Trends in gender and socioeconomic inequalities in adolescent health over 16 years (2002-2018): findings from the Canadian Health Behaviour in School-aged Children study.

Abstract

Monitoring health inequalities in adolescents informs policy approaches to reducing these inequalities early in the life course. The purpose of this study was to investigate trends in gender and socioeconomic inequalities in six health domains. Data were from five quadrennial survey cycles of the Health Behaviour in School-aged Children (HBSC) study in Canada (pooled n = 94 887 participants). Differences in health between socioeconomic groups (based on material deprivation) and between genders were assessed using slope and relative indices of inequality in six health domains: daily physical activity, excess body weight, frequent physical symptoms, frequent psychological symptoms, low life satisfaction, and fair or poor self-rated health. Over a 16-year period, adolescents in Canada reported progressively worse health in four health domains, with those at the lowest socioeconomic position showing the steepest declines. Socioeconomic differences increased in excess body weight, physical symptoms, low life satisfaction, and fair or poor health. Gender differences also increased. Females showed poorer health than males in all domains except excess body weight, and gender differences increased over time in physical symptoms, psychological symptoms and low life satisfaction. Socioeconomic and gender inequalities in health are persistent and widening among adolescents in Canada. Policies that address material and social factors that contribute to health disparities in adolescence are warranted.