Socioeconomic inequality in multiple health compl

Authors: Bjørn E Holstein Candace Currie Will Boyce Mogens T Damsgaard Inese Gobina Gyöngyi Kökönyei Jørn Hetland Margaretha de Looze Matthias Richter Pernille Due the HBSC Social Inequalities Focus Group

Publish Date: 2009/07/30

Volume: 54, Issue: 2, Pages: 260-270

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Abstract

To use comparable data from many countries to examine 1 socioeconomic inequality in multiple health complaints among adolescents 2 whether the countries’ absolute wealth and economic inequality was associated with symptom load among adolescents and 3 whether the countries’ absolute wealth and economic inequality explained part of the individual level socioeconomic variation in health complaintsThe Health Behaviour in Schoolaged Children HBSC international study from 2005/06 provided data on 204534 11 13 and 15year old students from nationally random samples of schools in 37 countries in Europe and North America The outcome measure was prevalence of at least two daily health complaints measured by the HBSC Symptom Check List We included three independent variables at the individual level sex age group family affluence measured by the Family Affluence Scale FAS and two macro level measures on the country’s economic situation wealth measured by Gross National Product GNP and distribution of income measured by the Gini coefficientThere was a significant socioeconomic variation in health complaints in 31 of the 37 countries The overall OR 95 CI for 2+ daily health complaints for all countries was 131 127–136 in the medium versus high FAS group and 207 200–214 in the low versus high FAS group This socioeconomic gradient in health complaints attenuated somewhat in the multilevel models which included macro level data There was no association between GNP and health complaints The OR for high symptom load was 135 108–169 per 10 increase in Gini coefficient The socioeconomic gradient in health complaints at the individual level was somewhat attenuated in the multilevel models which included macro level dataMembers of the HBSC Social Inequalities Focus Group Pernille Due DK Coordinator Laura Dörfler AT Sylvie Ackaert BEFl Isabelle Godin BEFr Irina Todorova BG Will Boyce CA Ivana Pavic Simetin HR Bjørn Holstein DK Rikke Kroelner DK Anette Andersen DK Mogens Trab Damsgaard DK Klaus Hurrelmann DE Andreas Klocke DE Matthias Richter DE Gabriella Pall HU Stefan H Jonsson IS Tryggvi Hallgrimsson IS Alessio Zambon IT Massimo Santinello IT Diana Puntule LV Yolande Wagener LU Lina Unkovska MK Margaretha de Looze NL Oana Marcu RO Candace Currie GBSCO Kate Levin GBSCO Tibor Baska SK Andrea Geckova SK Peter Kolarcik SK Jitse van Dijk SK Ivan Žežula SK Olga Balakireva UA Alexander Yaramenko UA

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