Tuesday, 18 March 2014

Educational inequalities in life satisfaction among teens – what do we know? A closer look at the role of health behaviour and gender differences

This post, written by HBSC's Irene Moor and Joseph Hancock, discusses a newly released study on life satisfaction among German adolescents. It also presents the health behaviour inequalities among German girls and boys following different education tracks. The blog is a part of Wikichild's series on Health.

       Research has identified a clear link between people’s social position and their health. Mackenbach (2006) found health inequalities among people with higher and lower socio-economic status in all European countries and, furthermore, a widening of some of these inequalities during the last decades. In some countries, differences in life expectancy amount to 10 years or more due to these inequalities in educational level, occupational class and income inequalities. In addition to social status, we know that gender also substantially affects an individual's health. In general, the social gradient in health is more pronounced among men than women. However, these gender differences vary by age, health outcome, and also social status. In a birth cohort from 1958, for instance, Matthews et al. (1999) found greater social inequalities among men in their 30’s for long-standing illness but greater inequalities among women for psychological distress at the same age.

      Previously, studies focusing on gender differences in health inequalities have looked almost exclusively at adults. There is now a growing body of work suggesting that inequalities in health and health behaviours are already well-established by the time of transition from adolescent to adult, resulting from the social experiences and living conditions that young people experience during this formative period. For example, behavioural factors such as smoking, physical activity, fruit and vegetable consumption, or illegal drug use have been shown to be socially patterned behaviours, ingrained during the teenage years. Understanding the mechanisms which link the social position and health of adolescents is essential if we want develop effective strategies that help place socially disadvantaged teens on healthier, happier trajectories into adult life.

      Previous international research from the Health Behaviour in School-aged Children study (HBSC) revealed that life satisfaction, a multi-factorial psychological concept of well-being, is unequally distributed among different social groups. Adolescents from families with high social positions were found to have higher levels of life satisfaction than adolescents from families with lower social positions. These socially determined inequalities appear in nearly all countries across Europe and North America, in both boys and girls, and are stronger for life satisfaction than other subjective health indicators among teens.

      Using data from over 5,000 school children, members of the German HBSC national team investigated the role of health behaviour in explaining educational inequalities in adolescent life satisfaction nationally.

In particular they looked at:

  1. The significance of differences in life satisfaction by educational track, in boys and girls. 
  2. The presence of gender differences in terms of how behavioural factors impact life satisfaction. 
  3. The different patterns of health behaviours among adolescents on different educational tracks.  
  4. The extent to which educational inequalities in life satisfaction can be explained by behavioural factors.

The main results can be summarised as follows:

1. Significant inequalities in life satisfaction by educational track were found for both genders. The higher the educational track, the more likely it is that an adolescent would report high levels of life satisfaction. This effect was found to be stronger among boys than girls.

2. Several behavioural factors were found to be associated with low life satisfaction in both boys and girls. Such as not eating breakfast every day and drinking soft drinks daily. However, gender differences in the effect of behavioural factors on life satisfaction were also found. For example, the association between low life satisfaction and not having breakfast every school day was much stronger for girls than boys. Other behaviours such as smoking regularly, drinking alcohol, having been drunk, both watching TV and eating fruits daily were associated with lower life satisfaction in girls but not in boys. Whereas lower levels of physical activity were more strongly related to lower life satisfaction in boys than girls.

3. Regular smoking, having been drunk, watching TV, drinking soft drinks and eating breakfast less than daily were more prevalent among boys and girls from lower education tracks. Whereas frequent alcohol drinking, fruit consumption (less than daily) and daily sweet consumption were associated with lower education tracks only in girls, and physical activity only in boys.

4. In boys, three indicators were significantly linked to life satisfaction as well as to their educational track, including physical activity levels, eating breakfast and the consumption of soft drinks. Whereas a total of seven indicators, including smoking, drinking alcohol, having been drunk, watching TV, eating breakfast, fruits, and the consumption of soft drinks, were significantly linked to life satisfaction in girls. Altogether, up to 40% of educational inequalities in life satisfaction among girls were explained by behavioural determinants, which is nearly twice the figure for boys.
      The study's findings confirm that educational inequalities in life satisfaction are already established by adolescence. These findings also indicate that behavioural factors are an important mediating force, acting upon educational inequalities in adolescent life satisfaction for both boys and girls, but to a much greater extent among girls. In order to tackle inequalities in adolescent health, targeting health behaviours among teens from lower educational tracks, with a gender specific perspective, looks like a promising approach. 

More information on the analysis
Moor I, Lampert T, Rathmann K, Kuntz B, Kolip P, Spallek J, Richter M (2013): Explaining educational inequalities in adolescent life satisfaction: do health behaviour and gender matter? International Journal of Public Health. DOI 10.1007/s00038-013-0531-9

About the HBSC Study

      The HBSC research network is an alliance of researchers who collaborate to collect data on the health, well-being, health behaviours, social environments and economic contexts of adolescents. The HBSC study is currently conducted in 44 countries across Europe and North America, and the network includes over 450 experts from a wide range of disciplines. Members of the HBSC network collaborate to develop a standardized questionnaire, which is used to survey nationally representative samples of school-aged children in each participating country.

      HBSC's research themes currently include: chronic conditions, eating and dieting, electronic media, family culture, gender, medicine-use, peer culture, physical activity, positive health, puberty, risk behaviours, school, sexual health, social inequality, and violence and injuries.

For more information visit www.hbsc.org

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