Socioeconomic inequalities in adolescent health behaviours across 32 different countries – The role of country-level social mobility
Schmengler, Heiko; Peeters, Margot; Stevens, Gonneke; Kunst, Anton E; Delaruelle, Katrijn; Dierckens, Maxim; Charrier, Lorena; Weinberg, Dom; Oldehinkel, Albertine J.; Vollebergh, Wilma
(2022) Social Science & Medicine, volume 310
(Article)
Abstract
Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence
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and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11–15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.
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Keywords: Social mobility, Socioeconomic inequality, Health behaviours, Adolescents, HBSC
ISSN: 0277-9536
Publisher: Elsevier Limited
Note: Funding Information: The first line of reasoning was not supported by our results, as for none of the health-behaviours investigated socioeconomic differences based on parental SES were larger in countries with low levels of social mobility. It is possible that adolescents from low-SES backgrounds living in these countries may not be aware of the structural inequalities of opportunity in their societies and may instead be more strongly affected by factors in their immediate social environment, for example at school. It has been found that socioeconomic inequalities in adolescent smoking and mental health tend to be smaller in highly stratified educational systems, which more commonly characterize countries with low social mobility (Hanushek and Wößmann, 2006; Högberg et al., 2019; Pekkarinen, 2018; Rathmann et al., 2016; Van de Werfhorst and Mijs, 2010). A potential explanation for this surprising result could be that socially disadvantaged adolescents may experience less pressure from social comparison in their immediate social environment if grouped together with adolescents from similar backgrounds at school (Högberg et al., 2019), and this could at least temporarily offset the negative psychosocial consequences of a lack of social mobility in a given society. The differences in the educational systems between high- and low mobility countries also raise the possibility of variations in the associations between adolescents' own educational level and their health behaviours, depending on country-level social mobility. This could also explain why putatively stronger associations between parental SES and adolescents' own educational level in low-mobility countries did not lead to wider socioeconomic inequalities in these countries. Future studies may attempt to delineate potential differences in associations between measures of adolescents’ own educational level and health behaviours between countries with high and low levels of social mobility.This study is made possible by the Consortium on Individual Development (CID). CID is funded through the Gravitation program of the Dutch Ministry of Education, Culture, and Science and the Netherlands Organization for Scientific Research (NWO) (grant number 024.001.003). The Health Behaviour in School-aged Children (HBSC) study is funded by public sources in each member country. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This study is made possible by the Consortium on Individual Development (CID). CID is funded through the Gravitation program of the Dutch Ministry of Education , Culture, and Science and the Netherlands Organization for Scientific Research ( NWO ) (grant number 024.001.003 ). The Health Behaviour in School-aged Children (HBSC) study is funded by public sources in each member country. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2022 The Authors
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