Health Inequalities among Adolescents - impacts of different measures of social position
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Health Inequalities among Adolescents- impacts of different measures of social position
Curt Hagquist, PhD
Centre for Research on Child and Adolescent Mental HealthKarlstad University, Sweden
Presentation at the 2nd International Conference of the International Society for Child Indicators, 4 – 5 November 2009
at the University of Western Sydney, Australia
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Measurement of Health Inequalities Measurement of Health Inequalities among Adolescents – distinctive featuresamong Adolescents – distinctive features
Inconsistent patterns and results reported in previous studies.
Socio-economic position primarily measured based on parents’ occupation, education or income.
Incomplete and bad measurement when based on children’s reports on their parents.
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Conceptual and pragmaticreasons for
shifting the focusFROM
socio-economic position of origin TO
socio-economic position of destination
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Academic orientation
- Rough indicator of future social position
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Theempirical example
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Adolescent survey data on health Adolescent survey data on health and health-related behavioursand health-related behaviours
Data set 1: Students in year 9 (15-16 years old) in a Swedish county. Data collections in 1988, 1991, 1995, 1998, 2002, 2005. About 15 000 participants.
Data set 2: Students in year 2 of upper secondary school (about 18 years old) in a city in Sweden. Data collections in 1999 and 2003. About 1 800 participants
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Academic orientationAcademic orientation- operationalisation- operationalisation
Students in Year 9: First choice of program in application for upper secondary school.
Students in Year 2 of upper secondary school: Current program affiliation.
Dichotomisation: Theoretical and non theoretical (vocational) programs.
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The PsychoSomatic Problems The PsychoSomatic Problems (PSP) - scale(PSP) - scale
During this school year, have you ..."Had difficulty in concentrating?""Had difficulty in sleeping?""Suffered from headaches?""Suffered from stomach aches?""Felt tense?""Had little appetite?""Felt sad?""Felt giddy?”
Composite measure: Person parameter estimates (”Rasch-scores”)
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Year 9
(i.e. last year in the compulsory school)
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Psychosomatic problemsPsychosomatic problems by academic orientation by academic orientation1995-2005, Year 9 - Boys1995-2005, Year 9 - Boys
0
2
4
6
8
10
12
1995 1998 2002 2005
Year of investigation
Pe
rce
nt
TheoreticalNon-theoretical
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Psychosomatic problems Psychosomatic problems by academic orientationby academic orientation1995-2005, Year 9 - Girls1995-2005, Year 9 - Girls
0
5
10
15
20
25
30
35
40
1995 1998 2002 2005
Year of investigation
Pe
rce
nt
TheoreticalNon-theoretical
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Binge drinkingBinge drinkingonce a month or moreonce a month or more
Year 9, 1995 – 2005Year 9, 1995 – 2005
21 22
39 40
1621
35 37
0
10
20
30
40
50
Theoretical,Boys
Theoretical,Girls
Non -theoretical,
Boys
Non-theoretical,
Girls
Perc
ent
20022005
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Ever used narcoticsEver used narcotics Year 9, 1995 – 2005Year 9, 1995 – 2005
6
3
1011
89
3 3
7 7
2
6
0
2
4
6
8
10
12
Theoretical,Boys
Theoretical,Girls
Non-theoretical,
Boys
Non-theoretical,
Girls
Perc
ent
199820022005
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Year 2
in upper secondary school
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Selection toprogram by
parentaleducation
in upper secondary school
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Program affiliationProgram affiliation distributed by parent’s educational leveldistributed by parent’s educational level
3443
6457
51
7257
3643
49
28
66
0
20
40
60
80
100
CompBOYS
UpSecBO
YS
UnivBOYS
CompGIR
LS
UpSecGIR
LS
UnivGIR
LS
Per
cen
t
Theoretical
Non theoretical
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The role ofAcademic orientation
Controlling forParental education
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Health and health-related behavioursHealth and health-related behavioursYear 2 of upper secondary school, 1999 & 2003Year 2 of upper secondary school, 1999 & 2003
Odds RatiosOdds Ratios
1,7
4,6
1,62,0
1,1 1,30,9 1,1
0,0
1,0
2,0
3,0
4,0
5,0
6,0
7,0
Psychosomaticcomplaints
Smoking Binge drinking Ever used drugs
Pee
rr
School programme:Non-theoretical vstheoretical
Parents' education:Compulsory schoolvs university
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In conclusion 1In conclusion 1 Strong link between academic orientation and
health/health-related behaviours.
No direct link between parents’ education and health/health-related behaviours, but mediating effects.
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In conclusion 2 In conclusion 2 Academic orientation is a useful concept to detect
health inequalities among adolescents.
Academic orientation is a powerful way of identifying adolescents at higher risk.
Social class of origin and social class of destination are not mutually exclusive but complementary concepts.
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References References Hagquist C
Socioeconomic differences in smoking behaviours among adolescents. The role of academic orientation. Childhood, 2000;7:467-478.
Hagquist C Health inequalities among adolescents – the impact of academic orientation and parents’ education. European Journal of Public Health 2007; 17: 21-26
Hagquist CPsychometric properties of the PsychoSomatic Problems scale – a Rasch analysis on adolescent data. Social Indicators Research 2008; 86: 511-523
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