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Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.ORCID iD: 0000-0002-0969-1288
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.ORCID iD: 0000-0003-4438-6673
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).ORCID iD: 0000-0002-4218-4499
Glasgow Caledonian University, Glasgow, United Kingdom.
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2017 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 17, article id 838Article in journal (Refereed) Published
Abstract [en]

Background

Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.

Method

Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.

Results

Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).

Conclusions

The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries. ©  The Author(s). 2017

Place, publisher, year, edition, pages
London: BioMed Central, 2017. Vol. 17, article id 838
Keywords [en]
Socioeconomic inequality, Self-rated health, Socioeconomic status, Adolescence, HBSC
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-34983DOI: 10.1186/s12889-017-4863-xISI: 000413475600007PubMedID: 29061173Scopus ID: 2-s2.0-85032185321OAI: oai:DiVA.org:hh-34983DiVA, id: diva2:1141693
Note

Funding: Ljungbergska Foundation, Länsförsäkringar Halland, the municipality of Halmstad and Halmstad University

Available from: 2017-09-15 Created: 2017-09-15 Last updated: 2023-08-28Bibliographically approved
In thesis
1. Social capital and inequalities in mental health among young adolescents in Sweden
Open this publication in new window or tab >>Social capital and inequalities in mental health among young adolescents in Sweden
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore social capital and inequalities in mental health among young adolescents in Sweden. This is a compilation thesis comprising four studies. Studies I and II are quantitative studies of crosssectional data from the Swedish Health Behaviour in School-aged Children survey. The aim of Study I was to investigate socioeconomic inequalities in health using both a subjective and an objective measure of socioeconomic status among Swedish adolescents. The findings showed that subjective socioeconomic status robustly and independently predicted mental health problems, poor life satisfaction and poor general health perception. The association between objective socioeconomic status and mental health was weakened, and even reversed, when subjective socioeconomic status was accounted for in regression models. A Latent Profile Analysis was applied in Study II with the aim of identifying distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles. The findings showed that five distinct profiles best represented the data for 11 and 15-year olds, while a four-profile model was optimal for 13-year olds. Significant inequalities were identified between profiles when these were examined in terms of mental health problems and life satisfaction. The design of Study III was a qualitative semi-structured interview study. The aim was to explore social capital from the perspective of adolescents in relation to mental health. Adolescents spoke of having access to a safe space, feeling connected to others and predictability as important aspects of social relationships and networks in relation to mental health. The aim of Study IV was to identify and evaluate the design and psychometric properties of instruments for assessing social capital specifically developed and validated for self-reporting among adolescents (10-19 years). The design was a systematic review, in which 20 instruments were identified. The results revealed a lack of instruments that covered both the multidimensionality of social capital and contextual relevance in relation to adolescents. The conclusion from this thesis is that social capital may be useful for identifying vulnerable individuals and for differentiating between the natural imbalance of adolescence and what may lead to serious illness. Longitudinal research and refinement of the operationalization of the concept are, however, needed to enhance the understanding of these findings.

Place, publisher, year, edition, pages
Halmstad: Halmstad University Press, 2022. p. 111
Keywords
Adolescence, Inequalities, Lifestyle, Mental health, Social capital, Socioeconomic status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-46311 (URN)978-91-88749-81-9 (ISBN)978-91-88749-82-6 (ISBN)
Public defence
2022-03-04, S1002, Kristian IV:s väg 3, Halmstad, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2022-02-10 Created: 2022-02-09 Last updated: 2023-01-10Bibliographically approved

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Ahlborg, MikaelSvedberg, PetraNyholm, MariaNygren, Jens M.

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