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J Epidemiol Community Health. Sep 2003; 57(9): 692–698.
PMCID: PMC1732594

Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations

Abstract

Study objective: To investigate the role of different types of social relations in adolescent health inequalities.

Design: Cross sectional study. Measures included family social class, indices of social relations to parents, friends, teachers, and school.

Setting: Random sample of 55 schools in Denmark.

Participants: Nationally representative sample of 5205 students from grades 5, 7, and 9.

Main outcome measures: Self reported physical and psychological symptoms.

Results: Adolescents from families of lower socioeconomic position reported more physical and psychological symptoms. This ranged from 40% increased odds for multiple physical symptoms among less advantaged girls, to 90% increased odds of multiple psychological symptoms for less advantaged boys. Relationships with friends or teachers showed small social class differences, while strong and consistent social class differences were found in the ways adolescents reported their own and their parents relations to school. For example, girls from families of lower socioeconomic position were more than four times as likely to report their parents unwilling to attend school meetings (odds ratio=4.54, 95% confidence intervals: 2.68 to 7.69). Poorer relations with parents, peers, teachers, and school were all associated with worse health. Patterns of parent-child relations with the school were the greatest contributors to socioeconomic differences in physical and psychological symptoms.

Conclusions: The school is one of the first important social institutions directly experienced by children and socioeconomic differences in how adolescents and their parents relate to the school may be part of the cascade of early life influences that can lead to later social and health disadvantage.

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Selected References

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  • Ford G, Ecob R, Hunt K, Macintyre S, West P. Patterns of class inequality in health through the lifespan: class gradients at 15, 35 and 55 years in the west of Scotland. Soc Sci Med. 1994 Oct;39(8):1037–1050. [PubMed]
  • Holstein BE, Ito H, Due P. Sociale forskelle i børns helbred. Ugeskr Laeger. 1990 Oct 1;152(40):2910–2913. [PubMed]
  • Goodman E. The role of socioeconomic status gradients in explaining differences in US adolescents' health. Am J Public Health. 1999 Oct;89(10):1522–1528. [PMC free article] [PubMed]
  • West P, Macintyre S, Annandale E, Hunt K. Social class and health in youth: findings from the west of Scotland twenty-07 study. Soc Sci Med. 1990;30(6):665–673. [PubMed]
  • Macintyre S, West P. Lack of class variation in health in adolescence: an artefact of an occupational measure of social class? Soc Sci Med. 1991;32(4):395–402. [PubMed]
  • Rahkonen O, Lahelma E. Gender, social class and illness among young people. Soc Sci Med. 1992 Mar;34(6):649–656. [PubMed]
  • Glendinning A, Love JG, Hendry LB, Shucksmith J. Adolescence and health inequalities: extensions to Macintyre and West. Soc Sci Med. 1992 Sep;35(5):679–687. [PubMed]
  • Rahkonen O, Arber S, Lahelma E. Health inequalities in early adulthood: a comparison of young men and women in Britain and Finland. Soc Sci Med. 1995 Jul;41(2):163–171. [PubMed]
  • Siahpush M, Singh GK. A multivariate analysis of the association between social class of origin and current social class with self-rated general health and psychological health among 16-year-old Australians. Aust N Z J Med. 2000 Dec;30(6):653–659. [PubMed]
  • Lynch JW, Kaplan GA, Shema SJ. Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med. 1997 Dec 25;337(26):1889–1895. [PubMed]
  • Sweeting H, West P. Health at age 11: reports from schoolchildren and their parents. Arch Dis Child. 1998 May;78(5):427–434. [PMC free article] [PubMed]
  • Siersted HC, Boldsen J, Hansen HS, Mostgaard G, Hyldebrandt N. Population based study of risk factors for underdiagnosis of asthma in adolescence: Odense schoolchild study. BMJ. 1998 Feb 28;316(7132):651–656. [PMC free article] [PubMed]
  • Eggen AE. The Tromsø Study: frequency and predicting factors of analgesic drug use in a free-living population (12-56 years). J Clin Epidemiol. 1993 Nov;46(11):1297–1304. [PubMed]
  • Hansen Ebba H, Holstein Bjørn E, Due Pernille, Currie Candace E. International survey of self-reported medicine use among adolescents. Ann Pharmacother. 2003 Mar;37(3):361–366. [PubMed]
  • Mortensen PB, Agerbo E, Erikson T, Qin P, Westergaard-Nielsen N. Psychiatric illness and risk factors for suicide in Denmark. Lancet. 2000 Jan 1;355(9197):9–12. [PubMed]
  • Doris A, Ebmeier K, Shajahan P. Depressive illness. Lancet. 1999 Oct 16;354(9187):1369–1375. [PubMed]
  • Hotopf M, Mayou R, Wadsworth M, Wessely S. Childhood risk factors for adults with medically unexplained symptoms: results from a national birth cohort study. Am J Psychiatry. 1999 Nov;156(11):1796–1800. [PubMed]
  • Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. BMJ. 2001 May 12;322(7295):1145–1145. [PMC free article] [PubMed]
  • Williams K, Chambers M, Logan S, Robinson D. Association of common health symptoms with bullying in primary school children. BMJ. 1996 Jul 6;313(7048):17–19. [PMC free article] [PubMed]
  • Due EP, Holstein BE, Jørgensen PS. Mobning som sundhedstrussel blandt store skoleelever. Ugeskr Laeger. 1999 Apr 12;161(15):2201–2206. [PubMed]
  • Forero R, McLellan L, Rissel C, Bauman A. Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey. BMJ. 1999 Aug 7;319(7206):344–348. [PMC free article] [PubMed]
  • Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P. Bullying behaviors among US youth: prevalence and association with psychosocial adjustment. JAMA. 2001 Apr 25;285(16):2094–2100. [PMC free article] [PubMed]
  • Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, Tabor J, Beuhring T, Sieving RE, Shew M, et al. Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. JAMA. 1997 Sep 10;278(10):823–832. [PubMed]
  • Kaltiala-Heino R, Rimpelä M, Marttunen M, Rimpelä A, Rantanen P. Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999 Aug 7;319(7206):348–351. [PMC free article] [PubMed]
  • Seidman E, Chesir-Teran D, Friedman JL, Yoshikawa H, Allen L, Roberts A, Aber JL. The risk and protective functions of perceived family and peer microsystems among urban adolescents in poverty. Am J Community Psychol. 1999 Apr;27(2):211–237. [PubMed]
  • Kessler RC, Davis CG, Kendler KS. Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med. 1997 Sep;27(5):1101–1119. [PubMed]
  • Hetland Jørn, Torsheim Torbjørn, Aarø Leif E. Subjective health complaints in adolescence: dimensional structure and variation across gender and age. Scand J Public Health. 2002;30(3):223–230. [PubMed]
  • Vingilis E, Wade TJ, Adlaf E. What factors predict student self-rated physical health? J Adolesc. 1998 Feb;21(1):83–97. [PubMed]
  • Bonny AE, Britto MT, Klostermann BK, Hornung RW, Slap GB. School disconnectedness: identifying adolescents at risk. Pediatrics. 2000 Nov;106(5):1017–1021. [PubMed]
  • Power C, Matthews S. Origins of health inequalities in a national population sample. Lancet. 1997 Nov 29;350(9091):1584–1589. [PubMed]
  • Due P, Holstein BE, Marklund U. Selvrapporteret helbred blandt skoleelever i Norden. Nord Med. 1991;106(3):71–74. [PubMed]
  • Poikolainen K, Kanerva R, Lönnqvist J. Life events and other risk factors for somatic symptoms in adolescence. Pediatrics. 1995 Jul;96(1 Pt 1):59–63. [PubMed]
  • Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S. Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ. 1998 Apr 18;316(7139):1196–1200. [PMC free article] [PubMed]
  • Mortimer MJ, Kay J, Jaron A, Good PA. Does a history of maternal migraine or depression predispose children to headache and stomach-ache? Headache. 1992 Jul;32(7):353–355. [PubMed]
  • Lynch J, Due P, Muntaner C, Smith GD. Social capital--is it a good investment strategy for public health? J Epidemiol Community Health. 2000 Jun;54(6):404–408. [PMC free article] [PubMed]
  • Olweus D. Bullying at school: basic facts and effects of a school based intervention program. J Child Psychol Psychiatry. 1994 Oct;35(7):1171–1190. [PubMed]
  • Goodman E, Amick BC, Rezendes MO, Levine S, Kagan J, Rogers WH, Tarlov AR. Adolescents' understanding of social class: a comparison of white upper middle class and working class youth. J Adolesc Health. 2000 Aug;27(2):80–83. [PubMed]

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