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;Richter, Matthias;et.al.
(2019) Journal of Epidemiology & Community Health : an international peer-reviewed journal for health professionals and researchers in all areas of epidemiology — p. 8p (2019)

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Authors
  • Moor, Irene
    Author
  • Kuipers, Mirte A.G.
    Author
  • Lorant, VincentUCLouvain
    Author
  • Pförtner, Timo-Kolja
    Author
  • Robert, Pierre-OlivierUCLouvain
    Author
  • Richter, Matthias
    Author
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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. 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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Moor, I., Kuipers, M. A. G., Lorant, V., Pförtner, T.-K., Kinnunen, J. M., Rathmann, K., Perelman, J., Alves, J., Robert, P.-O., Rimpelä, A., Kunst, A. E., & Richter, M. (2019). Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status. Journal of Epidemiology & Community Health : an international peer-reviewed journal for health professionals and researchers in all areas of epidemiology, 8p. https://doi.org/10.1136/jech-2018-211794 (Original work published 2019)