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Trends in material and non-material inequalities in adolescent health and health behaviours : a 12-year study in 23 European countries

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Abstract
Information on trends in adolescent health inequalities is scarce but the available evidence suggests that inequalities are increasing. Prior studies describe associations between material resources of socioeconomic status (SES) and health, while information on non-material SES resources and inequalities in health behaviours is lacking. To improve current understandings of evolutions in adolescent health inequalities, we examined how material and non-material SES resources were associated with changes in selected health outcomes (life satisfaction, physical and psychological symptoms) and health behaviours (physical activity, screen time, breakfast, fruit, vegetables, sweets and soft drinks consumption and alcohol and tobacco use) over a 12-year period. Repeated cross-sectional data came from the 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey from 23 European countries (n = 480,386). Measures of family affluence and occupational social class were used as indicators of material and non-material SES resources respectively. Regression-based slope indices of inequality indicated that absolute material and non-material inequalities remained stable from 2002 to 2014 in all health outcomes, except for life satisfaction for which a decrease in material inequalities was found between the highest and lowest affluence group (0.81 to 0.68 difference; p < 0.001). In terms of health behaviours, material inequalities decreased in screen time between highest and lowest affluence groups (0.53 to 0.34 h/day difference; p < 0.001), fruit (odds ratio [OR] 1.89 to 1.72 lower odds; p = 0.0088) and soft drinks consumption (OR 1.36 to 1.13 lower odds; p < 0.001) and remained stable in all others. Non-material inequalities increased in all health behaviours (except for sweets consumption) between highest and lowest occupational social class groups: physical activity (0.16 to 0.24 h/day difference; p = 0.0071), screen time (-0.41 to-0.58 h/day difference; p < 0.001), breakfast (0.21 to 0.51 day/week difference; p < 0.001), fruit (OR 1.23 to 1.48 higher odds; p < 0.001), vegetables (OR 1.39 to 1.74 higher odds; p < 0.001) and soft drinks consumption (OR 0.59 to 0.43 lower odds; p < 0.001) and alcohol (OR 0.99 to 0.85 lower odds; p = 0.0420) and tobacco use (OR 0.71 to 0.59 lower odds; p = 0.0183). In summary, non-material inequalities in most health behaviours increased, whereas material inequalities in adolescent health and health behaviours remain stable or decreased. Policies and interventions may consider non-material SES components as these can help in reducing future health inequalities.
Keywords
Public Health, Environmental and Occupational Health, Epidemiology, Inequalities, Adolescents, Health behaviour, Multilevel modelling, Trends, MODERN WELFARE STATES, SOCIOECONOMIC INEQUALITIES, SOCIAL INEQUALITIES, NORTH-AMERICA, EXPLANATION, PERSISTENCE, COMPLAINTS, PARENTS

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MLA
Dierckens, Maxim, et al. “Trends in Material and Non-Material Inequalities in Adolescent Health and Health Behaviours : A 12-Year Study in 23 European Countries.” PREVENTIVE MEDICINE, vol. 157, 2022, doi:10.1016/j.ypmed.2022.107018.
APA
Dierckens, M., Richter, M., Moor, I., Elgar, F. J., Clays, E., Deforche, B., & De Clercq, B. (2022). Trends in material and non-material inequalities in adolescent health and health behaviours : a 12-year study in 23 European countries. PREVENTIVE MEDICINE, 157. https://doi.org/10.1016/j.ypmed.2022.107018
Chicago author-date
Dierckens, Maxim, Matthias Richter, Irene Moor, Frank J. Elgar, Els Clays, Benedicte Deforche, and Bart De Clercq. 2022. “Trends in Material and Non-Material Inequalities in Adolescent Health and Health Behaviours : A 12-Year Study in 23 European Countries.” PREVENTIVE MEDICINE 157. https://doi.org/10.1016/j.ypmed.2022.107018.
Chicago author-date (all authors)
Dierckens, Maxim, Matthias Richter, Irene Moor, Frank J. Elgar, Els Clays, Benedicte Deforche, and Bart De Clercq. 2022. “Trends in Material and Non-Material Inequalities in Adolescent Health and Health Behaviours : A 12-Year Study in 23 European Countries.” PREVENTIVE MEDICINE 157. doi:10.1016/j.ypmed.2022.107018.
Vancouver
1.
Dierckens M, Richter M, Moor I, Elgar FJ, Clays E, Deforche B, et al. Trends in material and non-material inequalities in adolescent health and health behaviours : a 12-year study in 23 European countries. PREVENTIVE MEDICINE. 2022;157.
IEEE
[1]
M. Dierckens et al., “Trends in material and non-material inequalities in adolescent health and health behaviours : a 12-year study in 23 European countries,” PREVENTIVE MEDICINE, vol. 157, 2022.
@article{8745021,
  abstract     = {{Information on trends in adolescent health inequalities is scarce but the available evidence suggests that inequalities are increasing. Prior studies describe associations between material resources of socioeconomic status (SES) and health, while information on non-material SES resources and inequalities in health behaviours is lacking. To improve current understandings of evolutions in adolescent health inequalities, we examined how material and non-material SES resources were associated with changes in selected health outcomes (life satisfaction, physical and psychological symptoms) and health behaviours (physical activity, screen time, breakfast, fruit, vegetables, sweets and soft drinks consumption and alcohol and tobacco use) over a 12-year period. Repeated cross-sectional data came from the 2002, 2006, 2010 and 2014 waves of the Health Behaviour in School-aged Children (HBSC) survey from 23 European countries (n = 480,386). Measures of family affluence and occupational social class were used as indicators of material and non-material SES resources respectively. Regression-based slope indices of inequality indicated that absolute material and non-material inequalities remained stable from 2002 to 2014 in all health outcomes, except for life satisfaction for which a decrease in material inequalities was found between the highest and lowest affluence group (0.81 to 0.68 difference; p < 0.001). In terms of health behaviours, material inequalities decreased in screen time between highest and lowest affluence groups (0.53 to 0.34 h/day difference; p < 0.001), fruit (odds ratio [OR] 1.89 to 1.72 lower odds; p = 0.0088) and soft drinks consumption (OR 1.36 to 1.13 lower odds; p < 0.001) and remained stable in all others. Non-material inequalities increased in all health behaviours (except for sweets consumption) between highest and lowest occupational social class groups: physical activity (0.16 to 0.24 h/day difference; p = 0.0071), screen time (-0.41 to-0.58 h/day difference; p < 0.001), breakfast (0.21 to 0.51 day/week difference; p < 0.001), fruit (OR 1.23 to 1.48 higher odds; p < 0.001), vegetables (OR 1.39 to 1.74 higher odds; p < 0.001) and soft drinks consumption (OR 0.59 to 0.43 lower odds; p < 0.001) and alcohol (OR 0.99 to 0.85 lower odds; p = 0.0420) and tobacco use (OR 0.71 to 0.59 lower odds; p = 0.0183). In summary, non-material inequalities in most health behaviours increased, whereas material inequalities in adolescent health and health behaviours remain stable or decreased. Policies and interventions may consider non-material SES components as these can help in reducing future health inequalities.}},
  articleno    = {{107018}},
  author       = {{Dierckens, Maxim and Richter, Matthias and Moor, Irene and Elgar, Frank J. and Clays, Els and Deforche, Benedicte and De Clercq, Bart}},
  issn         = {{0091-7435}},
  journal      = {{PREVENTIVE MEDICINE}},
  keywords     = {{Public Health,Environmental and Occupational Health,Epidemiology,Inequalities,Adolescents,Health behaviour,Multilevel modelling,Trends,MODERN WELFARE STATES,SOCIOECONOMIC INEQUALITIES,SOCIAL INEQUALITIES,NORTH-AMERICA,EXPLANATION,PERSISTENCE,COMPLAINTS,PARENTS}},
  language     = {{eng}},
  pages        = {{9}},
  title        = {{Trends in material and non-material inequalities in adolescent health and health behaviours : a 12-year study in 23 European countries}},
  url          = {{http://doi.org/10.1016/j.ypmed.2022.107018}},
  volume       = {{157}},
  year         = {{2022}},
}

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