Publications

International studies of inequalities in adolescent health tend to focus on the socio-economic gradient in average outcomes rather than their dispersion within countries. Although understanding the extent to which differences in health are related to socio-economic disadvantage is important, focusing exclusively on socio-economic status risks neglecting differences in the distribution of health outcomes within and between countries. To fill this research gap, this study analyses variation in the extent of inequality in the lower half of the distribution in five indicators of adolescent health and well-being – health symptoms, physical activity, healthy eating, unhealthy eating, and life satisfaction – across EU and/or OECD countries that took part in the latest cycle of the Health Behaviour in School-aged Children study.

A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.