Abstract
To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related QOL of European and non-European immigrant adolescents and the contributions of socioeconomic difficulties, unhealthy behaviors, and violence. It included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3; 1,451 French adolescents, 54 European immigrants and 54 non-European immigrants), who completed a self-administered questionnaire including sex, age, socioeconomic characteristics (family structure, parents’ education, occupation, and income), unhealthy behaviors (uses of tobacco/alcohol/cannabis/hard drugs, obesity, and involvement in violence), having sustained violence, sexual abuse, and the four QOL domains measured with the World Health Organization’s WHOQOL-BREF (poor: score < 25th percentile). Data were analyzed using logistic regression models. Poor physical health, psychological health, social relationships, and living environment affected more European immigrants (26% to 35%) and non-European immigrants (43% to 54%) than French adolescents (21% to 26%). European immigrants had a higher risk of poor physical health and living environment (gender-age-adjusted odds ratio 2.00 and 1.88, respectively) while non-European immigrants had a higher risk for all poor physical health, psychological health, social relationships, and living environment (3.41, 2.07, 3.25, and 3.79, respectively). Between 20% and 58% of these risks were explained by socioeconomic difficulties, parts of which overlapped with unhealthy behaviors and violence. The associations between the two sets of covariates greatly differed among French adolescents and immigrants. Poor QOL was more common among European and non-European immigrants due to socioeconomic difficulties and associated unhealthy behaviors and violence. The different risk patterns observed between French adolescents and immigrants may help prevention.
Highlights
Healthy adolescent development includes self-awareness, positive behaviors, goal setting and achievement, successful transition into adulthood, and good health-related quality of life, trust, optimism, and meaning in life [1,2]
This study further reveals that unhealthy behaviors and violence sustained by adolescents contributed little to poor physical health, psychological health, social relationships, and living environment in addition to socioeconomic factors
We found that older age was related to poor physical health, psychological health and social relationships as observed by other studies [13,14]
Summary
Healthy adolescent development includes self-awareness, positive behaviors, goal setting and achievement, successful transition into adulthood, and good health-related quality of life, trust, optimism, and meaning in life [1,2]. Early adolescence coincides with the middle-school years, a period of transition from the total social and economic dependence of a child to relative independence with more contacts/exchanges with others and more access to licit and illicit drugs. It is important to study the adolescent’s perception of his/her position in life in the context of the culture and value systems in which he/she lives and in relation to his/her goals, expectations, standards, and concerns i.e., the health-related quality of life (QOL) as defined by The World Health Organization (WHO) [11]
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