Abstract

PurposeResearch demonstrates a strong socioeconomic gradient in health and well-being. However, many studies rely on unidimensional measures of socioeconomic status (SES) (e.g. educational qualifications, household income), and there is often a more limited consideration of how facets of SES combine to impact well-being. This paper develops a multidimensional measure of SES, drawing on family and school-level factors, to provide more nuanced understandings of socioeconomic patterns in adolescent substance use and mental well-being. MethodsData from the Student Health and Wellbeing Survey from Wales, UK was employed. The sample compromised 22,372 students and we used latent class analysis to identify distinct groups using three measures of SES. These classes were then used to estimate mental well-being, internalizing symptoms, and substance use. ResultsThe five-class solution offered the best fit. Findings indicated distinct classes of families as follows: “nonworking,” “deprived working families,” “affluent families in deprived schools,” “lower affluence,” and “higher affluence.” There was a clear relationship among the classes and mental well-being, internalizing symptoms, smoking, and cannabis use; alcohol was the exception to this. ConclusionsThe identification of these classes led to a fuller understanding of the health and well-being effects of SES, showing clearer patterning in health behaviors that often is not captured in research. The implications for adolescent health and well-being are discussed, including considerations for future research.

Highlights

  • Research demonstrates a strong socioeconomic gradient in health and well-being

  • We show that simultaneously using multiple socioeconomic indicators across varying socioecological levels can reveal more nuanced understandings of the association of socioeconomic status (SES) with adolescent health and well-being

  • Drawing on measures of family affluence, parental employment, and school-level deprivation collected from a large national sample of adolescents in Wales, UK, we identified five distinct latent classes of SES: “nonworking families,” “affluent families in deprived schools,” “lower affluence families,” “higher affluence families,” and “deprived families” and explored how these classes differed according to demographics and predicted well-being and substance use outcomes

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Summary

Introduction

Research demonstrates a strong socioeconomic gradient in health and well-being. many studies rely on unidimensional measures of socioeconomic status (SES) (e.g. educational qualifications, household income), and there is often a more limited consideration of how facets of SES combine to impact well-being. This paper develops a multidimensional measure of SES, drawing on family and school-level factors, to provide more nuanced understandings of socioeconomic patterns in adolescent substance use and mental well-being. The sample compromised 22,372 students and we used latent class analysis to identify distinct groups using three measures of SES. These classes were used to estimate mental well-being, internalizing symptoms, and substance use. This study identified five distinct classes of underlying SES patterns and dynamics. These classes predicted mental well-being and substance use, and two classes (10% of sample) were at near double the risk for greater substance use, internalizing symptoms, and poorer mental well-being

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