Inequalities in adolescent self-rated health and smoking in Europe

comparing different indicators of socioeconomic status

Irene Moor, Mirte A G Kuipers, Vincent Lorant, Timo-Kolja Pförtner, Jaana M Kinnunen, Katharina Rathmann, Julian Perelman, Joana Alves, Pierre-Olivier Robert, Arja Rimpelä, Anton E Kunst, Matthias Richter

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)963-970
JournalJournal Of Epidemiology And Community Health
Volume73
Issue number10
DOIs
Publication statusPublished - 2019

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Social Class
Smoking
Health
Education
Logistic Models
Health Behavior
Learning

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Moor, Irene ; Kuipers, Mirte A G ; Lorant, Vincent ; Pförtner, Timo-Kolja ; Kinnunen, Jaana M ; Rathmann, Katharina ; Perelman, Julian ; Alves, Joana ; Robert, Pierre-Olivier ; Rimpelä, Arja ; Kunst, Anton E ; Richter, Matthias. / Inequalities in adolescent self-rated health and smoking in Europe : comparing different indicators of socioeconomic status. In: Journal Of Epidemiology And Community Health. 2019 ; Vol. 73, No. 10. pp. 963-970.
@article{c33a341533aa4154bd4889bcfbfbba93,
title = "Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status",
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.",
author = "Irene Moor and Kuipers, {Mirte A G} and Vincent Lorant and Timo-Kolja Pf{\"o}rtner and Kinnunen, {Jaana M} and Katharina Rathmann and Julian Perelman and Joana Alves and Pierre-Olivier Robert and Arja Rimpel{\"a} and Kunst, {Anton E} and Matthias Richter",
note = "{\circledC} Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
doi = "10.1136/jech-2018-211794",
language = "English",
volume = "73",
pages = "963--970",
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Moor, I, Kuipers, MAG, Lorant, V, Pförtner, T-K, Kinnunen, JM, Rathmann, K, Perelman, J, Alves, J, Robert, P-O, Rimpelä, A, Kunst, AE & Richter, M 2019, 'Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status', Journal Of Epidemiology And Community Health, vol. 73, no. 10, pp. 963-970. https://doi.org/10.1136/jech-2018-211794

Inequalities in adolescent self-rated health and smoking in Europe : comparing different indicators of socioeconomic status. / Moor, Irene; Kuipers, Mirte A G; Lorant, Vincent; Pförtner, Timo-Kolja; Kinnunen, Jaana M; Rathmann, Katharina; Perelman, Julian; Alves, Joana; Robert, Pierre-Olivier; Rimpelä, Arja; Kunst, Anton E; Richter, Matthias.

In: Journal Of Epidemiology And Community Health, Vol. 73, No. 10, 2019, p. 963-970.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Inequalities in adolescent self-rated health and smoking in Europe

T2 - comparing different indicators of socioeconomic status

AU - Moor, Irene

AU - Kuipers, Mirte A G

AU - Lorant, Vincent

AU - Pförtner, Timo-Kolja

AU - Kinnunen, Jaana M

AU - Rathmann, Katharina

AU - Perelman, Julian

AU - Alves, Joana

AU - Robert, Pierre-Olivier

AU - Rimpelä, Arja

AU - Kunst, Anton E

AU - Richter, Matthias

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

U2 - 10.1136/jech-2018-211794

DO - 10.1136/jech-2018-211794

M3 - Article

VL - 73

SP - 963

EP - 970

JO - Journal Of Epidemiology And Community Health

JF - Journal Of Epidemiology And Community Health

SN - 0141-7681

IS - 10

ER -