Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

Bjørn E Holstein; Candace Currie; Will Boyce; Mogens T Damsgaard; Inese Gobina; Gyöngyi Kökönyei; Jørn Hetland; Margaretha de Looze; Matthias Richter; Pernille Due; HBSC Social Inequalities Focus Group

doi:10.1007/s00038-009-5418-4

Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

Bjørn E Holstein, Candace Currie, Will Boyce, Mogens T Damsgaard, Inese Gobina, Gyöngyi Kökönyei, Jørn Hetland, Margaretha de Looze, Matthias Richter, Pernille Due, HBSC Social Inequalities Focus Group

96 Citations (Scopus)

Abstract

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.

Original language	English
Journal	International Journal of Public Health (Print Edition)
Volume	54 Suppl 2
Pages (from-to)	260-70
Number of pages	10
ISSN	1661-8556
DOIs	https://doi.org/10.1007/s00038-009-5418-4
Publication status	Published - 2009

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Holstein, B. E., Currie, C., Boyce, W., Damsgaard, M. T., Gobina, I., Kökönyei, G., Hetland, J., de Looze, M., Richter, M., Due, P., & HBSC Social Inequalities Focus Group (2009). Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries. International Journal of Public Health (Print Edition), 54 Suppl 2, 260-70. https://doi.org/10.1007/s00038-009-5418-4

Holstein, BE, Currie, C, Boyce, W, Damsgaard, MT, Gobina, I, Kökönyei, G, Hetland, J, de Looze, M, Richter, M, Due, P & HBSC Social Inequalities Focus Group 2009, 'Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries', International Journal of Public Health (Print Edition), vol. 54 Suppl 2, pp. 260-70. https://doi.org/10.1007/s00038-009-5418-4

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title = "Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries",

abstract = "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.",

author = "Holstein, {Bj{\o}rn E} and Candace Currie and Will Boyce and Damsgaard, {Mogens T} and Inese Gobina and Gy{\"o}ngyi K{\"o}k{\"o}nyei and J{\o}rn Hetland and {de Looze}, Margaretha and Matthias Richter and Pernille Due and {HBSC Social Inequalities Focus Group}",

year = "2009",

doi = "10.1007/s00038-009-5418-4",

language = "English",

volume = "54 Suppl 2",

pages = "260--70",

journal = "International Journal of Public Health (Print Edition)",

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TY - JOUR

T1 - Socio-economic inequality in multiple health complaints among adolescents: 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 - HBSC Social Inequalities Focus Group

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.

U2 - 10.1007/s00038-009-5418-4

DO - 10.1007/s00038-009-5418-4

M3 - Journal article

C2 - 19639254

SN - 1661-8556

VL - 54 Suppl 2

SP - 260

EP - 270

JO - International Journal of Public Health (Print Edition)

JF - International Journal of Public Health (Print Edition)

ER -

Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries

Abstract

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