Katharina Rathmann1, Veronika Ottova2, Klaus Hurrelmann3, Margarethe de Looze4, Kate Levin5, Michal Molcho6, Frank Elgar7, Saoirse Nic Gabhainn6, Jitse P van Dijk8, Matthias Richter9. 1. Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany; Berlin Graduate School of Social Sciences (BGSS), Socioeconomic and Statistical Studies (SESS), Humboldt University Berlin, Germany. Electronic address: katharina.rathmann@medizin.uni-halle.de. 2. University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Hertie School of Governance, Berlin, Germany. 4. Faculty of Social and Behavioral Sciences, University of Utrecht, The Netherlands. 5. NHS Greater Glasgow & Clyde, Glasgow, Scotland, United Kingdom. 6. Department of Health Promotion, National University of Ireland, Galway, Ireland. 7. Institute for Health and Social Policy and Douglas Institute, McGill University, Montreal, Quebec, Canada. 8. Graduate School Kosice Institute for Society and Health, PJ Safarik University, Kosice, Slovak Republic; Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, The Netherlands. 9. Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Germany.
Abstract
OBJECTIVES: Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. STUDY DESIGN: Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. MAIN OUTCOME MEASURE: Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. RESULTS: Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. CONCLUSION: Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence.
OBJECTIVES: Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. STUDY DESIGN: Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. MAIN OUTCOME MEASURE: Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. RESULTS: Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. CONCLUSION: Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence.
Authors: Katharina Rathmann; Timo-Kolja Pförtner; Ana M Osorio; Klaus Hurrelmann; Frank J Elgar; Lucia Bosakova; Matthias Richter Journal: BMC Public Health Date: 2016-08-24 Impact factor: 3.295