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Influences of Gender and Social Class on Adolescents' Perceptions of Health
Abstract
To explore how gender and social class affect perceptions of health status among 16-year-old adolescents.
Cross-sectional survey.
University psychology laboratory. PARTICIPANS: Fifty upper-middle-class and 48 working-class adolescents stratified by gender.
The general health perceptions (GHP) scale of the Medical Outcomes Survey 36-Item Short Form Health Survey (SF-36). The other self-reported health status domains and 3 measures of different aspects of psychological well-being were included as covariates in analysis of variance models.
Upper-middle-class females reported the lowest and upper-middle-class males the highest GHP (76.7 vs 88.4, P=.003). A multivariate regression model (adjusted R2=0.08) revealed significant gender (P=.03) differences in GHP, but not a social class effect, and an interaction effect between gender and class (P=.01). With addition of psychological well-being covariates (P<.001), gender remained significant (P=.04) and a significant portion of the interaction effect (P=.13) was explained. When the self-reported physical health status scales (P<.001) were added to the model (adjusted R2=0.51), gender remained significant (P=.03) and the interaction effect was partially explained (P=.07).
Gender is a crucial factor in understanding the complex relationships between sociostructural inequalities and health differentials. These data suggest that psychological well-being and self-reported physical health status mediate the effects of gender and the gender and social class interaction in explaining variation in GHP. Contrary to the social class gradient hypothesis, upper-middle-class females reported the lowest GHP. These results suggest that the paradigms applicable to early childhood and adulthood may not be appropriate to understand the complex dynamics of adolescence.
... , . [2,16] [17] ...
... , Goodman [16] , [28] . Chang [29] 5, 6 (children's depression inventory ) . ...
This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students.
A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents.
Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim.
The perceived economic hardships predicted the health status among the eighth graders of South Korea. The overall satisfaction of life was associated with the socioeconomic position indicators. Further research efforts are needed to explore the mechanisms on how and why the socioeconomic position affects the health and health related behaviors in this age group.
... In several studies in adolescents, it is not clear if behavioural patterns in health among adolescents are a precocious phase of the individual trajectory towards adult health patterns, or if behavioural models in adolescence are a specific phase influenced by precise determinants. 15 The ways in which ethnicity affects adolescent health have been little studied, although it is true that studies relating to psychological wellbeing and ethnicity have been done. These studies show that the immigration experience can influence the mental health of adolescents, 16 and that the factors beyond SES, such as culture of origin, beliefs, religion, group cohesion, and a numerous presence act as protection against mental health disturbances. ...
... A cross sectional study of the entire school population, [12][13][14][15][16][17][18] year olds, in Lloret de Mar (Girona-Spain) was conducted. All secondary school student of the academic year 2004-05 (n = 1402) were invited to participate. ...
To compare health related quality of life (HRQL) between native and immigrant adolescents aged 12 to 18 years, and to analyse psychosocial factors associated with HRQL.
A cross sectional study of adolescents (12-18 years old) who answered a self administered questionnaire.
All the secondary schools from Lloret de Mar (Girona, Spain).
1246 participants (88.9% of the eligible students).
Main outcome was the Spanish version of the Vecu et Sante Percue de l'Adolescent (VSP-A), a HRQL measure addressed to adolescents. Mean scores of the VSP-A index of natives and immigrants were compared, as well as their sociodemographic and health related factors. Multiple regression examined the relation between HRQL and psychosocial factors, controlling for the effect of socioeconomic variables.
Half of the sample were boys, in the middle socioeconomic status, and 18.2% were immigrants (n = 226). HRQL score was higher in native Spanish adolescents than immigrants (p<0.01). Multiple regression model explaining 48.1% of the VSP-A variance showed that migration in itself has no statistically significant impact on HRQL, and age, socioeconomic status, social support, discrimination, and psychological distress do play a part.
Migrants have worse HRQL than natives but it seems to be mediated by their disadvantage in socioeconomic status, social support, and psychological distress.
... In adults and young children a positive association has consistently been demonstrated, i.e. higher SES is linked to less morbidity, lower risk of early mortality and better SRH [5,6]. For adolescent health, however, the association is more uncertain, with some studies showing a positive association [7,8] and others showing a weak or no association [9][10][11][12]. Traditionally, SES has been measured by objective measures, e.g. ...
Background
Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.
Methods
A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17–18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.
Results
In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.
Conclusions
The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.
... It also makes it possible to investigate a sample of adolescents and adults using the same questionnaires, which is crucial to assess changes in quality of life and follow longitudinally. According to the findings of the vast majority of research on quality of life, men reported higher scores than women ( Goodman et al., 1997;McAllister et al., 2001;Raty et al., 2003;Vingilis et al., 2002;White et al.1999) However, in the present study, girls scored higher on Physical Function and Physical Role than boys, and boys scored higher than girls Body Pain. ...
Background: Previous studies of basketball injury have not been able to compare injury incidence and risk with their healthy habits. Purpose: To determine rates and risks of injury in Spanish boys and girls basketball players. Study Type: Descriptive epidemiology study. Methods: A survey was carried out on injuries produced in basketball players during the seasons 2006-07, 2007-08 and 2008-09, which included their type, incidence and treatment. There took part 217 players - 12 to years old -. They were given a questionnaire related to habits and sports injuries and the SF-36 v2 Health Questionnaire. Results: The injuries took place both while competition and training, being ankle sprain the most frequent injury in both cases. After ankle sprain; the prevailing injuries were sprain - luxation of the fingers and knee sprain. Most of the players who got injured were the base, the forward, and the guard. A 53 % had suffered some injury in the last three seasons, being falling off the most frequent cause. The incidence of injuries out of every 1000 hours of exhibition found in the study is 1.39. There have been found significant differences in the exposure to injuries at the outcome of skill circuits at Interval Training work during training hours. The mental component is an important factor to be considered in all caused injuries.
... Gender. Sufficient evidence has indicated that gender is a significant predictor of adolescent health ratings, particularly for those adolescents of high-school age (Goodman et al., 1997;Mechanic & Hansell, 1987;Sweeting & West, 2003;Vingilis et al., 2002). Females consistently report more negative ratings than do males. ...
... It can be used in adolescents. 14,15 Statistical analysis Data normally distributed (lung function parameters) were analysed by means of parametric tests (analysis of variance followed by Bonferroni's test for post hoc comparisons). Considering a standardized effect size of 1, a sample size of 27 assures a power of 80% when conducting non-parametric pairwise comparisons at the 0.017 significance level considering Bonferroni's adjustment. ...
Background and objective:
Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease of infancy in the developed countries. Outcomes for BPD patients have traditionally been assessed using physiological parameters such as lung function, and no data are available on the health-related quality of life (HRQOL) for adolescents with BPD. The aim of this study was to assess HRQOL in adolescents with BPD, in comparison with age-matched and sex-matched control groups of healthy volunteers and asthmatic subjects.
Methods:
We enrolled 27 BPD patients (age range 11-19 years), 27 asthmatic patients and 27 healthy controls. HRQOL was assessed by the Short Form 36 (SF-36) questionnaire. Lung function was assessed by spirometry.
Results:
The BPD group did not differ significantly from the healthy controls in any scale or dimension of the SF-36 (the BPD group's summary scores were as follows: physical component summary mean 55.6 + 4.98 and mental component summary 51.8 + 7.75 vs 55.8 + 6.25 and 49.2 + 9.45 for the healthy control group, P > 0.5 and P = 0.26, respectively). Asthmatic adolescents scored lower than those of both healthy controls and patients with BPD in several SF-36 dimensions despite adolescents with BPD having lower lung function. No correlation emerged between lung function and HRQOL in BPD subjects.
Conclusion:
Despite their impaired lung function, BPD patients have an HRQOL comparable with healthy peers and better than asthmatic patients. We did not find any association between HRQOL and lung function parameters.
... Genusskillnader finns även mellan pojkar och flickor och de kan behöva förstås på egna villkor: det är nämligen inte givet att den kunskap som utvecklas för att förstå genusskillnader mellan vuxna, gäller för genusskillnader mellan barn. Det kan vara nödvändigt att ta hänsyn till de specifika faktorer som är relaterade till barnens utveckling, uppväxtvillkor och sociala sammanhang och hur de kan interagera med genus, på ett sätt som inte stämmer med de gängse modellerna (se Goodman et al. 1997 för ett exempel av hur genus interagerar med social klass och psykisk hälsa). ...
Denna rapport är en litteraturöversikt av forskning som behandlar relationer mellan psykisk hälsa och skola med ett särskilt fokus på frågor om pojkars och flickors erfarenheter i skolans miljö. Litterauröversikten har genomförts på uppdrag av Delegationen för Jäm-ställdhet i skolan under våren och sommaren 2010 av Mara Westling Allodi med medverkan av Siv Fischbein och Jan-Eric Gustafsson. Litteraturöversikten är en fördjupad analys som har genomförts på en databas av artiklar som har upprättats inom ramen för ett projekt med systematiska litteraturöversikter som har genomförts
mellan 2008 och 2010 av en arbetsgrupp på uppdrag av Kungliga Vetenskapsakademien (Gustafsson,
Allodi, Alin-Åkerman, Eriksson, Eriksson, Fischbein, Granlund, Gustafsson, Ogden, Persson, 2010a).
. Available from: https://www.researchgate.net/publication/267717315_Pojkars_och_flickors_psykiska_halsa_i_skolan_en_kunskapsoversikt [accessed Apr 14, 2016].
... Being married was also associated with satisfaction in both men and women in the present study, however more research is needed to delineate clearly the gender-specific factors related to both psychological well being and general life satisfaction. The way they interact with age may also be important (Goodman et al., 1997). The finding that there were different predictors for well being and life satisfaction supports the notion that they are conceptually distinct. ...
Background: Psychological well being and the degree of satisfaction with life are likely to affect a range of social behaviours and determine uptake of health and social services. It is important to identify the factors that inform these constructs. Aims: We sought to identify the variables which best predicted psychological well being in the Caribbean country, Jamaica and also those associated with feelings of satisfaction with life. Methods: Interviews were conducted on young adults aged 15–50 years as part of a sexual decision-making survey in Jamaica. Information was collected on a range of social, health and demographic variables and a measure of psychological well being – Centre for Epidemiological Studies of Depression (CES-D). Satisfaction with life was measured using a Likert scale in response to the question 'Are you satisfied with your life as a whole?' Multiple regression analyses were used to determine the predictors of psychological well being and satisfaction with life. Results: There were 2580 respondents (1601 women and 979 men). The mean age was 29.7 years (standard deviation 9.2 years). Women had lower levels of psychological well being and satisfaction with life. Independent predictors of lower psychological well being were having an acute illness, having a chronic illness in women and high religious behaviour in men. Satisfaction with life was predicted by younger age, marital status and employment. Conclusions: Our findings suggest that health variables are more important for psychological well being while social circumstances are more significant for satisfaction with life. There are important gender differences in the mediation of psychological well being as well as age differences in the variables associated with satisfaction with life.
... The earliest published studies of adolescents' self-rated health suggested that how adolescents learn to perceive, interpret, and report their health affects their future health ratings and actual health behaviours (Mechanic and Hansell, 1987). Research on self-rated health among adolescents has identified several important determinants of subjective health formulations: socioeconomic conditions (Piko and Fitzpatrick, 2001; Goodman et al., 1997); overall sense of functioning (Piko and Bak, 2006; Vingilis et al., 2002), particularly social functioning (both popularity and intimacy in peer relationships) and psychosocial characteristics (Mechanic and Hansell, 1987; You et al., 2008; Rayce et al., 2008; Rathi and Rastogi, 2007); psychological well-being (Saewyc and Tonkin, 2008; Hampel and Petermann, 2006); child-parent relations (Wilkinson, 2004; Tusaie et al., 2007); academic achievement (West et al., 2004; Samdal et al., 1998); and gender (Nic Gabhainn and Kelleher, 2000; Currie et al., 2008). While concepts of health well-being and happiness have previously been explored, ambiguity remains in the literature and in use of the terms. ...
Purpose
– The shared language of youth includes understandings of concepts that can be different from those of adults. Researchers, in their efforts to explore and illuminate the health behaviours and decision‐making processes of young people, use generic terms in their data collecting protocols. This study aims to explore what adolescents understand by the words “healthy” and “happy”.
Design/methodology/approach
– Semi‐structured interviews were conducted in three post‐primary schools with 31 students aged 12 and 13 years. Drawing on a grounded theory approach, interviews were transcribed and subjected to thematic content analysis.
Findings
– The students provided a description and explanation of what health and happiness meant to them and how they intended to maintain both as they grew older. Perceptions of these two concepts were found to contain gendered nuances. This was clear in relation to descriptions of how friends were part of well‐being; the girls were more likely to talk about feeling restricted and resentment at being treated like children and only the boys talked of looking forward to things.
Originality/value
– In order to gain an understanding of young people's perspectives about what matters and what influences their health behaviour, a clearer view of the different perspectives held by researcher and researched needs to be established so that more accurate conclusions can be drawn from data generated by young people.
... An individual's chance of encountering adverse health risks throughout life appears to be influenced by social position 1 . Indeed, current views sustain the thesis that adverse childhood environments have a negative impact on health and perceived health status in later life [2][3][4] . In addition, differences in social class have also been associated with differences in psychological attributes, particularly negative personality profiles and cognitive coping styles 5 . ...
... In general, females tend to report a lower HRQOL than males. [30][31][32][33] This was also observed in the reference group utilized in this study, with the exception of general health perception. 26 It was therefore surprising to find that the only gender difference in patients with BA was observed in general health perception. ...
Background Biliary atresia (BA) is a rare cholestatic disease of infancy. Kasai portoen-terostomy and liver transplantation (LT) are the two sequential treatment options. An increasing number of patients survive into adulthood. Little is known about their health-related quality of life (HRQOL). This study aims to compare HRQOL of transplanted and nontransplanted patients in a cohort of young adult BA survivors. Patients and Methods RAND-36 and Liver Disease Index Score (LDSI) questionnaires were sent to eligible adult patients with BA. Clinical characteristics were obtained from the NeSBAR (Netherlands Study group on Biliary Atresia Registry) and the national pediatric LT database. RAND-36 domain and summary scores were compared with those of an age-matched Dutch reference group. The correlations between several clinical variables and HRQOL were analyzed. Results Mean RAND-36 domain and summary scores of transplanted (n ¼ 15) and nontransplanted (n ¼ 25) patients with BA (response 74%) were similar to the reference scores, with the exception of a decreased general health perception in nontransplanted patients (63 AE 21 vs. 75 AE 17; [p < 0.001], particularly in females. RAND-36 domain and summary scores were not significantly correlated to age at LT, time since LT, serum bilirubin, aspartate amino transferase or albumin levels, but were moderately to strongly correlated to LDSI total scores (r values 0.35–0.77).
... In addition, we also anticipated that SES self-assessment (as the cognitive perception of one's own relative socioeconomic circumstances) might play the most significant role in influencing adolescents' health outcomes, similar to the findings in previous studies. 7,13,23 Since earlier research also suggests that different SES indicators may have an altering role in determining health outcomes 7 , the current study looked at the role that each SES indicator plays in health outcomes. Based on the results of binary and multivariate logistic regression analyses, our findings suggest the following: (i) SES self-assessment proved to be a significant predictor of adolescents' psychosocial health and health behaviours; (ii) family structure (namely, living in a non-intact family) also significantly influenced adolescents' psychosocial health and health behaviours; (iii) parents' employment status and schooling had a limited influence on their children's health outcomes; (iv) in a word, SES gradients in adolescents' psychosocial health and health behaviour were inconsistent and sometimes irregular (that is, inverse, negative). ...
The impact of social inequalities on somatic and mental health has been justified by a number of investigations in modern societies. This impact, however, does not appear to the same degree throughout the life-course; the association between social class and health status is significant in childhood and adulthood but the relationship is less evident and coherent among adolescents and elderly people. Whereas in adolescence, during which social inequalities may be seldom detected according to health status, the impact of objective but particularly subjective social class indicators on mental health has definitely been detected, such as psychosomatic symptoms, self-perceived health or depression. The main goal of the present study has been to explore high school students' mental health in light of socioeconomic status determined by their parents. Data collection was going on by using a survey method in the spring of 2008 in Szeged among high school students. Socioeconomic status was measured by the following indicators: parental schooling and employment status and SES self-assessment; among dependent variables, self-perceived health, depression, satisfaction with life and optimism were included. According to our results, both objective and subjective SES indicators were related to high school students' mental health. The role of subjective indicators was stronger and gradient-like; among objective indicators, parents' schooling and their nonmanual status (that is related to schooling) as well as self-employed status were associated with children's better mental health; father's unemployed status, however, might worsen adolescents' satisfaction with life.
... In general, females tend to report lower HRQOL than males. 6,53,119,202 This was also observed in the comparison group utilised in the current study. 164 General health perception was the only domain where we detected a gender difference in BA patients. ...
To investigate the course of life of young adults diagnosed with biliary atresia (BA) in infancy by comparing patients who did and did not underwent transplantation with an age-matched Dutch reference group.
All patients from the Dutch BA registry, aged >18 years, were invited to complete the course of life questionnaire.
Forty patients participated (response = 74%). Twenty-five had not undergone transplantation; 15 had undergone orthotopic liver transplantation. One significant between-group difference was found, namely in substance use and gambling. BA patients who underwent transplantation reported less use than the reference group (p = .01, moderate effect size). Additional moderate effect sizes were found for differences in psychosexual and social development and antisocial behavior. Patients who underwent transplantation had lower scores than one or both other groups.
Development of BA survivors who did not undergo transplantation seems not delayed, whereas that of transplanted patients does seem somewhat delayed. However, patients who underwent transplantation display less risk behavior. Larger samples are necessary to confirm these findings.
... SES, family structure, and social capital) are stronger for women than men across both subjective and objective measures of health (Denton & Walters, 1999). However, some studies find that gender effects on health that are apparent in adulthood do not translate to adolescence (Goodman, 1999;Goodman et al., 1997;Hetland, Torsheim, & Aaro, 2002). Because there has been less research devoted to gender and class disparities in the general health of adolescents (Rahkonen & Lahelma, 1992), this paper seeks to identify both the magnitude of the gender gap in self-reported health and its prevalence across adolescents of diverse racial and ethnic origins. ...
We investigate the factors that influence adolescent self-assessed health, based upon surveys conducted between 2000 and 2004 of high-school seniors in Washington State (N=6853). A large proportion of the sample (30%) was first and second generation immigrants from Asia, Latin America, and Eastern Europe. Findings include a robust negative effect of female gender on self-reported health that is largely unmodified by demographic, developmental, social capital, and parental support variables, gender differences in the covariates of self-reported health, and the tendency of male adolescents of Cambodian and Vietnamese origin to report lower levels of self-reported health despite controls for other health-related individual characteristics. Social capital dimensions such as positive school affiliation, social network cohesion, and a safe learning environment were found to covary with the self-reported health of adolescent females.
... In general, females tend to report lower HRQOL than males. 6,53,119,202 This was also observed in the comparison group utilised in the current study. 164 General health perception was the only domain where we detected a gender difference in BA patients. ...
Surgical treatment with Kasai portoenterostomy has improved the prognosis for patients with biliary atresia, although most patients ultimately require liver transplantation. Well-described patients with long-term, transplant-free survival are scarce; we assessed liver status and health perception among Dutch patients who survived 20 years after therapy and investigated whether the rate of transplant-free survival increases with time.
By using the Dutch national database for biliary atresia, we identified 104 patients, born between 1977 and 1988. We collected data on clinical characteristics, liver biochemistry, and ultrasonography from all transplant-free patients who were alive at age 20 years (n = 28; 27% of the patients). General health perception data (RAND-36) were collected at the last examination.
The 20-year transplant-free survival rate increased from 20% (10 of 49) in the 1977 to 1982 cohort to 32% (18 of 55) in the 1983 to 1988 cohort (P = .03). Twenty-one percent of the long-term survivors (6 of 28) had normal liver biochemistry test results and no clinical or ultrasonographic signs of cirrhosis. The general health perception of female, but not male, patients, was lower, compared with controls (RAND-36 score, 54 ± 14 vs 74 ± 18; P = .005).
More than 25% of patients with biliary atresia survive at least 20 years without liver transplantation in The Netherlands. Women with biliary atresia have a reduced perception of their health, compared with control patients. Twenty percent of long-term survivors are symptom-free, without clinical or ultrasonographic signs of cirrhosis or portal hypertension.
... Being married was also associated with satisfaction in both men and women in the present study, however more research is needed to delineate clearly the gender-specific factors related to both psychological well being and general life satisfaction. The way they interact with age may also be important (Goodman et al., 1997). The finding that there were different predictors for well being and life satisfaction supports the notion that they are conceptually distinct. ...
Psychological well being and the degree of satisfaction with life are likely to affect a range of social behaviours and determine uptake of health and social services. It is important to identify the factors that inform these constructs.
We sought to identify the variables which best predicted psychological well being in the Caribbean country, Jamaica and also those associated with feelings of satisfaction with life.
Interviews were conducted on young adults aged 15-50 years as part of a sexual decision-making survey in Jamaica. Information was collected on a range of social, health and demographic variables and a measure of psychological well being--Centre for Epidemiological Studies of Depression (CES-D). Satisfaction with life was measured using a Likert scale in response to the question 'Are you satisfied with your life as a whole?' Multiple regression analyses were used to determine the predictors of psychological well being and satisfaction with life.
There were 2580 respondents (1601 women and 979 men). The mean age was 29.7 years (standard deviation 9.2 years). Women had lower levels of psychological well being and satisfaction with life. Independent predictors of lower psychological well being were having an acute illness, having a chronic illness in women and high religious behaviour in men. Satisfaction with life was predicted by younger age, marital status and employment.
Our findings suggest that health variables are more important for psychological well being while social circumstances are more significant for satisfaction with life. There are important gender differences in the mediation of psychological well being as well as age differences in the variables associated with satisfaction with life.
... Gender, ethnicity and socioeconomic status. Health status and behaviors are associated with gender, ethnicity and socioeconomic status (Aarons et al., 1999; Goodman et al., 1997; Johnson and Richter, 2002; Johnston et al., 2002; Newcomb and Bentler, 1987; Schulenberg et al., 1996). Therefore, we controlled these factors to estimate the unique effect that heavy episodic drinking trajectories may have on health in young adulthood. ...
This study examined the association of trajectories of heavy episodic drinking (at least five alcoholic drinks on one occasion) during adolescence with health status and practices at age 24.
Semiparametric group-based modeling and logistic regressions were used to analyze data from a longitudinal panel of 808 youths interviewed between 10 and 24 years of age.
Four distinct trajectories of adolescent heavy episodic drinking were identified: nonheavy drinkers, late onsetters, escalators and chronic heavy drinkers. Overall, young adults who did not engage in heavy episodic drinking during adolescence had the lowest occurrence of health problems and were most likely to engage in safe health behaviors at age 24. Chronic and late-onset heavy episodic drinking during adolescence had negative effects on health status and practices at age 24. Adolescent chronic heavy drinkers were more likely to be overweight or obese and to have high blood pressure at age 24 than those who did not drink heavily in adolescence. Late-onset heavy drinkers were less likely to engage in safe driving practices at age 24 and were more likely to have been ill in the past year than adolescents who did not drink heavily. These health disparities remained even after current frequency of heavy episodic drinking at age 24, other adolescent drug use, ethnicity, gender and family poverty were controlled.
Heavy episodic alcohol use during adolescence has long-term, negative health consequences. Distinct patterns of adolescent heavy drinking affect health status and practices in young adulthood differently.
... The importance of gender perspective in this study is to look at patterns of similarity and differences among them and speculate on their implications (El-Tawila et al., 1997;Gijsbers van Wijk & Kolk, 1997;Goodman et al., 1997). It is widely known that gender differences exist in morbidity and mortality (Lahelma & Arber, 1994;Macintyre & West, 1991;Stronks & Gunning-Scheppers, 1993;West, Macintyre, Annadale, & Hunt, 1990). ...
In this paper we describe self‐reported health problems and haemoglobin status among 1200 Sudanese adolescents (53.2% females, 46.8% males). Many adolescents report their general health as excellent and good (84%). A large number, however, report separate physical and psychological complaints. Report of psychological complaints is equal for both gender, and more psychological problems are reported with increasing age. Females and age groups 13–15 more often report chronic diseases. Malaria consistently has a relatively high prevalence. The overall prevalence of anaemia in our study is 32% (46.9% males, 19.2% females). The findings in our study do not sustain the traditional assumption that adolescence is a healthy period in human life. Implications for Sudanese health policies are discussed.
... Clinical variables, such as pseudomonal infection, nutrition status, and history of co morbidities such as diabetes, and social variables such as socioeconomic or insurance status, were not available for many observations and thus were not controlled for, which may partially explain the HRQOL differences we found between genders. Multiple studies have shown that females, including adolescents , report poorer HRQOL than males [8,18,20,56], often despite having similar objective clinical measures like pulmonary function. It is possible that such differences were based on perception of health, rather than actual health status. ...
Female patients with cystic fibrosis (CF) have consistently poorer survival rates than males across all ages. To determine if gender differences exist in health-related quality of life (HRQOL) of adolescent patients with CF, we performed a cross-section analysis of CF patients recruited from 2 medical centers in 2 cities during 1997-2001.
We used the 87-item child self-report form of the Child Health Questionnaire to measure 12 health domains. Data was also collected on age and forced expiratory volume in 1 second (FEV1). We analyzed data from 98 subjects and performed univariate analyses and linear regression or ordinal logistic regression for multivariable analyses.
The mean (SD) age was 14.6 (2.5) years; 50 (51.0%) were female; and mean FEV1 was 71.6% (25.6%) of predicted. There were no statistically significant gender differences in age or FEV1. In univariate analyses, females reported significantly poorer HRQOL in 5 of the 12 domains. In multivariable analyses controlling for FEV1 and age, we found that female gender was associated with significantly lower global health (p < 0.05), mental health (p < 0.01), and general health perceptions (p < 0.05) scores.
Further research will need to focus on the causes of these differences in HRQOL and on potential interventions to improve HRQOL of adolescent patients with CF.
... In addition, we also anticipated that SES self-assessment (as the cognitive perception of one's own relative socioeconomic circumstances) might play the most significant role in influencing adolescents' health outcomes, similar to the findings in previous studies. 7,13,23 Since earlier research also suggests that different SES indicators may have an altering role in determining health outcomes 7 , the current study looked at the role that each SES indicator plays in health outcomes. Based on the results of binary and multivariate logistic regression analyses, our findings suggest the following: (i) SES self-assessment proved to be a significant predictor of adolescents' psychosocial health and health behaviours; (ii) family structure (namely, living in a non-intact family) also significantly influenced adolescents' psychosocial health and health behaviours; (iii) parents' employment status and schooling had a limited influence on their children's health outcomes; (iv) in a word, SES gradients in adolescents' psychosocial health and health behaviour were inconsistent and sometimes irregular (that is, inverse, negative). ...
While socioeconomic differences in health, morbidity, and disability are highest among middle-aged persons, there is a certain level of 'equalization' during adolescence and young adulthood. Despite this equalization, however, there still are differences in psychosocial variables or health-related behaviours, often very subtle and sometimes difficult to measure.
Using data (n = 1114) on high school students (aged between 14 and 21 years) from the Southern Plain Region, Hungary, the present study looks at the role of multiple SES indicators (objective and subjective; occupation and education; family structure) in adolescents' psychosocial health (self-perceived health, psychosomatic, and depressive symptomatology) and health behaviour (substance use and sports activity).
Based on the results of multivariate logistic regression analyses, findings suggest the following: (i) SES self-assessment proved to be a significant predictor of adolescents' psychosocial health and health behaviours; (ii) family structure (that is, living in a non-intact family) also significantly influenced adolescents' psychosocial health and health behaviours; (iii) parents' employment status and schooling had a limited influence on their children's health outcomes; (iv) in a word, SES gradients in adolescents' psychosocial health and health behaviour were inconsistent and sometimes irregular (that is, inverse). The subjective SES measurement plays an important role (positive association), whereas certain types of parents' inactive status (in terms of labour market, that is, unemployment or retirement) seem to act in a predictable way (negative association).
Our results indicate that despite certain level of equalization during adolescence, some important relationships between SES variables and health outcomes may occur.
... Notwithstanding, a very limited amount of studies has focused on adolescents , and most of these principally concern clinical groups. One of the few studies that has come to our attention where the SF-36 has been used with the aim to explore adolescents' self-assessment of HRQL is performed by Goodman et al. (1997). This study investigates how gender and social class affect perceptions of health among 16-year-olds [15]. ...
There is a paucity of research about health-related quality of life (HRQL) among adolescents, as studies have to a large extent focused on adults. The main aim was to provide information for future studies in this growing field by presenting normative data for the Short Form 36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS) for Swedish adolescents and young adults. Additionally, the influence of age and gender, as well as method of administration, was investigated.
A sample of 585 persons aged 13-23 was randomly chosen from the general population, and stratified regarding age group (young adolescents: 13-15 years; older adolescents: 16-19 years, and young adults: 20-23 years) and gender (an equal amount of males and females). Within each stratum, the participants were randomized according to two modes of administration, telephone interview and postal questionnaire, and asked to complete the SF-36 and the HADS. Descriptive statistics are presented by survey mode, gender, and age group. A gender comparison was made by independent t-test; and one-way ANOVA was conducted to evaluate age differences.
Effects of age and gender were found: males reported better health-related quality of life than females, and the young adolescents (13-15 years old) reported better HRQL than the two older age groups. The older participants (16-23 years old) reported higher scores when interviewed over the telephone than when they answered a postal questionnaire, a difference which was more marked among females. Interestingly, the 13-15-year-olds did not react to the mode of administration to the same extent.
The importance of taking age, gender, and method of administration into consideration, both when planning studies and when comparing results from different groups, studies, or over time, is stressed.
Purpose : Quality of Life (QoL) is an important outcome measure in health care and pharmacological trials. The trend towards multinational clinical trials may be problematic because it is unclear as to whether, or to what extent, QoL measures are comparable across cultures. This study compared QoL between English and German adolescents with Cystic Fibrosis (CF) and their healthy peers. Method : The study comprised a cross-sectional design. The English subjects formed two groups; 58 adolescents with CF and 49 healthy controls. The German subjects consisted of 26 adolescents with CF and 75 healthy controls. Quality of life was measured using the English and German versions of the SF-36. Demographic (age and gender) and clinical data (FEV 1 % predicted and BMI) were also recorded. Results : The English and German CF groups had similar age-adjusted lung function and body mass index. Both the English CF and control groups reported a poorer quality of life than their respective German counterparts across severa...
Background Biliary atresia (BA) is a rare cholestatic disease of infancy. Kasai portoenterostomy and liver transplantation (LT) are the two sequential treatment options. An increasing number of patients survive into adulthood. Little is known about their health-related quality of life (HRQOL). This study aims to compare HRQOL of transplanted and nontransplanted patients in a cohort of young adult BA survivors. Patients and Methods RAND-36 and Liver Disease Index Score (LDSI) questionnaires were sent to eligible adult patients with BA. Clinical characteristics were obtained from the NeSBAR (Netherlands Study group on Biliary Atresia Registry) and the national pediatric LT database. RAND-36 domain and summary scores were compared with those of an age-matched Dutch reference group. The correlations between several clinical variables and HRQOL were analyzed. Results Mean RAND-36 domain and summary scores of transplanted (n = 15) and nontransplanted (n = 25) patients with BA (response 74%) were similar to the reference scores, with the exception of a decreased general health perception in nontransplanted patients (63 ± 21 vs. 75 ± 17; [p < 0.001], particularly in females. RAND-36 domain and summary scores were not significantly correlated to age at LT, time since LT, serum bilirubin, aspartate amino transferase or albumin levels, but were moderately to strongly correlated to LDSI total scores (r values 0.35-0.77). Conclusions Overall, young adult patients with BA have a HRQOL similar to an age-matched reference group. However, general health perception of nontransplanted patients, particularly of females, was decreased. HRQOL is correlated to liver disease symptoms but not to liver biochemistry parameters. Nontransplanted females and patients suffering from liver disease-associated symptoms may be a target for tailored supportive interventions.
Georg Thieme Verlag KG Stuttgart · New York.
Objective: To describe gender differences in self-perceived health and health-related quality of life (HRQoL) in childhood and adolescence in Spain, to compare the results in distinct studies using different HRQoL instruments, and to analyze the influence of sociodemographic factors and reported morbidity on self-perceived health and HRQoL according to gender. Methods: We analyzed data from previous studies of HRQoL: the Child Health and Illness Profile (child and adolescent editions, n ¼ 2451), the KIDSCREEN (n ¼ 908), and VecuPerc -ue et Santede l'Adolescent (n ¼ 1,242). Logistic regression models of worse perceived health (good/fair/poor vs. excellent/very good) and worse HRQoL (less than 0.8 standard deviations from the mean vs. the remaining distribution) were adjusted to analyze gender differences. A summary measure of differences in perceived health according to gender was obtained. Results: The response rates varied among the studies (total sample n ¼ 4.601). Girls showed a higher odds ratio (OR) than boys for perceiving worse overall health and physical and emotional health, but a lower OR in school environment dimensions. The overall OR for worse perceived health was 1.28 (95% confidence interval (95%CI): 0.97-1.68) in younger girls and was 2.17 (95%CI: 1.88-2.51) in adolescent girls. Conclusions: Girls were twice as likely as boys to perceive worse health, as well as worse HRQoL in the physical and emotional dimensions. Gender perspective should be taken into account when implementing preventive and health promotion measures for children and adolescents.
To determine the physical and psychosocial impact of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents.
The following surveys were administered to adolescents with macromastia and control subjects, aged 12 to 21 years: Short-Form 36v2, Rosenberg Self-Esteem Scale, Breast-Related Symptoms Questionnaire, and Eating-Attitudes Test-26 (EAT-26). Demographic variables and self-reported breast symptoms were compared between the 2 groups. Linear regression models, unadjusted and adjusted for BMI category (normal weight, overweight, obese), were fit to determine the effect of case status on survey score. Odds ratios for the risk of disordered eating behaviors (EAT-26 score ≥ 20) in cases versus controls were also determined.
Ninety-six subjects with macromastia and 103 control subjects participated in this study. Age was similar between groups, but subjects with macromastia had a higher BMI (P = .02). Adolescents with macromastia had lower Short-Form 36v2 domain, Rosenberg Self-Esteem Scale, and Breast-Related Symptoms Questionnaire scores and higher EAT-26 scores compared with controls. Macromastia was also associated with a higher risk of disordered eating behaviors. In almost all cases, the impact of macromastia was independent of BMI category.
Macromastia has a substantial negative impact on health-related quality of life, self-esteem, physical symptoms, and eating behaviors in adolescents with this condition. These observations were largely independent of BMI category. Health care providers should be aware of these important negative health outcomes that are associated with macromastia and consider early evaluation for adolescents with this condition.
Objective: To study the self-reported health of young people visiting a Youth Centre (YC) at a University hospital, describe possible gender differences and to compare the results with those in previous Swedish reports on similar age groups using the same instrument.
Design: All young people who visited a YC at a particular, randomly chosen time, were verbally asked to fill out a questionnaire, Short Form 36. The interviews were conducted during a 12-month period to lessen the impact of seasonal variations.
Setting: A YC at the department for obstetrics and gynaecology, Uppsala University hospital.
Participants: A total of 1495 young people aged 14–25 years who visited the YC.
Results: The study population (n = 1495). Response rate was 96%. This population reported lower overall scores compared with the normative Swedish population from 1992. Further, females scored significantly lower than males on all subscales (p < 0.001), except for ‘Physical Functioning’. The lowest scores were reported for the subscales Vitality, Role Emotional and Mental Health.
Conclusion: This study describes physical functioning and mental health among young people visiting a YC. The results indicate a worsening of the perceived physical and MH in young individuals, especially in young women. Further studies are needed to monitor changes in MH and quality of life over time in this group and assess the effects of interventions. This study enhances the importance of a holistic approach towards health and health promotion comprising both physical and mental health issues.
Objectives The aim of this study was to shorten the Health-Related Quality of Life (HRQL) DISABKIDS Chronic Generic Measure (DCGM) for
children and adolescents and to test its reliability, construct, and external validity.
Study design 1153 children and adolescents (8–16years) with chronic health conditions (asthma, arthritis, epilepsy, cerebral palsy, diabetes,
atopic dermatitis, cystic fibrosis) and their family were recruited from different paediatric clinical settings in seven European
countries. A two-time assessment comprised reports on sociodemographics, health status and HRQL of children/adolescents. Results The 37-item DCGM describes six dimensions (Independence, Physical Limitation, Emotion, Social Inclusion, Social Exclusion
and Treatment) confirmed by Confirmatory Factor Analysis, multi-item scaling and item-goodness of fit to Rasch model. Internal
consistency (Cronbach’s alpha: 0.70–0.87) and test-retest reliability (ICC: 0.71–0.83) were satisfactory. Correlations between
DCGM-37 and other HRQL instruments were the highest between dimensions evaluating similar concepts. Regarding discriminant
validity of the DCGM-37, girls and older adolescents reported lower emotional we ll-being. Children belonging to families
with low level of affluence and those with severe health conditions were found to have worse HRQL in all domains. Conculsion Reliability, construct validity as well as convergent and discriminant validity of the DCGM-37 were shown.
Factors related to American Indian (AI) high school students' self-rated health were examined. Self-rated health was measured as a single-item with a four-point response option ranging from poor to excellent health. Of the 574 participants, 19% reported "fair" or "poor" health, a percentage more than twice that for U.S. high school students in general. Gender (related to family finances), school achievement, social competence, and cannabis use were significantly associated with the AI teens' self-rated health. In comparative examination, factors associated with AI teens' health ratings were found to be similar and dissimilar to ratings of other teens in important ways.
This study aimed to establish the normative values for the 12-item Short Form Health Survey version 2 (SF-12v2) and examine demographic differences among Hong Kong Chinese adolescents.
A total of 28,981 Hong Kong Chinese adolescents aged 12-18 participated in a school-based survey in 2006-2007. Sex- and age-specific SF-12v2 scores were obtained. Ordinal logistic regression models and linear regression models were used to examine the demographic differences for the eight subscales including physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health, and two component summary scores of Physical Component Summary and Mental Component Summary.
The mean (standard deviation) Physical Component Summary score was 50.28 (6.82) for boys and 49.37 (6.47) for girls. The corresponding Mental Component Summary score was 45.86 (9.86) for boys and 44.77 (9.56) for girls. Ceiling effects were observed in some of the eight subscales but not the two component summary scores. Ordinal logistic regression showed that girls had significantly lower scores than boys in most subscales including physical functioning with odds ratio (95% confidence interval) of 0.89 (0.84-0.93); role physical, 0.94 (0.90-0.98); bodily pain, 0.76 (0.73-0.80); general health, 0.55 (0.53-0.57); vitality, 0.72 (0.69-0.75); role emotional, 0.78 (0.74-0.81); and mental health, 0.91 (0.88-0.95). In general, older and non-local-born adolescents had lower component summary scores than their peers.
This study has provided norms and identified demographic differences of the Chinese SF-12v2.
To describe gender differences in self-perceived health and health-related quality of life (HRQoL) in childhood and adolescence in Spain, to compare the results in distinct studies using different HRQoL instruments, and to analyze the influence of sociodemographic factors and reported morbidity on self-perceived health and HRQoL according to gender.
We analyzed data from previous studies of HRQoL: the Child Health and Illness Profile (child and adolescent editions, n=2451), the KIDSCREEN (n=908), and Vecú Perçue et Santé de l'Adolescent (n=1,242). Logistic regression models of worse perceived health (good/fair/poor vs. excellent/very good) and worse HRQoL (less than 0.8 standard deviations from the mean vs. the remaining distribution) were adjusted to analyze gender differences. A summary measure of differences in perceived health according to gender was obtained.
The response rates varied among the studies (total sample n=4.601). Girls showed a higher odds ratio (OR) than boys for perceiving worse overall health and physical and emotional health, but a lower OR in school environment dimensions. The overall OR for worse perceived health was 1.28 (95% confidence interval [95%CI]: 0.97-1.68) in younger girls and was 2.17 (95%CI: 1.88-2.51) in adolescent girls.
Girls were twice as likely as boys to perceive worse health, as well as worse HRQoL in the physical and emotional dimensions. Gender perspective should be taken into account when implementing preventive and health promotion measures for children and adolescents.
Objetivo: El perfil de salud CHIP-AE (Child Health and Illness Profile, Adolescent Edition) es un instrumento genérico para adolescentes de 12 a 19 años que ha sido adaptado para uso en España. El objetivo del estudio fue obtener los valores poblacionales de referencia de la versión española del CHIP-AE. Métodos: Se administró el CHIP-AE a una muestra representativa de adolescentes escolarizados de Barcelona, mediante muestreo por conglomerados, estratificado según la titularidad del centro (público o concertado) y el índice de capacidad económica familiar (bajo, medio y alto). Se estandarizaron las puntuaciones a una media de 20 y desviación estándar (DE) de 5. Se calcularon las medias y los percentiles. Las medias se compararon por edad, género y nivel socioeconómico mediante análisis de la varianza. Resultados: Las proporción de respuesta fue del 81% (n = 902). Las puntuaciones presentaron un amplio rango de distribución, y aunque en general fueron algo sesgadas hacia las puntuaciones de buena salud, sugieren que la muestra de población general no está exenta de problemas de salud. El 25% presentó puntuaciones por debajo de 17,2 en la dimensión de bienestar, lo que indica un tamaño de efecto de 0,56 unidades estandarizadas de DE. La distribución de las puntuaciones de las muestras de referencia de Barcelona fueron muy similares a las originales de Baltimore (Estados Unidos), con diferencias mínimas en riesgo individual. Conclusiones: El CHIP-AE recoge de manera sistemática las dimensiones propias de la salud de los adolescentes. Los resultados permitirán establecer comparaciones con adolescentes de otras regiones, y/o con diferentes problemas de salud y analizar las desigualdades en salud durante la adolescencia.
To investigate health-related quality-of-life (HrQoL) in childhood diabetes and the level of agreement between West Sweden and European reference data for the new multi-cultural European questionnaire - DISABKIDS.
Twenty percent of the Swedish paediatric diabetes population was included in the survey. Child-parent pairs completed the DISABKIDS chronic generic (37 questions) and diabetes modules (10 questions) during their routine clinic visit. A one-page results summary, based on positive domains, was used to provide feedback to clinicians.
Three hundred and sixty-one child-parent pairs were included in the analysis. In Sweden, diabetes was perceived by the children as having less impact than the European average. Swedish parents rated the HrQoL of their children lower than did the European parents. Swedish girls had a lower HrQoL than boys and greater difficulty accepting their diabetes; adolescents had greater difficulty accepting the diagnosis than younger children. Parents reported greater impact of diabetes on their children than the children themselves but reported no difference between boys and girls. Parents reported better acceptance of treatment in boys. The child's reported quality-of-life (QoL) is related to age and gender.
Our results confirm the applicability of DISABKIDS to the Swedish paediatric diabetes population.
Little is known about mental health service use among children with anxiety disorders, and even less is known about these children in public sectors of care. In this study, 1,715 children were randomly sampled from one of five public service systems. Psychiatric diagnoses were assessed with a structured interview, and standardized measures were used to assess mental health service utilization. Data from a subsample (n = 779) of youth with psychiatric disorders were analyzed. Analyses revealed that comorbidity among children with anxiety disorders was substantially higher than general population estimates. Approximately 26% of children with anxiety had a comorbid mood disorder, and 62% had a disruptive behavior disorder. Among children with anxiety disorders, those who had comorbid conditions were more likely to receive inpatient services than those without comorbidity. Comorbidity, caregiver strain, and service sector were associated with inpatient and nonspecialty service use in this group. Findings underscore the substantial comorbidity among children with anxiety disorders in public sectors of care and the potential need to adapt evidence-based interventions to meet the complex and multiple needs of these children.
This study sought to determine whether socioeconomic status (SES) gradients exist among US adolescents for self-rated health and for 5 diseases that cause serious adolescent and continuing adult morbidity.
Baseline data from 15,483 adolescent and parental surveys from the National Longitudinal Study of Adolescent Health were used. SES indicators included parental education and occupation, and household income. Dependent variables included self-rated health and the presence of depression, obesity, asthma, suicide attempt in the past year, and prior sexually transmitted disease.
SES gradients were found for self-rated health, depression, and obesity (P < .01). Suicide attempt was linearly associated with income (P < .01). After adjustment for other SES and sociodemographic factors, education and income remained independent correlates of both depression and obesity; income remained an independent correlate of attempted suicide.
Differences in susceptibility to socially mediated etiologic mechanisms of disease may exist during adolescence. Understanding the sociostructural context and patterning of adolescents' lives is crucial to clearly understanding health and disease etiology throughout the course of life.
Social class is increasingly being recognized as an important factor in the development of population-based variation in health among teens. However, little consensus exists regarding its measurement or conceptualization.
This study examined beliefs about social class of 48 working class and 50 upper middle class 16-year-old, white teens.
Working class teens were more likely to misclassify themselves with regard to social class position. Significant class differences were present in beliefs regarding social mobility, parents' equity, equality of opportunity within society, and financial status as adults. How this conceptualization of social class translates into population-based variation in health remains an important area for further inquiry.
Eliminating health disparities, including those that are a result of socioeconomic status (SES), is one of the overarching goals of Healthy People 2010. This article reports on the development of a new, adolescent-specific measure of subjective social status (SSS) and on initial exploratory analyses of the relationship of SSS to adolescents' physical and psychological health.
A cross-sectional study of 10 843 adolescents and a subsample of 166 paired adolescent/mother dyads who participated in the Growing Up Today Study was conducted. The newly developed MacArthur Scale of Subjective Social Status (10-point scale) was used to measure SSS. Paternal education was the measure of SES. Indicators of psychological and physical health included depressive symptoms and obesity, respectively. Linear regression analyses determined the association of SSS to depressive symptoms, and logistic regression determined the association of SSS to overweight and obesity, controlling for sociodemographic factors and SES.
Mean society ladder ranking, a subjective measure of SES, was 7.2 +/- 1.3. Mean community ladder ranking, a measure of perceived placement in the school community, was 7.6 +/- 1.7. Reliability of the instrument was excellent: the intraclass correlation coefficient was 0.73 for the society ladder and 0.79 for the community ladder. Adolescents had higher society ladder rankings than their mothers (micro(teen) = 7.2 +/- 1.3 vs micro(mom) = 6.8 +/- 1.2; P =.002). Older adolescents' perceptions of familial placement in society were more closely correlated with maternal subjective perceptions of placement than those of younger adolescents (Spearman's rho(teens <15 years) = 0.31 vs Spearman's rho(teens 15 years) = 0.45; P <.001 for both). SSS explained 9.9% of the variance in depressive symptoms and was independently associated with obesity (odds ratio(society) = 0.89, 95% confidence interval = 0.83, 0.95; odds ratio(community) = 0.91, 95% confidence interval = 0.87, 0.97). For both depressive symptoms and obesity, community ladder rankings were more strongly associated with health than were society ladder rankings in models that controlled for both domains of SSS.
This new instrument can reliably measure SSS among adolescents. Social stratification as reflected by SSS is associated with adolescents' health. The findings suggest that as adolescents mature, SSS may undergo a developmental shift. Determining how these changes in SSS relate to health and how SSS functions prospectively with regard to health outcomes requires additional research.
This paper describes self-reported health problems among 2616 Slovak adolescents (52.4% boys, 47.6% girls). Adolescents consider their health as very good in general. They often feel 'vital', and rarely feel depressed or irritated. However, the psychological health of more than 20% of the boys and 40% of the girls was unsatisfactory. Furthermore, a sizeable number suffered from separate physical complaints, chronic diseases or used medical services. Findings are more unfavourable for girls in comparison with boys. Our findings indicate that adolescence is not such a healthy period in human life as is often considered. The Slovak Republic, a Central European country, does not differ in this respect from Western European countries.
To test a model of the early predictors and mediators of drug use and respiratory, neurobehavioral, and cognitive problems in adolescence and young adulthood.
We prospectively examined self-reported measures of unconventional behavior, peer- and self-drug use, and self-reported health problems in a sample of 286 males and 327 females. The sample represented the northeastern United States at the time the data were first collected in 1975. The participants were assessed in early, middle, and late adolescence and in young adulthood. Latent variable structural equation models were used to examine the data.
Structural equation modeling conducted on the data provided support for the proposed longitudinal model. The findings indicated that adolescent drug use was associated indirectly with respiratory and directly with neurobehavioral and cognitive symptoms in young adulthood. Adolescent drug use during middle and late adolescence served as a mediator between unconventional behavior in early adolescence and health problems in young adulthood.
A reduction in adolescent drug use may reduce respiratory and neurobehavioral and cognitive symptoms in young adulthood. This study identifies several points in the biopsychosocial pathways in adolescence leading to later health problems in young adulthood.
The Child Health and Illness Profile (CHIP-AE) is a generic health status instrument for adolescents aged 12-19 years adapted for use in Spain. The aim of this study was to obtain reference population values of the Spanish version of the CHIP-AE.
The CHIP-AE was administered to a representative sample of adolescents from schools in Barcelona. The sample was selected by using cluster-sampling, stratified by type of school (public or private) and an ecological socioeconomic index (Indice de Capacidad Familiar: low, middle, and high). The CHIP-AE scores were standardized to a mean of 20 and a standard deviation (SD) of 5. Means and percentiles were computed. Means were compared by age, gender, and socioeconomic status using analysis of variance.
The response rate was 81% (n = 902). The distribution of the CHIP-AE scores presented a wide range with scores generally skewed toward positive health status. Nevertheless, the results suggest that the sample selected from a general population was not free of health problems. Twenty-five percent of adolescents presented scores below 17.2 in the domain of discomfort, indicating an effect size of 0.56 standardized SD units. The distribution of scores in the reference samples from Barcelona was similar to the original results in Baltimore (USA), with some marginal differences in individual risks.
The CHIP-AE systematically gathers information on health domains in adolescents. The results from this reference sample will allow comparisons with adolescents from other regions, and/or with different health problems, as well as description of inequalities in health during adolescence.
The prevalence of childhood asthma in Scotland is one of the highest in the world. The morbidity secondary to allergic diseases is significant in terms of costs to the nation and effects on the family including the child.
The aims of this study were to describe the prevalence of asthma, eczema and hay fever in the Highlands of Scotland and in the Shetland Isles and to examine factors in relation to quality of life and social deprivation.
A total population survey of 12 year old children using a parent completed questionnaire.
86.3% (2658/3080) returned questionnaires. Of the 2549 questionnaires analysed, 476 (18.7%) reported asthma ever, 362 (14.2%) wheeze in last 12 months, 508 (19.9%) reported hay fever ever and 555 (21.8%) reported eczema ever. Of the children reporting asthma or wheeze, 35.4% (229/647) had missed school because of asthma or wheeze, 38.0% (246/647) had missed physical education. 62.5% (354/566) of subjects with wheeze ever reported sleep disturbance. Deprivation measured by DEPCAT scores was associated with maternal smoking and bronchitis in the child but not with allergic diseases.
Compared with previous studies, the prevalence of asthma was unchanged but eczema has increased in Highland adolescents. Allergic disease has a significant impact on school attendance and physical activity. Deprivation was associated with maternal smoking and bronchitis in the child but not with allergic diseases. The impact of allergic diseases in rural areas may be different from urban areas.
Valid, comprehensive instruments to describe, monitor, and evaluate health from childhood through adolescence are almost nonexistent, but are critical for health resource planning, evaluation of policy, preventive, and clinical interventions, and understanding trajectories of health during this important period of life.
The objectives of this study were to describe the development, testing, and final versions of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/PRF), designed to measure the health of children 6 to 11 years old from the caregiver perspective.
Parents (N=1049) completed a version of the CHIP-CE/PRF in 4 locations in the United States, either in clinic waiting rooms or their homes. They differed in race/ethnicity, socioeconomic level, and native language.
The Parent CHIP-CE is feasible; parents with a 5th-grade reading level complete the 76-item PRF in 20 minutes. Its domains (Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement) measure structurally distinct, interrelated aspects of health. Domain reliability is high: internal consistency=0.79-0.88; retest reliability (ICC)=0.71-0.85. Validity is supported. The scale scores are sensitive to predicted age, gender, and socioeconomic status differences in health.
The CHIP-Child Edition/Parent Report Form is a psychometrically sound, conceptually based measure of child health that works well in diverse populations. It produces scores that parallel those of children on the CHIP-CE/CRF and adolescents on the CHIP-AE and allows health to be consistently assessed from childhood through adolescence. It should meet many needs for describing, monitoring, and understanding child health and evaluating outcomes of interventions.
Unlabelled:
The objective of this study was to investigate health status of Turkish adolescents and to determine the factors affecting their self perceptions of health. The subjects of the study were 4,153 grade 9-11 students from 26 randomly selected high schools in Istanbul. In total, 78% (n = 3231) and 62% (n = 2537) of the students reported that they were feeling healthy and happy, respectively. Prevalence of headache, abdominal pain and backache; feeling low, irritable, nervous and dizzy; medication use for headache, abdominal pain and nervousness were higher in females than in males (P < 0.05 for each comparison). Prevalence of difficulty in getting to sleep and medication use for it were quite similar in both genders. Perceived higher socio-economic status, feeling happy and exercising longer than 2-3 h a week were found as protective factors related to feeling healthy for both genders. In females, ease of talking to mother and perceived adequate parental support on school matters and in males, ease of talking to father and satisfaction with body size were protective factors related to feeling healthy, respectively. Cigarette smoking and having headaches put feeling healthy at risk in both genders. In females, feeling left out of things, having backache and dizziness and medication use for nervousness and in males, feeling pressured by school work, abdominal pain and difficulty in getting to sleep were risk factors related to feeling healthy, respectively.
Conclusion:
the findings of this study suggest that a significant number of Turkish adolescents perceive themselves as not very healthy and experience psychosomatic symptoms. Perception of health differed to some extent according to gender. Programmes promoting health-related activities and coping strategies with parental participation need to be developed for improving health in high school students.
We evaluated the safety of a measles-mumps-rubella (MMR) immunization campaign for Saudi children (age range: 6-13 years) and gender differences in reporting post-MMR adverse events. After vaccinations were administered, we monitored 160 schools for 14 days and 19 hospitals in the 8 cities under study for 10 weeks. Incidence rates were: all MMR adverse events, 26.5/10,000 MMR vaccines (significantly higher in females than males); Urabe strain aseptic meningitis, 1.0/295,000; fever, 40.2/10,000 (females) and 0.9/10,000 (males); and parotitis, 5.4/10,000 (females) and 0.9/10,000 (males). Combined MMR vaccine containing the Urabe mumps strain was safe for children aged 6-13 years. Gender differences regarding reactogenicity were evident and should be considered when designing future studies.
In adolescence, due to the ongoing biological-hormonal and psychosocial changes, the formation of psychosomatic symptoms becomes more frequent. The psychosomatic symptom formation has an influence on adolescents' self-perceived health as well as on their later health and illness related attitudes and behaviors. The main goal of the present study has been to detect the occurrence of psychosomatic symptoms among early adolescents, and to see the impact of psychosocial and psychological variables on the symptom formation.
In the frame of the South Plain Youth Study, the survey was going on among middle school aged students (N = 548, classes 5-8, mean age of 12.2 years). Data were collected by means of self-completed questionnaires which contained items on sociodemographics (age, gender, parental schooling, socioeconomic status of the family), mapping psychosomatic symptoms, and certain psychosocial and psychological variables affecting psychosomatic symptom formation (such as academic achievement, health-compromising behaviors, the lack of aggression control and social comparison). Statistical analyses included chi2 test, student's t-test, ANOVA, and multiple linear regression analyses.
Fatigue proved to be the most frequent psychosomatic symptoms in both sexes which was followed by headache and lower back pain. These latter symptoms were more common among girls (p < 0.001). Good academic achievement was a protective factor (p < 0.05), while the lack of aggression control increased the psychosomatic symptom formation (boys: beta = 0.37, p < 0.001, girls: beta = 0.21, p < 0.01). Smoking (beta = 0.24, p < 0.01) and social comparison (beta = 0.16, p < 0.05) were predictors only among girls.
The results draw the attention to the importance of psychosomatic symptom formation in clinical practice. Beyond the difficulties in differential diagnosis, all efforts should be made to start a causal therapy of the latent psychosocial problems so as to prevent the onset of more serious ill health states.
17 serum samples from cats after surgery operations in one of veterinary clinic in Olsztyn have been examined. The study on anti-Toxoplasma gondii immunoglobulin IgG presence was carried out by direct agglutination method using the Toxo-Screen DA test. 70.6% positive samples in 1:40 titration, 58.8% in 1:4000 titration and 5.9% questionable result in both dilutions were obtained.
The authors examined self-perceived health and psychosocial health in 10-15 year old children and the relationship between children's self-perceived health and a set of psychosocial health status measurements.
Data were collected from middle school students (n = 548; age range, 10-15 years of age; mean, 12.2 years; SD, 1.2 years) using randomly selected classes from four schools in different school districts in Szeged, Hungary. The self-administered questionnaires contained items on sociodemographics; school achievement; height and weight (body mass index); self-perceived health and fitness; health behaviors; and anger and psychosomatic health. The self-perceived health variable was dichotomized and expressed with poor/fair or good/excellent perceptions of one's own health.
Most of the children evaluated their own health as excellent or good. Logistic regression analyses revealed that poor academic achievement, socioeconomic status self-assessment, smoking, alcohol use, sports activity, self-perceived fitness, and high levels of anger and psychosomatic symptoms were associated with an increased likelihood of reported poor/fair perceptions of health.
Findings reflect that psychosocial factors are important influences of self-perceived health in an early adolescent population.
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