Abstract
BackgroundAnalyzing social differences in the health of adolescents is a challenge. The accuracy of adolescent's report on familial socio-economic position is unknown. The aims of the study were to examine the validity of measuring occupational social class and family level of education reported by adolescents aged 12 to 18, and the relationship between social position and self-reported health.MethodsA sample of 1453 Spanish adolescents 12 to 18 years old from urban and rural areas completed a self-administered questionnaire including the Child Health and Illness Profile-Adolescent Edition (CHIP-AE), and data on parental occupational social class (OSC) and level of education (LE). The responsible person for a sub-sample of teenagers (n = 91) were interviewed by phone. Kappa coefficients were estimated to analyze agreement between adolescents and proxy-respondents, and logistic regression models were adjusted to analyze factors associated with missing answers and disagreements. Effect size (ES) was calculated to analyze the relationship between OSC, LE and the CHIP-AE domain scores.ResultsMissing answers were higher for father's (24.2%) and mother's (45.7%) occupational status than for parental education (8.4%, and 8.1% respectively), and belonging to a non-standard family was associated with more incomplete reporting of social position (OR = 4,98; 95%CI = 1,3–18,8) as was agreement between a parent and the adolescent. There were significant social class gradients, most notably for aspects of health related to resilience to threats to illness.ConclusionAdolescents can acceptably self-report on family occupation and level of education. Social class gradients are present in important aspects of health in adolescents.
Highlights
IntroductionThe accuracy of adolescent's report on familial socio-economic position is unknown
Analyzing social differences in the health of adolescents is a challenge
A total of 1453 adolescents was included in the final analysis. 259 adolescents were absent on the day of questionnaire administration and in 62 cases, parents refused permission for their children to participate in the study. 60% were aged less than 16; 51.2% were boys; 60.1% came from the urban sample of which 17.3% lived in a neighborhood with a low ICEF
Summary
The accuracy of adolescent's report on familial socio-economic position is unknown. The aims of the study were to examine the validity of measuring occupational social class and family level of education reported by adolescents aged 12 to 18, and the relationship between social position and self-reported health. Measurement of social difference in health of adolescents presents challenges not present in the study of social gradients in health among adults. Reports of socio-economic position by adults are assumed to be accurate but the accuracy of child reports is unknown [1,2]. The level of agreement between adolescents and proxy-respondents reporting education and occupation has been shown as moderate [9,10] improving with age, and worsening when the adolescent does not live with the parent about whom information is being asked.
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