Family Affluence and Inequality in Adolescent Health and Life Satisfaction

A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). For this analysis, we use data from the last four cycles of the Health Behaviour in School-aged Children study (2001/02, 2005/06, 2009/10, and 2013/14) for 32 European and North American countries in the EU and/or OECD. We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. Family affluence is used as a measure of adolescents’ socioeconomic background (transformed to ridit score). In the vast majority of the countries studied, adolescents from families with a relatively low socio-economic status had a greater likelihood of reporting poor health. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.