Relationships between Physical and Mental Health in Adolescents from Low-Income, Rural Communities: Univariate and Multivariate Analyses.

Robyn Feiss,Melissa M. Pangelinan

doi:10.3390/ijerph18041372

Robyn Feiss, Melissa M. Pangelinan

Open Access

https://doi.org/10.3390/ijerph18041372

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Abstract

Environment (i.e., rural vs. urban) and socioeconomic status (SES) are moderating factors of physical (i.e., obesity and/or physical activity) and internalizing mental health (i.e., stress, anxiety, and depressive symptoms) in adolescents. Relationships between physical and mental health have been shown in adolescents; however, research has not addressed these relationships in those from low-income, rural backgrounds. Thus, the present study characterized physical and mental health in rural, low-SES adolescents and investigated relationships between physical and mental health in this population. Data were collected from 253 10th and 11th-grade students from Title I schools in rural Alabama. Self-report measures of mental health, self-esteem, body image, and physical activity were obtained, in addition to functional fitness and physical health assessments completed at each school. Relationships between mental and physical health were assessed using Pearson correlations and multivariate data-driven cluster analysis. Positive correlations were observed between body composition and mental health symptoms, while negative correlations were observed between body image and mental health and body composition. However, sex differences were present in these relationships. The multivariate cluster analysis identified groups of individuals based on profiles of mental and physical health. This individual-level analysis identified students with greater mental and/or physical health burdens (n = 53 and n = 40) who may benefit from targeted interventions. Overall, these results provide evidence of elevated mental and physical health burdens among rural, low-income adolescents. Moreover, targeted programs are needed to provide education about the relationship between physical and mental health to reduce health burdens in both domains in this population.

Highlights

Adolescence represents a critical period during which problems in physical health and internalizing mental health emerge and may lead to long-term health burdens [1]
The present analysis demonstrated that relationships between body composition, body satisfaction, and mental health outcomes are different for males and females
Elevated physical and internalizing mental health burdens were observed in a group of adolescents from rural, low-income backgrounds

Summary

Introduction

Adolescence represents a critical period during which problems in physical health (e.g., lower physical activity levels, increased obesity) and internalizing mental health (e.g., increased symptoms of depression, anxiety, stress) emerge and may lead to long-term health burdens [1]. The current estimates of adolescent obesity (having a BMI in the 95th percentile) range from 14.8% [2] to 20.6% [5]. These percentages have increased steadily over the past three decades [6] justifying the critical need for physical health interventions. An estimated 31.9% of adolescents ages 13–18 years have been or are currently diagnosed with an anxiety disorder [7]. 13.3% of adolescents ages 12–17 years have experienced

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