Mental health inequalities in Slovenian 15-year-old adolescents explained by personal social position and family socioeconomic status

International Journal for Equity in Health

Tit Albreht²  Joca Zurc¹  Aleš Korošec²  Janina Žiberna²  Helena Jeriček Klanšček² 

[1] College of Nursing Jesenice, Sp. Plavž 3, 4270 Jesenice, Slovenia;National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia

关键词: Inequalities;    Mental health;    Adolescents;    Socioeconomic position;    Slovenia;   

Others  :  803818
DOI  :  10.1186/1475-9276-13-26

 received in 2013-10-09, accepted in 2014-03-18,  发布年份 2014

【 摘 要 】

Introduction

Mental health inequalities are an increasingly important global problem. This study examined the association between mental health status and certain socioeconomic indicators (personal social position and the socioeconomic status of the family) in Slovenian 15-year-old adolescents.

Methods

Data originate from the WHO-Collaborative cross-national ‘Health Behavior in School-aged Children’ study conducted in Slovenia in 2010 (1,815 secondary school pupils, aged 15). Mental health status was measured by: KIDSCREEN-10, the Strength and Difficulties questionnaire (SDQ), a life satisfaction scale, and one question about feelings of depression. Socioeconomic position was measured by the socioeconomic status of the family (Family Affluence Scale, perceived material welfare, family type, occupational status of parents) and personal social position (number of friends and the type of school). Logistic regression and a multivariate analysis of variance (MANOVA) were performed.

Results

Girls had 2.5-times higher odds of suffering feelings of depression (p < 0.001), 1.5-times higher odds of low life satisfaction (p = 0.008), and a greater chance of a lower quality of life and a higher SDQ score than boys (p = 0.001). The adolescents who perceived their family’s material welfare as worse had 4-times higher odds (p < 0.001) of a low life satisfaction, a greater chance of a low quality of life, and a higher SDQ score than those who perceived it as better (p < 0.001). Adolescents with no friends had lower KIDSCREEN-10 and higher SDQ scores than those who had more than three friends.

Conclusions

Despite the fact that Slovenia is among the EU members with the lowest rates of social inequalities, it was found that adolescents with a lower socioeconomic position have poorer mental health than those with a higher socioeconomic position. Because of the financial crisis, we can expect an increase in social inequalities and a greater impact on adolescents’ mental health status in Slovenia in the future.

【 授权许可】

   
2014 Klanšček et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Goldie I: Public mental health today: a handbook. Brighton: Pavilion Publishing Ltd; 2010.
• [2]Marmot M, Bell R: Fair society, healthy lives. Public Health 2012, 126(Suppl 3):S4-S10.
• [3]Fisher M, Baum F: The social determinants of mental health: implications for research and health promotion. Aust N Z J Psychiatry 2010, 44:1057-1063.
• [4]Fryers T, Melzer D, Jenkins R: Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol 2003, 38:229-237.
• [5]WHO: Promoting Mental Health: Concepts, Emerging Evidence, Practice: Summary Report/A Report from the World Health Organization, Department of Mental Health and Substance Abuse in collaboration with the Victorian Health Promotion Foundation (VicHealth) and the University of Melbourne. Geneva: World Health Organization; 2004.
• [6]Vicente N, Leiyu S: The political context of social inequalities and health. Soc Sci Med 2001, 52:481-491.
• [7]Wroblewska W: Womens health status in Poland in the transiton to a market economy. Soc Sci Med 2002, 54:707-726.
• [8]Demirchyan A, Petrosyan V, Thompson ME: Gender differences in predictors of self-rated health in Armenia: a population-based study of an economy in transition. Int J Equity Health 2012, 11:67.
• [9]Picket K, Oliver J, Wilkinson R: Income inequality and the prevalence of mental illness: a preliminary international analysis. J Epidemiol Community Health 2006, 60:646-647.
• [10]Črnak Meglič A: Children and youth in the transitional society: analysis of the situation in Slovenia. Maribor: Aristej; 2006.
• [11]Urad RS za makroekonomske analize in razvoj: Development report. 2013. http://www.umar.gov.si/fileadmin/user_upload/publikacije/dr/13/A_por13_s.pdf webcite
• [12]Malnar B, Kurdija S: Trends in subjective health assessment between 1981 and 2011 as an indicator of persistent social inequalities. Zdrav Var 2012, 51:11-20.
• [13]Kamin T, Berzelak N, Ule M: The influence of education on differences in depressive symptoms between men and women in Slovenia. Zdrav Var 2011, 51:33-42.
• [14]Von dem Knesebeck O, Pattyn E, Bracke P: Education and depressive symptoms in 22 European countries. Int J Public Health 2010, 56:107-110.
• [15]Lubotsky LB, Becker MA (Eds): A public health perspective of womens’ mental health. New York, London: Springer; 2010.
• [16]Annandale E, Hunt K: Gender inequalities in health. Philadelphia: Open University Press; 2000.
• [17]Davis E, Sawyer MG, Lo SK, Priest N, Wake M: Socioeconomic risk factors for mental health problems in 4-5-Year-Old Children; Australian population study. Acad Pediatr 2010, 10:41-47.
• [18]Magklara K, Skapinakis P, Niakas D, Bellos S, Zissi A, Stylianidis S, Mavreas V: Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece. Int J Equity Health 2010, 9:3.
• [19]Amone-P’Olak K, Burger H, Ormel J, Huisman M, Oldehinkel AJ, Verhulst FC: Socioeconomic position and mental health problems in pre- and early-adolescents: the trails study. Soc Psychiatry Psychiatr Epidemiol 2009, 44:231-238.
• [20]Dashiff C, DiMicco W, Myers B, Sheppard K: Poverty and adolescent mental health. J Child Adolesc Psychiatr Nurs 2009, 22:23-32.
• [21]McLaughlin KA, Breslau J, Green JG, Lakoma MD, Sampson NA, Zaslavsky AM: Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample. Soc Sci Med 2011, 73:1088-1096.
• [22]Reiss F: Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 2013, 90:24-31.
• [23]Koivusilta LK, Rimpelä AH, Kautiainen SM: Health inequality in adolescence: does stratification occur by familial social background, family affluence or personal social position? BMC Public Health 2006, 6:110. BioMed Central Full Text
• [24]Murali V, Oyebode F: Poverty, social inequality and mental health. Adv Psychiatr Treat 2004, 10:216.
• [25]Ule M: Za vedno mladi? Socialna psihologija odraščanja. Ljubljana: Fakulteta za družbene vede; 2008.
• [26]Ule M, Rener T, Mencin-Čeplak M, Tivadar B: Socialna ranljivost mladih. Maribor: Aristej; 2000.
• [27]Kurdija S, Ule M, Živoder A: A generation presents itself: “teenagers” satisfaction and processing of the social reality in Slovenia. Teorija Praksa 2011, 48:1486-1504.
• [28]Ule M, Tivadar B, Kurdija S, Rajšp S: Socialnoekonomski položaj študentov v Sloveniji. Ljubljana: Univerza v Ljubljani, Fakulteta za družbene vede, Center za socialno psihologijo; 2008.
• [29]Ule M, Kuhar M: Kakovost življenja otrok in mladostnikov v Sloveniji: Študija osipništva. Ljubljana: FDV; 2003.
• [30]Klemenc-Ketiš Z, Hladnik Ž, Rotar-Pavlič D, Post M, Kersnik J: Self-reported chronic conditions in student populations in Slovenia. Zdrav Vestn 2010, 79:31-41.
• [31]Lavrič M: Mladina 2010: Družbeni profil mladih v Sloveniji. Maribor: Aristej; 2011.
• [32]Currie C, Nic Gabhainn S, Godeau E, Roberts C, Smith R, Currie D, Picket W, Richter M, Morgan A, Barnekow V (Eds): Inequalities in young people’s health: HBSC international report from the 2005/06 survey. Copenhagen, Denmark: WHO, Regional Office for Europe (health policy for Children and Adolescents, No. 5); 2008.
• [33]Currie C, Zanotti C, Morgan A, Currie D, Looze M de, Roberts C, Samdal O, Smith ORF, Barnekow V (Eds): Social determinants of health and well-being among young people. Health Behaviour in School- aged children (HBSC) study; International report from the 2009/2010 survey. Copenhagen: WHO, Regional Office for Europe (health policy for Children and Adolescents, No. 6); 2012.
• [34]Ravens-Sieberer U, Erhart M, Gosch A, Wille N, The European KIDSCREEN Group: Mental health of children and adolescents in 12 European Countries – results from the European KIDSCREEN study. Clin Psychol Psychother 2008, 15:154-163.
• [35]Goodman R, Meltzer H, Bailey V: The strengths and difficulties questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 1998, 7:125-130.
• [36]Boyce W, Torsheim T, Currie C, Zambon A: The family affluence scale as a measure of national wealth: validation of an adolescent self-report measure. Soc Indic Res 2006, 78:473-487.
• [37]Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M: Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med 2008, 66:1429-1436.
• [38]Artnik B, Drev A, Drglin Z, Fajdiga VT, Gabrijelčič MB, Gregorič M, Hočevar T, Jeriček HK, Koprivnikar H, Kovše K, Mihevc BP, Pucelj V, Rok MS, Roškar S, Scagnetti N, Zupančič T: Neenakosti v zdravju in z zdravjem povezanih vedenjih slovenskih mladostnikov (Inequalities in health and health behavior among Slovenian adolescents). Ljubljana: Inštitut za varovanje zdravja Republike Slovenije; 2008.
• [39]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: Socio-economic inequality in multiple health complaints among adolescents: international comparative study in 37 countries. Int J Public Health 2009, 45:260-270.
• [40]Chhabra GS, Sodhi MK: Factors contributing to psycho-social Ill-health in male adolescents. Online J Health Allied Scs 2011, 10:2.
• [41]Bisegger C, Cloetta B, Von Rueden U, Abel T, Ravens-Sieberer U, European Kidscreen Group: Health-related quality of life: gender differences in childhood and adolescence. Soz Preventivmed 2005, 50:281-291.
• [42]Levin KA, Dallago L, Currie C: The association between adolescent life satisfaction, family structure, family affluence and gender differences in parent–child communication. Soc Indic Res 2012, 106:287-305.
• [43]Piko FB, Hamvai C: Parent, school and peer-related correlates of adolescents’ life satisfaction. Child Youth Serv Rev 2010, 32:1479-1482.
• [44]Pfau-Effinger B: Gender cultures and the gender arrangement: a theoretical framework for cross-national gender research. Innovation 1998, 11:147-162.
• [45]Dan žensk 2012, SURS http://www.stat.si/novica_prikazi.aspx?id=4548 webcite
• [46]Šribar R, Ule M: Status and social opportunities of the girl child: expert study. Ljubljana: University of Ljubljana, Faculty of Social Sciences; 2008.
• [47]Hölling H, Kurth BM, Rothenbergerer A, Becker A, Schlack R: Assessing psychopathological problems of children and adolescents from 3 to 17 years in a nationwide representative sample: results of the German health interview and examination survey for children and adolescents (KIGGS). Eur Child Adolesc Psychiatry 2008, 17:34-41.
• [48]Proctor CL, Linley PA, Maltby J: Youth life satisfaction: a review of the literature. J Happiness Stud 2009, 10:583-630.
• [49]Starfield B, Riley AW, Witt WP, Robertson J: Social class gradients in health during adolescence. J Epidemiol Community Health 2002, 56:354-361.
• [50]Von Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U, The European KIDSCREEN group: Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health 2006, 60:130-135.
• [51]De Matos M, Gaspar M, Simones C, Batista-Fouget J, Cottraux J: Personal and social factors associated with the perception of health and the perception of happiness in a nonclinical adolescent population. Encéphale 2010, 36:39-45.
• [52]Goodman E, Adler NE, Kawachi I, Frazier AL, Huang B, Colditz GA: Adolescents’ perceptions of social status: development and evaluation of a new indicator. Pediatrics 2001, 108:E31.
• [53]Hall-Lande JA, Eisenberg ME, Christenson SL, Neumark-Sztainer D: Social isolation, psychological health, and protective factors in adolescence. Adolescence 2007, 42:265-286.
• [54]Simetin IP, Kuzman M, Franelic IP, Pristas I, Benjak T, Dezeljin JD: Inequalities in Croatian pupils’ unhealthy behaviors and health outcomes: role of school, peers and family affluence. Eur J Public Health 2011, 21:122-128.
• [55]Intihar S: Income and poverty indicators, Slovenia – provisional data. 2011. http://www.stat.si/eng/novica_prikazi.aspx?id=4177 webcite