Download PDF
Klin Padiatr 2015; 227(04): 193-198
DOI: 10.1055/s-0035-1549976
Review
© Georg Thieme Verlag KG Stuttgart · New York

The Social Dimension of Adolescent Health: Challenges for Paediatric Research and Practice

Die soziale Dimension der Gesundheit in der Adoleszenz: Herausforderungen für die pädiatrische Foschung und Praxis
M. Richter
1   Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Halle, Germany
,
D. Körholz
2   Department of Pediatrics, Martin Luther University Medical Center, Halle, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
12 June 2015 (online)

Also available at
    Permissions and Reprints

Abstract

Innumerable studies have shown that socioeconomic inequalities have a serious impact on mortality and morbidity. Disease and premature mortality are thus embodied expressions of the conditions under which we live and work. The increasing discussion of adolescence as an independent stage of life has generated a growth of interest in the social determinants of young people’s health. The review outlines that a large part of the prevailing diseases in adolescence are strongly influenced by social, economic and political determinants and analyses which determinants and mechanisms are responsible that social inequalities get under the skin and cause adverse health. Paediatrics offers a central interdisciplinary link between the natural and social sciences to better understand how we biologically incorporate our lived experience and thus create social patterns of health and illness not only in societies but also between societies. Such research could contribute to further sensitise clinical and therapeutic practice on the social determinants of health and to integrate them in daily routine processes, such as anamnesis and therapy.

Zusammenfassung

Unzählige Studien haben aufzeigen können, dass soziale Ungleichheiten einen gravierenden Einfluss auf die Mortalität und Morbidität ausüben. Krankheit und frühzeitige Sterblichkeit sind damit verkörperte Expressionen der Bedingungen, unter denen wir leben. Im Zuge des steigenden Interesses an der Lebensphase „Adoleszenz“ ist auch die Bedeutung sozialer Determinanten für die gesundheitliche Lage der Heranwachsenden in den Fokus der wissenschaftliche Auseinandersetzung geraten. Der Beitrag skizziert, dass ein großer Teil der aktuell vorherrschenden Krankheiten in der Adoleszenz maßgeblich durch soziale, ökonomische und politische Faktoren beeinflusst wird und geht der Frage nach, welche Determinanten und Mechanismen dafür verantwortlich sind, dass soziale Ungleichheiten unter die Haut kommen und krank machen. Die Kinder- und Jugendmedizin bietet eine interdisziplinäre Schnittmenge zwischen Natur- und Sozialwissenschaften, um besser als bislang die Prozesse und Einflüsse zu verstehen, wie wir unsere gelebte Erfahrung biologisch verkörpern und so gesellschaftliche Muster der Verteilung von Gesundheit und Krankheit sowohl innerhalb als auch zwischen Gesellschaften generieren. Eine derartig ausgerichtete Forschung kann auch dazu beitragen, die klinische und therapeutische Praxis stärker als bislang für soziale Faktoren zu sensibilisieren und sie stärker in den Anamneseprozess und Therapiealltag zu integrieren.

Key words

adolescence - social inequalities - socioeconomic position - explanation - health - risk behavior

Schlüsselwörter

Adoleszenz - Soziale Ungleichheiten - Sozialer Status - Erklärung - Gesundheit - Risikoverhalten
 

  • References

  • 1 Bergström E, Hernell O, Persson LA. Cardiovascular risk indicators cluster in girls from families of low socio-economic status. Acta Paediatr 1996; 85: 1083-1090
    CrossrefPubMedGoogle Scholar
  • 2 Bleich SN, Jarlenski MP, Bell CN et al. Health inequalities. trends, progress, and policy. Annu Rev of Public Health 2012; 33: 7-40
    PubMedGoogle Scholar
  • 3 Blum RW, Bastos Francisco IPM. et al. Adolescent health in the 21st century. Lancet 2012; 379: 1567-1568
    CrossrefPubMedGoogle Scholar
  • 4 Borgers D, Steinkamp G. Sozialepidemiologie – Gesundheitsforschung zu Krankheit, Sozialstruktur und gesundheitsrelevanter Handlungsfähigkeit. In: Schwenkmezger P, Schmidt LR, Borgers D. (Eds.) Lehrbuch der Gesundheitspsychologie. 18 Tabellen. Enke, Stuttgart: 1994
    Google Scholar
  • 5 Borghol N, Suderman M, McArdle W et al. Associations with early-life socio-economic position in adult DNA methylation. Int J Epidemiol 2012; 41: 62-74
    CrossrefPubMedGoogle Scholar
  • 6 Brunner EJ, Marmot MG. Social organization, stress, and health. In: Marmot MG, Wilkinson RG. (Eds.) Social determinants of health. Oxford University Press; Oxford: 2006
    Google Scholar
  • 7 Chen E, Martin AD, Matthews KA. Socioeconomic status and health. Do gradients differ within childhood and adolescence?. Soc Sci Med 2006; 62: 2161-2170
    CrossrefPubMedGoogle Scholar
  • 8 Chen E, Matthews KA, Boyce WT. Socioeconomic differences in children’s health. how and why do these relationships change with age?. Psychol Bull 2002; 128: 295-329
    CrossrefPubMedGoogle Scholar
  • 9 CSDH WH. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO; 2008
    Google Scholar
  • 10 Currie C, Nic Gabhainn S, Godeau E et al. Inequalities in Young People’s Health. HBSC International Report from the 2005/2006 Survey. World Health Organization (WHO); Copenhagen: 2008
    Google Scholar
  • 11 Currie C, Zanotti C, Morgan A et al. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study. international report from the 2009/2010 survey. Health Policy for Children and Adolescents, No. 6. WHO Regional Office for Europe; Copenhagen: 2012
    Google Scholar
  • 12 Denny K, Brownell M. Taking a social determinants perspective on children’s health and development. Can J Public Health 2010; 101 (Suppl. 03) S4-S7
    PubMedGoogle Scholar
  • 13 Diderichsen F, Andersen I, Manuel C et al. Health inequality–determinants and policies. Scand J Public Health 2012; 40: 12-105
    CrossrefPubMedGoogle Scholar
  • 14 Diez-Roux AV. Conceptual approaches to the study of health disparities. Annu Rev of Public Health 2012; 33: 41-58
    PubMedGoogle Scholar
  • 15 Dowler E, Spencer N. Challenging health inequalities. From Acheson to ‚choosing health‘. Policy Press; Bristol: 2007
    Google Scholar
  • 16 Due P, Krølner R, Rasmussen M et al. Pathways and mechanisms in adolescence contribute to adult health inequalities. Scand J Public Health 2011; 39: 62-78
    PubMedGoogle Scholar
  • 17 Elo IT. Social Class Differentials in Health and Mortality: Patterns and Explanations in Comparative Perspective. Annu Rev Sociol 2009; 35: 553-572
    CrossrefPubMedGoogle Scholar
  • 18 Frederick CB, Snellman K, Putnam RD. Increasing socioeconomic disparities in adolescent obesity. Proc Natl Acad Sci USA. 2014; 111: 1338-1342
    CrossrefPubMedGoogle Scholar
  • 19 Geyer S. Manifestation, Erklärung und Reduzierung gesundheitlicher Ungleichheiten. Ethik Med 2010; 22: 249-262
    CrossrefPubMedGoogle Scholar
  • 20 Geyer S, Peter R. Unfallbedingte Krankenhausaufnahmen von Kindern und Jugendlichen in Abhängigkeit von ihrem sozialen Status–Befunde mit Daten einer nordrhein-westfälischen AOK. Gesundheitswesen 1998; 60: 493-499
    PubMedGoogle Scholar
  • 21 Gissler M, Rahkonen O, Järvelin MR et al. Social class differences in health until the age of seven years among the Finnish 1987 birth cohort. Soc Sci Med 1998; 46: 1543-1552
    CrossrefPubMedGoogle Scholar
  • 22 Goodman E, Huang B. Socioeconomic status, depressive symptoms, and adolescent substance use. Archives of pediatrics & adolescent medicine 2002; 156: 448-453
    CrossrefPubMedGoogle Scholar
  • 23 Gore FM, Bloem Paul JN. et al. Global burden of disease in young people aged 10-24 years: a systematic analysis. Lancet 2011; 377: 2093-2102
    CrossrefPubMedGoogle Scholar
  • 24 Hagquist CE. Health inequalities among adolescents. the impact of academic orientation and parents’ education. Eur J Public Health 2007; 17: 21-26
    CrossrefPubMedGoogle Scholar
  • 25 Halfon N. Socioeconomic influences on child health: building new ladders of social opportunity. JAMA 2014; 311: 915-917
    CrossrefPubMedGoogle Scholar
  • 26 Hanson MD, Chen E. Socioeconomic status and health behaviors in adolescence. A review of the literature. J Behav Med 2007; 30: 263-285
    CrossrefPubMedGoogle Scholar
  • 27 Holstein BE, Currie C, Boyce WT et al. Socio-economic inequality in multiple health complaints among adolescents. International comparative study in 37 countries. Int J Public Health 2009; 54: 260-270
    PubMedGoogle Scholar
  • 28 Koivusilta LK, Rimpela AH, Kautiainen SM. Health inequality in adolescence. Does stratification occur by familial social background, family affluence, or personal social position?. BMC public health 2006; 6: 110
    CrossrefPubMedGoogle Scholar
  • 29 Krieger N. Epidemiology and the people’s health. Theory and context. Oxford University Press; New York: 2012
    Google Scholar
  • 30 Kroll LE, Lampert T. Soziale Unterschiede in der Lebenserwartung. Datenquellen in Deutschland und Analysemöglichkeiten des SOEP=Socio-economic differences in life expectancy. MDA 2009; 3: 3-30
    PubMedGoogle Scholar
  • 31 Laflamme L, Engström K, Huisman M. Is there equalisation in socioeconomic differences in the risk of traffic injuries in childhood? A study of three cohorts of Swedish school children. Int J Adolesc Med Health 2004; 16: 253-263
    PubMedGoogle Scholar
  • 32 Lampert T, Kroll LE. Armut und Gesundheit. GBE kompakt 5/2010. www.rki.de/gbe-kompakt (Stand: 01.12.2010) 2010
    PubMedGoogle Scholar
  • 33 Lampert T, Kroll LE, Kuntz B et al. Gesundheitliche Ungleichheit. WZB, Destatis 2011
    PubMedGoogle Scholar
  • 34 Lampert T, Kurth B. Sozialer Status und Gesundheit von Kindern und Jugendlichen. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS). Deutsches Ärzteblatt 2007; 43: 2944-2949
    PubMedGoogle Scholar
  • 35 Lampert T, Richter M. Gesundheitliche Ungleichheit bei Kindern und Jugendlichen. In: Richter M, Hurrelmann K. (Eds.) Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven. VS Verlag für Sozialwissenschaften; Wiesbaden: 2009
    CrossrefGoogle Scholar
  • 36 Law C. Mother, fetus, infant and family. socio-economic inequalities. In: Gordon D, Shaw M, Dorling D, et al (Eds.) Inequalities in Health – the evidence. Polity Press; Bristol: 1999
    Google Scholar
  • 37 Levin KA, Currie C, Muldoon J. Mental well-being and subjective health of 11- to 15-year-old boys and girls in Scotland, 1994-2006. Eur J Public Health 2009; 19: 605-610
    CrossrefPubMedGoogle Scholar
  • 38 Loi M, Del Savio L, Stupka E. Social Epigenetics and Equality of Opportunity. Public Health Ethics 2013; 6: 142-153
    CrossrefPubMedGoogle Scholar
  • 39 Mackenbach JP. Health inequalities: Europe in Profile. An independent expert report commissioned by the UK presidency of the EU. Department of Health; London: 2006
    Google Scholar
  • 40 Mackenbach JP, Stirbu I, Roskam AR et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med 2008; 358: 2468-2481
    CrossrefPubMedGoogle Scholar
  • 41 Marmot M, Allen JJ. Social determinants of health equity. Am J Public Health 2014; 104 (Suppl. 04) S517-S519
    CrossrefPubMedGoogle Scholar
  • 42 Marmot MG, Wilkinson RG. Social determinants of health. Oxford: Oxford University Press; 2006
    Google Scholar
  • 43 Marmot MG. Status syndrome. How your social standing directly affects your health and life expectancy. Bloomsbury Press; London: 2004
    Google Scholar
  • 44 Mielck A, Reitmeir P, Wjst M. Severity of childhood asthma by socioeconomic status. Int J Epidemiol 1996; 25: 388-393
    CrossrefPubMedGoogle Scholar
  • 45 Moor I, Rathmann K, Stronks K et al. Psychosocial and behavioural factors in the explanation of socioeconomic inequalities in adolescent health: a multilevel analysis in 28 European and North American countries. J Epidemiol Community Health 2014; 68: 912-921
    CrossrefPubMedGoogle Scholar
  • 46 Mortimer JT, Larson R. The changing adolescent experience. Societal trends and the transition to adulthood. Cambridge University Press; Cambridge, UK, New York: 2002
    CrossrefGoogle Scholar
  • 47 Najman JM. A General Model of the Social Origins of Health and Well-Being. In: Eckersley R, Dixon J, Douglas RM. (Eds.) The social origins of health and well-being. Cambridge University Press; Cambridge, UK, New York, NY, USA: 2001
    Google Scholar
  • 48 Needham BL, Fernandez JR, Lin J et al. Socioeconomic status and cell aging in children. Soc Sci Med 2012; 74: 1948-1951
    CrossrefPubMedGoogle Scholar
  • 49 Patton GC, Coffey C, Cappa C et al. Health of the world’s adolescents: a synthesis of internationally comparable data. Lancet 2012; 379: 1665-1675
    CrossrefPubMedGoogle Scholar
  • 50 Patton GC, Ross DA, Santelli JS et al. Next steps for adolescent health: a Lancet Commission. Lancet 2014; 383: 385-386
    CrossrefPubMedGoogle Scholar
  • 51 Piko BF, Fitzpatrick KM. Socioeconomic status, psychosocial health and health behaviours among Hungarian adolescents. Eur J Public Health 2007; 17: 353-360
    CrossrefPubMedGoogle Scholar
  • 52 Quon EC, McGrath JJ. Subjective socioeconomic status and adolescent health: a meta-analysis. Health Psychol 2014; 33: 433-447
    CrossrefPubMedGoogle Scholar
  • 53 Raphael D. Social determinants of health. present status, unanswered questions, and future directions. Int J Health Serv 2006; 36: 651-677
    CrossrefPubMedGoogle Scholar
  • 54 Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med 2013; 90: 24-31
    CrossrefPubMedGoogle Scholar
  • 55 Richardson LJ, Hussey JM, Strutz KL. A life course perspective on maternal and child health. In: Kotch JB. (Ed.) Maternal and Child Health: Programs, Problems, and Policy. Jones & Bartlett; Sudbury, MA: 2013
    Google Scholar
  • 56 Richter M. Gesundheit und Gesundheitsverhalten im Jugendalter. Der Einfluss sozialer Ungleichheit. VS Verlag für Sozialwissenschaften; Wiesbaden: 2005
    CrossrefGoogle Scholar
  • 57 Richter M. Risk behaviour in adolescence: Patterns, determinants and consequences. Wiesbaden: VS-Verlag; 2010
    CrossrefGoogle Scholar
  • 58 Richter M. Verkörperte Ungleichheiten: Herausforderungen für die psychosomatische Medizin. Psychother Psychosom Med Psychol 2013; 63: 19-25
    Article in Thieme ConnectPubMedGoogle Scholar
  • 59 Richter M, Lampert T. Verkörperte Ungleichheiten. Die Rolle multipler Statusindikatoren für das Gesundheitsverhalten im Jugendalter. ZSE 2008; 28: 174-190
    PubMedGoogle Scholar
  • 60 Richter M, Moor I, van Lenthe FJ. Explaining socioeconomic differences in adolescent self-rated health. The contribution of material, psychosocial and behavioural factors. J Epidemiol Community Health 2012; 691-697
    PubMedGoogle Scholar
  • 61 Richter M, Hurrelmann K. Gesundheitliche Ungleichheit. Grundlagen, Probleme, Perspektiven, Wiesbaden. VS Verlag für Sozialwissenschaften; 2009
    CrossrefGoogle Scholar
  • 62 Roberts H. What works in reducing inequalities in child health?. Policy Press; Bristol, Chicago, IL: 2012
    Google Scholar
  • 63 Roberts J, Sanci L, Haller D. Global adolescent health: is there a role for general practice?. Br J Gen Pract 2012; 62: 608-610
    CrossrefPubMedGoogle Scholar
  • 64 Rosenbach F, Richter M, Pförtner T. Sozioökonomischer Status und inflammatorische Biomarker für Herz-Kreislauf-Erkrankungen. Wie wirken Bildung, Beruf und Einkommen? Herz 2014
    PubMedGoogle Scholar
  • 65 Sawyer SM, Afifi RA, Bearinger LH et al. Adolescence: a foundation for future health. Lancet 2012; 379: 1630-1640
    CrossrefPubMedGoogle Scholar
  • 66 Schreier HMC, Chen E. Health Disparities in Adolescence. In: Steptoe A. (Ed.) Handbook of Behavioral Medicine. Springer Science+Business Media, LCC; New York: 2010
    CrossrefGoogle Scholar
  • 67 Schreier HMC, Roy LB, Frimer LT et al. Family chaos and adolescent inflammatory profiles: the moderating role of socioeconomic status. Psychosom Med 2014; 76: 460-467
    CrossrefPubMedGoogle Scholar
  • 68 Scrambler G. Health inequalities. Soc Health Illn 2012; 34: 130-146
    CrossrefPubMedGoogle Scholar
  • 69 Siegrist J, Marmot MG. Social inequalities in health: new evidence and policy implications. Oxford: Oxford University Press; 2006
    CrossrefGoogle Scholar
  • 70 Solar O, Irwin A. A Conceptual Framework for Action on the Social Determinants of Health. World Health Organization; Geneva: 2007
    Google Scholar
  • 71 Spencer N. Reducing child health inequalities: what's the problem?. Arch Dis Child 2013; 98: 836-837
    CrossrefPubMedGoogle Scholar
  • 72 Spencer NJ. Social equalization in youth. evidence from a cross-sectional British survey. Eur J Public Health 2006; 16: 368-375
    CrossrefPubMedGoogle Scholar
  • 73 Starfield B, Riley AW, Witt WP et al. Social class gradients in health during adolescence. J Epidemiol Community Health 2002; 56: 354-361
    CrossrefPubMedGoogle Scholar
  • 74 Torsheim T, Currie C, Boyce WT et al. Material deprivation and self-rated health. a multilevel study of adolescents from 22 European and North American countries. Soc Sci Med 2004; 59: 1-12
    CrossrefPubMedGoogle Scholar
  • 75 Torsheim T, Currie C, Boyce WT et al. Country material distribution and adolescents’ perceived health. multilevel study of adolescents in 27 countries. J Epidemiol Community Health 2006; 60: 156-161
    CrossrefPubMedGoogle Scholar
  • 76 Tuinstra J, Groothoff JW, Van den Heuvel WJ et al. Socio-economic differences in health risk behavior in adolescence. do they exist?. Soc Sci Med 1998; 47: 67-74
    CrossrefPubMedGoogle Scholar
  • 77 UNICEF . State of the world’s children 2011. adolescence – an age of opportunity. United Nations Children’s Fund; New York, NY: 2011
    Google Scholar
  • 78 Vallejo-Torres L, Hale D, Morris S et al. Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis. J Epidemiol Community Health 2014; 68: 615-621
    CrossrefPubMedGoogle Scholar
  • 79 Viner RM, Barker M. Young people’s health: the need for action. BMJ 2005; 330: 901-903
    CrossrefPubMedGoogle Scholar
  • 80 Viner RM, Ozer EM, Denny S et al. Adolescence and the social determinants of health. Lancet 2012; 379: 1641-1652
    CrossrefPubMedGoogle Scholar
  • 81 Von Rueden U, Gosch A, Rajmil L et al. Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health 2006; 60: 130-135
    CrossrefPubMedGoogle Scholar
  • 82 Wardle J, Jarvis MJ, Steggles N et al. Socioeconomic disparities in cancer-risk behaviors in adolescence. baseline results from the Health and Behaviour in Teenagers Study (HABITS). Prev Med 2003; 36: 721-730
    CrossrefPubMedGoogle Scholar
  • 83 West P. Health inequalities in the early years. is there equalisation in youth?. Soc Sci Med 1997; 44: 833-858
    CrossrefPubMedGoogle Scholar
  • 84 West P, Sweeting H. Evidence on equalisation in health in youth from the West of Scotland. Soc Sci Med 2004; 59: 13-27
    CrossrefPubMedGoogle Scholar
  • 85 Wickrama KAS, Noh S, Elder GH. An investigation of family SES-based inequalities in depressive symptoms from early adolescence to emerging adulthood. Adv Life Course Res 2009; 14: 147-161
    CrossrefPubMedGoogle Scholar
  • 86 Williams RB. Lower Socioeconomic Status and Increased Mortality. Early Childhood Roots and the Potential for Successful Interventions. JAMA 1998; 279: 1745-1746
    CrossrefPubMedGoogle Scholar
  • 87 Xie B, Gilliland FD, Li Y et al. Effects of ethnicity, family income, and education on dietary intake among adolescents. Prev Med 2003; 36: 30-40
    CrossrefPubMedGoogle Scholar