BackgroundResearch has linked food insecurity to mental health problems, though little is known about this relationship among Canadian youth. We investigate the association between food insecurity ...severity and mental illnesses in a nationally representative youth sample.MethodsWe sampled 55 700 youth 12–24 years from recent cycles of Canadian Community Health Survey. Household food insecurity was measured using a standard 18-item questionnaire. We fitted Poisson regressions on self-rated mental health and diagnosed mood and anxiety disorders, controlling for sociodemographic confounders. Clinical assessments of emotional distress, major depression and suicidal ideation were examined in subsamples with available data. We stratified the sample by gender, age and survey cycle to test potential demographic heterogeneity.ResultsOne in seven youth lived in marginal (5.30%), moderate (8.08%) or severe (1.44%) food insecurity. Results showed that food insecurity was associated with higher likelihood of every mental health problem examined. The association was graded, with more severe food insecurity linked to progressively worse mental health. Notably, marginal, moderate and severe food insecurity were associated with 1.77, 2.44 and 6.49 times higher risk of suicidal thoughts, respectively. The corresponding relative risk for mood disorders were 1.57, 2.00 and 2.89; those for anxiety disorders were 1.41, 1.65 and 2.58. Moderate food insecurity was more closely associated with mental health problems in 18–24 year olds than in 12–17 year olds.ConclusionsFood insecurity severity was associated with poorer mental health among Canadian youth independent of household income and other socioeconomic differences. Targeted policy intervention alleviating food insecurity may improve youth mental health.
To estimate prevalence of suicidal ideation and suicidal ideation with a plan in each surveyed country and to examine cross-national differences in associated risk factors.
We analysed data of ...students aged 13-17 years who participated in the 2003-2012 Global School-based Health Surveys in 32 countries, of which 29 are low- and middle-income. We used random effects meta-analysis to generate regional and overall pooled estimates. Multivariable logistic regression was used to estimate risk ratios for the associated risk factors. Population attributable fractions were estimated based on adjusted risk ratios and the prevalence of the determinants within each exposure level.
Across all countries, the pooled 12-month prevalence of suicide ideation were 16.2% (95% confidence interval, CI: 15.6 to 16.7) among females and 12.2% (95% CI: 11.7 to 12.7) among males and ideation with a plan were 8.3% (95% CI: 7.9 to 8.7) among females and 5.8% (95% CI: 5.5 to 6.1) among males. Suicide ideation in the WHO Region of the Americas was higher in females than males, with an estimated prevalence ratio of 1.70 (95% CI: 1.60 to 1.81), while this ratio was 1.04 (95% CI: 0.98 to 1.10) in the WHO African Region. Factors associated with suicidal ideation in most countries included experiences of bullying and physical violence, loneliness, limited parental support and alcohol and tobacco use.
The prevalence of adolescent suicidal behaviours varies across countries, yet a consistent set of risk factors of suicidal behaviours emerged across all regions and most countries.
Can social contextual factors explain international differences in the spread of COVID-19? It is widely assumed that social cohesion, public confidence in government sources of health information and ...general concern for the welfare of others support health advisories during a pandemic and save lives. We tested this assumption through a time-series analysis of cross-national differences in COVID-19 mortality during an early phase of the pandemic. Country data on income inequality and four dimensions of social capital (trust, group affiliations, civic responsibility and confidence in public institutions) were linked to data on COVID-19 deaths in 84 countries. Associations with deaths were examined using Poisson regression with population-averaged estimators. During a 30-day period after recording their tenth death, mortality was positively related to income inequality, trust and group affiliations and negatively related to social capital from civic engagement and confidence in state institutions. These associations held in bivariate and mutually controlled regression models with controls for population size, age and wealth. The results indicate that societies that are more economically unequal and lack capacity in some dimensions of social capital experienced more COVID-19 deaths. Social trust and belonging to groups were associated with more deaths, possibly due to behavioural contagion and incongruence with physical distancing policy. Some countries require a more robust public health response to contain the spread and impact of COVID-19 due to economic and social divisions within them.
•Income inequality was associated with 30-day mortality rates in 84 countries.•Some dimensions of social capital are associated with fewer COVID-19 deaths.•Social trust is associated with more deaths, possibly due to behavioural contagion.
Summary Background Information about trends in adolescent health inequalities is scarce, especially at an international level. We examined secular trends in socioeconomic inequality in five domains ...of adolescent health and the association of socioeconomic inequality with national wealth and income inequality. Methods We undertook a time-series analysis of data from the Health Behaviour in School-aged Children study, in which cross-sectional surveys were done in 34 North American and European countries in 2002, 2006, and 2010 (pooled n 492 788). We used individual data for socioeconomic status (Health Behaviour in School-aged Children Family Affluence Scale) and health (days of physical activity per week, body-mass index Z score zBMI, frequency of psychological and physical symptoms on 0–5 scale, and life satisfaction scored 0–10 on the Cantril ladder) to examine trends in health and socioeconomic inequalities in health. We also investigated whether international differences in health and health inequalities were associated with per person income and income inequality. Findings From 2002 to 2010, average levels of physical activity (3·90 to 4·08 days per week; p<0·0001), body mass (zBMI −0·08 to 0·03; p<0·0001), and physical symptoms (3·06 to 3·20, p<0·0001), and life satisfaction (7·58 to 7·61; p=0·0034) slightly increased. Inequalities between socioeconomic groups increased in physical activity (−0·79 to −0·83 days per week difference between most and least affluent groups; p=0·0008), zBMI (0·15 to 0·18; p<0·0001), and psychological (0·58 to 0·67; p=0·0360) and physical (0·21 to 0·26; p=0·0018) symptoms. Only in life satisfaction did health inequality fall during this period (−0·98 to −0·95; p=0·0198). Internationally, the higher the per person income, the better and more equal health was in terms of physical activity (0·06 days per SD increase in income; p<0·0001), psychological symptoms (−0·09; p<0·0001), and life satisfaction (0·08; p<0·0001). However, higher income inequality uniquely related to fewer days of physical activity (−0·05 days; p=0·0295), higher zBMI (0·06; p<0·0001), more psychological (0·18; p<0·0001) and physical (0·16; p<0·0001) symptoms, and larger health inequalities between socioeconomic groups in psychological (0·13; p=0·0080) and physical (0·07; p=0·0022) symptoms, and life satisfaction (−0·10; p=0·0092). Interpretation Socioeconomic inequality has increased in many domains of adolescent health. These trends coincide with unequal distribution of income between rich and poor people. Widening gaps in adolescent health could predict future inequalities in adult health and need urgent policy action. Funding Canadian Institutes of Health Research.
I examined the association between income inequality and population health and tested whether this association was mediated by interpersonal trust or public expenditures on health.
Individual data on ...trust were collected from 48 641 adults in 33 countries. These data were linked to country data on income inequality, public health expenditures, healthy life expectancy, and adult mortality. Regression analyses tested for statistical mediation of the association between income inequality and population health outcomes by country differences in trust and health expenditures.
Income inequality correlated with country differences in trust (r = -0.51), health expenditures (r = -0.45), life expectancy (r = -0.74), and mortality (r = 0.55). Trust correlated with life expectancy (r = 0.48) and mortality (r = -0.47) and partly mediated their relations to income inequality. Health expenditures did not correlate with life expectancy and mortality, and health expenditures did not mediate links between inequality and health.
Income inequality might contribute to short life expectancy and adult mortality in part because of societal differences in trust. Societies with low levels of trust may lack the capacity to create the kind of social supports and connections that promote health and successful aging.
Full text
Available for:
CEKLJ, FSPLJ, ODKLJ, UL, VSZLJ
Abstract Purspose The prevention of youth violence is a public health priority in many countries. We examined the prevalence of bullying victimization and physical fighting in youths in 79 high- and ...low-income countries and the relations between structural determinants of adolescent health (country wealth, income inequality, and government spending on education) and international differences in youth violence. Methods Cross-sectional surveys were administered in schools between 2003 and 2011. These surveys provided national prevalence rates of bullying victimization (n = 334,736) and four or more episodes of physical fighting in the past year (n = 342,312) in eligible and consenting 11–16 year olds. Contextual measures included per capita income, income inequality, and government expenditures on education. We used meta-regression to examine relations between country characteristics and youth violence. Results Approximately 30% of adolescents reported bullying victimization and 10.7% of males and 2.7% of females were involved in frequent physical fighting. More youth were exposed to violence in African and Eastern Mediterranean countries than in Europe and Asia. Violence directly related to country wealth; a 1 standard deviation increase in per capita income corresponded to less bullying (−3.9% in males and −4.2% in females) and less fighting (−2.9% in males and −1.0% in females). Income inequality and education spending modified the relation between country wealth and fighting; where inequality was high, country wealth related more closely to fighting if education spending was also high. Conclusions Country wealth is a robust determinant of youth violence. Fighting in affluent but economically unequal countries might be reduced through increased government spending on education.
Abstract Purpose To examine the association between the frequency of family dinners and positive and negative dimensions of mental health in adolescents and to determine whether this association is ...explained by the quality of communication between adolescents and parents. Methods A community sample of 26,069 adolescents (aged 11 to 15 years) participated in the 2010 Canadian Health Behaviour of School-aged Children study. Adolescents gave self-report data on the weekly frequency of family dinners, ease of parent–adolescent communication, and five dimensions of mental health (internalizing and externalizing problems, emotional well-being, prosocial behavior, and life satisfaction). Regression analyses tested relations between family dinners, parent–adolescent communication, and mental health. Results The frequency of family dinners negatively related to internalizing and externalizing symptoms and positively related to emotional well-being, prosocial behavior, and life satisfaction. These associations did not interact with differences in gender, grade level, or family affluence. However, hierarchical regression analyses found that these associations were partially mediated by differences in parent–adolescent communication, which explained 13% to 30% of the effect of family dinners on mental health, depending on the outcome. Conclusions These findings, though correlational, revealed a dose–response association between the frequency of family dinners and positive and negative dimensions of adolescent mental health. The ease of communication between parents and adolescents accounted for some of this association.
A prevailing hypothesis about the association between income inequality and poor health is that inequality intensifies social hierarchies, increases stress, erodes social and material resources that ...support health, and subsequently harms health. However, the evidence in support of this hypothesis is limited by cross-sectional, ecological studies and a scarcity of developmental studies. To address this limitation, we used pooled, multilevel data from the Health Behaviour in School-aged Children study to examine lagged, cumulative, and trajectory associations between early-life income inequality and adolescent health and well-being. Psychosomatic symptoms and life satisfaction were assessed in surveys of 11- to 15-year-olds in 40 countries between 1994 and 2014. We linked these data to national Gini indices of income inequality for every life year from 1979 to 2014. The results showed that exposure to income inequality from 0 to 4 years predicted psychosomatic symptoms and lower life satisfaction in females after controlling lifetime mean income inequality, national per capita income, family affluence, age, and cohort and period effects. The cumulative income inequality exposure in infancy and childhood (i.e., average Gini index from birth to age 10) related to lower life satisfaction in female adolescents but not to symptoms. Finally, individual trajectories in early-life inequality (i.e., linear slopes in Gini indices from birth to 10 years) related to fewer symptoms and higher life satisfaction in females, indicating that earlier exposures mattered more to predicting health and wellbeing. No such associations with early-life income inequality were found in males. These results help to establish the antecedent-consequence conditions in the association between income inequality and health and suggest that both the magnitude and timing of income inequality in early life have developmental consequences that manifest in reduced health and well-being in adolescent girls.
•Income inequality in infancy relates to poor health in adolescent females.•Both the magnitude and timing of inequality matter to their health and well-being.•No such associations with early-life income inequality were found in males.•The results establish temporality in the association between inequality and health.
Exposure to corporal punishment during childhood is associated with suicidal behaviors during adolescence. To date, the protective effects of national policies governing the use of corporal ...punishment have rarely been studied for adolescent suicide outcomes.
To investigate contemporaneous and lagged associations between national legislation banning corporal punishment and adolescent suicide rates.
We used population-level administrative and mortality data from 97 countries spanning the years 1950 to 2017.
Negative binomial models were used to investigate the relationship between the existence of official corporal punishment bans in countries and national adolescent suicide mortality rates and the potential time lag between the enactment of such bans and reductions in adolescent suicide rates.
National policies that permitted corporal punishment in all settings (homes, schools, daycares, and alternative care) were associated with a higher relative risk (RR) for suicide in females aged 15–19 (RR = 2.07, p = .03), as were policies allowing corporal punishment in schools specifically (RR = 2.01, p = .02). Partial bans of corporal punishment and bans of school corporal punishment showed lagged effects on suicide rates which peaked after 12 years for females aged 15–19 and after 13 years for males aged 15–19.
Study findings add to a body of evidence that suggests that official policies banning corporal punishment may promote adolescent health and well-being. The benefits of such policies in terms of reduced risk for adolescent suicide appear to peak approximately 12 to 13 years after enactment of the legislation.
•National bans of corporal punishment may support adolescent health and well-being.•Countries that banned corporal punishment report lower adolescent suicide rates.•Effects of corporal punishment bans on adolescent suicide peak after 12 to 13 years.
Subjective well-being (SWB) in youths positively relates to family income, however its association with income during childhood is unclear. Using longitudinal data from the US Panel Study of Income ...Dynamics (n = 2234 adolescents, age 12-19 years), we examined whether the timing and duration of low family income in childhood was associated with adolescent SWB.
We categorized family income during childhood into state-specific quintiles. Adolescent SWB was assessed using a 12-item questionnaire (score range 3-18). We used marginal structural modelling to test for sensitive periods of exposure to low income and tested cumulative effects of income by modelling the number of years spent in the poorest income quintiles.
A period in early childhood (age 0-2 years) was particularly sensitive to low family income. Adolescent SWB was 1.65 (95% CI 0.40, 2.91) points lower in those who grew up in the poorest income quintiles during early childhood compared with the top quintile. Further, each childhood year spent in the poorest income quintiles was associated with a 0.10 point (95% CI 0.04, 0.16) lower SWB score in adolescence.
The timing and duration of low family income in childhood both predict individual differences in adolescent SWB. Further studies are needed to clarify the mechanisms of these models and inform public policies.
PDF
