there is little evidence about the associations between parental involvement, health behaviours and mental health among Ghanaian youth. This study sought to examine the role of parental involvement in the association between physical activity, dietary habits and mental health among Ghanaian youth. Methods Data were obtained from the 2012 Ghana Global School-based Student Health Survey (GSHS). The study population consisted of 1,984 school going youth in high schools with a median age of 15 years old, (53.7%) males. Bivariate and multivariate logistic regression statistical models using complex samples method were performed. Results The prevalence of mental distress was 18.1%, 16.6% and 23% for loneliness, feeling worried and suicidal ideation respectively. Younger students were more likely to feel lonely, worried and have suicidal ideation than older students. Students from low socio-economic backgrounds were significantly more likely to report loneliness, worry and suicidal ideation. After adjusting for socio-demographic characteristics, some physical activity and eating habits were associated with experiencing loneliness, worry and suicidal ideation but after introducing parental involvement, there was a decrease in the likelihood of some health behaviour factors in both physical activity and dietary habits to be associated with loneliness, worry and suicidal ideation. Conclusion Physical inactivity and poor dietary habits could have a negative effect on mental distress, however, parental involvement could mitigate the impact of these lifestyle habits on mental distress and should therefore be taken into consideration in efforts aimed at encouraging positive lifestyle habits for good mental health among Ghanaian youth.
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Affiliation(s)
- Franklin N. Glozah
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
- Institute for Psychosocial Research in Child and Adolescent Wellbeing, Accra, Ghana
- * E-mail:
| | - Kwaku Oppong Asante
- Institute for Psychosocial Research in Child and Adolescent Wellbeing, Accra, Ghana
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Nuworza Kugbey
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
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18
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Kehm RD, Spector LG, Poynter JN, Vock DM, Osypuk TL. Socioeconomic Status and Childhood Cancer Incidence: A Population-Based Multilevel Analysis. Am J Epidemiol 2018; 187:982-991. [PMID: 29036606 DOI: 10.1093/aje/kwx322] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/18/2017] [Indexed: 12/19/2022] Open
Abstract
The etiology of childhood cancers remains largely unknown, especially regarding environmental and behavioral risk factors. Unpacking the association between socioeconomic status (SES) and incidence may offer insight into such etiology. We tested associations between SES and childhood cancer incidence in a population-based case-cohort study (source cohort: Minnesota birth registry, 1989-2014). Cases, ages 0-14 years, were linked from the Minnesota Cancer Surveillance System to birth records through probabilistic record linkage. Controls were 4:1 frequency matched on birth year (2,947 cases and 11,907 controls). We tested associations of individual-level (maternal education) and neighborhood-level (census tract composite index) SES using logistic mixed models. In crude models, maternal education was positively associated with incidence of acute lymphoblastic leukemia (odds ratio (OR) = 1.10, 95% confidence interval (CI): 1.02, 1.19), central nervous system tumors (OR = 1.12, 95% CI: 1.04, 1.21), and neuroblastoma (OR = 1.15, 95% CI: 1.02, 1.30). Adjustment for established risk factors-including race/ethnicity, maternal age, and birth weight-substantially attenuated these positive associations. Similar patterns were observed for neighborhood-level SES. Conversely, higher maternal education was inversely associated with hepatoblastoma incidence (adjusted OR = 0.70, 95% CI: 0.51, 0.98). Overall, beyond the social patterning of established demographic and pregnancy-related exposures, SES is not strongly associated with childhood cancer incidence.
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Affiliation(s)
- Rebecca D Kehm
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Logan G Spector
- University of Minnesota, Division of Epidemiology and Clinical Research, Department of Pediatrics, Minneapolis, Minnesota
| | - Jenny N Poynter
- University of Minnesota, Division of Epidemiology and Clinical Research, Department of Pediatrics, Minneapolis, Minnesota
| | - David M Vock
- University of Minnesota School of Public Health, Division of Biostatistics, Minneapolis, Minnesota
| | - Theresa L Osypuk
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota
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Lampert T, Hoebel J, Kuntz B, Müters S, Kroll LE. Socioeconomic status and subjective social status measurement in KiGGS Wave 2. JOURNAL OF HEALTH MONITORING 2018; 3:108-125. [PMID: 35586179 PMCID: PMC8848848 DOI: 10.17886/rki-gbe-2018-033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article describes the method applied to measure socioeconomic status (SES) and subjective social status (SSS) in the current wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2), which was conducted over three years between 2014 and 2017. The composite multidimensional SES index was calculated as a sum of point scores for the parents' education level, occupational status and equivalised disposable income. SSS was assessed in the 11 to 17 year age group using a German version of the MacArthur Scale for children and adolescents. To demonstrate the use of both instruments, we present examples that highlight the association between SES and SSS with the general health of children and adolescents in the 3 to 17 and/or 11 to 17 age groups. Over 95% of parents rated the general health of their children as 'very good' or 'good'. However, the analyses clearly reveal that children and adolescents from families with low SES and SSS have poorer general health than their better-off peers. Even when mutually adjusted, both low SES and SSS are independently associated with poorer general health. In addition to the SES index, studies on the health of children and adolescents should therefore also consider SSS. In this way, additional aspects of the socioeconomic conditions of families can be taken into account.
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Affiliation(s)
- Thomas Lampert
- Robert Koch Institute, Berlin, Department of Epidemiology and Health Monitoring
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20
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Bøe T, Serlachius AS, Sivertsen B, Petrie KJ, Hysing M. Cumulative effects of negative life events and family stress on children's mental health: the Bergen Child Study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1-9. [PMID: 29090324 DOI: 10.1007/s00127-017-1451-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 10/22/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE Numerous studies have documented that lower socioeconomic status (SES) is associated with increased mental health problems in children. One proposed pathway for this association has been differential exposure to accumulated risk factors in children of lower SES. The aim of the current study was to investigate the socioeconomic distribution of exposure to negative life events and family stress and to examine the direct and interactive association between lower SES and exposure to life events and family stress in relation with mental health problems. METHODS Using cross-sectional data from the second wave of the Bergen Child Study (conducted in 2006), the current study investigated the association between lower SES and exposure to negative life events, family life stressors, and mental health problems in a sample of 2043 Norwegian 11-13 years and their parents. Information about mental health was self-reported by the children using the Strengths and Difficulties Questionnaire, whereas information about SES and exposure to negative life events and family stressors were provided by their parents. RESULTS The findings showed that lower SES was associated with more symptoms of emotional-, conduct-, hyperactivity/inattention-, and peer problems and that exposure to life events and family stress explained some of this association (10-29% of the total effects). CONCLUSIONS Low SES and higher prevalence of negative life events and family stressors were associated with more symptoms of mental health problems. Overall, the effect sizes were smaller than previous investigations (f 2s = 0.015-0.031), perhaps suggesting a buffering effect of the social safety net in place in Norway.
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Affiliation(s)
- Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway.
| | | | - Børge Sivertsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Mailbox 7810, 5020, Norway
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21
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Moving into poverty during childhood is associated with later sleep problems. Sleep Med 2017; 37:54-59. [DOI: 10.1016/j.sleep.2017.06.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 11/22/2022]
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Being Poorer Than the Rest of the Neighborhood: Relative Deprivation and Problem Behavior of Youth. J Youth Adolesc 2017; 46:1891-1904. [PMID: 28364210 PMCID: PMC5561161 DOI: 10.1007/s10964-017-0668-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/21/2017] [Indexed: 11/02/2022]
Abstract
According to the neighborhood effects hypothesis, there is a negative relation between neighborhood wealth and youth's problem behavior. It is often assumed that there are more problems in deprived neighborhoods, but there are also reports of higher rates of behavioral problems in more affluent neighborhoods. Much of this literature does not take into account relative wealth. Our central question was whether the economic position of adolescents' families, relative to the neighborhood in which they lived, was related to adolescents' internalizing and externalizing problem behavior. We used longitudinal data for youth between 12-16 and 16-20 years of age, combined with population register data (N = 926; 55% females). We employ between-within models to account for time-invariant confounders, including parental background characteristics. Our findings show that, for adolescents, moving to a more affluent neighborhood was related to increased levels of depression, social phobia, aggression, and conflict with fathers and mothers. This could be indirect evidence for the relative deprivation mechanism, but we could not confirm this, and we did not find any gender differences. The results do suggest that future research should further investigate the role of individuals' relative position in their neighborhood in order not to overgeneralize neighborhood effects and to find out for whom neighborhoods matter.
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Tenkorang EY, Kuuire VZ. Noncommunicable Diseases in Ghana: Does the Theory of Social Gradient in Health Hold? HEALTH EDUCATION & BEHAVIOR 2017; 43:25S-36S. [PMID: 27037145 DOI: 10.1177/1090198115602675] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The theory of social gradient in health posits that individuals with lower socioeconomic status (SES) have poorer health outcomes, compared with those in higher socioeconomic brackets. Applied to noncommunicable diseases (NCDs), this theory has largely been corroborated by studies from the West. However, evidence from sub-Saharan Africa are mixed, with those from Ghana conspicuously missing in the literature. Using data from the Study on Global Ageing and Adult Health, and applying random-effects C log-log models, this study examined the relationship between SES and the risks of living with NCDs in Ghana. Results confirmed a negative social gradient, as Ghanaians with higher SES were more likely to live with NCDs compared with those with low SES. The addition of lifestyle factors attenuated the risks of living with NCDs among Ghanaian men and women with higher SES. This study underscores the need for policies targeted at specific socioeconomic and demographic groups, such as the emerging middle and upper class Ghanaians. It is similarly important for interventions to move beyond biomedical solutions that put more emphasis on epidemiological risk factors to strategies that embrace psychosocial factors as important correlates of cardiovascular health.
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Affiliation(s)
- Eric Y Tenkorang
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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24
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Liu Y, Lintonen T, Tynjälä J, Villberg J, Välimaa R, Ojala K, Kannas L. Socioeconomic differences in the use of alcohol and drunkenness in adolescents: Trends in the Health Behaviour in School-aged Children study in Finland 1990-2014. Scand J Public Health 2016; 46:102-111. [PMID: 29468953 DOI: 10.1177/1403494816684118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aims of this study were to explore time-based trends of socioeconomic differences in alcohol use and drunkenness in Finnish adolescents from 1990 to 2014 and to investigate the significance of two indicators in detecting socioeconomic differences in alcohol use and drunkenness. METHODS Data were retrieved from seven surveys conducted as part of the Health Behaviour in School-aged Children (HBSC) study in Finland from 1990 to 2014. The alcohol use and drunkenness of 15-year-old students, as well as socioeconomic status, including educational aspiration and perceived family wealth, were assessed via a self-report questionnaire. Logistic regression models were used to investigate the relationships between alcohol use, drunkenness and indicators of socioeconomic status. RESULTS The study showed that the alcohol use and drunkenness of Finnish 15-year-old adolescents have decreased since the late 1990s. However, the level of decrease is not consistent among different socioeconomic groups and socioeconomic differences in drinking behaviour between two educational aspiration groups have persisted over two decades. Girls from the groups with low perceived family wealth were more likely to be frequently drunk in the time period 2006-2014. CONCLUSIONS This study suggests that students with low educational aspiration should be the target population for interventions aiming at reducing the alcohol use and drunkenness of Finnish adolescents. In future interventions aimed at reducing heavier drinking, adolescents (especially girls) from less wealthy families should be the first priority. Further studies on trends in socioeconomic differences in alcohol use and drunkenness in adolescence should be conducted using different indicators of socioeconomic status and other social context factors should also be taken into account.
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Affiliation(s)
- Yang Liu
- 1 School of Physical Education and Sport Training, Shanghai University of Sport, China.,2 Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, China
| | | | - Jorma Tynjälä
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Jari Villberg
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Raili Välimaa
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Kristiina Ojala
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Lasse Kannas
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
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25
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Rathmann K, Heilmann K, Moor I, Richter M. Schulisches Wohlbefinden, Schulform und Tabakkonsum von Jugendlichen: Ergebnisse der SILNE-Studie. SUCHT-ZEITSCHRIFT FUR WISSENSCHAFT UND PRAXIS 2016. [DOI: 10.1024/0939-5911/a000458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Zielsetzung: Der Beitrag untersucht die Bedeutung der besuchten Schulform und des schulischen Wohlbefindens für den Tabakkonsum von Jugendlichen und prüft erstmals, ob sich dieser Zusammenhang im Sinne einer doppelten Benachteiligung auf den Tabakkonsum auswirkt. Methodik: Datenbasis bildet der deutsche Survey der europäischen SILNE-Studie „Tackling socioeconomic inequalities in smoking: learning from natural experiments by time trend analyses and cross-national comparisons“ (Schüler der 8. und 9. Klasse) in Hannover (n = 1.190). In bi- und multivariaten Analysen werden die Zusammenhänge zwischen den Merkmalen des schulischen Wohlbefindens (Schulengagement, Schulverbundenheit und Burnout), der besuchten Schulform und dem Tabakkonsum überprüft. Ergebnisse: Jugendliche mit niedrigem Schulengagement, geringer Schulverbundenheit sowie erhöhtem schulbezogenen Burnout zeigen eine erhöhte Wahrscheinlichkeit zu rauchen, ebenso wie Schüler, die eine andere Schulform als das Gymnasium besuchen. Belege der doppelten Benachteiligung für den Tabakkonsum von Jugendlichen konnten nicht gefunden werden. Gymnasiasten besitzen im Vergleich zu Schülern anderer Schulformen eine erhöhte Wahrscheinlichkeit zu rauchen, wenn sie über schulbezogenes Burnout berichten. Schlussfolgerungen: Unsere Ergebnisse geben wichtige Hinweise für schulformspezifische Maßnahmen der Gesundheitsförderung, um das schulische Wohlbefinden zu fördern und dem Tabakkonsum im Jugendalter entgegenzuwirken.
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Affiliation(s)
- Katharina Rathmann
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg
| | - Kristina Heilmann
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg
| | - Irene Moor
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg
| | - Matthias Richter
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg
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Hysing M, Petrie KJ, Bøe T, Lallukka T, Sivertsen B. The social gradient of sleep in adolescence: results from the youth@hordaland survey. Eur J Public Health 2016; 27:65-71. [DOI: 10.1093/eurpub/ckw200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rathmann K, Moor I, Kunst AE, Dragano N, Pförtner TK, Elgar FJ, Hurrelmann K, Kannas L, Baška T, Richter M. Is educational differentiation associated with smoking and smoking inequalities in adolescence? A multilevel analysis across 27 European and North American countries. SOCIOLOGY OF HEALTH & ILLNESS 2016; 38:1005-1025. [PMID: 27214054 DOI: 10.1111/1467-9566.12420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aims to determine whether educational differentiation (i.e. early and long tracking to different school types) relate to socioeconomic inequalities in adolescent smoking. Data were collected from the WHO-Collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, which included 48,025 15-year-old students (Nboys = 23,008, Ngirls = 25,017) from 27 European and North American countries. Socioeconomic position was measured using the HBSC family affluence scale. Educational differentiation was determined by the number of different school types, age of selection, and length of differentiated curriculum at the country-level. We used multilevel logistic regression to assess the association of daily smoking and early smoking initiation predicted by family affluence, educational differentiation, and their interactions. Socioeconomic inequalities in both smoking outcomes were larger in countries that are characterised by a lower degree of educational differentiation (e.g. Canada, Scandinavia and the United Kingdom) than in countries with higher levels of educational differentiation (e.g. Austria, Belgium, Hungary and The Netherlands). This study found that high educational differentiation does not relate to greater relative inequalities in smoking. Features of educational systems are important to consider as they are related to overall prevalence in smoking and smoking inequalities in adolescence.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
| | - Anton E Kunst
- Department of Public Health, AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nico Dragano
- Institute of Medical Sociology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
| | | | - Lasse Kannas
- Faculty of Sport and Health Sciences, Department of Health Sciences, University of Jyväskylä, Finland
| | - Tibor Baška
- Department of Public Health, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
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Rathmann K, Pförtner TK, Hurrelmann K, Osorio AM, Bosakova L, Elgar FJ, Richter M. The great recession, youth unemployment and inequalities in psychological health complaints in adolescents: a multilevel study in 31 countries. Int J Public Health 2016; 61:809-19. [PMID: 27502510 DOI: 10.1007/s00038-016-0866-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Little is known about the impact of recessions on young people's socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America. METHODS Data from the WHO collaborative 'Health Behaviour in School-aged Children' (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005-2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10. RESULTS Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005-2010) were not associated with adolescents' psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment. CONCLUSIONS This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Ana M Osorio
- Department of Economics, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Lucia Bosakova
- Health Psychology Unit, Institute of Public Health, Medical Faculty, P. J. Safarik University in Kosice, Kosice, Slovak Republic.,Department of Quantitative Methods, Faculty of Business Economy in Kosice, University of Economics in Bratislava, Kosice, Slovak Republic.,Olomouc University Social Health Institute (OUSHI), Palacky University in Olomouc, Olomouc, Czech Republic
| | - Frank J Elgar
- Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, QC, Canada
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Demirsoy N, Sayligil O. Validity and reliability of a quality-of-life assessment instrument in children aged between 6 and 11 years. Ann Saudi Med 2016; 36:269-81. [PMID: 27478913 PMCID: PMC6074397 DOI: 10.5144/0256-4947.2016.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is increasing recognition of the importance of obtaining children's reports of their health, but significant challenges remain in accomplishing these goals in a systematic, community-based approach. OBJECTIVES The aim of study was to evaluate the validity and reliability of the culturally adapted Turkish version of the "Child Health and Illness Profile - Child Edition (CHIP-CE) (6-11) for children 6 to 11 years of age. DESIGN Cross-sectional analytical study conducted at Eskisehir Osmangazi University, Faculty of Medicine, Department of Pediatrics, Eskisehir, Turkey. SETTING Children's health and diseases clinic. PATIENTS AND METHODS For the purpose of this study, face-to-face interviews were conducted with inpatients (children aged between 6 and 11 years staying in the hospital) and healthy children (children aged between 6 and 11 years attending a private elementary school in the spring semester of 2010-2011). The Turkish version of CHIP-CE (6-11) was administered after the original version of CHIP-CE in English was translated into Turkish, and then back translated into English. All steps in the cultural adaptation process were undertaken meticulously by an expert committee. Confirmatory factor analysis (CFA) was conducted to test construct validity. The Cronbach's alpha and item-total correlations were used to evaluate internal consistency for reliability testing. MAIN OUTCOME MEASURES Domain scores on the CHIP-CE questionnaire, Cronbach's alpha and item-total correlations. RESULTS The Turkish version of CHIP-CE (6-11) was administered to 235 children, including 109 (46.4%) girls and 126 (53.6%) boys receiving inpatient treatment in the hospital, and 194 healthy children, including 89 (45.9%) girls and 105 (54.1%) boys. The mean (standard deviation) age was 6.9 (1.6) years in the group of children receiving inpatient treatment, and 9.2 (1.6) years in the healthy children. In the reliability testing of the CHIP-CE form, Cronbach's alpha was 0.79 in children receiving inpatient treatment, and 0.80 in healthy children. These values indicate excellent reliability. The CFA measurement model produced results consistent with standards: c2=185.76 df=160 P=.07986 RMSEA=0.026 in the children receiving inpatient treatment, and c2=180.20 df=109 P=.00002 RMSEA=0.058 in healthy children. CONCLUSION CHIP-CE proved to be a reliable and valid measurement instrument for children receiving treatment for various diseases and healthy children. The internal consistency of the Turkish version of CHIP-CE is acceptable. LIMITATIONS The sample, although large and diverse, was self-selected and does not represent the population of children in Turkey.
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Affiliation(s)
- Nilüfer Demirsoy
- Dr. Nilüfer Demirsoy, Department of History of Medicine and Ethics,, Faculty of Medicine, Eskisehir Osmangazi University,, Eskisehir 26480, Turkey, T: +902222290170, , ORCID: http://orcid.org/0000-0002-2647-0807
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Oudin A, Bråbäck L, Åström DO, Strömgren M, Forsberg B. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents. BMJ Open 2016; 6:e010004. [PMID: 27259522 PMCID: PMC4893847 DOI: 10.1136/bmjopen-2015-010004] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To investigate associations between exposure to air pollution and child and adolescent mental health. DESIGN Observational study. SETTING Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. PARTICIPANTS The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. MAIN OUTCOME MEASURES Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. RESULTS The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m(3). Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m(3) increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. CONCLUSION There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others.
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Affiliation(s)
- Anna Oudin
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Lennart Bråbäck
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Daniel Oudin Åström
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Magnus Strömgren
- Department of Geography and Economic History, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
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Schnall R, John RM, Carballo-Dieguez A. Do High-Risk Young Adults Use the HIV Self-Test Appropriately? Observations from a Think-Aloud Study. AIDS Behav 2016; 20:939-48. [PMID: 26518679 DOI: 10.1007/s10461-015-1240-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to understand high-risk young adults' use of the rapid human immunodeficiency virus (HIV) self-test. The highest rate of new HIV infections occurs in people between 15 and 24 years. Improving identification of young people infected with HIV is a critical public health priority. The first rapid HIV self-testing kit was approved in the US in 2012. Despite the product's promise, its use by untrained young adults is not well-understood. We conducted a mixed methods study using surveys, a think-aloud protocol, observations, and in-depth interviews. A systematic checklist was developed to assess participants' use of the test. A total of 21 racial and/or ethnic minority young adults aged 18-24 participated in this study. Analysis of our interview data was guided by the theory of reasoned action (TRA). Participants completed the initial procedures of the test with a mean time of 8:36 min (range of 2:04'-16:33'). On a 14-point checklist, participants had a mean score of 10.8 (SD 2.26, range 3-14). In the qualitative analysis of the participants' interviews, guided by the theoretical constructs of the TRA, the following themes emerged: "Did I use it correctly?", "Can I trust the results?" (attitude); "How will my partner react?!", "What will people think?" (subjective norm); "Quick, easy and blood free," and "Avoids the hassle of dealing with the healthcare system" (behavioral intention). This study provided evidence of the usefulness of the test perceived by young adults, especially in light of their concerns about lack of privacy in medical settings. Since many participants did not follow all of the instructions while using the test, it is not evident that young adults can correctly use the HIV self-test. Development of instructions manuals that are understandable and guide proper use of medical devices is a great need, especially in the context of home testing technology.
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Affiliation(s)
- Rebecca Schnall
- Columbia University, School of Nursing, 617 W. 168th Street, New York, NY, 10032, USA.
| | - Rita Marie John
- Columbia University, School of Nursing, 617 W. 168th Street, New York, NY, 10032, USA
| | - Alex Carballo-Dieguez
- Columbia University Medical Center, HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute, Unit 15, 1051 Riverside Drive, New York, NY, 10032, USA
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Kwak K. An evaluation of the healthy immigrant effect with adolescents in Canada: Examinations of gender and length of residence. Soc Sci Med 2016; 157:87-95. [PMID: 27064656 DOI: 10.1016/j.socscimed.2016.03.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 02/18/2016] [Accepted: 03/11/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The healthy immigrant effect, HIE, is the finding that immigrants initially arrive in the settlement society in the same or better health than their native-born counterparts, yet this advantage is lost as their length of residence increases. This phenomenon has been found among adult populations. OBJECTIVE The present study sought to extend the premise of HIE to adolescents in Canada. METHODS Utilizing national data sets of three years (Canadian Community Health Survey 2007, 2009, 2011; Statistics Canada), adolescents (aged 12-19), foreign-born immigrants (N = 2919) and native-born non-immigrants (N = 39,083), were compared for their perceived general health and mental health as well as diagnosed chronic illnesses and psychological illnesses. Multiple imputations were first carried out for the degrees of missing values, and multivariate analyses were conducted to find differences between non-immigrants and immigrants, and between recent and long-term immigrants to verify (1) whether immigrant adolescents show better health than their non-immigrant peers, (2) whether the health of immigrant adolescents vary with length of residence and gender, and (3) whether persistent trends would be shown across the three survey years. RESULTS After adjusting for age, visible minority status, household income and household size as covariates, immigrant adolescents indeed reported better health in all four measures in each survey year. Girls experienced more health problems regardless of immigrant status, especially for chronic and psychological illnesses. However, only in 2009 the long-term immigrant adolescents reported less favorite health than recent immigrants, and length of residence influenced boys' and girls' mental health in different directions. CONCLUSIONS The HIE was confirmed with national community population samples of adolescents in Canada: foreign-born immigrant adolescents experience better health than their native-born peers. However, understanding of the HIE needs to be further extended to encompass the influence of societal contexts and their impact on various segments of populations.
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Affiliation(s)
- Kyunghwa Kwak
- Centre for Research on Migration, Refugees, and Belonging, School of Law and Social Sciences, University of East London, London E15 1NF, United Kingdom.
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Skalamera J, Hummer RA. Educational attainment and the clustering of health-related behavior among U.S. young adults. Prev Med 2016; 84:83-9. [PMID: 26740348 PMCID: PMC4758886 DOI: 10.1016/j.ypmed.2015.12.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/14/2015] [Accepted: 12/17/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We documented health-related behavior clustering among US young adults and assessed the extent to which educational attainment was associated with the identified clusters. METHODS Using data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we performed latent class analysis on 8 health-related behaviors (n=14,338), documenting clustering of behavior separately by gender. Subsequently, we used multinomial logistic regression and estimated associations between educational attainment and the health-related behavior clusters. RESULTS Twenty-eight percent of young women grouped into the most favorable health behavior cluster, while 22% grouped into a very high-risk cluster. A larger percentage of young men (40%) grouped into the highest risk cluster. Individuals with educational attainment at the college and advanced degree levels exhibited much lower risk of being in the unhealthy behavioral clusters than individuals with lower educational attainment, net of a range of confounders. CONCLUSION Substantial fractions of US young adults, particularly those with less than college degrees, exhibit unhealthy behavior profiles. Efforts to improve health among young adults should focus particular attention on the clustering of poor health-related behavior, especially among individuals who have less than a college degree.
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Affiliation(s)
- Julie Skalamera
- University of Texas at Austin, Population Research Center, 305 East 23rd Street, G1800, Austin, TX 78712-1699, USA.
| | - Robert A Hummer
- Carolina Population Center and Department of Sociology, University of North Carolina, Chapel Hill, 206 W. Franklin Street, Room 208, Chapel Hill, NC 27516, USA
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Chen E, Shalowitz MU, Story RE, Ehrlich KB, Levine CS, Hayen R, Leigh AKK, Miller GE. Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations. Psychosom Med 2016; 78:1043-1052. [PMID: 27749682 PMCID: PMC5096956 DOI: 10.1097/psy.0000000000000392] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. METHODS Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. RESULTS Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values < .05). Higher prestige, but not resources, was associated with better home environment control behaviors and less exposure to smoke (β's from |.21 to .22|, p values < .05). Higher resources, but not prestige, was associated with more favorable immune regulation, as manifest in smaller peripheral blood mononuclear cell (PBMC) TH1 and TH2 cytokine responses (β's from -.18 to -.19; p values < .05), and smaller proinflammatory cytokine responses (β = -.19; p < .05) after ex vivo stimulation. Higher resources also were associated with more sensitivity to glucocorticoid inhibition of TH1 and TH2 cytokine production (β's from -.18 to -.22; p values < .05). CONCLUSIONS These results suggest that prestige and resources in childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.
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Affiliation(s)
- Edith Chen
- Northwestern University, Institute for Policy Research & Department of Psychology
| | | | | | - Katherine B. Ehrlich
- Northwestern University, Institute for Policy Research & Department of Psychology
| | - Cynthia S. Levine
- Northwestern University, Institute for Policy Research & Department of Psychology
| | - Robin Hayen
- Northwestern University, Institute for Policy Research & Department of Psychology
| | - Adam K. K. Leigh
- Northwestern University, Institute for Policy Research & Department of Psychology
| | - Gregory E. Miller
- Northwestern University, Institute for Policy Research & Department of Psychology
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Moor I, Richter M, Ravens-Sieberer U, Ottová-Jordan V, Elgar FJ, Pförtner TK. Trends in social inequalities in adolescent health complaints from 1994 to 2010 in Europe, North America and Israel: The HBSC study. Eur J Public Health 2015; 25 Suppl 2:57-60. [PMID: 25805789 DOI: 10.1093/eurpub/ckv028] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies have shown constant or increasing health inequalities in adulthood in the last decades, but less is known about trends in health inequalities among adolescents. The aim is to analyse changes in socioeconomic differences in subjective health complaints from 1994 to 2010 among 11- to 15-year-olds in Europe, North America and Israel. METHODS Data were obtained from the international 'Health Behaviour in School-aged Children' (HBSC) survey. Analyses were based on the HBSC surveys conducted in 1994 (19 countries), 1998 (25 countries), 2002 (32 countries), 2006 (37 countries) and 2010 (36 countries) covering a time period of up to 16 years. Log binomial regression models were used to assess inequalities in multiple health complaints. Socioeconomic position was measured using perceived family wealth. RESULTS Inequalities in multiple health complaints emerged in almost all countries, in particular since 2002 (RR 1.1-1.7). Trend analyses showed stable (29 countries), increased (5 countries), decreased (one country) and no social inequalities (2 countries) in adolescent health complaints. CONCLUSION In almost all countries, social inequalities in health complaints remained constant over a period of up to 16 years. Our findings suggest a need to intensify efforts in social and health policy to tackle existing inequalities.
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Affiliation(s)
- Irene Moor
- 1 Institute of Medical Sociology (IMS), Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Matthias Richter
- 1 Institute of Medical Sociology (IMS), Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Ulrike Ravens-Sieberer
- 2 Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Veronika Ottová-Jordan
- 2 Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank J Elgar
- 3 Institute for Health and Social Policy and Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Timo-Kolja Pförtner
- 1 Institute of Medical Sociology (IMS), Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Springer AE, Li L, Ranjit N, Delk J, Mehta K, Kelder SH. School-level economic disadvantage and obesity in middle school children in central Texas, USA: a cross-sectional study. Int J Behav Nutr Phys Act 2015; 12 Suppl 1:S8. [PMID: 26222099 PMCID: PMC4518903 DOI: 10.1186/1479-5868-12-s1-s8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Although children of lower socio-economic status (SES) in the United States have generally been found to be at greater risk for obesity, the SES-obesity association varies when stratified by racial/ethnic groups-with no consistent association found for African American and Hispanic children. Research on contextual and setting-related factors may provide further insights into ethnic and SES disparities in obesity. We examined whether obesity levels among central Texas 8th grade students (n=2682) vary by school-level economic disadvantage across individual-level family SES and racial/ethnicity groups. As a secondary aim, we compared the association of school-level economic disadvantage and obesity by language spoken with parents (English or Spanish) among Hispanic students. METHODS Multilevel regression models stratified by family SES and ethnicity were run using cross-sectional baseline data from five school districts participating in the Central Texas CATCH Middle School project. For family SES, independent multi-level logistic regression models were run for total sample and by gender for each family SES stratum (poor/near poor/just getting by, living comfortably, and very well off), adjusting for age, ethnicity, and gender. Similarly, multi-level regression models were run by race/ethnic group (African American, Hispanic, and White), adjusting for age, family SES, and gender. RESULTS Students attending highly economically disadvantaged (ED) schools were between 1.7 (95% CI: 1.1-2.6) and 2.4 (95% CI: 1.2-4.8) times more likely to be obese as students attending low ED schools across family SES groups (p<.05). African American (OR(Adj) =3.4, 95% CI: 1.1-11.4), Hispanic (OR(Adj)=1.8, 95% CI 1.1-3.0) and White (OR(Adj)=3.8, 95% CI: 1.6-8.9) students attending high ED schools were more likely to be obese as counterparts at low ED schools (p<.05). Gender-stratified findings were similar to findings for total sample, although fewer results reached significance. While no obesity differences across school ED categories were found for Hispanic Spanish-speaking students, Hispanic English-speaking students (HES) attending high ED schools were 2.4 times more likely to be obese as HES students at low ED schools (p=.003). CONCLUSION Findings support the need to prioritize economically disadvantaged schools for obesity prevention efforts and support further exploration of school SES context in shaping children’s physical activity and dietary behaviors.
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Affiliation(s)
- Andrew E Springer
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Linlin Li
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Nalini Ranjit
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Joanne Delk
- Texas Department of State Health Services, Austin, TX, 78756, USA
| | - Kajal Mehta
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
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Elgar FJ, Pförtner TK, Moor I, De Clercq B, Stevens GWJM, Currie C. Socioeconomic inequalities in adolescent health 2002-2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. Lancet 2015; 385:2088-95. [PMID: 25659283 DOI: 10.1016/s0140-6736(14)61460-4] [Citation(s) in RCA: 277] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains of adolescent health and the association of socioeconomic inequality with national wealth and income inequality. METHODS We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492,788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score [zBMI], frequency of psychological and physical symptoms on 0-5 scale, and life satisfaction scored 0-10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality. FINDINGS From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI -0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (-0·79 to -0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (-0·98 to -0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (-0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (-0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (-0·10; p=0·0092). INTERPRETATION Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action. FUNDING Canadian Institutes of Health Research.
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Affiliation(s)
- Frank J Elgar
- Institute for Health and Social Policy, and Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
| | - Timo-Kolja Pförtner
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany
| | - Irene Moor
- Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Bart De Clercq
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Gonneke W J M Stevens
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands
| | - Candace Currie
- Child and Adolescent Health Research Unit, School of Medicine, University of St Andrews, St Andrews, UK
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Ritterman Weintraub ML, Fernald LCH, Adler N, Bertozzi S, Syme SL. Perceptions of social mobility: development of a new psychosocial indicator associated with adolescent risk behaviors. Front Public Health 2015; 3:62. [PMID: 25932460 PMCID: PMC4399326 DOI: 10.3389/fpubh.2015.00062] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/31/2015] [Indexed: 11/13/2022] Open
Abstract
Social class gradients have been explored in adults and children, but not extensively during adolescence. The first objective of this study was to examine the association between adolescent risk behaviors and a new indicator of adolescent relative social position, adolescent "perceived social mobility." Second, it investigated potential underlying demographic, socioeconomic, and psychosocial determinants of this indicator. Data were taken from the 2004 urban adolescent module of Oportunidades, a cross-sectional study of Mexican adolescents living in poverty. Perceived social mobility was calculated for each subject by taking the difference between their rankings on two 10-rung ladder scales that measured (1) projected future social status and (2) current subjective social status within Mexican society. Adolescents with higher perceived social mobility were significantly less likely to report alcohol consumption, drinking with repercussions, compensated sex, police detainment, physical fighting, consumption of junk food or soda, or watching ≥4 h of television during the last viewing. They were significantly more likely to report exercising during the past week and using a condom during last sexual intercourse. These associations remained significant with the inclusion of covariates, including parental education and household expenditures. Multiple logistic regression analyses show higher perceived social mobility to be associated with staying in school longer and having higher perceived control. The present study provides evidence for the usefulness of perceived social mobility as an indicator for understanding the social gradient in health during adolescence. This research suggests the possibility of implementing policies and interventions that provide adolescents with real reasons to be hopeful about their trajectories.
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Affiliation(s)
| | - Lia C H Fernald
- School of Public Health, University of California Berkeley , Berkeley, CA , USA
| | - Nancy Adler
- Department of Psychiatry, University of San Francisco , San Francisco, CA , USA
| | - Stefano Bertozzi
- School of Public Health, University of California Berkeley , Berkeley, CA , USA
| | - S Leonard Syme
- School of Public Health, University of California Berkeley , Berkeley, CA , USA
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Lampert T, Müters S, Stolzenberg H, Kroll LE. [Measurement of socioeconomic status in the KiGGS study: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:762-70. [PMID: 24950825 DOI: 10.1007/s00103-014-1974-8] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article describes the measurement of socioeconomic status in the first follow-up of the KiGGS study (KiGGS Wave 1) conducted from 2009 to 2012. A multidimensional index score was used. The score is the sum of three metric components: Education and Occupational Qualification, Occupational Status, and Net Income. Compared with the approach in the KiGGS baseline study, some modifications were made in accordance with changes in the other components of the health-monitoring program at the Robert Koch Institute, i.e., the German Health Update (GEDA) and the German Health Interview and Examination Survey for Adults (DEGS1). These changes facilitate the analysis of temporal developments and trends, ensure international comparability of the data, and support the transfer of the results into politics and practice. In order to demonstrate the application of the revised instrument, we report on exemplary results of KiGGS Wave 1 regarding the relationship between socioeconomic status and the general health status of children and adolescents aged 3-17 years.
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Affiliation(s)
- Thomas Lampert
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62-64, 12101, Berlin, Deutschland,
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Rathmann K, Ottova V, Hurrelmann K, de Looze M, Levin K, Molcho M, Elgar F, Gabhainn SN, van Dijk JP, Richter M. Macro-level determinants of young people's subjective health and health inequalities: a multilevel analysis in 27 welfare states. Maturitas 2015; 80:414-20. [PMID: 25703273 DOI: 10.1016/j.maturitas.2015.01.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/19/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. STUDY DESIGN Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. MAIN OUTCOME MEASURE Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. RESULTS Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. CONCLUSION Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence.
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Affiliation(s)
- Katharina Rathmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany; Berlin Graduate School of Social Sciences (BGSS), Socioeconomic and Statistical Studies (SESS), Humboldt University Berlin, Germany.
| | - Veronika Ottova
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Margarethe de Looze
- Faculty of Social and Behavioral Sciences, University of Utrecht, The Netherlands
| | - Kate Levin
- NHS Greater Glasgow & Clyde, Glasgow, Scotland, United Kingdom
| | - Michal Molcho
- Department of Health Promotion, National University of Ireland, Galway, Ireland
| | - Frank Elgar
- Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, Quebec, Canada
| | | | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovak Republic; Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany
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Janssen E. Assessing the ties of socioeconomic background and gender on the frequency and the type of alcoholic beverages consumed by French adolescents. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.987835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kwak K, Rudmin F. Adolescent health and adaptation in Canada: examination of gender and age aspects of the healthy immigrant effect. Int J Equity Health 2014; 13:103. [PMID: 25394371 PMCID: PMC4243294 DOI: 10.1186/s12939-014-0103-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 10/17/2014] [Indexed: 12/04/2022] Open
Abstract
Introduction A longstanding and widely held assumption is that immigrants suffer from ill health and adaptation problems. Yet recent studies show that immigrants report the same or better state of health compared to their native-born counterparts. This phenomenon, known as the healthy immigrant effect, has been found in studies of specific health conditions of adults. The present study focuses instead on adolescents and extends its examination of the healthy immigrant effect, measuring both health and adaptation. Methods Using data from population samples in the Canadian Community Health Survey (2007), foreign-born immigrant adolescents (n = 920) were compared to non-immigrant adolescents (n = 13,572) for their self-report to questionnaire items for health (general health, mental health, chronic illnesses with psychosomatic symptoms, and psychological illnesses) and adaptation (daily life stress, life satisfaction, and sense of belonging). Adolescents’ gender, age, and length of residence were analyzed for the effects. Results Immigrant adolescents were better than non-immigrant peers on the four health measures, and did not differ from non-immigrants on the three adaptation measures despite having less household income and more family members in the household. Immigrant girls exhibited more resilient adaptability, while young immigrant boys and older non-immigrant girls displayed some potential vulnerability. Length of residence, on the other hand, did not contribute to differences for the health and adaptation of immigrant adolescents. Conclusions The healthy immigrant effect was confirmed in a community population sample of adolescents in Canada. Foreign-born immigrant adolescents experience better health, as well as good adaptation equal to their native-born peers. These outcomes call for further research on sustaining good health and adaptation of the immigrant population, in particular by providing age-related effective services and prevention strategies.
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Affiliation(s)
- Kyunghwa Kwak
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway. .,Centre for Research on Migration, Refugees, and Belonging, School of Law and Social Sciences, University of East London, London, UK.
| | - Floyd Rudmin
- Department of Psychology, UIT Norway's Arctic University, Tromsø, N-9037, Norway.
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Varga S, Piko BF, Fitzpatrick KM. Socioeconomic inequalities in mental well-being among Hungarian adolescents: a cross-sectional study. Int J Equity Health 2014; 13:100. [PMID: 25348821 PMCID: PMC4219095 DOI: 10.1186/s12939-014-0100-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 10/13/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction According to several empirical studies, mental well-being is significant in adolescence; adolescent’s social network is undergoing radical changes while at the same time depression is increasing. The primary goal of our study is to determine whether socioeconomic status (SES) is associated with mental health status of Hungarian adolescents and the strength and nature of this association. Methods Our sample was comprised of three high schools of Debrecen (the second largest city of Hungary). Data were collected in January 2013. In all, 471 students filled out the questionnaire from 22 classes (14–18 years old). ‘Absolute’ (education and occupational status of the parents, assessed by the adolescent) and ‘subjective’ (self-assessment of family’s social class) SES measures and five mental health indicators (shyness, loneliness, need to belong, psychosomatic symptoms, self-esteem) were involved. Descriptive statistics and binary logistic regression analyses were used to examine the relationships between family SES and mental health indicators. Results Our results indicate that association between adolescents’ ‘subjective’ SES and mental well-being is not gradient-like. Manual employment and unemployment status of both parents also proved to be significant determinants of mental health status. Conclusions According to our results, professionals of school-based mental health programs should consider students whose parents are unemployed or have manual occupational status as a high risk group in terms of mental well-being.
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Skårdal M, Western IM, Ask AMS, Øverby NC. Socioeconomic differences in selected dietary habits among Norwegian 13-14 year-olds: a cross-sectional study. Food Nutr Res 2014; 58:23590. [PMID: 25140123 PMCID: PMC4111874 DOI: 10.3402/fnr.v58.23590] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 07/05/2014] [Accepted: 07/07/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Social inequalities in health are a major and even growing problem in all European countries. OBJECTIVE The aim of the present study was to describe 1) differences in dietary habits among Norwegian adolescents by gender and socioeconomic status; 2) differences in self-reported knowledge of dietary guidelines among their parents according to socioeconomic status. DESIGN In 2012, a cross-sectional study where students filled in a web-based food frequency questionnaire at school was conducted in nine lower secondary schools in Vest-Agder County, Norway. Socioeconomic status (SES) and knowledge of dietary guidelines were obtained from the parents using a web-based questionnaire. In total, 517 ninth-grade students (mean age 13.9) out of 742 invited students participated in the study, giving a participation rate of 69.7%. The total number of dyads with information on both parents and students was 308 (41.5%). RESULTS The findings indicate that there is a tendency for girls to have a healthier diet than boys, with greater intake of fruits and vegetables (girls intake in median 3.5 units per day and boys 2.9 units per day), and lower intake of soft drinks (girls 0.25 l in median versus boys 0.5 l per week). Students from families with higher SES reported a significant higher intake of vegetables and fish, and lower intake of soft drinks and fast food than those from lower SES. Parents with higher SES reported a significantly better knowledge of dietary guidelines compared to those with lower SES. CONCLUSIONS Differences in dietary habits were found between groups of students by gender and SES. Differences were also found in parents' self-reported knowledge of dietary guidelines. This social patterning should be recognized in public health interventions.
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Affiliation(s)
| | | | | | - Nina C. Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Moor I, Rathmann K, Stronks K, Levin K, Spallek J, Richter M. Psychosocial and behavioural factors in the explanation of socioeconomic inequalities in adolescent health: a multilevel analysis in 28 European and North American countries. J Epidemiol Community Health 2014; 68:912-21. [DOI: 10.1136/jech-2014-203933] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Guo H, Yang W, Cao Y, Li J, Siegrist J. Effort-reward imbalance at school and depressive symptoms in Chinese adolescents: the role of family socioeconomic status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6085-98. [PMID: 24919130 PMCID: PMC4078567 DOI: 10.3390/ijerph110606085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/16/2014] [Accepted: 05/26/2014] [Indexed: 11/25/2022]
Abstract
Depression is a major mental health problem during adolescence. This study, using a sample of Chinese adolescents, examined the separate and combined effects of perceived school-related stress and of family socioeconomic status (SES) on the prevalence of depressive symptoms. A total of 1774 Chinese students from Grades 7–12 were recruited into our questionnaire survey. School-related stress was measured by the Effort-Reward Imbalance Questionnaire-School Version, family SES was assessed by a standardized question, and depressive symptoms were evaluated by the Center for Epidemiological Studies Depression Scale for Children. Multivariate logistic regression was applied, adjusting for age, gender, grade, smoking, alcohol drinking and physical activity. It was found that high school-related stress and low family SES were associated with elevated odds of depressive symptoms, respectively. The effect of school-related stress was particularly strong in low SES group. In adolescents with both high stress at school and low SES, the odds ratio was 9.18 (95% confidence interval = 6.53–12.89) compared to the reference group (low stress at school and high SES). A significant synergistic interaction effect was observed (synergy index = 2.28, 95% confidence interval = 1.56–3.32). The findings indicated that perceived school-related stress, in terms of effort-reward imbalance, was related to depressive symptoms in this sample of Chinese adolescents. The strong interaction with family SES suggests that health promoting efforts in school settings should be targeted specifically at these socially deprived groups.
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Affiliation(s)
- Hongxiang Guo
- Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
| | - Wenjie Yang
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China.
| | - Ying Cao
- First High School of Zhengzhou, Zhengzhou 450000, China.
| | - Jian Li
- Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany.
| | - Johannes Siegrist
- Senior Professorship on Work Stress Research, Life-Science Centre, University of Düsseldorf, Düsseldorf 40225, Germany.
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Klanšček HJ, Ziberna J, Korošec A, Zurc J, Albreht T. Mental health inequalities in Slovenian 15-year-old adolescents explained by personal social position and family socioeconomic status. Int J Equity Health 2014; 13:26. [PMID: 24673838 PMCID: PMC3976171 DOI: 10.1186/1475-9276-13-26] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 03/18/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Mental health inequalities are an increasingly important global problem. This study examined the association between mental health status and certain socioeconomic indicators (personal social position and the socioeconomic status of the family) in Slovenian 15-year-old adolescents. Methods Data originate from the WHO-Collaborative cross-national ‘Health Behavior in School-aged Children’ study conducted in Slovenia in 2010 (1,815 secondary school pupils, aged 15). Mental health status was measured by: KIDSCREEN-10, the Strength and Difficulties questionnaire (SDQ), a life satisfaction scale, and one question about feelings of depression. Socioeconomic position was measured by the socioeconomic status of the family (Family Affluence Scale, perceived material welfare, family type, occupational status of parents) and personal social position (number of friends and the type of school). Logistic regression and a multivariate analysis of variance (MANOVA) were performed. Results Girls had 2.5-times higher odds of suffering feelings of depression (p < 0.001), 1.5-times higher odds of low life satisfaction (p = 0.008), and a greater chance of a lower quality of life and a higher SDQ score than boys (p = 0.001). The adolescents who perceived their family’s material welfare as worse had 4-times higher odds (p < 0.001) of a low life satisfaction, a greater chance of a low quality of life, and a higher SDQ score than those who perceived it as better (p < 0.001). Adolescents with no friends had lower KIDSCREEN-10 and higher SDQ scores than those who had more than three friends. Conclusions Despite the fact that Slovenia is among the EU members with the lowest rates of social inequalities, it was found that adolescents with a lower socioeconomic position have poorer mental health than those with a higher socioeconomic position. Because of the financial crisis, we can expect an increase in social inequalities and a greater impact on adolescents’ mental health status in Slovenia in the future.
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Moor I, Lampert T, Rathmann K, Kuntz B, Kolip P, Spallek J, Richter M. Explaining educational inequalities in adolescent life satisfaction: do health behaviour and gender matter? Int J Public Health 2013; 59:309-17. [PMID: 24368542 DOI: 10.1007/s00038-013-0531-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 11/12/2013] [Accepted: 11/27/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES There is little evidence on the explanation of health inequalities based on a gender sensitive perspective. The aim was to investigate to what extent health behaviours mediate the association between educational inequalities and life satisfaction of boys and girls. METHODS Data were derived from the German part of the Health Behaviour in School-aged Children (HBSC) study 2010 (n = 5,005). Logistic regression models were conducted to investigate educational inequalities in life satisfaction among 11- to 15-year-old students and the relative impact of health behaviour in explaining these inequalities. RESULTS Educational inequalities in life satisfaction were more pronounced in boys than in girls from lower educational tracks (OR 2.82, 95 % CI 1.97-4.05 and OR 2.30, 95 % CI 1.68-3.14). For adolescents belonging to the lowest educational track, behavioural factors contributed to 18 % (boys) and 39 % (girls) in the explanation of educational inequalities in life satisfaction. CONCLUSIONS The relationship between educational track and life satisfaction is substantially mediated by health-related behaviours. To tackle inequalities in adolescent health, behavioural factors should be targeted at adolescents from lower educational tracks, with special focus on gender differences.
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Affiliation(s)
- Irene Moor
- Medical Faculty, Institute of Medical Sociology (IMS), Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle/Saale, Germany,
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Children’s Quality of Life in Europe: National Wealth and Familial Socioeconomic Position Explain Variations in Mental Health and Wellbeing—A Multilevel Analysis in 27 EU Countries. ACTA ACUST UNITED AC 2013. [DOI: 10.1155/2013/419530] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sizeable variations in quality of life (QoL) and wellbeing according to socioeconomic status and national wealth have been observed. The assessment of children’s wellbeing may vary, depending on whether a parental or a child perspective is taken. Still, both perspectives provide important and valid information on children’s wellbeing. The Flash Eurobarometer no. 246 which was conducted for the European Commission assesses parents’ reports on their children’s health and wellbeing in 27 EU member states. Overall, 12,783 parents of 6–17-year-old children in the 27 EU states participated in telephone interviews. Parents reported children’s QoL and wellbeing using the KIDSCREEN-10 measure, as well as their occupational status and education level. Within a multilevel analysis, the KIDSCREEN-10 was regressed on parental occupation and education level. Random intercepts and slopes were regressed on gross domestic product per capita and income inequality. Low QoL was reported in 11.6% of cases, whereby cross-national variation accounted for 13% of the total variance in QoL. Children from countries with higher national wealth and lower income inequality were at lower risk for low QoL and wellbeing. Higher age of the child, a medium or low parental occupational status, and low parental educational status were associated with a higher risk for low QoL and wellbeing.
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Griffiths PL, Johnson W, Cameron N, Pettifor JM, Norris SA. In urban South Africa, 16 year old adolescents experience greater health equality than children. ECONOMICS AND HUMAN BIOLOGY 2013; 11:502-514. [PMID: 23876525 PMCID: PMC3857590 DOI: 10.1016/j.ehb.2013.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 05/09/2013] [Accepted: 05/09/2013] [Indexed: 06/02/2023]
Abstract
Despite the strongly established link between socio-economic status (SES) and health across most stages of the life-course, the evidence for a socio-economic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n=346, 53% male) with measures taken at birth and 16 years of age to establish socio-economic, biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9-10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9-10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.
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Affiliation(s)
- Paula L. Griffiths
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, UK
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - William Johnson
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Noël Cameron
- Centre for Global Health and Human Development, School of Sport, Exercise and Health Sciences, Loughborough University, UK
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John M. Pettifor
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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