Sakari Karvonen

Social mobility and health related behaviours in young people.

STUDY OBJECTIVE: To assess the influences related to social mobility, particularly health related behaviours, as one potential explanation for the social class variation in health among adults. DESIGN: The study is based on questionnaire data from the Adolescent Health and Lifestyle Surveys of 1985, 1987, and 1989. SETTING: The whole of Finland. PARTICIPANTS: A representative sample of 8355 adolescents. The response rate was 79%. MEASUREMENT AND MAIN RESULTS: The relation between social mobility and health related behaviours among 16 and 18 year old young people was studied. The measure of social mobility was based on a combination of the social class of origin and achieved social position measured by the present educational status, educational attainment, and labour market position. Three mobility groups were constructed: the downwardly mobile, the upwardly mobile and the stable. Health related behaviours in an upwardly or downwardly mobile group were compared with a stable group from the same social class of origin by calculating relative risks (RR). RRs were assessed by calculating age and sex adjusted rate ratios approximating a Mantel-Haenszel estimate. In logistic regression analyses the independent effects of the social class of origin and the achieved social position were investigated. Most of the nine behaviours studied (smoking, alcohol use, heavy intoxication, coffee drinking, tooth brushing, consumption of sweets, lack of physical exercise, choice of bread spread, and consumption of milk) were related to the direction of mobility so that health compromising behaviours were more frequent among downwardly mobile and less frequent among upwardly mobile young people than their stable peers. Achieved social position proved to determine health related behaviours more strongly than class of origin, thus emphasising the way education facilitates both health values and behaviours as well as the future social position. CONCLUSIONS: The close relation between social mobility and health related behaviours is concluded to be a part of an explanation of social class differences in health observed among adults.

Subjective social status and health in young people

Health inequalities according to objective socioeconomic position (SEP), have been well-documented. Yet, in young people the associations are negligible. Recently, research on the association of subjective social status (SSS), and adult health has begun to accumulate. Studies on young people are rare and describe societies with large income inequalities. Here, we investigated the association between SSS and health, while controlling for own and familial SEP. The study population consisted of 15-year-olds (N = 2369) who have grown up in a context of low social inequalities. Data were derived from surveys carried out in 2004 in 29 secondary schools in Helsinki. The SSS was measured with an indicator specific to and validated for adolescents (a societal ladder). Outcome measures were self-rated health, health complaints, presence of limiting longstanding illness (LLI) and GHQ-12 caseness (indicating psychiatric morbidity). The SSS associated strongly with all health measures. Adjusting for objective socioeconomic measures attenuated the associations; although they all remained statistically significant apart from LLI among girls. The subjective assessment contributes to health inequalities in young people largely independent of objective SEP. Subjective ratings most probably capture aspects of social hierarchy that are more subtle and less well represented than in conventional measures.

A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage

AIMS The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood. METHODS Finnish cohort studys participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42. RESULTS Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage. CONCLUSION Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.

All in the Family? The Structure and Meaning of Family Life among Young People

The aim of this article is to explore young peoples everyday family life with special reference to the use of time. First, we ask what kinds of activities young people engage in with their families, what kinds of families spend most time together, and whether this has changed over time. These analyses were based on two surveys conducted in the school setting in 1998 (N=2420) and in 2004 (N=2477). Second, we analyse the way young people perceive family life when talking about their life (34 interviews carried out in 2000/01). All participants were in their final year of the secondary school (i.e. 15-year-olds). The family meal and watching television were the most common family activities. High use of time was more typical of families with both birth parents whereas the level of education or region of residence did not make a difference. Contrary to public views on eroding family lives, young people spend more time with their families than before. The importance of the family for young peoples well-being was also emphasised in the interviews. Use of time was more complex than simple quantity. The quality of time appears to be essential. Intense family time may even imply problematic peer relationships. It is important to avoid simplistic conclusions concerning family time.

Lifestyle, Social Class and Health-Related Behaviour: A Cross-Cultural Comparison of 15 Year Olds in Glasgow and Helsinki

The extent to which young peoples lifestyles are related to social class, their relationship with health behaviours, and variations in these relationships between countries are of central relevance to an assessment of the extent to which post-modern (global) influences have replaced those associated with traditional (local) social structures. A comparison between 15 year olds in Glasgow and Helsinki reveals a remarkably similar pattern of relationships. In both locations, involvement in commercial leisure was unrelated to class, as was sports/games in Glasgow, while conventional lifestyles (more middle class) and street-based lifestyles (more working class) were class associated. Furthermore, while lifestyles were strongly related to smoking, drinking and drug use, street-based and commercial leisure orientations elevating rates, sports/games reducing them, social class was of negligible consequence for health behaviours in both places. We conclude that, while there remains a link between social class and some lifestyles, notably in relation to street-based leisure, for the most part young peoples lifestyles cut across class and national boundaries and have similar consequences for health behaviour.

Smoking in context – a multilevel approach to smoking among females in Helsinki

BackgroundSmoking is associated with disadvantage. As people with lower social status reside in less privileged areas, the extent of contextual influences for smoking remains unclear. The aims were to examine the spatial patterning of daily smoking within the city of Helsinki, to analyse whether contextual variation can be observed and which spatial factors associate with current daily smoking in the employed female population.MethodsData from a cross-sectional questionnaire were collected for municipal employees of Helsinki (aged 40–60 years). The response rate was 69%. As almost 4/5 of the employees are females, the analyses were restricted to women (n = 5028). Measures included smoking status, individual level socio-demographic characteristics (age, occupational social class, education, family type) and statistical data describing areas in terms of social structure (unemployment rate, proportion of manual workers) and social cohesion (proportions of single parents and single households). Logistic multilevel analysis was used to analyse data.ResultsAfter adjusting for the individual-level composition, smoking was significantly more prevalent according to all social structural and social cohesion indicators apart from the proportion of manual workers. For example, high unemployment in the area of domicile increased the risk of smoking by almost a half. The largest observed area difference in smoking – 8 percentage points – was found according to the proportion of single households.ConclusionThe large variation in smoking rates between areas appears mainly to result from variation in the characteristics of residents within areas. Yet, living in an area with a high level of unemployment appears to be an additional risk for smoking that cannot be fully accounted for by individual level characteristics even in a cohort of female municipal employees.

Lifestyles, social background and eating patterns of 15‐year‐old boys and girls in Finland

The aim was to investigate whether lifestyles or social background have stronger impact on eating patterns among young people. A school‐based survey carried out in 1998 among 15‐year‐old pupils (n=2388) in Helsinki was used as data. The lifestyle dimensions of leisure‐time activities used were street‐oriented lifestyle, commercialised lifestyle, home‐oriented lifestyle, and arts‐oriented and hobby‐oriented lifestyle. Social background was indicated by fathers educational level. Three family‐related and school‐related eating measures (eating school lunch, having dinner at home and consumption of recommended foods) and two peer‐related eating measures (consumption of fast food and consumption of sweets) were analysed. Those from households with higher educational level more often took part in meals at home (boys) and at school (all), and also consumed recommended food items more often. A more street‐oriented lifestyle and a more commercialised leisure time were associated with higher intake of fast food and sweets. The results suggest that structural factors such as social background continue to have more influence than lifestyles on young peoples daily diet

Health Risks in Adolescents in Europe

No Abstract..

Regional diversity in smoking among Finnish adolescents—a comparison of conventional administrative and cultural categorizations

Abstract Two regional categorizations in smoking were compared. A categorization that was based on historical folk culture was expected to predict smoking stronger than one based on administrative division. Regionally representative samples of 16- and 18-year-olds were surveyed. A data set for administrative ( N 1 = 23 478) and a data set for cultural categorization ( N 2 = 15 709) were constructed. In logistic regression analyzes regional variance was largest in snuff experiments. After socio-demographic background was controlled, cultural categorization did not predict snuff experiments, non-smoking and frequent smoking better than the administrative one. On this evidence regional smoking patterns are unlikely to be based on historical smoking cultures.

Drinking, Self-Reported Health and Strenuous Life-Style among Young People in Finland

It has been widely debated whether the association between alcohol and health is linear or a U-shaped curve and whether having a daily drink is hazardous to ones health or not. The aim of this paper is to describe associations between drinking, self-reported health and strenuous life-style among young people in a cross-sectional setting. Are abstainers healthier than drinkers?This study is a part of a larger research programme in progress, the Adolescent Health and Life-style Survey. The data came from questionnaires sent to a representative nationwide sample of 16–18-year-olds in 1987 (N=5002, response rate 80%). The young people were divided into four groups according to their drinking; ‘heavy drinkers’ (heavily drunk at least once a week); ‘frequent drinkers’ (drink at least once a week but get heavily drunk once or twice a month at the most); ‘moderate drinkers’ (drink less frequently); and ‘abstainers’ (do not use alcohol).No association was observed between drinking and limiting long-standing illne...