What is the relationship between socio-economic factors and self-reported health in adolescents?

Problem

Evidence on health inequalities is mostly collected on younger children and adults; therefore, socio-economic predictors of adolescent health are not well understood. Physical morbidity is not common among adolescents and young people (YP); however, many health conditions are initiated in those life stages. This project includes four inter-related studies that will improve the understanding of the relationship between socio-economic factors and self-reported health (SRH) at ages 10-24; and whether and how this relationship is associated with future health outcomes.

Approach

First, the 2001 and 2011 Census microdata from Scotland, England, and Wales were used. Bivariate analysis and logistic regression were applied to examine SRH by the socio-economic status (NS-SEC) of the family reference person, controlled for gender, age, household deprivation, and the UK country. The second study examines the change in the SRH from 2001 to 2011; data from the Scottish Longitudinal Study (SLS) is being analysed by bivariate analysis and gender-stratified multivariate logistic regression. The third study will link SLS data to administrative prescribing data to analyse the relationship between SRH status and the uptake of prescription medicines using sequence analysis. Fourth, a systematic review of qualitative studies that explore YP’s conceptualisation of health is in progress.

Findings

The results of the 2001 and 2011 Census data analysis are reported below. Odds are relative to the higher managerial and professional group and are statistically significant (p<0.001). YP from all NS-SEC groups, except the lower supervisory and self-employed group in 2001, had higher odds of reporting poor health. YP from never worked or long-term unemployed households were 2.4 times more likely to report poor health; the respective figure in 2011 was 3.1 In 2001, respondents from households where the reference person’s occupation cannot be grouped had 2.8 times higher odds of reporting poor health (data not available for 2011). YP from semi-routine and routine households had 21% higher odds to report poor health in 2001; the odds were 74% higher in 2011. The results of the analysis of the SLS data and systematic review will be available by the time of the conference.

Consequences

Analysis of the Census data shows that socio-economic patterning of SRH is evident among Young People; we hypothesise that this will also be visible in the change of SRH over time and in the uptake of prescription medicines. The interpretation of quantitative results will be supported by the synthesis of qualitative studies that explore YP’s conceptualisations of health.