Absolute and relative family affluence and psychosomatic symptoms in adolescents.

Previous research on the links between income inequality and health and socioeconomic differences in health suggests that relative differences in affluence impact health and well-being more than absolute affluence. This study explored whether self-reported psychosomatic symptoms in adolescents relate more closely to relative affluence (i.e., relative deprivation or rank affluence within regions or schools) than to absolute affluence. Data on family material assets and psychosomatic symptoms were collected from 48,523 adolescents in eight countries (Austria, Belgium, Canada, Norway, Scotland, Poland, Turkey, and Ukraine) as part of the 2009/10 Health Behaviour in School-aged Children study. Multilevel regression analyses of the data showed that relative deprivation (Yitzhaki Index, calculated in regions and in schools) and rank affluence (in regions) (1) related more closely to symptoms than absolute affluence, and (2) related to symptoms after differences in absolute affluence were held constant. However, differences in family material assets, whether they are measured in absolute or relative terms, account for a significant variation in adolescent psychosomatic symptoms. Conceptual and empirical issues relating to the use of material affluence indices to estimate socioeconomic position are discussed.