Trends in adolescents’ material and occupational social class-based inequalities in health

• Published in: European journal of public health Vol. 28; no. suppl_4
• Main Authors: Dierckens, M, Richter, M, Moor, I, Elgar, F, Clays, E, Deforche, B, De Clercq, B
• Format: Journal Article
• Language: English
• Published: Oxford Oxford Publishing Limited (England) 01-11-2018
• Subjects: Adolescents; Affluence; Behavior; Beverage industry; Childrens health; Evolution; Fruits; Health behavior; Health disparities; Inequalities; Life satisfaction; Physical activity; Physical fitness; Public health; Regression analysis; Resources; Screen time; Social classes; Social inequality; Socioeconomic status; Soft drinks; Teenagers; Tobacco; Trends
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/cky213.274

Background:Studies have shown increasing trends in adolescent health inequalities but explanations for this evolution are currently lacking. This study aimed to provide a better understanding by examining trends in material and occupational social class-based inequalities in adolescent health and health behaviours over a 12-year period and to assess whether this evolution differs depending on the SES-indicator.Methods:Repeated cross-sectional data from the Health Behaviour in School-aged Children survey (HBSC) collected across 23 countries in 2002, 2006, 2010, and 2014 was used. Multilevel regression analyses were conducted on a sample from 11 to 15-year old adolescents (n = 480386). Trends in material (family affluence scale) and occupational social class-based inequalities were assessed for adolescent health and health behaviours.Findings:Between 2002 to 2014 material inequalities in adolescent health and health behaviours decreased (life satisfaction: 0·81 to 0·68 (scale 0-10), screen time: 0·53 to 0·34 hours/day, fruit: OR 1·89 to 1·72 and soft drinks: OR 1·36 to 1·13 (consumption of at least once daily); p < 0·05). Material inequalities in all other variables remained stable (p > 0·05). Occupational social class-based inequalities increased between 2002 to 2014 in almost all health behaviours (physical activity: 0·16 to 0·24 hours/day, breakfast: 0·31 to 0·51 days/week, vegetable and fruit: OR range 1·23 to 1·74, screen time and use of soft drinks, alcohol and tobacco: OR range 0·99 to 0·43; p < 0·05) but remained stable in health outcomes (p > 0·05).Conclusions:Adolescents from higher occupational social classes systematically performed healthier behaviours over time compared to those from lower occupational social classes, whereas material inequalities in adolescent health and health behaviours remained stable or decreased. Therefore, effective interventions focusing on intangible resources are key in reducing future health inequalities.