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. 2017 Oct 23;17(1):838.
doi: 10.1186/s12889-017-4863-x.

Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective

Mikael Ahlborg  1 , Petra Svedberg  2 , Maria Nyholm  2 , Antony Morgan  2   3 , Jens M Nygren  2
Affiliations

Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective

Mikael Ahlborg et al. BMC Public Health. .

Abstract

Background: Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.

Method: Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11-15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by "perceived family wealth" (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.

Results: Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).

Conclusions: The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries.

Keywords: Adolescence; HBSC; Self-rated health; Socioeconomic inequality; Socioeconomic status.

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Conflict of interest statement

Authors’ information

School of Health and Welfare at Halmstad University, SE 301 18 Halmstad, Sweden.

Ethics approval and consent to participate

The HBSC-survey is carried out every fourth year and follows the ethical principles of the WMA Helsinki declarations in protecting integrity, privacy and confidentiality of participants. The national Data Inspection Board monitors the standards of privacy. The Swedish HBSC-survey also fulfils the rules and guidelines from the Swedish Research Council regarding information, consent, confidentiality and usage of data. Participation in the HBSC-survey is voluntary and all participants are informed about the objectives of the survey.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Descriptive trends showing mean values of subjective SES and FAS for groups above and below cut-off points of health outcomes by each survey year. Independent t-tests to show significant inequalities between groups. * p = <0.05 ** p = <0.01 *** p = <0.001
See this image and copyright information in PMC

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