Health and health behaviours in adolescence as predictors of education and socioeconomic status in adulthood - a longitudinal study.

BACKGROUND: The positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adolescent health and health behaviours predict higher education and higher SES in adulthood and if family background and school performance in adolescence explain these associations. METHODS: Surveys on health and health behaviours were sent to representative samples of 12-18-year-old Finns in 1981-1997 every second year (response rate 77.8%, N = 55,682). The survey data were linked with the respondents' and their parents' socioeconomic data from the Finnish national registries. Both latent variables, namely, health (perceived health, health complaints, chronic disease), health-compromising behaviours (smoking status, drunkenness frequency), and family background (parents' occupation-based SES, education, family type) and variables directly measuring health-enhancing behaviours (toothbrushing, physical activity) and school performance were used to predict higher education and higher occupation-based SES at age 34. Logistic regression analysis and structural equation models (SEM) were used. RESULTS: In logistic regression analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours were related to higher education and SES, also after controlling for family background and school performance. In the SEM analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours directly predicted higher SES and higher education, although the standardised coefficients were low (from 0.034 to 0.12). In all models, health, lack of health-compromising behaviours, and health-enhancing behaviours predicted school performance, which in turn, predicted the outcomes, suggesting indirect routes to these. Good socioeconomic prospects in terms of family background predicted good health, healthy behaviours, and good school performance in adolescence and higher SES and higher education in adulthood. CONCLUSION: Health and health behaviours in adolescence predicted education and SES in adulthood. Even though the relationships were modest, they support the health selection hypotheses and emphasise the importance of adolescence for health inequalities during the life-course. Health and health behaviours were strongly associated with school performance and family background which together modified the paths from health and health behaviours to the outcomes.

Adolescent physical activity predicts high education and socio-economic position in adulthood.

BACKGROUND: Based on the knowledge on beneficial effects of physical activity (PA) on health and fitness, we hypothesized that PA in adolescence is related to high education and socio-economic position (SEP) in adulthood. Improved school performance may mediate the hypothesized relationship. METHODS: The Adolescent Health and Lifestyle Surveys (AHLS), collected biennially in 1981-89 (baseline) and representing 14- and 16-year-old Finns were individually linked with national registries of the highest educational level and SEP. Of the sample, 10 498 (78%) responded the surveys and were followed till the end of 2001 (age group of 28-38 years). Multinomial logistic regression analysis was used to study the associations between the outcomes (highest attained educational level, SEP) and PA (sports clubs, spontaneous, intensity). RESULTS: Participating in sports club or spontaneous PA and practicing with high intensity in adolescence were associated with higher educational levels and SEP in adulthood. Childhood socio-economic background only slightly influenced the associations and largely, PA predicted the outcomes independently of background. Particularly among girls, school performance partly accounted for the associations between PA and the highest educational level and the highest SEP. CONCLUSIONS: Participation in PA in adolescence and particularly its high intensity, predicts higher educational levels and SEP in early middle age. School performance to some degree mediates the impact of PA. PA behaviours in adolescence-or possibilities to participate in PA-are a potential mechanism in generating better health of higher socio-economic and educational groups in adult age.

The change in child self-assessed and parent proxy-assessed Health Related Quality of Life (HRQL) in early adolescence (age 10-12).

AIMS: To examine the development of self-assessed and parent proxy-assessed health related quality of life (HRQL) in pre-adolescent schoolchildren. METHODS: The population (n = 1,346) consisted of the total cohort of children starting 4th grade (age 10) in 2004 in primary schools in a Finnish city of 175,000 inhabitants. HRQL was assessed using the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0). The baseline study was conducted in 2004 (child age 10) and follow-up in a panel setting in 2006 (child age 12). The response rate for the children was 80% (n = 1,094) in 2004 and 85% (n = 1,139) in 2006. The response rate for children having responded both in 2004 and 2006 was 73% (n = 986). For parents of the children, one parent participated in the parents' survey (n = 999 in 2004, n = 888 in 2006). RESULTS: HRQL scores increased significantly in the two-year follow up (child t = 10.16-5.95, p < 0.0001, parent-proxy t = 6.35-2.76, p < 0.0001-0.006). Correlation between baseline and follow-up assessments was significant (child r = 0.4-0.5, p < 0.0001, parent r = 0.47-0.57, p < 0.0001). The correlation between baseline HRQL and change was negative (child r =-0.67 to -0.56, p < 0.0001, parent r =-0.62 to -0.46, p < 0.0001). Correlation between child and parent assessments increased from baseline (r = 0.20-0.39, p < 0.0001) to follow up (r = 0.3-0.42, p < 0.0001). CONCLUSIONS: Child-assessed and parent proxy-assessed HRQL scores increase, suggesting HRQL improves, when children grow from age 10 to age 12. Baseline HRQL may not strongly predict future HRQL in early adolescence. The correlation between child self-assessment and parent proxy-assessment is fragile.

Orientations in adolescent use of information and communication technology: a digital divide by sociodemographic background, educational career, and health.

AIMS: The role of information and communication technology (ICT) in adolescents' lives was studied, with emphasis on whether there exists a digital divide based on sociodemographic background, educational career, and health. The assumption was that some groups of adolescents use ICT more so that their information utilization skills improve (computer use), while others use it primarily for entertainment (digital gaming, contacting friends by mobile phone). METHODS: Data were collected by mailed survey from a nationally representative sample of 12- to 18-year-olds (n=7,292; response 70%) in 2001 and analysed using ANOVA. RESULTS: Computer use was most frequent among adolescents whose fathers had higher education or socioeconomic status, who came from nuclear families, and who continued studies after compulsory education. Digital gaming was associated with poor school achievement and attending vocational rather than upper secondary school. Mobile phone use was frequent among adolescents whose fathers had lower education or socioeconomic status, who came from non-nuclear families, and whose educational prospects were poor. Intensive use of each ICT form, especially of mobile phones, was associated with health problems. High social position, nuclear family, and a successful educational career signified good health in general, independently of the diverse usage of ICT. CONCLUSIONS: There exists a digital divide among adolescents: orientation to computer use is more common in educated well-off families while digital gaming and mobile phone use accumulate at the opposite end of the spectrum. Poorest health was reported by mobile phone users. High social background and success at school signify better health, independently of the ways of using ICT.

To have or not to have a pet for better health?

BACKGROUND: Pet ownership is thought to have health benefits, but not all scientific explorations have been founded on proper applications of representative samples or statistically correct methodologies. Databanks have been too small for proper statistical analyses; or, instead of a random sample, participation has been voluntary. The direction of causality has been evaluated incorrectly or control of relevant factors noted deficient. This study examined the associations of pet ownership with perceived health and disease indicators by taking into account socio-demographic background factors together with health risk factors, including exercise. METHODOLOGY/PRINCIPAL FINDINGS: The present study used baseline data from the 15-year Health and Social Support Study (the HeSSup Study). The Finnish Population Register Centre was used to draw population-based random samples stratified according to gender and four age groups (20-24, 30-34, 40-44, and 50-54 years). A total of 21,101 working-aged Finns responded to the baseline survey questionnaire of the 15-year HeSSup Study in 1998. Ordinal and binary logistic regression was used to analyze the cross-sectional data. Pet ownership was associated with poor rather than good perceived health. BMI surfaced as the risk factor most strongly associated with pet ownership. CONCLUSIONS/SIGNIFICANCE: Pet owners set in their ways and getting older were found to have a slightly higher BMI than the rest. Additional research is needed for the testing of hypotheses involving effects of pet ownership with various health dimensions within population groups that are composed of different kinds of background characteristics.