Veronika Ottova

Subjective health, symptom load and quality of life of children and adolescents in Europe.

Objectives:To examine cross-cultural differences in the prevalence of school childrens subjective health types and the pattern of socio-demographic and socio-economic differences.Methods:Within the cross-sectional Health Behaviour in Schoolaged Children 2005/2006 Survey 200,000 school children aged 11, 13 and 15 answered a general health item, the Cantrill life satisfaction ladder and a subjective health complaints checklist. ANOVA and multilevel logistic regression models were conducted.Results:Overall, 44% of the respondents reported multiple recurrent health complaints, only poor to fair general health, low life satisfaction or a combination of these. Older adolescents (OR: 1.1–1.6) and girls (OR: 1.2–1.4) reported more health problems, the gender difference increased with age (OR: 1.3–1.6). Low socio-economic status was also associated with health problems (OR: 1.4–2.3). Sizeable cross-national variation in the prevalence of health types and the impact of the above mentioned factors were observed, yet the main pattern of impact could be confirmed cross-culturally.Conclusions:Increasing social and gender role pressure with growing age, as well as restricted access to material resources and psychosocial strains are discussed as potential explanations for the observed health inequalities.

Measuring mental health and well-being of school-children in 15 European countries using the KIDSCREEN-10 index

Objectives:To test the psychometric properties and measurement results of the KIDSCREEN-10 Mental Health Index in school children from 15 European countries.Methods:Within the cross-sectional Health Behaviour in School-aged Children 2005/2006 Survey, 78,000 pupils aged 11, 13, 15 answered the KIDSCREEN and additional measures. Cronbach’s alpha, Rasch partial credit model itemfit and ANOVAs were conducted.Results:Cronbach’s alpha was 0.81, Rasch infit mean square residuals were 0.7–1.3. Mean scores varied 0.8 standard deviation across countries. Older pupils (effect size [ES] = 0.6), girls (ES = 0.2), pupils with low socio-economic status (ES = 0.5) or frequent health complaints (r = 0.5) reported decreased mental health.Conclusions:The KIDSCREEN-10 displayed good psychometric properties. Measured differences between countries, age, gender, SES, and health complaints comply with theoretical considerations.

The Role of Individual- and Macro-Level Social Determinants on Young Adolescents’ Psychosomatic Complaints:

This study examines the social determinants of psychosomatic complaints in young adolescents. Using data from the Health Behaviour in School-aged Children (HBSC) study, psychosomatic complaints are studied in 98,773 adolescents (11- and 13-year-olds; 48% 11-year-olds, 52% 13-year-olds; 52% females, 48% males) from 34 European countries. Individual-level determinants, including family-, peer- and school-related factors as well as country-level determinants (Human Development Index [HDI]) are considered. In line with existing evidence, results revealed more psychosomatic complaints in young adolescents experiencing stress inducing familial-, peer- and school-related factors. Negative effects of poor friendships, negative class climate, school pressure, and high media use were more pronounced for girls. After controlling for these factors, a higher HDI was related to a lower risk for psychosomatic complaints. Gender-specific intervention programs should aim at improving the quality of relationships, especially among peers, to prevent psychosomatic complaints among young adolescents.

Physical and emotional health problems experienced by youth engaged in physical fighting and weapon carrying

Then aims of the current study were 1) to provide cross-national estimates of the prevalence of physical fighting and weapon carrying among adolescents aged 11–15 years; (2) To examine the possible effects of physical fighting and weapon carrying on the occurrence of physical (medically treated injuries) and emotional health outcomes (multiple health complaints) among adolescents within the theoretical framework of Problem Behaviour Theory. 20,125 adolescents aged 11–15 in five countries (Belgium, Israel, USA, Canada, FYR Macedonia) were surveyed via the 2006 Health Behaviour in School Aged Children survey. Prevalence was calculated for physical fighting and weapon carrying along with physical and emotional measures that potentially result from violence. Regression analyses were used to quantify associations between violence/weapon carrying and the potential health consequences within each country. Large variations in fighting and weapon carrying were observed across countries. Boys reported more frequent episodes of fighting/weapon carrying and medically attended injuries in every country, while girls reported more emotional symptoms. Although there were some notable variations in findings between different participating countries, increased weapon carrying and physical fighting were both independently and consistently associated with more frequent reports of the potential health outcomes. Adolescents engaging in fighting and weapon carrying are also at risk for physical and emotional health outcomes. Involvement in fighting and weapon carrying can be seen as part of a constellation of risk behaviours with obvious health implications. Our findings also highlight the importance of the cultural context when examining the nature of violent behaviour for adolescents.

Macro-level determinants of young people's subjective health and health inequalities: A multilevel analysis in 27 welfare states

OBJECTIVES Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young peoples health. STUDY DESIGN Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. MAIN OUTCOME MEASURE Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. RESULTS Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. CONCLUSION Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence.

Perceived teacher unfairness and headache in adolescence: a cross-national comparison

ObjectivesThe present study examines the prevalence of headache in early adolescents in 21 European and North-American countries and the role of perceived teacher unfairness in predicting this health complaint across different countries.MethodsData were taken from the “Health Behaviour in School-aged Children” study (HBSC), a World Health Organization cross-national survey on health behaviors in 11-, 13- and 15-year-old students. Headache and perceived teacher unfairness were measured through a self-administered questionnaire filled out by 115,212 adolescents.ResultsThe overall prevalence of frequent headaches (at least once a week) was 28.8%, ranging from 18.9% in Slovenia to 49.4% in Israel. After adjusting for gender, grade, family affluence, school achievement, being bullied and lifestyles (drinking, smoking, eating and physical activity), teacher unfairness showed a significant association with frequent headache in all but two countries (Ukraine and Luxembourg).ConclusionsOur results show that headache is a common health symptom in European and North-American countries, even though there are substantial differences in its prevalence across countries. The study indicates that perceived teacher unfairness can be a significant predictor of frequent headache during adolescence, and this association is consistent across countries.

Wohlbefinden und gesundheitsbezogene Lebensqualität aus einer bevölkerungsbezogenen Perspektive

Zusammenfassung. Bevolkerungsbezogene Untersuchungen des Wohlbefindens von Kindern und Jugendlichen ermoglichen die Identifikation von Risikofaktoren und Risikogruppen fur ein beeintrachtigtes Wohlbefinden und gesundheitliche Belastungen. In dieser Arbeit wird am Beispiel dreier internationaler bzw. nationaler bevolkerungsbezogener Studien aufgezeigt, wie sich die komplexen Beziehungen zwischen Wohlbefinden und fur das Wohlbefinden relevanten Aspekten unter Verwendung komplexer statistischer Modellierungsansatze untersuchen lassen. Die im Modul „Seelisches Wohlbefinden und Verhalten” des Kinder- und Jugendgesundheitssurveys (BELLA-Studie; n = 1700), der Health Behaviour in School-aged Children (HBSC; n = 7000) und der KIDSCREEN Studie (n = 8000) an 11 bis 18jahrigen Kindern und Jugendlichen erhobenen Daten zu ihrem Wohlbefinden, psychischen Problemen, personalen familiaren und sozialen Ressourcen, schulischer Umgebung sowie Tabak- und Alkoholkonsum werden dazu ausgewertet. Uber die Daten jeder der drei St...

Child Mental Health Measurement: Reflections and Future Directions

Over the course of the past decades, mental health has enjoyed increased interest, particularly in research on subjective health and well-being. In 2008, the EU has launched the European Pact for Mental Health and Well-being in which European Member States declared mental health as an important health issue and recognized it as their responsibility to undertake action. The Pact for Mental Health and Well-being recognizes youth and education as one of the top priority areas for action and sees prevention and reduction of mental disorders (i.e. mental ill-health) as one of the primary objectives (European Commission & WHO, 2008).