Limits...
School-related mediators in social inequalities in smoking: a comparative cross-sectional study of 20,399 adolescents.

Schnohr CW, Kreiner S, Rasmussen M, Due P, Diderichsen F - Int J Equity Health (2009)

Bottom Line: The study found social inequality in daily smoking in Denmark, Sweden, Norway, Finland and United Kingdom, as well as inequalities in students' academic achievement and school satisfaction.The analyses also showed that above average academic achievement was associated with lower OR of smoking.Subsequently this prioritisation might contribute to reducing smoking in this group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark. c.schnohr@pubhealth.ku.dk.

ABSTRACT

Background: The aim of this study was to examine the associations between social inequalities and daily smoking among 13 and 15 year olds, and to determine the role of students' academic achievement and school satisfaction in these associations.

Methods: HBSC is an international study including adolescents from 32 countries in Europe, Israel, and North America. The present study was based on information from 20,399 adolescents from Denmark, Sweden, Norway, Finland and the United Kingdom. Data were analysed by regression models.

Results: The initial analyses showed significant inequality in daily smoking in all countries except for Sweden. When adjusted for the mediating role of academic achievement, estimates were attenuated, but remained significant in three countries.

Conclusion: The study found social inequality in daily smoking in Denmark, Sweden, Norway, Finland and United Kingdom, as well as inequalities in students' academic achievement and school satisfaction. The analyses also showed that above average academic achievement was associated with lower OR of smoking. Teachers and politicians may find this information useful, and allocate resources to give higher priority to a supportive environment in schools especially for children and adolescents in lower social groups. Subsequently this prioritisation might contribute to reducing smoking in this group.

No MeSH data available.


Related in: MedlinePlus

A conceptual framework for studying health impact of socio economic position. Adapted from Whitehead et al [20].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2690589&req=5

Figure 1: A conceptual framework for studying health impact of socio economic position. Adapted from Whitehead et al [20].

Mentions: Diderichsen has proposed a framework [19] for the understanding of health inequalities. The framework delineates four main mechanisms: social stratification, differential exposure, differential susceptibility, and differential consequences. These mechanisms are used to explain how the social position and social context may play roles in generating the social patterning of disease and injury, and in the case of the present study, to examine the patterning of health risk behaviour measured by daily smoking. This framework has been used in comparative studies on mediating factors in health disadvantaged groups in Sweden and the United Kingdom [20]. The simplified version of the conceptual framework adapted from Whitehead (figure 1), shows these associations at an individual level. This line of enquiry considers how different social positions may carry different probabilities of being exposed to specific determinants or health hazards, the association or mechanism being denoted as differential exposure (figure 1, I). In addition, the health effect of a specific determinant may vary depending on the exposure to other interacting causes. This mechanism is denoted as differential susceptibility (figure 1, II). In line with this framework, the study analyses the mediating effect(s) of academic achievement in the social inequality of adolescent smoking.


School-related mediators in social inequalities in smoking: a comparative cross-sectional study of 20,399 adolescents.

Schnohr CW, Kreiner S, Rasmussen M, Due P, Diderichsen F - Int J Equity Health (2009)

A conceptual framework for studying health impact of socio economic position. Adapted from Whitehead et al [20].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2690589&req=5

Figure 1: A conceptual framework for studying health impact of socio economic position. Adapted from Whitehead et al [20].
Mentions: Diderichsen has proposed a framework [19] for the understanding of health inequalities. The framework delineates four main mechanisms: social stratification, differential exposure, differential susceptibility, and differential consequences. These mechanisms are used to explain how the social position and social context may play roles in generating the social patterning of disease and injury, and in the case of the present study, to examine the patterning of health risk behaviour measured by daily smoking. This framework has been used in comparative studies on mediating factors in health disadvantaged groups in Sweden and the United Kingdom [20]. The simplified version of the conceptual framework adapted from Whitehead (figure 1), shows these associations at an individual level. This line of enquiry considers how different social positions may carry different probabilities of being exposed to specific determinants or health hazards, the association or mechanism being denoted as differential exposure (figure 1, I). In addition, the health effect of a specific determinant may vary depending on the exposure to other interacting causes. This mechanism is denoted as differential susceptibility (figure 1, II). In line with this framework, the study analyses the mediating effect(s) of academic achievement in the social inequality of adolescent smoking.

Bottom Line: The study found social inequality in daily smoking in Denmark, Sweden, Norway, Finland and United Kingdom, as well as inequalities in students' academic achievement and school satisfaction.The analyses also showed that above average academic achievement was associated with lower OR of smoking.Subsequently this prioritisation might contribute to reducing smoking in this group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Social Medicine, Institute of Public Health, University of Copenhagen, Denmark. c.schnohr@pubhealth.ku.dk.

ABSTRACT

Background: The aim of this study was to examine the associations between social inequalities and daily smoking among 13 and 15 year olds, and to determine the role of students' academic achievement and school satisfaction in these associations.

Methods: HBSC is an international study including adolescents from 32 countries in Europe, Israel, and North America. The present study was based on information from 20,399 adolescents from Denmark, Sweden, Norway, Finland and the United Kingdom. Data were analysed by regression models.

Results: The initial analyses showed significant inequality in daily smoking in all countries except for Sweden. When adjusted for the mediating role of academic achievement, estimates were attenuated, but remained significant in three countries.

Conclusion: The study found social inequality in daily smoking in Denmark, Sweden, Norway, Finland and United Kingdom, as well as inequalities in students' academic achievement and school satisfaction. The analyses also showed that above average academic achievement was associated with lower OR of smoking. Teachers and politicians may find this information useful, and allocate resources to give higher priority to a supportive environment in schools especially for children and adolescents in lower social groups. Subsequently this prioritisation might contribute to reducing smoking in this group.

No MeSH data available.


Related in: MedlinePlus