Socioeconomic Status Adolescents Research Articles

Family Socioeconomic Status in Adolescence and Gender Identification in Emerging Adulthood

This study contributes to research exploring social factors shaping gender identification. Informed by structural symbolic interactionism, social identity theory, and Levitt’s psychosocial theory of gender, we explore how a key aspect of external social structure—adolescent family socioeconomic status—is associated with gender identification in emerging adulthood. We examine whether correlates of family socioeconomic status, including adolescent family and educational experiences and friend and high school characteristics, are associated with a cisgender, binary transgender, nonbinary, or gender unsure identification. Using data from High School Longitudinal Study of 2009 (HSLS:09), we find a positive association between adolescent family socioeconomic status and a nonbinary gender identification. Analyses indicate that educational and family experiences account for the largest percentage of the association between adolescent family socioeconomic status and nonbinary gender identification, potentially representing higher SES youths’ heightened access to middle- and upper-class cultural schemas and resources.

The Influence of Adolescent health-related Behaviors on Degenerative Low Back Pain Hospitalizations and Surgeries in Adulthood: A Longitudinal Study.

Retrospective longitudinal study. This study aims to investigate the influence of adolescent health-related behaviors (physical activity, high BMI, drunkenness, smoking), self-reported chronic disease, and low socioeconomic status (SES) on the development of low back pain requiring hospitalization or surgery. The baseline data were surveys gathered biennially in 1981-1997 (the Adolescent Health and Lifestyle Survey) and individually linked with outcome data, degenerative low back pain hospitalizations, and spine surgeries retrieved from the Care Register for Health Care. A total of 47 724 participants were included. Explanatory variables included physical activity, high BMI, smoking, monthly drunkenness, chronic diseases, and family SES. A logistic regression model was used to analyze the influence of adolescent health-related behaviors (physical activity, high BMI, drunkenness, smoking), self-reported chronic disease, and low socioeconomic status (SES) on degenerative low back pain hospitalization, lumbar disc herniation (LDH) hospitalization and/or spine surgery. Covariates were selected using directed acyclic graphs (DAGs). A total of 5538 participants had degenerative low back pain hospitalizations, 2104 had LDH hospitalizations, and 913 had spinal surgery over an average of 27-years follow-up. High BMI (aOR 1.25, CI 1.12-1.38), smoking (aOR 1.53, CI 1.43-1.62), monthly drunkenness (aOR 1.17, CI 1.10-1.26), and chronic diseases (aOR 1.47, CI 1.35-1.61) in adolescence increased the odds of hospitalizations during follow-up. In addition, high BMI (aOR 1.37, CI 1.09-1.72), smoking (aOR 1.40, CI 1.21-1.61), and monthly drunkenness (aOR 1.19, CI 1.01-1.39) increased the odds of spine surgeries. We found that smoking, high BMI, monthly drunkenness, chronic diseases, and low family SES in adolescence increased the likelihood of degenerative low back pain hospitalizations in adulthood. In addition, high BMI, smoking, and monthly drunkenness in adolescence increased the odds of spinal surgeries.

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province.

The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure.Contribution:The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth.

Health and health behaviours in adolescence as predictors of education and socioeconomic status in adulthood – a longitudinal study

BackgroundThe positive association of health with education level and socioeconomic status (SES) is well-established. Two theoretical frameworks have been delineated to understand main mechanisms leading to socioeconomic health inequalities: social causation and health selection but how these work in adolescence is poorly known. We studied if adolescent health and health behaviours predict higher education and higher SES in adulthood and if family background and school performance in adolescence explain these associations.MethodsSurveys on health and health behaviours were sent to representative samples of 12–18-year-old Finns in 1981–1997 every second year (response rate 77.8%, N = 55,682). The survey data were linked with the respondents’ and their parents’ socioeconomic data from the Finnish national registries. Both latent variables, namely, health (perceived health, health complaints, chronic disease), health-compromising behaviours (smoking status, drunkenness frequency), and family background (parents’ occupation-based SES, education, family type) and variables directly measuring health-enhancing behaviours (toothbrushing, physical activity) and school performance were used to predict higher education and higher occupation-based SES at age 34. Logistic regression analysis and structural equation models (SEM) were used.ResultsIn logistic regression analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours were related to higher education and SES, also after controlling for family background and school performance. In the SEM analyses, good health, health-enhancing behaviours, and lack of health-compromising behaviours directly predicted higher SES and higher education, although the standardised coefficients were low (from 0.034 to 0.12). In all models, health, lack of health-compromising behaviours, and health-enhancing behaviours predicted school performance, which in turn, predicted the outcomes, suggesting indirect routes to these. Good socioeconomic prospects in terms of family background predicted good health, healthy behaviours, and good school performance in adolescence and higher SES and higher education in adulthood.ConclusionHealth and health behaviours in adolescence predicted education and SES in adulthood. Even though the relationships were modest, they support the health selection hypotheses and emphasise the importance of adolescence for health inequalities during the life-course. Health and health behaviours were strongly associated with school performance and family background which together modified the paths from health and health behaviours to the outcomes.

Changes over time of fruit, vegetable and sweets consumption among European adolescents and associations with sociodemographic characteristics: an HBSC study.

European adolescents do not eat enough fruits and vegetables and have a high sweets consumption. This study aims to analyse the changes in time of dietary behaviours related to sociodemographic characteristics, among European adolescents. Health Behaviour in School Age Children data (2013/14 to 2017/18), of European adolescents, aged 11- to15-year-old, were used. Family Affluence Scale identified socioeconomic status (SES). Changes in time of dietary behaviours and associations with sociodemographic characteristics were estimated by binary and multilevel logistic regression. 182719 adolescents were included, and 10/36 European countries showed a significant increase in daily fruit and vegetable consumption and 12/36 countries a significant decrease in sweets consumption over 4years. The multilevel analysis showed that 13- and 15-year-old adolescents consumed fewer daily fruits and vegetables (P<0.001) and more daily sweets (P<0.001) than 11-year-old adolescents. Also, 15-year-old adolescents' sweets consumption change over time was less favourable (P=0.006). Girls consumed more daily fruits, vegetables and sweets than boys (P<0.001).Low SES adolescents consumed fewer daily fruits and vegetables than medium/high SES adolescents. Additionally, the low SES adolescents' vegetable consumption change over time was less favourable (P<0.001). Dietary behaviour policy recommendations should be adapted for the sex, age and SES of the population.

The impact of family socioeconomic status on depression in Chinese adolescents: A comparison of life course models

BackgroundLow socioeconomic status (SES) is a well-recognized risk factor for depression. However, the relationship between the timing of exposure to disadvantaged SES in childhood and depression in adolescence remains to be explored. We examined the differential influence of SES in early childhood, late childhood and adolescence on adolescent depression by modeling life course models. MethodsWe used longitudinal data from the China Family Panel Studies (N = 2245). SES was measured using average household income (objective SES) and maternal subjective SES and grouped into three time points: 5–8 years, 9–12 years, and 13–16 years of age. The main outcome was depression at 13–16 years of age. Structured linear regression analysis was used to predict depression by low SES over the three time periods. A partial F test was used to compare the nested life course models to the saturated model. ResultsAmong objective SES permutations, approximately 24.63 % of the adolescents had low SES in all periods, and 73.63 % had low SES in at least one period. Among subjective SES permutations, approximately 5.48 % of the adolescents had low SES in all periods, and 54.65 % had low SES in at least one period. Regardless of objective SES or subjective SES, the accumulation of risk (relaxed) model was the best-fit model. In this model, chronic low SES exposure in late childhood was the best predictor. ConclusionWe suggest that interventions targeting the late childhood period may have a practical effect on reducing depression in adolescents.

Striatal and Behavioral Responses to Reward Vary by Socioeconomic Status in Adolescents.

Disparities in socioeconomic status (SES) lead to unequal access to financial and social support. These disparities are believed to influence reward sensitivity, which in turn are hypothesized to shape how individuals respond to and pursue rewarding experiences. However, surprisingly little is known about how SES shapes reward sensitivity in adolescence. Here, we investigated how SES influenced adolescent responses to reward, both in behavior and the striatum-a brain region that is highly sensitive to reward. We examined responses to both immediate reward (tracked by phasic dopamine) and average reward rate fluctuations (tracked by tonic dopamine) as these distinct signals independently shape learning and motivation. Adolescents (n = 114; 12-14 years; 58 female) performed a gambling task during functional magnetic resonance imaging. We manipulated trial-by-trial reward and loss outcomes, leading to fluctuations between periods of reward scarcity and abundance. We found that a higher reward rate hastened behavioral responses, and increased guess switching, consistent with the idea that reward abundance increases response vigor and exploration. Moreover, immediate reward reinforced previously rewarding decisions (win-stay, lose-switch) and slowed responses (postreward pausing), particularly when rewards were scarce. Notably, lower-SES adolescents slowed down less after rare rewards than higher-SES adolescents. In the brain, striatal activations covaried with the average reward rate across time and showed greater activations during rewarding blocks. However, these striatal effects were diminished in lower-SES adolescents. These findings show that the striatum tracks reward rate fluctuations, which shape decisions and motivation. Moreover, lower SES appears to attenuate reward-driven behavioral and brain responses.

The relation between family socioeconomic status and depressive symptoms among children and adolescents in mainland China: a meta-analysis.

Family socioeconomic status (SES) is widely believed to be associated with depressive symptoms in children and adolescents. The correlation between SES and depressive symptoms changes based on social culture and the economic development level. In China, which includes many children and adolescents, the magnitude of the relationship between SES and depressive symptoms and its potential moderators remains unclear. The current meta-analysis was conducted to determine the overall association between SES and depressive symptoms in children and adolescents in mainland China. We included 197 estimates in mainland China from 2000-2023. Among 147,613 children and adolescents aged 7-18 years, the results showed a weak but significant overall negative association between SES and depression (r = -0.076). Moderator testing showed that the composite SES indicator (r = -0.104) had a stronger association with depression than parental educational level (r = -0.065) and occupational status (r = -0.025) but not family income (r = -0.088). Additionally, the negative association between SES and depression became weaker over the past 20 years in China (β = 0.010). Furthermore, the magnitude of the relationship between SES and depression was stronger in West China (r = -0.094) than in Middle China (r = -0.065), but not East China (r = -0.075). These findings indicate that the relationship between SES and depression among children and adolescents in mainland China may vary based on social contexts. It is necessary to further explore the effect of these social factors and the underlying mechanisms.

Does adult socioeconomic status mediate the relationship between adolescent socioeconomic status and adult quality of life?

This study aimed to determine the association between adolescent socioeconomic status (father's education and adolescent subjective socioeconomic status) and adult quality of life and the mediation roles of adult socioeconomic status, social capital and lifestyle (physical activity and exposure to smoke) among the "Tehran University of Medical Sciences Employees Cohort (TEC) Study" participants. Data of 4455 participants were derived from the Tehran University of Medical Sciences Employees Cohort (TEC) Study. In this study, the World Health Organization quality of life-BREF, the World Bank's Integrated and the International Physical Activity Questionnaire were used. Data were analyzed with structural equation modeling using SPSS Amos 24.0 program. The mean age of the participants was 42.31 years (SD: 8.37) and most of the subjects were female (60.7%). Correlation analysis results revealed that, quality of life had a significant and positive association with adolescent subjective socioeconomic status (r = 0.169, p < 0.01) and father's education (r = 0.091, p < 0.01). A mediation model testing the direct relationship between adolescent socioeconomic status and adult socioeconomic status and quality of life, showed a positive relationship between adolescent subjective socioeconomic status (β = 0.229, p < 0.001) and father's education (β = 0.443, p < 0.001) with adult socioeconomic status. Adult socioeconomic status was positively related to quality of life (β = 0.205, p < 0.001). Adult socioeconomic status mediated the relationship between adolescent subjective socioeconomic status (β = 0.047, p < 0.01) and father's education (β = 0.091, p < 0.01) with quality of life. While adult socioeconomic status fully mediated the relationship between the father's education and quality of life, it partially mediated the adolescent subjective socioeconomic status-quality of life association. Other variables such as social capital and lifestyle did not have mediator role in a mediation model. This study provides the evidence for the role of adult socioeconomic status as a partial mediator between adolescent subjective socioeconomic status and quality of life. Therefore, there are several unknown mediators other than adult socioeconomic status that need to be explored in future studies.

Communication and Social Determinants of Cancer Preventive Behaviors in Adolescents From Low Socio-Economic Backgrounds in India: A Cross-Sectional Study.

Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.

The international Family Affluence Scale (FAS): Charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities

In the absence of suitable indicators of adolescent socioeconomic status, the Family Affluence Scale (FAS) was first developed in Scotland 25 years ago. Since then, it has been adapted for use in the Health Behaviour in School-Aged Children (HBSC) Study to research inequalities in adolescent health in Europe and North America. FAS has also been used as an indicator of adolescent socioeconomic status in research studies outside of HBSC, worldwide. There has been a need for FAS to evolve and change its component items over time in order to take into account social and technological changes influencing the families of adolescents. This paper uniquely charts the development of FAS describing the methodological work carried out to validate the measure internationally and over time. It also presents an overview of the body of evidence on adolescent health inequalities produced over years from the HBSC Study and other research studies. Interviews conducted with policy stakeholders reveal that the evidence from FAS-related HBSC work has influenced their strategic work to raise awareness of inequalities and make the case for action to address these. Finally, the future of FAS is discussed with respect to its continual evolution in the context of technological, environmental and social change.

Adolescent Hazardous Drinking and Socioeconomic Status in France: Insights Into the Alcohol Harm Paradox

PurposeThe “alcohol harm paradox” has been evidenced among adults, but it is still largely unexplored among adolescents. We examined in a sample of French adolescents the relation between family socioeconomic status (SES), family living arrangement and parental substance use on 1 hand, and heavy episodic drinking (HED), lifetime alcohol-induced emergency room visits (A-ERV), and number of alcoholic drinks and solitary drinking during the last episode on the other hand. MethodsA cross-sectional nationwide survey in March 2017 involved 13,314 French adolescents aged 17–18.5 years. They completed a pen and paper questionnaire about their own and their parents’ alcohol and tobacco consumption. We used risk ratios (RRs) from modified Poisson regressions to assess the relationships. ResultsAdolescents from the lowest SES had reduced likelihood of reporting 1–2 or 3–5 episodes of heavy drinking compared to those from the highest SES (RR = 0.58, 95% confidence interval = [0.50; 0.66] and 0.35 [0.27; 0.45]), but no difference for six or more episodes (RR = 0.81 [0.59; 1.12]). A-ERV was more frequent among lowest SES adolescents (RR = 1.86 [1.05; 3.30]), possibly due to drinking larger quantities of alcohol and to more frequent solitary drinking in their last episode (p < .001). SES, parental substance use, and family living arrangement were independently associated with HED. DiscussionOur findings reveal an “alcohol harm paradox” in late adolescence in France. Lower SES adolescents exhibit reduced HED but were more likely to consume large quantities alone and experience A-ERV. This emphasizes the significance of considering social determinants in alcohol-related research and interventions.

Supplemental Material for Peer Support as Moderator of Association Between Socioeconomic Status and Low-Grade Inflammation in Adolescents

Supplemental Material for Peer Support as Moderator of Association Between Socioeconomic Status and Low-Grade Inflammation in Adolescents

The Implications of the COVID-19 Pandemic for the Construction of the Family Affluence Scale: Findings from 16 Countries

The Family Affluence Scale (FAS) is a widely used and validated instrument to measure adolescents’ socioeconomic status (SES). It is plausible that the COVID-19 pandemic and resulting social and economic changes have affected the capacity of the six-item FAS-III to measure adolescent SES, particularly the holiday and computer items. Using data from 247,503 adolescents from 16 European countries participating in the Health Behaviour in School-aged Children (HBSC) study before (2013/14 and 2017/18) and during (2021/22) the pandemic, the present study aims to fill this gap. Findings showed that although the internal consistency of the scale decreased during the pandemic, related to the functioning of the computer and especially the holiday item, it was still acceptable in all countries. Furthermore, measurement invariance analysis showed that during the pandemic the item thresholds of the computer and particularly the holiday item deviated from the thresholds of these items before the pandemic. However, all item factor loadings were comparable to the factor loadings before the pandemic. In addition, during the pandemic the computer and holiday item and their correlations with health-related outcomes were mostly still in the expected direction. Removing these items from the scale yielded comparable or decreased scale criterion validity as compared to the original FAS-III scale in most countries. These findings inform future research that although mean differences in family affluence levels before and during the pandemic should be interpreted with caution, it is a suitable tool to study (changes in) socioeconomic health inequalities among adolescents during the pandemic.

Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study

BackgroundSocioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called “alcohol harm paradox” (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible “smoking harm paradox” (SHP). We aim to fill this gap.MethodsWe conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report.ResultsOverall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income.ConclusionsWhile our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking.

The role of psychological flexibility and socioeconomic status in adolescent identity development

This study examined the roles of psychological flexibility and socioeconomic status (SES) in adolescents' identity development during the transition from lower secondary school to upper secondary education. Psychological flexibility was measured using the Avoidance and Fusion Questionnaire (AFQ-8; Greco et al., 2008) and identity processes were measured with the Dimensions of Identity Development Scale (DIDS; Luyckx et al., 2008). SES was assessed using the educational level of the highest-educated parent. The sample comprised 885 adolescents who answered surveys in Grade 9, as well as in the first and third year of upper secondary education. The results showed, first, that psychological flexibility was both concurrently and prospectively related to adolescents' identity formation (exploration in breadth and commitment making) as well as to their identity evaluation (exploration in depth, identification with commitment, ruminative exploration) processes. Second, the higher SES adolescents had, the more they had exploration in breadth and exploration in depth in the first year of upper secondary education. Thirdly, associations of psychological flexibility with commitment making and identification with commitments were stronger for adolescents with a higher SES than for adolescents with lower SES. The results suggest that psychological flexibility may play a key role in adolescents’ identity development during critical educational transitions.

Socioeconomic Status, Protective Factors, and Mental Health Problems in Transition from Adolescence to Emerging Adulthood: Results of the Longitudinal BELLA Study.

Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.

Mathematics learning gap during pandemic among early adolescents: Roles of own aspiration and parental involvement

The Covid-19 Pandemic has affected school learning broadly, and particularly for students from low socioeconomic status families. The present study aimed to quantify the heterogeneous learning loss in mathematical learning due to the pandemic, and more importantly, to understand whether parents' involvement or adolescents' aspiration is more responsible for the learning gap. Using the Propensity Score Matching method, 678 adolescents aged 10–15 in China were selected from the 2016 and 2020 China Family Panel Study database (339 for each year) and controlled for demographic variables, educational aspirations, family socioeconomic status (SES) and parental involvement. The results showed that during the pandemic, (1) learning loss in mathematical reasoning skill was about 12 % among Chinese adolescents, and the loss was more significant for low SES adolescents (20 %) than high SES adolescents (8 %); and (2) adolescents' educational aspiration directly mediated the association between SES and mathematical reasoning skill, whereas parents' involvement in academics only had an indirect effect through aspiration. Findings implies that facilitating adolescents' educational aspiration can be a more effective strategy to buffer the pandemic-induced mathematics learning loss. Thus, parents, especially those from low SES families, are advised to facilitate adolescents' aspiration than simply involving in adolescents' learning.

Pattern and Socio-demographic characteristics of Drug Users at the National Drug Law Enforcement Agency (NDLEA) Rehabilitation Facility, Port Harcourt

Background: Substance abuse particularly among young people has become a large phenomenon globally affecting all segments of society. The abuse of alcohol, tobacco, cannabis and other psychoactive drugs among young people has become an issue of public health concern with untold negative consequences on human existence. Aim: This study sought to examine the sociodemographic profiles and patterns of drug use among drug users at the NDLEA Rehabilitation Facility, Port Harcourt. Materials and Methods: This was a descriptive cross-sectional study conducted among inmates of the National Drug Law Enforcement Agency (NDLEA), Port Harcourt. A structured questionnaire covering socio-demographic characteristics and other factors were self-administered to inmates of the facility, who have been brought by their relative for addiction care over a period of 3 years (2017 to 2020). Ethical approval was obtained from the ethical committee of the University of Port Harcourt Teaching Hospital and approval was obtained from the NDLEA Authority. All other ethical provisions were followed. Descriptive statistics was used to analyzed the data. Data were analyzed with number count, percentage, and then Chi-square of independence. Results: Majority of the drug users were male (98,8%), single (72.5%), unemployed (27.5%) and apprentice (40.0%), between the ages of 15 and 35 (67.5%) and with tertiary education. Cannabis was the most consumed drug (75.7%), followed by nicotine (30.8%) alcohol (28.3%), cocaine (27.4%) and heroine (25.8%). Majority of the users were introduced to drug by friends and family members and referred to the feeling they got on the first day of use as high and happy. Majority had 15 to 25 years as age of onset of drug use and there were no family history of psychoactive substance use or mental illness. Conclusion: Substance use is common among young people between the ages of 26 and 30, single, with higher level of education and low-income earners. Majority use illicit drugs, which they started at early age of 15 to 25 and introduced to by friends and family members. Improvement in socio-economic status of adolescents and sustained public health enlightenment will help to reduce the rising prevalence of drug use.

Lower socio-economicstatus in adolescence is associated with poor oral health at an older age: Mediation by social and behavioural factors.

To examine the mediators between lower socio-economic status (SES) in adolescence and oral health at an older age to uncover the underlying mechanisms of the association. Participants (n = 21 536) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated. The dependent variables were self-rated chewing difficulty and having ≤19 remaining teeth. The main independent variable was self-perceived SES in adolescence. The Karlson-Holm-Breen method was used for mediation analysis. Mean age of the participants was 74.8 years (standard deviation = 6.4), and 51.5% were female. Overall, 5598 (26.0%) participants reported chewing difficulty and 9404 (43.7%) had ≤19 remaining teeth. Lower SES in adolescence was associated with a higher prevalence of chewing difficulty (odds ratio [OR] = 1.38, 95%confidence interval [CI] = 1.29-1.48; total effect). After controlling for mediators, OR for lower SES in adolescence was 1.22 (95%CI = 1.13-1.30; direct effect) and 1.13 (95%CI = 1.11-1.16; indirect effect). Mediators, prominently the number of teeth and income, explained 39.3% of the associations. Lower SES in adolescence increased the odds of ≤19 remaining teeth by OR = 1.23 (95% CI = 1.16-1.31; total effect). After controlling for mediators, the OR for lower SES in adolescence was 1.03 (95%CI = 0.97-1.10; direct effect) and 1.19 (95%CI = 1.16-1.23; indirect effect). Mediators, prominently educational attainment, explained 85.0% of the associations. Lower SES in adolescence was associated with poor oral health at an older age through mediators. Approaches that consider social determinants from the beginning of the life course are required.