[Social determinants of subjective health in school children aged 11-15 years in Poland in the light of European data].

BACKGROUND

Adolescence is a particularly significant period due to the risk of psycho-social disorders, life-style formation and making many important decisions about the future. THE AIM of the study is to provide an overall assessment of the impact of various elements of the environment on the risk of disorders of subjective health of schoolchildren aged 11-15 yrs, and to compare of the Polish data with European Union statistics.

METHODS

The data source is the last series of international studies on health related behaviour of schoolchildren (HBSC), conducted during the school year 2005/06. In general, the object of analysis comprises data related to 142 478 schoolchildren from a combined sample from 25 countries, on average aged 13.6 yrs (SD = 1.65), including 5489 Polish schoolchildren. The main outcome variable was the occurrence of at least one of three subjective health disorders: poor self-rated health, dissatisfaction with life and the intensity of recurrent subjective symptoms. The analysis included the impact of gender, age (in three age groups), country of residence (Poland vs. the other 24 countries) and the five components of the growing up environment: economic and social status of the family, communication with parents, functioning at school, peer support, problems in the area of domicile. Logistic regression models were estimated with a step-block procedure of variable selection, which provided relative risk indices (OR) with a 95% confidence interval (CI).

RESULTS

The studies have shown that the strongest predictor of subjective health disorders consists of problems with functioning at school (OR = 3.14), disrupted communication with parents (OR = 2.15) and absence of peer support (OR = 1.87). However, after these factors were taken into account, the weak impact of the material status of the family (OR = 1.65) and area of residence (OR-= 1.94) continued to be noted. Young people in Poland report subjective health problems more often than their average European counterparts. In the analyses adjusted for socioeconomic and psychosocial factors the differences between Polish adolescents and their peers from EU countries are leveling. Analyzing the social environment in Poland we discover a better assessment of communication in the family, coupled with a lower than European average assessment of the other elements of that environment, especially in relation to material status.

CONCLUSION

Intervention activities aimed at reducing health inequalities has to tackle inequalities in the broad socioeconomic context underlying child and adolescent environment.