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Social capital and inequalities in mental health among young adolescents in Sweden
Halmstad University, School of Health and Welfare.ORCID iD: 0000-0002-0969-1288
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 [en]
Adolescence, Inequalities, Lifestyle, Mental health, Social capital, Socioeconomic status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hh:diva-46311ISBN: 978-91-88749-81-9 (print)ISBN: 978-91-88749-82-6 (electronic)OAI: oai:DiVA.org:hh-46311DiVA, id: diva2:1636492
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
List of papers
1. Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective
Open this publication in new window or tab >>Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective
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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
Keywords
Socioeconomic inequality, Self-rated health, Socioeconomic status, Adolescence, HBSC
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-34983 (URN)10.1186/s12889-017-4863-x (DOI)000413475600007 ()29061173 (PubMedID)2-s2.0-85032185321 (Scopus ID)
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
2. Into the realm of social capital for adolescents: A latent profile analysis
Open this publication in new window or tab >>Into the realm of social capital for adolescents: A latent profile analysis
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2019 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 2, article id e0212564Article in journal (Refereed) Published
Abstract [en]

Background

Recent reports of increasing prevalence of frequent health complaints and mental health problems among adolescents call for directing more attention on determinants of adolescent health. The relationship between health and social capital has gained increased attention since the early 2000’s and research at review level confirms the importance of social capital for health outcomes, despite methodological heterogeneity. The aim of this study was to identify distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles.

Method

Cross-sectional data from the Swedish Health Behaviour of School-aged Children 2013/14 was used for this study. The analytical sample consisted of 7,804 adolescents aged 11-, 13- and 15-years. Items representing sense of belonging and emotional support were assessed in three contexts; family, school and among peers. Latent profile analyses (LPA) were run to determine social capital profiles. Health outcomes included frequent health complaints and life satisfaction, while socioeconomic status and genders were included as predictors.

Results

The results show that five distinct profiles best represent the data for 11- and 15-year olds, while a four-profile model was optimal for 13-year olds. Some profiles were recurrent between age groups but unique profiles were also found. Health outcomes were significantly different between profiles depending on levels of social capital in the different contexts.

Conclusions

This study provides novel insight into how social capital co-occurs among adolescents within the contexts of family, school and peers and how this translates into differences in health outcomes. The national representativeness of the sample increases the implications of the results and contributes to meaningful insights that help explain the interactions of social capital in multiple contexts, complementing what is previously known about the relationship with adolescent health. © 2019 Ahlborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Place, publisher, year, edition, pages
San Francisco, CA: Public Library of Science, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-39476 (URN)10.1371/journal.pone.0212564 (DOI)000459330800040 ()30789947 (PubMedID)2-s2.0-85061940871 (Scopus ID)
Funder
Knowledge Foundation
Available from: 2019-05-26 Created: 2019-05-26 Last updated: 2022-02-09Bibliographically approved
3. Social Capital in Relation to Mental Health—The Voices of Adolescents in Sweden
Open this publication in new window or tab >>Social Capital in Relation to Mental Health—The Voices of Adolescents in Sweden
2023 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 13, article id 6223Article in journal (Refereed) Published
Abstract [en]

The social environment that adolescents interact in has undoubtedly changed over the past decades. The latent constructs of social capital that have been described in theory may be universal, but it is necessary to reveal sociocultural specific pathways and manifestation in order to validly operationalize social capital for adolescents. There is a call for qualitative data to enhance our understanding of social capital for adolescents today and the specific sociocultural context they live in. The aim of this study was to explore social capital from the perspective of adolescents in relation to mental health. Twenty-three semi-structured interviews were conducted in a school setting with a sample of adolescents aged 11 and 15 years. Qualitative content analysis was applied, and analysis remained on a manifest level. From having adolescents describe their social relations and networks in relation to mental health, three main categories were formed: accessing a safe space, with sub-categories of trusting enough to share, having someone close to you, and being part of an inclusive and honest environment; feeling connected to others, with sub-categories of hanging out and having things in common; and maintaining control, with sub-categories of deciding for yourself, dealing with change, and having social skills. Having access to a safe space is vital for adolescents’ mental health, by providing resources such as mutual trust, honesty, and unconditional access. Feeling connected to others is important in close relationships and reveals the glue that holds networks together, but also links to sociability in a wider sense. Predictability in adolescents’ social relationships and networks, influenced by internal and external factors, may be a resource of increasing importance in todays’ society and an interesting subject for intervention and future research on social capital and adolescent mental health. © 2023 by the authors.

Place, publisher, year, edition, pages
Basel: MDPI, 2023
Keywords
Adolescents, Content analysis, Mental health, Networks, Qualitative, Relationships, Social capital
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing Health Sciences
Identifiers
urn:nbn:se:hh:diva-46315 (URN)10.3390/ijerph20136223 (DOI)37444071 (PubMedID)2-s2.0-85164844887 (Scopus ID)
Note

Funding: The Laholm Municipality DNR: S2018/171.

Available from: 2022-02-10 Created: 2022-02-10 Last updated: 2024-01-24Bibliographically approved
4. Current Conceptualization and Operationalization of Adolescents’ Social Capital: A Systematic Review of Self-Reported Instruments
Open this publication in new window or tab >>Current Conceptualization and Operationalization of Adolescents’ Social Capital: A Systematic Review of Self-Reported Instruments
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 15596Article, review/survey (Refereed) Published
Abstract [en]

There is a great heterogeneity in the conceptualization and operationalization of social capital in empirical research targeting adolescents. There has not yet been an attempt to systematically map and psychometrically evaluate the existing instruments for measuring social capital that have been developed and validated for adolescent samples. The aim of this systematic review was to identify and evaluate the design and psychometric properties of self-reported instruments for social capital, specifically developed and validated for use among adolescents. The design of this study was a systematic review guided by the COSMIN methodology for systematic reviews of Patient Reported Outcome Measures. The search included six electronic databases and no time frame was applied. Twenty studies were identified as describing the development and validation of a social capital instrument for adolescent samples. The results reveal common denominators, but also great variation in the design and validation of the instruments. Adolescents were only involved in the development procedures of four instruments. There is a lack of social capital instruments that cover both the multidimensionality of social capital and contextual relevance in relation to adolescents. Careful examination of instruments should thus precede a decision when designing studies and further instrument development involving the target group is encouraged. © 2022 by the authors.

Place, publisher, year, edition, pages
Basel: MDPI, 2022
Keywords
adolescents, instrument, measurement, psychometric properties, questionnaire, social capital, validation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health Innovation, IDC
Identifiers
urn:nbn:se:hh:diva-49102 (URN)10.3390/ijerph192315596 (DOI)000896481100001 ()36497690 (PubMedID)2-s2.0-85143657850 (Scopus ID)
Available from: 2023-01-05 Created: 2023-01-05 Last updated: 2023-04-19Bibliographically approved

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