Health inequalities among Slovak adolescents over time

PhD ceremony: Mr. F. Salonna, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Health inequalities among Slovak adolescents over time

Promotor(s): prof. S.A. Reijneveld, prof. J.W. Groothoff

Faculty: Medical Sciences

This study contributes to our understanding of socioeconomic inequalities in adolescence. Firstly, we evaluated changes in self-rated health (SRH) in a cohort of 15-year-old adolescents in Slovakia who were followed up to the age of 19; we then evaluated the socioeconomic differences in changes of SRH in the same cohort. We identified not only deterioration but also improvement and stability in SRH. Socioeconomic differences in the SRH of 15-year-old males were shallow and remained stable up to age 19, while the traditional gradient of socioeconomic differences (low socioeconomic status – poor health outcomes) in SRH among females became more distinct from age 15 to 19. Thirdly, we assessed the differences in socioeconomic inequalities in SRH among cohorts of Slovak adolescents in 1998 and in 2006. Traditional socioeconomic gradients in SRH were found in both males and females in 1998 and 2006, although these were more visible for females. We found a trend of decreasing indexes of dissimilarity from 1998 to 2006, i.e., socioeconomic gradients in SRH decreased. We also explored how changes in health-related behaviours affect a cohort of 15-year-old adolescents up to the age 19. Unhealthy health-related behaviour increased during adolescence. Changes in socioeconomic differences in health-related behaviour were more apparent among females. Finally, we assessed whether social support from mother, father and friends mediates or moderates socioeconomic differences in SRH among adolescents. While the importance of social support from the mother is often emphasised in stressful life situations, paternal involvement also seems to have the potential to mediate socioeconomic differences in health.