Universität zu Köln

Moor, Irene ORCID: 0000-0003-3245-5176, Kuipers, Mirte A. G., Lorant, Vincent, Pfoertner, Timo-Kolja, Kinnunen, Jaana M., Rathmann, Katharina, Perelman, Julian ORCID: 0000-0001-6634-9000, Alves, Joana ORCID: 0000-0002-5736-6519, Robert, Pierre-Olivier, Rimpela, Arja, Kunst, Anton E. and Richter, Matthias (2019). Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status. J. Epidemiol. Community Health, 73 (10). S. 963 - 971. LONDON: BMJ PUBLISHING GROUP. ISSN 1470-2738

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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 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moor, Irene UNSPECIFIED orcid.org/0000-0003-3245-5176 UNSPECIFIED Kuipers, Mirte A. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lorant, Vincent UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfoertner, Timo-Kolja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kinnunen, Jaana M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rathmann, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Perelman, Julian UNSPECIFIED orcid.org/0000-0001-6634-9000 UNSPECIFIED Alves, Joana UNSPECIFIED orcid.org/0000-0002-5736-6519 UNSPECIFIED Robert, Pierre-Olivier UNSPECIFIED UNSPECIFIED UNSPECIFIED Rimpela, Arja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kunst, Anton E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Richter, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133106
DOI:	10.1136/jech-2018-211794
Journal or Publication Title:	J. Epidemiol. Community Health
Volume:	73
Number:	10
Page Range:	S. 963 - 971
Date:	2019
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1470-2738
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SUBJECTIVE SOCIAL-STATUS; MULTILEVEL ANALYSIS; SCHOOL; ASSOCIATION; MORTALITY; COUNTRIES; BEHAVIOR; IDENTIFICATION; NETHERLANDS; STYLES Multiple languages Public, Environmental & Occupational Health Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13310