Zróżnicowanie zachowań zdrowotnych młodzieży na tle warunków życia i percepcji środowiska miejsca zamieszkania

Zdrowie stanowi najcenniejszą wartość osobistą i społeczną. W obszarze badań nad zachowaniami zdrowotnymi coraz większe znaczenie nadaje się czynnikom ekonomiczno-społecznym, związanym z zamożnością, pozycją społeczną i kapitałem społecznym. Przypuszcza się, że nierówności społeczne mogą w istotny sposób bezpośrednio lub pośrednio oddziaływać na zdrowie młodzieży i na jej przyszłość. Celem niniejszych badań jest zidentyfikowanie zależności między zachowaniami sprzyjającymi zdrowiu i ryzykownymi dla zdrowia deklarowanymi przez piętnastoletnią wrocławską młodzież a warunkami życia i środowiskiem lokalnym. Materiał niniejszego artykułu stanowią dane uzyskane w wyniku badań 34 szkół we Wrocławiu. W ocenie zachowań zdrowotnych posłużono się: Międzynarodowym Kwestionariuszem Zachowań Zdrowotnych Młodzieży Szkolnej HBSC (Health Behaviour in School-aged Children) o potwierdzonej trafności i rzetelności. Zróżnicowanie wybranych zachowań zdrowotnych odniesiono do zasobów materialnych rodziny FAS (Family Affluence Scale), nasilenia problemów w środowisku lokalnym, a także percepcji kapitału społecznego w badanym środowisku. Z przeprowadzonych badań wynika, że wrocławska młodzież o wyższym poziomie zamożności rodziny mniej czasu wolnego poświęca na oglądanie telewizji, granie w gry komputerowe czy korzystanie z Internetu. Wzrost zamożności rodziny mierzony skalą FAS nie zawsze był skorelowany z zachowaniami sprzyjającymi zdrowiu. Młodzież o najniższym poziomie zamożności rodziny najczęściej deklarowała niespożywanie alkoholu. Wysoki poziom postrzegania kapitału społecznego w środowisku lokalnym okazał się istotnie skorelowany z zalecaną codzienną aktywnością fizyczną. Ponadto, im wyższy deklarowano poziom postrzegania kapitału społecznego, tym częściej piętnastolatkowie palili tytoń. Nasilenie problemów w środowisku lokalnym nie było istotnie skorelowane z zachowaniami zdrowotnymi.

The social gradient in adolescent mental health: mediated or moderated by belief in a just world?

Purpose A social gradient in adolescent mental health exists: adolescents with higher socioeconomic status (SES) have fewer mental health problems than their peers with lower SES. Little is known about whether adolescents’ societal beliefs play a role in this social gradient. Belief in a just world (BJW) may be a mediator or moderator of the social gradient in adolescent mental health. Methods Using data from 848 adolescents (Mage = 17) in the Netherlands, path analyses examined whether two indicators of BJW (general and personal) mediated or moderated the associations between two indicators of SES (family affluence and perceived family wealth), and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). Results Adolescents with lower family affluence and lower perceived family wealth reported more emotional symptoms, and the association between perceived family wealth and emotional symptoms was mediated by lower personal and general BJW. Furthermore, higher personal BJW amplified the negative association between SES and peer problems. Conclusion This study suggests BJW may both mediate and amplify the social gradient in adolescent mental health. Adolescents’ beliefs about society may be important to include in research aimed at understanding this social gradient.

Does the family affluence scale reflect actual parental earned income, level of education and occupational status? A validation study using register data in Sweden

Aim To examine the external validity of the Family Affluence Scale (FAS) among adolescents in Sweden by using register data for parental earned income, level of education and occupational status. Methods Data from the baseline (2015–2019) of the Study of Adolescence Resilience and Stress (STARS), comprising 2283 13-year-olds in the region of Västra Götaland, were used. The FAS III consists of six items: unshared bedroom, car ownership, computer/tablet ownership, dishwasher, number of bathrooms and number of holidays abroad. Register data regarding earned income, educational level and occupational status from Statistics Sweden (2014–2018) were linked to adolescents. In total, survey data were available for 2280 adolescents, and register data were available for 2258 mothers and 2204 fathers. Results Total parental earned income was moderately correlated with adolescents’ scoring on FAS (0.31 < r < 0.48, p < 0.001), depending on examination year. The low FAS group mainly comprised low-income households, and the high FAS group mainly comprised high-income households. Correlations between mothers’ and fathers’ educational level and adolescents’ scoring on FAS were low (r = 0.19 and r = 0.21, respectively, p < 0.001). FAS was higher among adolescents whose parents were working, but the correlation between parents’ occupational status and FAS was low (r = 0.22, p < 0.001). Conclusions The FAS can mainly identify low- and high-income households in Sweden. It may be used as an alternative measure of parental earned income in studies using self-reported socioeconomic status among adolescents.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Tracking of General and Abdominal Obesity in Children Between 4 and 9 Years of Age: The Longitudinal Childhood Obesity Study (ELOIN)

Background A relationship between obesity early life has been reported. The aim of this study was to evaluate the variations in general (GO) and abdominal (AO) obesity between 4 and 9 years of age. Methods Children who participated in all three follow-ups at 4, 6 and 9 years participating in ELOIN study (N = 1902). Measurements of BMI and waist circumference were taken by physical examination. Prevalence ratios (PRs) were estimated by sex and family affluence by generalized estimation equation models, and the relative risks (RRs) of obesity by Poisson regression. Results The prevalence of GO was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, yielding a PR between 9 − 4 years of 3.05 (95%CI: 2.58–3.60). The prevalence of AO was 6.8%, 8.4%, 14.5%, and the PR (9 vs 4y) was 2.14 (95%CI: 1.85–2.48). GO and AO presented an inverse correlation with family affluence. Among participants who were in GO or AO at 4 years, 77.3% and 63.6% remained in obesity after 5 years. The RRs of GO and AO at 9 years were 4.6 and 4.1 if they were obese at 4 years (p < 0.001), which increased to 9.4 and 9.5 in children obese at 6 years (p < 0.001), and those with obesity at both 4–6 years had RRs of 10.3 and 9.9 (p < 0.001). Conclusions GO and AO begin at early age, persist with age and linked with low socioeconomic status. Obesity at 9 years is associated with early obesity, either stably or intermittently, so preventive interventions should be established very early.

Psychological distress in late adolescence: The role of inequalities in family affluence and municipal socioeconomic characteristics in Norway

The present study aims to explore, in the national context of Norway, how municipal socioeconomic indicators affect anxiety and depressive symptom scores among senior high school students and whether this potential municipal effect is dependent on the adolescents’ family affluence levels. This cross-sectional study is based on questionnaire data collected in five waves (2014–2018) of the Ungdata survey. The study sample consisted of 97,460 adolescents aged 16–18 years attending high school in 156 municipalities in Norway. Measures of psychological distress, depression, and anxiety symptoms were based on the screening instrument, Hopkins Symptom Checklist-10. Two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents’ mental health. In general, the results indicate substantial psychological symptom load among the study sample. Inequalities in adolescents’ psychological distress between family affluence groups were evident, with the lowest symptom loads in the most affluent families. The predicted depressive and anxiety symptoms among the students increased slightly along with the percentage of municipal residents with tertiary educations and with increasing income inequalities in their residential municipality. However, the interaction models suggest that the adverse effects of higher municipal education level and greater income inequality are, to a certain extent, steepest for adolescents with medium family affluence. This study highlights two key findings. Both municipality effects and family affluence account for a relatively small proportion of the total variance in the students’ psychological symptoms loads; however, the mental health inequalities we explored between socioeconomic strata on both the individual and municipal levels are not insignificant in a public health perspective. Results are discussed in the context of psychosocial mechanisms related to social comparison and perceptions of social status that may be applicable in egalitarian welfare states such as Norway.

Association of clinical severity with family-affluence-based socioeconomic status among hospitalized pediatric hand, foot, and mouth disease in Henan, China: a single hospital-based case-series study

Background The association between the clinical severity of HFMD inpatients and socioeconomic status (SES) is important for quantifying SES inequality in HFMD disease burden and informing decision-makers regarding medical subsidy and reimbursement policies. Here, this association was investigated using a quantitative SES measurement. Methods Laboratory-confirmed HFMD cases hospitalized at Henan Children’s Hospital from February 15, 2017 to February 15, 2018 were invited. We utilized the revised Family Affluence Scale for family-affluence-based SES measurement. Clinical severity was diagnosed based on central nervous system (CNS) complications, treatments and length of stay. We applied logistic regression for association analyses and multiple imputation for missing data. Results A total of 1229 laboratory-confirmed HFMD inpatients responded. Adjusted by age, sex, rural residence, EV-A71 infection and health-seeking behavior, CNS complications (OR=2.72, 95%CI: 1.41-5.31), ICU admission (OR=7.30, 95%CI: 2.21-25.97) and prolonged hospitalization (OR=4.28, 95%CI: 2.44-7.58) were significantly associated with lower family-affluence-based SES. These associations increased as SES category descended. For EV-A71-infected inpatients, severe HFMD was significantly associated with low and intermediate SES. For non-EV-A71-infected inpatients, only the association of prolonged hospitalization with low SES increased significantly. Also, severe HFMD inpatients, especially those admitted to ICU, incurred high hospitalization costs. Conclusions The clinical severity of HMFD inpatients was significantly associated with family-affluence-based SES. Severe HFMD inpatients were more likely to have lower SES than non-severe inpatients and suffered heavy economic burden. Therefore, medical subsidy and reimbursement policies should offer sufficient monetary support to severe HFMD inpatients, to alleviate economic burden of low-SES populations and reduce potential SES inequality.

12-Year Trends in Active School Transport across Four European Countries—Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Active school transport (AST) is a source of daily physical activity uptake. However, AST seems to have decreased worldwide over recent decades. We aimed to examine recent trends in AST and associations with gender, age, family affluence, and time to school, using data from the Health Behaviour in School-Aged Children (HBSC) study collected in 2006, 2010, 2014, and 2018 in the Czech Republic, Norway, Scotland, and Wales. Data from 88,212 students (11, 13 and 15 years old) revealed stable patterns of AST from 2006 to 2018, apart from a decrease in the Czech Republic between 2006 and 2010. For survey waves combined, walking to and from school was most common in the Czech Republic (55%) and least common in Wales (30%). Cycling was only common in Norway (22%). AST differed by gender (Scotland and Wales), by age (Norway), and by family affluence (everywhere but Norway). In the Czech Republic, family affluence was associated with change over time in AST, and the effect of travel time on AST was stronger. The findings indicate that the decrease in AST could be levelling off in the countries considered here. Differential associations with sociodemographic factors and travel time should be considered in the development of strategies for AST.