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Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status

Published on Jul 13, 2019in Journal of Epidemiology and Community Health3.87
· DOI :10.1136/jech-2018-211794
Irene Moor12
Estimated H-index: 12
(MLU: Martin Luther University of Halle-Wittenberg),
Mirte A. G. Kuipers8
Estimated H-index: 8
(PHRI: Public Health Research Institute)
+ 9 AuthorsMatthias Richter26
Estimated H-index: 26
(MLU: Martin Luther University of Halle-Wittenberg)
Abstract
Background Although there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities) in Europe. Methods Data of adolescents aged 14–17 years old were obtained from the 2013 SILNE survey (smoking inequalities: learning from natural experiments), carried out in 50 schools in 6 European cities (N=10 900). Capturing subjective perceptions of relative SES and objective measures of education and wealth, we measured adolescents’ own SES (academic performance, pocket money), parental SES (parental educational level) and family SES (Family Affluence Scale, subjective social status (SSS)). Logistic regression models with SRH and smoking as dependent variables included all SES indicators, age and gender. Results Correlations between SES indicators were weak to moderate. Low academic performance (OR=1.96, 95% CI 1.53 to 2.51) and low SSS (OR=2.75, 95% CI 2.12 to 3.55) were the strongest indicators of poor SRH after adjusting for other SES-indicators. Results for SSS were consistent across countries, while associations with academic performance varied. Low academic performance (OR=5.71, 95% CI 4.63 to 7.06) and more pocket money (OR=0.21, 95% CI 0.18 to 0.26) were most strongly associated with smoking in all countries. Conclusions Socioeconomic inequalities in adolescent health were largest according to SES indicators more closely related to the adolescent’s education as well as the adolescent’s perception of relative family SES, rather than objective indicators of parental education and material family affluence. For future studies on adolescent health inequalities, consideration of adolescent-related SES indicators was recommended.
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#1Pierre Olivier Robert (UCL: Université catholique de Louvain)H-Index: 1
#2Mirte A. G. Kuipers (UvA: University of Amsterdam)H-Index: 8
Last.Anton E. Kunst (UvA: University of Amsterdam)H-Index: 71
view all 11 authors...
#1Irene Moor (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 12
#2Jacob Spallek (BTU: Brandenburg University of Technology)H-Index: 17
Last.Matthias Richter (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 26
view all 3 authors...
#1Julian Perelman (NOVA: Universidade Nova de Lisboa)H-Index: 10
#2Joana Alves (NOVA: Universidade Nova de Lisboa)H-Index: 8
Last.Vincent Lorant (UCL: Université catholique de Louvain)H-Index: 22
view all 10 authors...
#1Katharina Rathmann (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 12
#2Irene Moor (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 12
Last.Matthias Richter (MLU: Martin Luther University of Halle-Wittenberg)H-Index: 26
view all 10 authors...
#1Vincent Lorant (UCL: Université catholique de Louvain)H-Index: 22
#2Victoria Eugenia Soto (UCL: Université catholique de Louvain)H-Index: 4
Last.Arja Rimpelä (UTA: University of Tampere)H-Index: 41
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#1Mirte A. G. Kuipers (UvA: University of Amsterdam)H-Index: 8
#2Karin Monshouwer (UU: Utrecht University)H-Index: 23
Last.Anton E. Kunst (UvA: University of Amsterdam)H-Index: 71
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