When does hardship matter for health? Neighborhood and individual disadvantages and functional somatic symptoms from adolescence to mid-life in The Northern Swedish Cohort.

Per E Gustafsson,Miguel San Sebastian,Christina Van Der Feltz-Cornelis

doi:10.1371/journal.pone.0099558

Per E Gustafsson, Miguel San Sebastian + Show 1 more

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https://doi.org/10.1371/journal.pone.0099558

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Journal: PloS one	Publication Date: Jun 12, 2014
Citations: 49	License type: CC BY 4.0

Affiliation: Umeå University

Abstract

A large body of research has shown that health is influenced by disadvantaged living conditions, including both personal and neighborhood conditions. Little is however known to what degree the health impact of different forms of disadvantage differ along the life course. The present study aims to examine when, during the life course, neighborhood and individual disadvantages relate to functional somatic symptoms. Participants (n = 992) came from The Northern Swedish Cohort and followed from age 16, 21, 30 until 42 years. Functional somatic symptoms, socioeconomic disadvantage, and social and material adversity were measured through questionnaires and linked to register data on neighborhood disadvantage. Data was analyzed with longitudinal and cross-sectional multilevel models. Results showed that neighborhood disadvantage, social and material adversity and gender all contributed independently to overall levels of symptoms across the life course. Cross-sectional analyses also suggested that the impact of disadvantage differed between life course periods; neighborhood disadvantage was most important in young adulthood, and the relative importance of material versus social adversity increased as participants grew older. In summary, the study suggests that disadvantages from different contextual sources may affect functional somatic health across the life course, but also through life course specific patterns.

Highlights

It is well-known that a plethora of burdening socioeconomic, psychosocial and material living conditions impacts on health
Socioeconomic disadvantage was related to higher functional somatic symptoms (FSS) at all periods except at age 16, while both social and material adversity were positively associated to FSS at all surveys
Neighborhood disadvantage showed a positive relationship to FSS over the life course, with one SD increase in ND corresponding to 0.11 SD increase in FSS (Model 2)

Summary

Introduction

It is well-known that a plethora of burdening socioeconomic, psychosocial and material living conditions impacts on health. The substantial heterogeneity of studies, each one limited to a restricted period of the life course, hampers any inferences about developmental variability in effect; e.g. whether the neighborhood represents a more important context in early or later life. As Sampson et al [16] point out, the neighborhood boundaries can represent a spatial restriction for at least young children’s daily routines, which could mean that the neighborhood context is relevant for the well-being of children compared to later in life [8].

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