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Dieser Beitrag untersucht die Relevanz makro-struktureller Merkmale für die Gesundheit und sozioökonomische Ungleichheit in der Gesundheit von Jugendlichen in hochentwickelten Wohlfahrtsstaaten. Datenbasis ist die internationale "Health Behaviour in School-aged Child-ren (HBSC)"-Studie 2005/06. Sie umfasst 11- bis 15-jährige Jugendliche in 27 europäischen und nordamerikanischen Länder (n=134.632), die in fünf Wohlfahrtsstaatsregimes (sozialde-mokratisch, konservativ, liberal, süd- und osteuropäisch) zusammengefasst wurden. In hierar-chischen Regressionsmodellen wurden für die psychosomatische Beschwerdelast als gesund-heitliche Zielgrößee individuelle (familiärer Wohlstand) und makro-strukturelle Determinanten (Einkommensungleichheit, Ausgaben für das Gesundheitssystem, Regime-Dummies) unter Kontrolle des nationalen Wohlstands analysiert. Im liberalen Regime und damit in Ländern mit hoher Einkommensungleichheit fallen die Beschwerderate und sozioökonomische Un-gleichheiten in der Beschwerdelast am höchsten aus. Der gesellschaftliche Wohlstand und die Ausgaben für das Gesundheitssystem sind dagegen nicht mit den Beschwerden assoziiert
This paper reviews life course approaches applied in epidemiology, sociology and psychology and proposes a theoretical framework that integrates the concept of socialisation. We argue that the paradigmatic principles of interdisciplinary life course research (human agency, timing in lives, linked lives and historical context) provide a strong basis for a more holistic and theory-driven view of the life course and its interdependent pathways. The ´agency within structure´ paradigm on which these principles are based is an essential part of socialisation theory. We emphasize that socialisation theory has the potential to act as a theoretical link between social science and epidemiology, because it offers a multi-causal framework to illuminate the association between social structure and health across the life course. In order to better understand the development of health and health inequalities in a life course perspective, an interdisciplinary approach is required. The increased attention to socialisation principles might open new dialogue and empirical research perspectives for health sociology and epidemiology. Keywords: ageing, health, life course, social inequalities, socialisation theory
Objectives
Little is known about the impact of recessions on young people’s socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America.
Methods
Data from the WHO collaborative ‘Health Behaviour in School-aged Children’ (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005–2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10.
Results
Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005–2010) were not associated with adolescents’ psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment.
Conclusions
This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.
This study aims to determine whether educational differentiation (i.e. early and long tracking to different school types) relate to socioeconomic inequalities in adolescent smoking. Data were collected from the WHO-Collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, which included 48,025 15-year-old students (Nboys = 23,008, Ngirls = 25,017) from 27 European and North American countries. Socioeconomic position was measured using the HBSC family affluence scale. Educational differentiation was determined by the number of different school types, age of selection, and length of differentiated curriculum at the country-level. We used multilevel logistic regression to assess the association of daily smoking and early smoking initiation predicted by family affluence, educational differentiation, and their interactions. Socioeconomic inequalities in both smoking outcomes were larger in countries that are characterised by a lower degree of educational differentiation (e.g. Canada, Scandinavia and the United Kingdom) than in countries with higher levels of educational differentiation (e.g. Austria, Belgium, Hungary and The Netherlands). This study found that high educational differentiation does not relate to greater relative inequalities in smoking. Features of educational systems are important to consider as they are related to overall prevalence in smoking and smoking inequalities in adolescence.
BACKGROUND:
Health literacy is of increasing importance in public health research. It is a necessary pre-condition for the involvement in decisions about health and health care and related to health outcomes. Knowledge about limited health literacy in different age groups is crucial to better target public health interventions for subgroups of the population. However, little is known about health literacy in Germany. The study therefore assesses the prevalence of limited health literacy and associated factors among different age groups.
METHODS:
The Health Literacy Survey Germany is a cross-sectional study with 2,000 participants aged 15 years or older in private households. Perceived health literacy was assessed via computer-assisted personal interviews using the HLS-EU-Q-47 questionnaire. Descriptive analyses, chi-square tests and odds ratios were performed stratified for different age groups.
RESULTS:
The population affected by limited perceived health literacy increases by age. Of the respondents aged 15-29 years, 47.3 % had limited perceived health literacy and 47.2 % of those aged 30-45 years, whereas 55.2 % of the respondents aged 46-64 years and 66.4 % aged 65 years and older showed limited perceived health literacy. In all age groups, limited perceived health literacy was associated with limited functional health literacy, low social status, and a high frequency of doctor visits.
CONCLUSIONS:
The results suggest a need to further investigate perceived health literacy in all phases of the life-course. Particular attention should be devoted to persons with lower social status, limited functional health literacy and/or a high number of doctor visits in all age groups.