Direct and indirect influences of objective socioeconomic position on adolescent health: the mediating roles of subjective socioeconomic status and lifestyles

The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine the direct and indirect contribution of objective and subjective socioeconomic factors in a broad range of health and lifestyles outcomes. The data come from a representative sample of adolescents (N = 15,340; M age = 13.69) of the Health Behavior in School-aged Children study in Spain. Structural equation modeling was used for data analysis. A global index for evaluating objective socioeconomic position predicted both health and healthy lifestyles. Subjective socioeconomic status mediated the relationship between objective socioeconomic position and health but did not have a significant effect on healthy lifestyles when objective indicators were considered. Lastly, fit indices of the multiple-mediator model—including the direct effect of objective socioeconomic position on health and its indirect effects through the subjective perception of wealth and lifestyles—explained 28.7% of global health variance. Interventions aimed at reducing the impact of health inequalities should address, in addition to material deprivation, the psychological and behavioral consequences of feeling poor.Consejería de Economía, Innovación y Ciencia de la Junta de Andalucía P11—SEJ—800

Sex differences in body image, weight control and Body Mass Index of Spanish adolescents

Este estudio examinó las diferencias entre 21.811 chicos y chicas adolescentes (11-18 años) en variables clave en el desarrollo de trastornos de la alimentación, como son el Índice de Masa Corporal, la percepción y satisfacción con la imagen corporal y las conductas destinadas a controlar el peso. A pesar de que las chicas tenían una puntuación en el Índice de Masa Corporal más ajustada y presentaban un nivel menor de sobrepeso y obesidad, se encontró que eran ellas las que se percibían más obesas, las que estaban más insatisfechas con su imagen corporal y las que realizaban con más frecuencia dietas para adelgazar. Por otra parte, se encontró que la razón que mueve a chicos y chicas a realizar dietas para adelgazar no es el peso corporal real, sino la percepción que tienen de su cuerpo, en primer lugar, y cómo de satisfechos están con él, en segundo lugar. Por lo tanto, en este artículo se encuentran importantes diferencias entre chicos y chicas, a tener en cuenta en el diseño y desarrollo de los diversos programas que se destinen a la prevención de problemas con la imagen corporal y la conducta de hacer dieta.This research paper studied the differences among 21,811 adolescents (between the ages of 11 and 18) in key variables in the development of eating disorders, including the Body Mass Index, the perception of and satisfaction with their body image, and the behaviours used to control weight. In spite of the fact that the girls had a better adjusted BMI and a lesser degree of overweight and obesity, we found that they perceived themselves as being fatter, were less satisfied with body image, and the ones who dieted the most to lose weight. On the other hand, we found that the main reason for boys and girls to diet in an effort to lose weight was not their real body weight, but rather their perception of their own bodies, followed by just how satisfied they were with their bodies. Therefore, important differences are revealed between boys and girls in this article, which must be taken into consideration in the design and development of the various programs that are aimed at the prevention of problems with body image and diet behaviour

The role of body image in internalizing mental health problems in Spanish adolescents: An analysis according to sex, age, and socioeconomic status

During adolescence there is a relatively high prevalence of weight problems and eating disorders. Furthermore, body image plays an important role in weight control and eating behaviors as well as in mental health. This study analyses the influence of body mass index, perception of being overweight, and body image satisfaction (BIS) on internalizing symptoms related to mental health in adolescents. In addition, sex, age, socioeconomic status (SES), dieting, and physical activity are taken into consideration. This research is based on the international study Health Behaviour in School-aged Children (HBSC). The sample consists of 4531 Spanish adolescents from 13 to 18 years old. Participants were selected through random multi-stage sampling stratified by conglomerates. Two instruments were employed: the HBSC questionnaire and the Youth Self-Report (Achenbach System of Empirically Based Assessment, ASEBA). Results demonstrated that BIS –the emotional component related to body image–was the main predictor of adolescent internalizing symptoms. In addition, results show double-inequalities according to the interaction effects of sex, age, and SES. Likewise, interesting results are shown regarding how dieting behaviors to lose or gain weight/volume and physical activity relate to body image perception and satisfaction, as well as with internalizing symptoms. This study highlights important body image aspects relevant to intervention and prevention of internalized mental health problems in adolescence.Ministerio de Sanidad, Servicios Sociales e Igualdad de España PRJ20170315

How family socioeconomic status, peer behaviors, and school-based intervention on healthy habits influence adolescent eating behaviors

Psychologists in schools can play an important role in developing policies and programs to promote healthy eating habits. This study analyzes the contributions of family socioeconomic status, peer influence (schoolmates’ food consumption), and school-based nutrition interventions to explain adolescent eating behaviors. Data were obtained from the 2014 Health Behaviour in School-aged Children survey in Spain, with a sample of 6,851 adolescents (11–16 years old). The results suggest that school-based healthy-eating programs could improve by considering parental education leveland by implementing interventions focused on the peer social network. Policies that limitaccess to unhealthy products in schools—rather than simply offering healthy foods alongside unhealthy products—could be more effective

Análisis del modelo salutogénico en España: aplicación en salud pública e implicaciones para el modelo de activos en salud

This article seeks to provide an in depth review about one of the most revolutionary and influential methods used in understanding the variables and processes that explain human health. Based on a new vision in the analysis of the consequences of the Nazi Holocaust, a doctor-sociologist-Aaron Antonovsky-managed to influence medicine and behavioral science by facilitating the keys for the optimal development of public health today. Despite the fact that this theory began appearing in the 1970s in the 20th century, its real development and expansion have been seen in recent years. In fact, in Spain, there is little scientific literature that analyses the theoretic keys of the model in depth. This work seek to cover this gap; to achieve this objective, it first presents how the construct of salutogenesis arose, the social-cultural context that promoted it, as well as the importance public health acquires today. This is the aim of this work, which analyses the theoretical bases of the salutogenesis model, with specific emphasis on its background and precursors, as well as its inception, development and current expansion.Este artículo tiene el objetivo de tratar en profundidad uno de los modelos más revolucionarios e influyentes para la comprensión de las variables y procesos que explican la salud humana. A partir de una nueva visión en el análisis de las consecuencias del holocausto nazi, un médico-sociólogo -Aaron Antonovsky-, consiguió influir en la medicina y la ciencia del comportamiento, facilitando las claves para el óptimo desarrollo de la salud pública actual. A pesar de que esta teoría empezó a forjarse en los años 70 del siglo XX, su desarrollo real y su expansión están sucediendo en los últimos años. De hecho, en España existe muy poca literatura con base científica que analice con detalle las claves teóricas del modelo. Este trabajo trata de cubrir esa carencia y, para ello, y en primer lugar, expone cómo surgió el constructo salutogénesis, el contexto sociocultural que lo impulsó, así como la importancia que adquiere en la salud pública actual. Con este objetivo, en estas páginas se analizan las bases teóricas del modelo salutogénico, con especial énfasis en sus antecedentes y precursores, así como en sus inicios, desarrollo y expansión actual

Ajuste psicológico y clasificación de mujeres cuidadoras de nietos y nietas y/o ascendientes en función de su inteligencia emocional

El envejecimiento de la población y la cultura actual en torno a los cuidados han propiciado un aumento del número de abuelas cuidadoras, ya sea de sus nietos o nietas, de sus ascendentes, o incluso de ambas generaciones simultáneamente. Con el objetivo de conocer más en profundidad las consecuencias psicológicas de este fenómeno, se llevaron a cabo entrevistas estructuradas a 115 mujeres del suroeste de España que eran abuelas, a la vez que hijas o nueras de una generación anterior. Se ha realizado un análisis de cluster bietápico para clasificar a estas mujeres según su inteligencia emocional. Las mujeres han quedado distribuidas casi al 50% en dos grupos claramente diferenciados. El primer grupo, caracterizado por mayor flexibilidad, tolerancia al estrés y control de los impulsos, aglutina una mayor proporción de mujeres residentes en entornos urbanos y con mayor nivel de estudios, y muestra niveles significativamente más altos de salud psicológica y felicidad. En cambio, el segundo grupo de mujeres, caracterizadas por menor inteligencia emocional, obtiene puntuaciones significativamente más altas en estrés y ansiedad. Este estudio pone de manifiesto la importancia de incluir la promoción de estas habilidades de inteligencia emocional en programas de prevención y promoción de la salud en este colectivo.The aging of the population and the current culture of caregiving have led to an increase in the number of grandmothers who care for their grandchildren, their ancestors, or even both generations simultaneously. In order to know more deeply the psychological consequences of this phenomenon, 115 structured interviews were conducted with women from southwestern Spain who were grandmothers and, at the same time, who were daughters or daughters-in-law from a previous generation. A two-stage cluster analysis was performed to classify these women according to their emotional intelligence. Women have been distributed almost 50% in two clearly differentiated groups. The first group, characterized by higher flexibility, stress tolerance and impulse control, brings together a greater proportion of women living in urban environments and with a higher level of studies, and shows significantly higher levels of psychological health and happiness. In contrast, the second group of women, characterized by lower emotional intelligence, scores significantly higher in stress and anxiety. This study highlights the importance of including the promotion of these emotional intelligence skills in prevention and health promotion programs in this collective of women

Alcohol consumption trends among Spanish school-aged adolescents in the first decade of the 21st century

Objetivo: Conocer la tendencia en el consumo de cerveza, vino y licores destilados de los adolescentes españoles en 2002, 2006 y 2010, así como la tendencia de haber experimentado episodios de embriaguez durante este mismo periodo de tiempo. Método: La muestra está conformada por 23.169 adolescentes de 15 a 18 años de edad: 7103 en 2002, 10.443 en 2006 y 5623 en 2010. En las tres ediciones del estudio, los datos son representativos de los escolares de esas edades en España. Se utilizó el cuestionario de consumo de alcohol consensuado por el equipo internacional del estudio Health Behaviour in School-aged Children (HBSC). Se estimaron las odds ratio y los intervalos de confianza del 95% mediante regresiones logísticas. Resultados: Los resultados principales muestran un descenso del consumo frecuente de vino y licores destilados de 2002 a 2010, que se mantiene cuando se controla la variabilidad debida al sexo y a la edad de los participantes. Sin embargo, se encontró una tendencia al alza de los episodios de embriaguez en las diferentes cohortes de adolescentes estudiadas. Conclusiones: Se obtienen resultados de especial importancia para el análisis de las consecuencias de las políticas de salud pública implementadas durante los años que abarca el estudio. Se encuentran cambios en los patrones de consumo de las diferentes bebidas alcohólicas, lo que puede constituir una información clave para el diseño de nuevas políticas de salud pública.Objective: To determine trends in beer, wine, and liquor consumption among Spanish adolescents in 2002, 2006, and 2010, as well as drunkenness trends during the same period. Method: The study sample was composed of 23,169 adolescents aged 15 to 18 years old: 7,103 in 2002, 10,443 in 2006 and 5,623 in 2010. In the three time points of the study, the data were representative of Spanish adolescent students. We used the alcohol consumption questionnaire designed by the international team of the Health Behavior in School-aged Children (HBSC) study. We estimated odds ratios and 95% confidence intervals through logistic regressions. Results: The main results showed a decrease in frequent consumption of wine and liquor from 2002 to 2010. This decrease was maintained after controlling for the variability due to the participants’ gender and age. However, an increasing trend was found in drunkenness episodes in the different cohorts of the adolescents under study. Conclusions: The results ofthis study are of particular importance in the analysis ofthe effects ofthe public health policies implemented during this time period. We also found changes in consumption patterns of the various alcoholic drinks, which may constitute key information in the design of new public health policies.Ministerio de Sanidad, Servicios Sociales e IgualdadMinisterio de Sanidad y Política Social (Sanidad, Política Social e Igualdad/Sanidad y Política Social/Sanidad y Consumo

Integrated analysis of the health and social inequalities of Spanish adolescents

Este estudio descriptivo presenta el proceso hasta la creación de una puntuación global de la salud en los adolescentes. En los últimos años, el concepto de salud, en el que se basa este estudio, ha sufrido cambios para incluir tanto los elementos disfuncionales como las fortalezas que protegen la salud. La muestra estuvo formada por 18.955 adolescentes, representativos de la población de 11 a 18 años en España y en cada una de las Comunidades Autónomas que conforman el Estado español. Utilizando técnicas de análisis factorial exploratorio y confirmatorio, los resultados mostraron una dimensión global de la salud, a partir de indicadores autoinformados de satisfacción vital, calidad de vida relacionada con la salud, percepción del estado general de salud y malestar psicosomático. Esta puntuación de salud disminuía a medida que aumentaba la edad y de manera más marcada en mujeres, así como en adolescentes de familias con capacidad adquisitiva baja. Los análisis comparativos entre Comunidades Autónomas mostraron diferencias entre ellas, no atribuibles en principio al bienestar económico de la región. Finalmente, se discutieron estos resultados y sus implicaciones, así como la importancia de la medida utilizada en el análisis de las desigualdades sociales en salud.This survey descriptive study presents the process leading up to the creation of a global health score for adolescents. In recent years, the concept of health, which is the bases for this study, has undergone changes to include both dysfunctional elements as well as the individual resources that protect health. The sample was made up of 18,955 adolescents between 11 to 18 years of age, in Spain and with participants in each of the regions making up the kingdom of Spain. Using exploratory and confirmatory factorial analysis techniques, the results showed a global dimension of the health, starting from self-report indicators of life satisfaction, health-related quality of life, perception of the general state of health and psychosomatic complaints. This health score decreased as age increased and more notably among girls, as well as in adolescents from low-income families. The comparative analyses between regions showed differences which were, in principle, not attributable to the economic well-being of the geographic area. Finally, these results and their implications were discussed, as well as the importance of the calculation used in the analysis of the social inequalities in health

Actividad física en la adolescencia

Este artículo se centra en la importancia que adquiere en la adolescencia el estilo de vida activo. Se comentan los bajos índices de actividad física que se registran durante esta etapa evolutiva y se analizan con detalle las razones que subyacen a los cada vez más altos índices de sedentarismo y de incumplimiento de las recomendaciones de los expertos sobre la intensidad y duración de la actividad física en estos años. Así mismo, se examinan variables de interés en la promoción de la actividad física en nuestro país, unas tienen que ver con características del sujeto (como son el género y la edad), otras con características de sus microsistemas más cercanos (las condiciones socioeconómicas familiares) y otras están referidas a aspectos más macrosistémicos (como son los indicadores de renta per cápita en las diferentes comunidades autónomas de España).This article focuses on the importance an active lifestyle has in adolescence. The low scores for physical activity registered during this developmental stage are discussed, and the underlying reasons for the ever increasing scores for sedentary lifestyles are analyzed in-depth along with the non-fulfillment of recommendations with regards to the intensity and duration of physical activity at this age. Likewise, variables of interest in the promotion of physical activity in Spain are examined. Some of these are related to individual characteristics (such as gender and age), to immediate micro-system (socioeconomic conditions of the family) aspects or to more macro-system-related aspects (such as the indicators for income per capita in the various regions of Spain)