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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 Health Karlstad University, Sweden
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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 Health Karlstad 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 [firstname.lastname@example.org]
Measurement of Health Inequalities among 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.
Conceptual and pragmatic reasons for shifting the focus FROM socio-economic position of origin TO socio-economic position of destination
Academic orientation - Rough indicator of future social position
The empirical example
Adolescent survey data on health and 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
Academic orientation- 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.
The PsychoSomatic Problems (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”)
Year 9 (i.e. last year in the compulsory school)
Psychosomatic problems by academic orientation1995-2005, Year 9 - Boys
Psychosomatic problems by academic orientation1995-2005, Year 9 - Girls
Year 2 in upper secondary school
Selection to program by parental education in upper secondary school
The role of Academic orientation Controlling for Parental education
Health and health-related behavioursYear 2 of upper secondary school, 1999 & 2003Odds Ratios
In 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.
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.
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 C Psychometric properties of the PsychoSomatic Problems scale – a Rasch analysis on adolescent data. Social Indicators Research 2008; 86: 511-523