TY - JOUR
T1 - Socio-economic inequality in multiple health complaints among adolescents
T2 - International comparative study in 37 countries
AU - Holstein, Bjørn E.
AU - Currie, Candace
AU - Boyce, Will
AU - Damsgaard, Mogens T.
AU - Gobina, Inese
AU - Kökönyei, Gyöngyi
AU - Hetland, Jørn
AU - de Looze, Margaretha
AU - Richter, Matthias
AU - Due, Pernille
AU - Dörfler, Laura
AU - Ackaert, Sylvie
AU - Godin, Isabelle
AU - Todorova, Irina
AU - Boyce, Will
AU - Simetin, Ivana Pavic
AU - Kroelner, Rikke
AU - Andersen, Anette
AU - Hurrelmann, Klaus
AU - Klocke, Andreas
AU - Pall, Gabriella
AU - Jonsson, Stefan H.
AU - Hallgrimsson, Tryggvi
AU - Zambon, Alessio
AU - Santinello, Massimo
AU - Puntule, Diana
AU - Wagener, Yolande
AU - Unkovska, Lina
AU - de Looze, Margaretha
AU - Marcu, Oana
AU - Currie, Candace
AU - Levin, Kate
AU - Baska, Tibor
AU - Geckova, Andrea
AU - Kolarcik, Peter
AU - van Dijk, Jitse
AU - Žežula, Ivan
AU - Balakireva, Olga
AU - Yaramenko, Alexander
PY - 2009
Y1 - 2009
N2 - Objectives: To use comparable data from many countries to examine 1) socio-economic inequality in multiple health complaints among adolescents, 2) whether the countries' absolute wealth and economic inequality was associated with symptom load among adolescents, and 3) whether the countries' absolute wealth and economic inequality explained part of the individual level socio-economic variation in health complaints. Methods: The Health Behaviour in School-aged Children (HBSC) international study from 2005/06 provided data on 204,534 11-, 13- and 15-year old students from nationally random samples of schools in 37 countries in Europe and North America. The outcome measure was prevalence of at least two daily health complaints, measured by the HBSC Symptom Check List. We included three independent variables at the individual level (sex, age group, family affluence measured by the Family Affluence Scale FAS) and two macro level measures on the country's economic situation: wealth measured by Gross National Product (GNP) and distribution of income measured by the Gini coefficient. Results: There was a significant socio-economic variation in health complaints in 31 of the 37 countries. The overall OR (95 % CI) for 2+ daily health complaints for all countries was 1.31 (1.27-1.36) in the medium versus high FAS group and 2.07 (2.00-2.14) in the low versus high FAS group. This socio-economic gradient in health complaints attenuated somewhat in the multilevel models which included macro level data. There was no association between GNP and health complaints. The OR for high symptom load was 1.35 (1.08-1.69) per 10 % increase in Gini coefficient. The socio-economic gradient in health complaints at the individual level was somewhat attenuated in the multilevel models which included macro level data. Conclusions: There was a significant association between low FAS and high level of health complaints in 30 of 37 countries. Health complaints increased significantly by increasing income inequality in the country.
AB - Objectives: To use comparable data from many countries to examine 1) socio-economic inequality in multiple health complaints among adolescents, 2) whether the countries' absolute wealth and economic inequality was associated with symptom load among adolescents, and 3) whether the countries' absolute wealth and economic inequality explained part of the individual level socio-economic variation in health complaints. Methods: The Health Behaviour in School-aged Children (HBSC) international study from 2005/06 provided data on 204,534 11-, 13- and 15-year old students from nationally random samples of schools in 37 countries in Europe and North America. The outcome measure was prevalence of at least two daily health complaints, measured by the HBSC Symptom Check List. We included three independent variables at the individual level (sex, age group, family affluence measured by the Family Affluence Scale FAS) and two macro level measures on the country's economic situation: wealth measured by Gross National Product (GNP) and distribution of income measured by the Gini coefficient. Results: There was a significant socio-economic variation in health complaints in 31 of the 37 countries. The overall OR (95 % CI) for 2+ daily health complaints for all countries was 1.31 (1.27-1.36) in the medium versus high FAS group and 2.07 (2.00-2.14) in the low versus high FAS group. This socio-economic gradient in health complaints attenuated somewhat in the multilevel models which included macro level data. There was no association between GNP and health complaints. The OR for high symptom load was 1.35 (1.08-1.69) per 10 % increase in Gini coefficient. The socio-economic gradient in health complaints at the individual level was somewhat attenuated in the multilevel models which included macro level data. Conclusions: There was a significant association between low FAS and high level of health complaints in 30 of 37 countries. Health complaints increased significantly by increasing income inequality in the country.
KW - Adolescents
KW - Comparative study
KW - Complaints
KW - HBSC
KW - School survey
KW - Social inequalities
UR - http://www.scopus.com/inward/record.url?scp=69249220147&partnerID=8YFLogxK
U2 - 10.1007/s00038-009-5418-4
DO - 10.1007/s00038-009-5418-4
M3 - Article
C2 - 19639254
AN - SCOPUS:69249220147
SN - 1661-8556
VL - 54
SP - S260-S270
JO - International Journal of Public Health
JF - International Journal of Public Health
IS - SUPPL. 2
ER -