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Advanced Inequalities in Child and Adolescent Health and Well-being

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (30 September 2019) | Viewed by 91691

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Guest Editor
Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
Interests: social pediatrics; basic epidemiology; biostatistics; health, well-being and health behaviour in children and adolescents; health inequality
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Special Issue Information

Dear Colleagues,

Inequalities in health and well-being are established early enough in life that they can already be observed among children and adolescents. Young people may be particularly vulnerable to the health-impairing effects of inequity as they are unlikely to possess or control much of the wealth or power held by society. A growing body of research over the last decades shows that children and adolescents who live in disadvantaged circumstances are more prone to illness, distress, disability, risk behaviours and lower well-being than those living in more advantaged circumstances. Evidence from around the world points to an increase in gaps in health status and health care by socioeconomic status, geographical location, gender, race, ethnicity and age group. Inequalities in young people health are likely to persist into adulthood. On the other hand, children and adolescents are among the most important population groups to target for health promotion and protection. The issue of health inequality with the focus on children and adolescents is now firmly set at the centre of the national and global health policy agenda. Therefore, the aim of this Special Issue is to highlight where inequalities exist in aspects of young people's health and well-being to inform and influence policy and practice and to contribute to health improvement for all young people. This fits with the development of an equity-oriented strategy for child and adolescent health, as expressed in the WHO European strategy for child and adolescent health and development.

This Special Issue is open to any research in the area of inequalities in child and adolescent health and well-being, encompassing gender, age, socioeconomic, cross-national and other dimensions of health differentials.

Prof. Dr. habil. Apolinaras Zaborskis
Guest Editor

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Keywords

  • children
  • adolescents
  • health
  • health behaviour
  • quality of life
  • well-being
  • inequality
  • social gradient
  • measures and indicators of inequality
  • monitoring and control of inequality

Published Papers (15 papers)

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Research

15 pages, 352 KiB  
Article
Social Determinants of Health, the Family, and Children’s Personal Hygiene: A Comparative Study
by Antonio Jesús Ramos-Morcillo, Francisco José Moreno-Martínez, Ana María Hernández Susarte, César Hueso-Montoro and María Ruzafa-Martínez
Int. J. Environ. Res. Public Health 2019, 16(23), 4713; https://doi.org/10.3390/ijerph16234713 - 26 Nov 2019
Cited by 9 | Viewed by 4810
Abstract
Habits of personal hygiene are mostly acquired during childhood, and are, therefore, influenced by one’s family. Poor hygiene habits are a risk factor for preventable disease and social rejection. Social Determinants of Health (SDH) consist of contextual factors, structural mechanisms, and the individual’s [...] Read more.
Habits of personal hygiene are mostly acquired during childhood, and are, therefore, influenced by one’s family. Poor hygiene habits are a risk factor for preventable disease and social rejection. Social Determinants of Health (SDH) consist of contextual factors, structural mechanisms, and the individual’s socioeconomic position, which, via intermediary determinants, result in inequities of health and well–being. Dysfunctional family situations may, therefore, be generated by an unequal distribution of factors determining SDH. Little attention has been paid to the influence of the family on personal hygiene and the perception of social rejection in children. We designed a study to examine differences in personal hygiene and in the perception of social rejection between children in reception centers and children living in a family setting. A validated questionnaire on children’s personal hygiene habits was completed by 51 children in reception centers and 454 children in normal families. Hygiene habits were more deficient among the children in reception centers than among the other children in all dimensions studied. Deficient hygiene habits were observed in the offspring of families affected by the main features of social inequality, who were more likely to perceive social rejection for this reason and less likely to consider their family as the greatest influence on their personal hygiene practices. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
18 pages, 748 KiB  
Article
Adolescent Socioeconomic Status and Mental Health Inequalities in the Netherlands, 2001–2017
by Dominic Weinberg, Gonneke W. J. M. Stevens, Elisa L. Duinhof and Catrin Finkenauer
Int. J. Environ. Res. Public Health 2019, 16(19), 3605; https://doi.org/10.3390/ijerph16193605 - 26 Sep 2019
Cited by 43 | Viewed by 8810
Abstract
Even in wealthy countries there are substantial socioeconomic inequalities in adolescent mental health. Socioeconomic status (SES) indicators—parental SES, adolescent subjective SES and adolescent educational level—are negatively associated with adolescent mental health problems, but little is known about the interplay between these SES indicators [...] Read more.
Even in wealthy countries there are substantial socioeconomic inequalities in adolescent mental health. Socioeconomic status (SES) indicators—parental SES, adolescent subjective SES and adolescent educational level—are negatively associated with adolescent mental health problems, but little is known about the interplay between these SES indicators and whether associations have changed over time. Using data from the Dutch Health Behaviour in School-Aged Children (HBSC) studies (n = 27,020) between 2001 and 2017, we examined associations between three SES indicators and six indicators of adolescent mental health problems. Linear regressions revealed that adolescent subjective SES and adolescent educational level were independently negatively associated with adolescent mental health problems and positively associated with adolescent life satisfaction, but parental SES had negligible independent associations with adolescent mental health problems and life satisfaction. However, when interactions between SES indicators were considered, high adolescent subjective SES was shown to buffer the negative association between parental SES and adolescent mental health problems and the positive association between parental SES and life satisfaction. Despite societal changes between 2001 and 2017, socioeconomic inequalities in adolescent mental health were stable during this period. Findings suggest that all three SES indicators—parental SES, adolescent subjective SES and adolescent educational level—are important for studying socioeconomic inequalities in adolescent mental health. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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18 pages, 1087 KiB  
Article
Subjective Emotional Well-Being, Emotional Intelligence, and Mood of Gifted vs. Unidentified Students: A Relationship Model
by Ana María Casino-García, Josefa García-Pérez and Lucía Inmaculada Llinares-Insa
Int. J. Environ. Res. Public Health 2019, 16(18), 3266; https://doi.org/10.3390/ijerph16183266 - 05 Sep 2019
Cited by 20 | Viewed by 7114
Abstract
Subjective well-being (SWB) is a basic component of the health of children and adolescents. Studies of SWB in gifted students are scarce and show contradictory results. Some researchers consider these groups to be vulnerable, and according to some reports they are more often [...] Read more.
Subjective well-being (SWB) is a basic component of the health of children and adolescents. Studies of SWB in gifted students are scarce and show contradictory results. Some researchers consider these groups to be vulnerable, and according to some reports they are more often involved in situations of harassment as victims and/or harassers. Emotional intelligence (EI) is related to SWB and can be a protective factor in these situations. However, the underlying mechanism remains relatively unexplored, especially in the affective dimension of SWB. The present study develops and tests a model for the mediating role of mood in the relationship between EI and SWB. The participants were 273 Spanish students aged 8 to 18 years, distributed into two samples: sample 1, gifted students, and sample 2, unidentified students. The results showed that (1) gifted students exhibited lower scores in EI (specifically, in clarity) and SWB (specifically, in positive experiences) and higher scores on the sadness dimension of mood states and that (2) EI was positively related to SWB, and mood was a significant mediator in the relationship between EI and SWB. The mediating role of the positive mood is given in both groups; however, the negative mood only mediates this relationship in gifted students. The results are discussed, theoretical and practical contributions to the literature are proposed, and implications for parents and teachers are suggested. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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12 pages, 1216 KiB  
Article
Correlates of School Children’s Handwashing: A Study in Tibetan Primary Schools
by Chang Sun, Qingzhi Wang, Sasmita Poudel Adhikari, Ruixue Ye, Sha Meng, Yuju Wu, Yuping Mao, Hein Raat and Huan Zhou
Int. J. Environ. Res. Public Health 2019, 16(17), 3217; https://doi.org/10.3390/ijerph16173217 - 03 Sep 2019
Cited by 7 | Viewed by 4582
Abstract
Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, [...] Read more.
Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, Qinghai, China). The theory of reasoned action (TRA) was applied. Data was collected by questionnaire. Structural equation modeling (SEM) analysis showed that students’ attitude (β = 0.22, 95% CI 0.13–0.31) and subjective norms in terms of compliance to teachers’, parents’ and peers’ suggestions to wash hands (β = 0.09, 95% CI 0.01–0.18) were directly associated with students’ handwashing behavior. Students’ knowledge (β = 0.04, 95% CI 0.03–0.07) had an indirect association with handwashing behavior, mediated by students’ attitudes and subjective norms. Subjective norms (β = 0.12, 95% CI 0.07–0.17) were also indirectly correlated with handwashing through students’ attitudes. Therefore, our study supported the theory of reasoned action through our findings that students’ attitude and knowledge, and also attitudes from teachers, parents and peers were correlated with student handwashing behavior. Students reported higher level of compliance to teachers than to their parents and classmates. Based on this information, we recommend teacher-involved participatory hygiene education to promote students’ handwashing behaviors in areas at high risk for infectious diseases that can be prevented by handwashing. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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11 pages, 664 KiB  
Article
Adolescents’ Psychological Consequences and Cyber Victimization: The Moderation of School-Belongingness and Ethnicity
by Michelle F. Wright and Sebastian Wachs
Int. J. Environ. Res. Public Health 2019, 16(14), 2493; https://doi.org/10.3390/ijerph16142493 - 12 Jul 2019
Cited by 29 | Viewed by 4226
Abstract
Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating [...] Read more.
Cyber victimization research reveals various personal and contextual correlations and negative consequences associated with this experience. Despite increasing attention on cyber victimization, few studies have examined such experiences among ethnic minority adolescents. The purpose of the present study was to examine the moderating effect of ethnicity in the longitudinal associations among cyber victimization, school-belongingness, and psychological consequences (i.e., depression, loneliness, anxiety). These associations were investigated among 416 Latinx and white adolescents (46% female; M age = 13.89, SD = 0.41) from one middle school in the United States. They answered questionnaires on cyber victimization, school belongingness, depression, loneliness, and anxiety in the 7th grade (Time 1). One year later, in the 8th grade (Time 2), they completed questionnaires on depression, loneliness, and anxiety. Low levels of school-belongingness strengthened the positive relationships between cyber victimization and Time 2 depression and anxiety, especially among Latinx adolescents. The positive association between cyber victimization and Time 2 loneliness was strengthened for low levels of school-belongingness for all adolescents. These findings may indicate that cyber victimization threatens adolescents’ school-belongingness, which has implications for their emotional adjustment. Such findings underscore the importance of considering diverse populations when examining cyber victimization. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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11 pages, 615 KiB  
Article
An Empirical Investigation of Factors Affecting Perceived Quality and Well-Being of Children Using an Online Child Helpline
by Willemijn van Dolen and Charles B. Weinberg
Int. J. Environ. Res. Public Health 2019, 16(12), 2193; https://doi.org/10.3390/ijerph16122193 - 21 Jun 2019
Cited by 8 | Viewed by 2945
Abstract
Child helplines provide free, accessible, and confidential support for children suffering from issues such as violence and abuse. Helplines lack the barriers often associated with the use of many other health services; and for many children, the helpline is the first point of [...] Read more.
Child helplines provide free, accessible, and confidential support for children suffering from issues such as violence and abuse. Helplines lack the barriers often associated with the use of many other health services; and for many children, the helpline is the first point of contact with any kind of child protection and an important venue to go to in times of socio-economic distress. For instance, more children attempt to call the helpline in times of high unemployment, and relatively more of those conversations are about violence. Empirical evidence is scarce regarding how to implement online chat communication to improve quality and the child’s well-being. In this study, we focus on the impact of chat duration, number of words, and the type of support. The results show that for children seeking emotional support, a longer chat negatively influences the immediate well-being and the counsellor needs to listen (i.e., not type), as relatively more child words result in higher evaluations. We conclude that for emotional support, the counsellor should be prepared to listen carefully, but also manage the duration. However, for children chatting for instrumental support, the counsellor needs to type more to create positive perceptions of quality. Since the impact of chat share is different for children seeking emotional support (negative) versus instrumental support (positive), counsellors need to be sensitive to early indicators of the reason for the chat. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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14 pages, 643 KiB  
Article
Family Affluence Based Inequality in Oral Health-Related Quality of Life in a Population of Lithuanian Adolescents
by Apolinaras Zaborskis, Aistė Kavaliauskienė and Antanas Šidlauskas
Int. J. Environ. Res. Public Health 2019, 16(12), 2106; https://doi.org/10.3390/ijerph16122106 - 14 Jun 2019
Cited by 4 | Viewed by 2337
Abstract
Background: The social inequalities in oral health have had increasing attention in recent years. The present study aimed to explore the impact of family affluence on Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 years. Methods: The cross-sectional, population-based study [...] Read more.
Background: The social inequalities in oral health have had increasing attention in recent years. The present study aimed to explore the impact of family affluence on Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 years. Methods: The cross-sectional, population-based study included a representative sample of 881 adolescents aged 11–18 years (mean = 15.55; SD = 1.51) randomly selected from 20 schools in Lithuania. The schoolchildren completed questionnaires to evaluate their OHRQoL using a Lithuanian version of the Child Perceptions Questionnaire (CPQ). The adolescents’ family affluence was indirectly assessed by inquiring whether they possessed various modern life items. In dental examination, the severity of malocclusion was predetermined by the Index of Complexity, Outcome, and Need (ICON). The relationship among variables was examined employing the negative binomial regression and the path analysis. Results: The sum score of CPQ as a whole and the sum scores of all four domains were significantly associated with family affluence, indicating higher OHRQoL among adolescents from more affluent families. The severity of malocclusion had a significant association with emotional and social well-being domains of OHRQoL only. Conclusion: This study evidences the family affluence based inequality in OHRQoL among Lithuanian adolescents. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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18 pages, 354 KiB  
Article
School Choice at a Cost? Academic Achievement, School Satisfaction and Psychological Complaints among Students in Disadvantaged Areas of Stockholm
by Maria Granvik Saminathen, Sara B. Låftman and Bitte Modin
Int. J. Environ. Res. Public Health 2019, 16(11), 1912; https://doi.org/10.3390/ijerph16111912 - 30 May 2019
Cited by 12 | Viewed by 2947
Abstract
School choice allows students from more disadvantaged district areas in metropolitan Swedish cities to commute to more prestigious schools outside of their residential area. This study examined how such students fare compared to their peers who attend more deprived schools in their own [...] Read more.
School choice allows students from more disadvantaged district areas in metropolitan Swedish cities to commute to more prestigious schools outside of their residential area. This study examined how such students fare compared to their peers who attend more deprived schools in their own district area. Multilevel analysis was applied, estimating 2-level random intercept linear regression models based on cross-sectional survey data collected among ninth grade students in 2014 and 2016 (n = 2105). Analyses showed that students living in relatively disadvantaged district areas of Stockholm who chose to attend more prestigious schools outside of their residential area performed better academically compared to students who opted to remain at more deprived schools in their catchment area, an association that was partly mediated by school quality in terms of teacher-rated school ethos. Yet, commuting students reported lower school satisfaction and more psychological complaints than students who stayed behind, even when taking academic achievement and school ethos into account. The association with psychological complaints was partly mediated by school satisfaction. Thus, the academic gain associated with having chosen to commute from a disadvantaged area to a more prestigious school does not appear to translate into higher school satisfaction and better psychological well-being. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
9 pages, 311 KiB  
Article
The Effects of Gender and Family Wealth on Sexual Abuse of Adolescents
by Eyglo Runarsdottir, Edward Smith and Arsaell Arnarsson
Int. J. Environ. Res. Public Health 2019, 16(10), 1788; https://doi.org/10.3390/ijerph16101788 - 20 May 2019
Cited by 20 | Viewed by 5376
Abstract
Background: Sexual abuse and sexual assaults against adolescents are among the most significant threats to their health and well-being. Some studies have found poverty to be a risk factor for sexual abuse. The present study investigates the effects of gender and family affluence [...] Read more.
Background: Sexual abuse and sexual assaults against adolescents are among the most significant threats to their health and well-being. Some studies have found poverty to be a risk factor for sexual abuse. The present study investigates the effects of gender and family affluence on the prevalence of sexual abuse of 15-year-old Icelanders in the 10th grade. Methods: The study is based on data collected for the Icelandic part of the Health Behaviour in School-aged Children study in 2014. Standardized questionnaires were sent to all students in the 10th grade in Iceland, of which 3618 participated (85% of all registered students in this grade). Results: Girls were more than twice as likely to be sexually abused as boys (20.2% versus 9.1%). Adolescents perceiving their families to be less well off than others were twice as likely to report sexual abuse as those of ample or medium family affluence. However, family affluence had more effect on the prevalence of abuse in girls than in boys. Conclusion: Female gender and low socioeconomic status may independently contribute to the risk of sexual abuse. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
12 pages, 521 KiB  
Article
Emotional Intelligence and Psychological Well-Being in Adolescents
by Joan Guerra-Bustamante, Benito León-del-Barco, Rocío Yuste-Tosina, Víctor M. López-Ramos and Santiago Mendo-Lázaro
Int. J. Environ. Res. Public Health 2019, 16(10), 1720; https://doi.org/10.3390/ijerph16101720 - 16 May 2019
Cited by 71 | Viewed by 18542
Abstract
The present study aimed to analyze the association between of the dimensions of emotional intelligence (attention, clarity, and repair) and different levels of perceived happiness (low, medium, and high) in adolescents. The sample consists of 646 students in the first, second, third, and [...] Read more.
The present study aimed to analyze the association between of the dimensions of emotional intelligence (attention, clarity, and repair) and different levels of perceived happiness (low, medium, and high) in adolescents. The sample consists of 646 students in the first, second, third, and fourth years of Secondary Education, 47.5% females and 52.5% males, between 12 and 17 years of age. The instruments used were the Spanish version of the Trait Meta Mood Scale-24 Questionnaire to measure perceived emotional intelligence and the Oxford Happiness Questionnaire. Multinomial logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The results suggest that as the capacity of understanding and regulation of emotional intelligence increases, happiness also increases. Adolescence is seen as an ideal time in life to encourage the development of emotional capacities that contribute to the greater happiness of individuals. In this way, the present study stresses the need to carry out practices leading to improvements in the adolescents’ emotional intelligence and therefore increase their happiness and emotional well-being. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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21 pages, 2535 KiB  
Article
Direct and Indirect Influences of Objective Socioeconomic Position on Adolescent Health: The Mediating Roles of Subjective Socioeconomic Status and Lifestyles
by Concepción Moreno-Maldonado, Pilar Ramos, Carmen Moreno and Francisco Rivera
Int. J. Environ. Res. Public Health 2019, 16(9), 1637; https://doi.org/10.3390/ijerph16091637 - 10 May 2019
Cited by 12 | Viewed by 4083
Abstract
The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine [...] Read more.
The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine the direct and indirect contribution of objective and subjective socioeconomic factors in a broad range of health and lifestyles outcomes. The data come from a representative sample of adolescents (N = 15,340; M age = 13.69) of the Health Behavior in School-aged Children study in Spain. Structural equation modeling was used for data analysis. A global index for evaluating objective socioeconomic position predicted both health and healthy lifestyles. Subjective socioeconomic status mediated the relationship between objective socioeconomic position and health but did not have a significant effect on healthy lifestyles when objective indicators were considered. Lastly, fit indices of the multiple-mediator model—including the direct effect of objective socioeconomic position on health and its indirect effects through the subjective perception of wealth and lifestyles—explained 28.7% of global health variance. Interventions aimed at reducing the impact of health inequalities should address, in addition to material deprivation, the psychological and behavioral consequences of feeling poor. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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13 pages, 893 KiB  
Article
Socio-Economic Inequalities in Adolescent Summer Holiday Experiences, and Mental Wellbeing on Return to School: Analysis of the School Health Research Network/Health Behaviour in School-Aged Children Survey in Wales
by Kelly Morgan, G. J. Melendez-Torres, Amy Bond, Jemma Hawkins, Gillian Hewitt, Simon Murphy and Graham Moore
Int. J. Environ. Res. Public Health 2019, 16(7), 1107; https://doi.org/10.3390/ijerph16071107 - 28 Mar 2019
Cited by 31 | Viewed by 13903
Abstract
The socioeconomic inequalities found in child and adolescent mental wellbeing are increasingly acknowledged. Although interventions increasingly focus on school holidays as a critical period for intervention to reduce inequalities, no studies have modelled the role of summer holiday experiences in explaining socioeconomic inequalities [...] Read more.
The socioeconomic inequalities found in child and adolescent mental wellbeing are increasingly acknowledged. Although interventions increasingly focus on school holidays as a critical period for intervention to reduce inequalities, no studies have modelled the role of summer holiday experiences in explaining socioeconomic inequalities in wellbeing. For this study, we analysed survey data of 103,971 adolescents from 193 secondary schools in Wales, United Kingdom, which included measures of family affluence, experiences during the summer holidays (hunger, loneliness, time with friends and physical activity) and mental wellbeing and internalising symptoms on return to school. Structural equation modelling was used to analyse the data. Although family affluence retained a direct inverse association with student mental wellbeing (r = −0.04, p < 0.001), 65.2% of its association with mental wellbeing was mediated by the experiences over the summer holidays. FAS score was not directly associated with the student’s self-reports of internalising symptoms (r = 0.00, p > 0.05). Of all summer holiday experiences, the strongest mediational pathway was observed for reports of loneliness. Although more structural solutions to poverty remain essential, school holiday interventions may have significant potential for reducing socioeconomic inequalities in mental health and wellbeing on young people’s return to school through reducing loneliness, providing nutritious food and opportunities for social interaction. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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12 pages, 1448 KiB  
Article
The Global Financial Crisis and Overweight among Children of Single Parents: A Nationwide 10-Year Birth Cohort Study in Japan
by Koichiro Shiba and Naoki Kondo
Int. J. Environ. Res. Public Health 2019, 16(6), 1001; https://doi.org/10.3390/ijerph16061001 - 20 Mar 2019
Cited by 8 | Viewed by 4077
Abstract
Evidence suggests that socioeconomically disadvantaged children may experience a greater increase in overweight risk during macroeconomic downturns. We examined whether inequalities in the risk of overweight between Japanese children from single- and two-parent households increased after the 2008 global financial crisis. We used [...] Read more.
Evidence suggests that socioeconomically disadvantaged children may experience a greater increase in overweight risk during macroeconomic downturns. We examined whether inequalities in the risk of overweight between Japanese children from single- and two-parent households increased after the 2008 global financial crisis. We used data from ten waves (2001 to 2011) of a nationwide longitudinal survey following all Japanese children born within 2 weeks in 2001 (boys: n = 15,417, girls: n = 14,245). Child overweight was defined according to age- and sex-specific cut-offs for Body Mass Index (BMI). Interaction between a binary measure of crisis onset (September 2008) and single-parent status was assessed using generalized estimating equation models. Covariates included baseline household income and income loss during the crisis. Girls from single-parent households showed a greater increase in the odds of overweight after crisis onset (adjusted odds ratio (AOR), 1.23; 95% confidence interval (CI), 1.04–1.46) compared to girls from households with two parents, regardless of household financial status. A similar though statistically non-significant trend was observed among boys (AOR, 1.10; 95% CI, 0.92–1.30). Child overweight risk by single-parent status may increase during macroeconomic downturns, at least among girls. Financial aid to single-parent households may not suffice to redress this gap. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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19 pages, 1277 KiB  
Article
Do Drinking Motives Mediate the Relationship between Neighborhood Characteristics and Alcohol Use among Adolescents?
by Gina Martin, Joanna Inchley and Candace Currie
Int. J. Environ. Res. Public Health 2019, 16(5), 853; https://doi.org/10.3390/ijerph16050853 - 08 Mar 2019
Cited by 7 | Viewed by 4720
Abstract
Adolescents not only vary in their alcohol use behavior but also in their motivations for drinking. Young people living in different neighborhoods may drink for different reasons. The aims of this study were to determine if neighborhood characteristics were associated with adolescent drinking [...] Read more.
Adolescents not only vary in their alcohol use behavior but also in their motivations for drinking. Young people living in different neighborhoods may drink for different reasons. The aims of this study were to determine if neighborhood characteristics were associated with adolescent drinking motives, and whether drinking motives mediate the relationship between neighborhood context and regular alcohol use. Data from the Scottish Health Behaviours in School-aged Children 2010 survey of students in their 4th year of secondary school were used. The study included 1119 participants who had data on neighborhood characteristics and had used alcohol in the past year. Students were asked questions about the local area where they lived, their alcohol use, and their motives for drinking alcohol, based on the Drinking Motives Questionnaire Revised Short Form (DMQR-SF). Multilevel multivariable models and structural equation models were used in this study. Coping motives showed significant variation across neighborhoods. Structural equation models showed coping motives mediated the relationships between neighborhood deprivation, living in an accessible small-town, and neighborhood-level disorder with regular alcohol use. Public health policies that improve neighborhood conditions and develop adaptive strategies, aimed at improving alcohol-free methods for young people to cope better with life’s stresses, may be particularly effective in reducing inequalities in adolescent alcohol use if targeted at small towns and areas of increased deprivation. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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9 pages, 452 KiB  
Article
Rationale, Design and Methods of “Set the Rules”: A Tailored Peer-to-Peer Health Information Intervention
by Jennifer R. Warren and Brandi M. White
Int. J. Environ. Res. Public Health 2018, 15(11), 2391; https://doi.org/10.3390/ijerph15112391 - 29 Oct 2018
Cited by 4 | Viewed by 2519
Abstract
Ensuring equitable access to health information is one strategy to promote health equity for underserved communities, especially for low-income African Americans (AAs). Childcare centers are one viable site to deliver health information to address this disparity. This paper describes the methods used in [...] Read more.
Ensuring equitable access to health information is one strategy to promote health equity for underserved communities, especially for low-income African Americans (AAs). Childcare centers are one viable site to deliver health information to address this disparity. This paper describes the methods used in a community-based participatory research project with a childcare facility that aimed to reduce environmental tobacco smoke (ETS) exposure among low-income AA children. Through collaboration and multiple data collection methods, partners identified communication strategies to overcome informational barriers. These initial findings indicated a peer-to-peer health information intervention, entitled “Set the Rules”, as the best strategy to increase awareness. The goal of the intervention was to build knowledge in reducing the harms of ETS exposure. Twelve community members were trained as parent leaders for the “Set the Rules” workshops and conducted workshops with parents. Even though there were barriers interfacing with all centers, parents that attended the workshop (n = 32) found the peer-to-peer intervention novel and quite helpful and will share the information learned with others. This intervention suggests that a childcare setting is a relevant space to increase access to health information to optimize child health outcomes. More research is necessary to determine if this intervention has salience in other childcare settings and across racial/ethnic groups. Full article
(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)
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