The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis.

Néboa Zozaya,Laura Vallejo

doi:10.3390/ijerph17020643

Abstract

Background: Previous studies have analyzed the impact of economic crises on adult’s health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. Methods: We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. Results: Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. Conclusion: The child’s social context—family, peers, school, and region—play an important role on the effects of the economic crisis on health and risk behaviors.

Highlights

The global economic recession initiated at the end of the first decade of the 21st century had important macroeconomic effects in most developed countries
We focus on analyzing the impact on health indicators as well as on lifestyles factors, as the latter might be a mechanism that explains changes in health that have accrued and/or will develop in the long run
Data were obtained from the Health Behavior in School-Aged Children (HBSC), an international cross-sectional survey supported by the World Health Organization (WHO) aimed at understanding young people’s health-related behaviors, well-being, and developmental contexts [32]

Summary

Introduction

The global economic recession initiated at the end of the first decade of the 21st century had important macroeconomic effects in most developed countries. The unemployment rate of the general population rose from 7.9% in 2007 to 26.9% in 2013, with marked differences between regions, and the number of unemployed individuals increased by 4.5 million [1]. There is an extensive body of literature focused on analyzing the impact of the economic crisis on the health and lifestyles of the population, with mixed findings [1,2,3]. Previous studies have analyzed the impact of economic crises on adult’s health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. Median odds ratios were estimated to quantify the cross-region and cross-school variation

Objectives

Methods

Discussion

Conclusion