The social determinants of self-reported mental health among adolescents in Sweden and the Nordic countries - focusing on socioeconomic inequalities

Abstract

Mental health problems have increased among children and adolescents in the Nordic countries during the last decades. Such problems may have both short- and long-term negative consequences for both the individual and society at large. Knowledge of the determinants and distribution of mental health problems is essential for prevention and treatment of such problems. This thesis examined the social determinants and distribution of subjective health complaints (SHCs), self-reported stress and life satisfaction among adolescents in Sweden and the other Nordic countries. It comprises four studies, which are based on cross-sectional data from two studies: the Health Behaviour in School-aged Children (HBSC) study and the Study of Adolescence Resilience and Stress (STARS), along with register data and official statistics. The results showed persistent social inequalities in adolescent mental health related to gender, country of birth, family structure and socioeconomic conditions in Sweden. Socioeconomic conditions, as well as the at-risk-of-poverty rate, were related to adolescent mental health in all Nordic countries. Furthermore, the results showed that SHCs were strongly associated with stress. Various school experiences, such as school satisfaction, schoolwork pressure and bullying, were also shown to be associated with SHCs. The thesis also includes a validation of the Family Affluence Scale using Swedish register data, showing that the scale may be used in surveys using self-reported socioeconomic status among children and adolescents. The studies in this thesis demonstrate the need of policy measures at several levels of society to improve, and reduce social inequalities in, adolescents’ mental health and well-being.