Individual socio-demographic factors and perceptions of the environment as determinants of inequalities in adolescent physical and psychological health: the Olympic Regeneration in East London (ORiEL) study

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• 作者：Neil R Smith (1)
  Daniel J Lewis (2)
  Amanda Fahy (1)
  Sandra Eldridge (3)
  Stephanie JC Taylor (3)
  Derek G Moore (4)
  Charlotte Clark (1)
  Stephen A Stansfeld (1)
  Steven Cummins (2)
  
  1. Centre for Psychiatry ; Barts and The London School of Medicine and Dentistry ; Queen Mary University of London ; Old Anatomy Building ; Charterhouse Square ; London ; EC1M 6BQ ; UK
  2. Department of Social and Environmental Health Research ; London School of Hygiene and Tropical Medicine ; 15-17 Tavistock Place ; London ; WC1H 9SH ; UK
  3. Centre for Primary Care and Public Health ; Barts and The London School of Medicine and Dentistry ; Queen Mary University of London ; 4 Newark Street ; London ; E1 2AT ; UK
  4. Institute for Research in Child Development ; School of Psychology ; University of East London ; Stratford Campus ; Water Lane Stratford ; London ; E15 4NO ; UK
  
• 关键词：Public health ; Adolescent ; Health inequalities ; East London ; Social determinants ; Neighbourhood ; Mental health ; Physical activity ; Self ; rated general health ; Longstanding illness
• 刊名：BMC Public Health
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：15
• 期：1
• 全文大小：434 KB
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• 刊物主题：Public Health; Medicine/Public Health, general; Epidemiology; Environmental Health; Biostatistics; Vaccine;
• 出版者：BioMed Central
• ISSN：1471-2458

文摘

Background Populations living in urban areas experience greater health inequalities as well as higher absolute burdens of illness. It is well-established that a range of social and environmental factors determine these differences. Less is known about the relative importance of these factors in determining adolescent health within a super diverse urban context. Methods A cross-sectional sample of 3,105 adolescent participants aged 11 to 12 were recruited from 25 schools in the London boroughs of Newham, Tower Hamlets, Hackney and Barking & Dagenham. Participants completed a pseudo-anonymised paper-based questionnaire incorporating: the Warwick-Edinburgh Mental Well-being Scale used for assessing positive mental well-being, the Short Moods and Feelings Questionnaire based on the DSM III-R criteria for assessment of depressive symptoms, the Youth-Physical Activity Questionnaire and a self-assessment of general health and longstanding illness. Prevalence estimates and unadjusted linear models estimate the extent to which positive well-being scores and time spent in physical/sedentary activity vary by socio-demographic and environmental indicators. Logistic regression estimated the unadjusted odds of having fair/(very)poor general health, a long standing illness, or depressive symptoms. Fully adjusted mixed effects models accounted for clustering within schools and for all socio-demographic and environmental indicators. Results Compared to boys, girls had significantly lower mental well-being and higher rates of depressive symptoms, reported fewer hours physically active and more hours sedentary, and had poorer general health after full adjustment. Positive mental well-being was significantly and positively associated with family affluence but the overall relationship between mental health and socioeconomic factors was weak. Mental health advantage increased as positive perceptions of the neighbourhood safety, aesthetics, walkability and services increased. Prevalence of poor health varied by ethnic group, particularly for depressive symptoms, general health and longstanding illness suggesting differences in the distribution of the determinants of health across ethnic groups. Conclusions During adolescence perceptions of the urban physical environment, along with the social and economic characteristics of their household, are important factors in explaining patterns of health inequality.