Even in wealthy countries there are substantial socioeconomic inequalities in adolescent mental health. Socioeconomic status (SES) indicators—parental SES, adolescent subjective SES and adolescent educational level—are negatively associated with adolescent mental health problems, but little is known about the interplay between these SES indicators and whether associations have changed over time. Using data from the Dutch Health Behaviour in School-Aged Children (HBSC) studies (n = 27,020) between 2001 and 2017, we examined associations between three SES indicators and six indicators of adolescent mental health problems. Linear regressions revealed that adolescent subjective SES and adolescent educational level were independently negatively associated with adolescent mental health problems and positively associated with adolescent life satisfaction, but parental SES had negligible independent associations with adolescent mental health problems and life satisfaction. However, when interactions between SES indicators were considered, high adolescent subjective SES was shown to buffer the negative association between parental SES and adolescent mental health problems and the positive association between parental SES and life satisfaction. Despite societal changes between 2001 and 2017, socioeconomic inequalities in adolescent mental health were stable during this period. Findings suggest that all three SES indicators—parental SES, adolescent subjective SES and adolescent educational level—are important for studying socioeconomic inequalities in adolescent mental health.
Background Worldwide, roughly 80% of adolescents fail to meet World Health Organization (WHO) recommendations regarding physical activity, though there is substantial variation in adolescent physical activity prevalence across countries. This study explored whether country-level environmental differences explained cross-national variation in adolescent moderate- to vigorous-intensity physical activity (MVPA) and vigorous-intensity activity (VPA). Method Using the data of 138,014 11- to 15-year-olds from 29 European countries in the 2013/2014 Health Behaviour in School-aged Children (HBSC) study, multilevel regression models examined the influence of four types of country-level environmental factors (physical, socio-cultural, economic, and political) on self-reported individual-level physical activity (MVPA and VPA). Results The environmental variables explained 38% of country-level variance in MVPA and 81% of country-level variance in VPA. Lower annual average national temperature, higher community safety, lower average national household income and a weaker physical education policy were significantly associated with more MVPA. Greater urbanisation, lower annual average national temperature, higher adult physical activity and higher average national household income were significantly associated with more VPA. Conclusions The findings showed that national differences in the physical, socio-cultural and economic environment were related to adolescent physical activity. They point to potential avenues for future research looking at interactions between individual and environmental factors. Electronic supplementary material The online version of this article (10.1186/s12889-019-6908-9) contains supplementary material, which is available to authorized users.
Although previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level. Methods: Data were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n ¼ 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups. Results: Higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated IMPLICATIONS AND CONTRIBUTIONResearch has established the positive association between national income inequality and adolescent socioeconomic health inequalities, but little is known about national-level wealth inequalities (i.e., accumulated financial resources). This study linked national wealth and income inequality to socioeconomic inequalities in Conflicts of interest: B.D.C. is working for a financial company under supervision of the Financial Services and Markets Authority. The authors have no other conflicts of interest to disclose. Authors' contributions: B.D.C. and M.D. designed the study. M.D. had primary responsibility for writing and editing of the article and supervised the interpretation of the results. B.D.C. conceptualized and developed the wealth inequality indicator. D.W. and Y.Y.H. further improved the conceptualization of the wealth inequality indicator, collected reliable financial and economic data, and calculated the wealth inequality indicator. F.E. performed the analysis, and L.A. and N.L. interpreted the results. All authors critically reviewed the article. G.W.J.M.S. and C.C. made substantial and equal contributions to the writing of the whole article. All authors listed gave final approval for the article to be published. Disclosure: This supplement was supported by the World Health Organization European Office and the University of Glasgow. The articles have been peerreviewed and edited by the editorial staff of the Journal of Adolescent Health. The opinions or views expressed in this supplement are those of the authors and do not necessarily represent the official position of the funder.
Adolescents with high educational attainment generally have better outcomes across the lifespan than adolescents with lower educational attainment. This study investigated how three measures of socioeconomic status (SES)–maternal education, paternal education, and neighbourhood SES–combined to predict adolescent educational attainment (track level at age 17). We proposed three mechanisms for this pathway: cognitive ability (at age 11), primary school teacher assessment (stating the secondary education level suitable for a child at age 11), and educational expectations (at age 14). Using the data of 2,814 Dutch adolescents from the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study, logistic regressions tested associations between SES and educational attainment. Structural equation modelling (SEM) tested mediational pathways between SES and educational attainment. In models with three SES measures, having a medium-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 1.83; 1.41–2.38), and having a high-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 3.44; 2.59–4.55). The odds ratios for paternal education showed a similar pattern. We found no association between neighbourhood SES and adolescent educational attainment, so neighbourhood SES was removed from further analyses. Mediational analyses revealed that cognitive ability (30.0%), teacher assessment (28.5%), and educational expectations (1.2%) explained 59.8% of the total association between parental SES and educational attainment. The results showed that mother education and father education were both important for understanding the strong association between parental SES and adolescent educational attainment. In the Netherlands, the association between parental SES and educational attainment can be largely explained by cognitive ability and teacher assessments.
This study examined socioeconomic disparities in changes in adolescent mental health between fall 2019 (pre‐COVID‐19), spring 2020 (initial coronavirus disease 2019 (COVID‐19) phase), and fall 2020 (prevailing COVID‐19 phase). Using data from 1429 adolescents ( M age = 17.9) from tertiary vocational schools in the Netherlands with n = 386 participating in all three waves, linear and latent basis growth curve models were assessed and multigroup analyses conducted. Results showed a small but significant decrease in life satisfaction and small but significant increases in emotional problems, peer relationship problems, conduct problems, and hyperactivity‐inattention problems. For emotional problems and peer relationship problems, increases between pre‐COVID‐19 and the initial COVID‐19 phase were more pronounced than increases between the initial and prevailing COVID‐19 phase. In contrast, linear decreases were found for life satisfaction and linear increases for conduct problems and hyperactivity‐inattention problems over the course of the study. Mental health patterns were largely comparable for adolescents from families with varying socioeconomic status.
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