Psychosocial School Conditions and Mental Wellbeing Among Mid-adolescents: Findings From the 2017/18 Swedish HBSC Study

Objectives: To investigate mid-adolescent boys’ and girls’ experiences of school demands, teacher support, and classmate support, and explore the associations of these factors with mental wellbeing.Methods: Data were derived from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, with information collected among 1,418 students in grade 9 (∼15–16 years). School demands, teacher support, and classmate support were measured by indices based on three items each. Mental wellbeing was measured by the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Linear regression analyses were performed.Results: Higher demands were associated with lower mental wellbeing. Conversely, mental wellbeing increased with greater teacher support and classmate support. Interactions between demands and the support variables showed that at the lowest levels of teacher and of classmate support, mental wellbeing was low and not associated with school demands. With increasing levels of teacher and classmate support, the overall level of mental wellbeing increased and revealed an inverse association between school demands and mental wellbeing.Conclusion: The study contributes with knowledge about how psychosocial conditions in school may hinder or enhance wellbeing among students

Trends in perceived school stress among adolescents in five Nordic countries 2002–2014

Associations between school-related stress and poor health, risk behaviours and low well-being are well documented. The aim of this paper was to estimate trends of perceived school stress experienced by boys and girls of different ages in the Nordic countries, and to describe trends in school stress between the Nordic countries. Nordic data from the Health Behaviour in School-aged Children study (HBSC) between 2002 and 2014 were used. The participants were aged 11–16 years. School stress was measured by a single item; “How pressured do you feel by schoolwork?” The participants answering “some” or “a lot” were categorised as reporting school stress.  Sweden, Norway and Denmark had lower prevalence of school stress compared to Finland and Iceland. There was an increase in Iceland, Finland and Denmark, whereas adolescents from Sweden showed a decreasing trend. In Norway, the level was stable. Boys showed a marginal decline in school stress whereas girls showed an increase, and school stress increased by age for the whole period. It is a challenge for the public education systems in the Nordic countries to develop policies and practices that provide children with the necessary tools to achieve knowledge and skill, and at the same minimise stress in school.</p

Towards enhancing research on adolescent positive mental health

The positive mental health and well-being perspective represents innovative public health research of first-rank priority in Europe. Good mental health is both a state and a resource for everyday life. Hence, the concept often refers to a subjective feeling (hedonic component) as well as positive functioning (eudaimonic component). Different conceptualisations of mental health-related issues are a background to this paper, which gives a brief overview of three research issues in the Nordic countries. First, the development in the occurrences of adolescent mental health-related indicators such as life satisfaction, health, sleep, and school pressure. Second, review of Nordic methodological studies reporting on different mental health-related measures. Third, the selection of measures of positive mental health employed in the 2017–2018 Health Behaviour among School-aged Children (HBSC) data collection in the Nordic countries. Using the Nordic HBSC data for 2002–2014, it was found that symptom and problem-oriented analyses of mental health can improve our understanding of the challenges adolescents face. However, there is also a need to examine positive aspects of mental health in order to enhance our understanding of different mental health-related dimensions. New measures were included in the 2017–18 HBSC data collection in the Nordic countries, enabling researchers to answer different research questions including analysing factors mediating and moderating positive mental health among school-aged children. Extending the perspective from a symptom- and problem-oriented view to a more positive and asset-based perspective adds additional value to studies of mental health.</p

Changing reproductive patterns in rural China : The influence of policy and gender

Background: In 1949, at the time for the foundation of the People's Republic of China, PRC, China had a Total Fertility Rate (TFR) of 5-6 children per woman, and it remained at that level throughout the 1950s and 1960s. In the beginning of the 1970s, the problems of rapid population growth began to receive serious attention and family planning programs were implemented. The TFR of around 6 births per woman in the early 1970s dropped to 2.8 in 1978. The one-child policy was introduced in 1979, and the fertility continued to drop, and in year 2000, it was estimated to be 1.8 children per woman. Paralleling this fertility decline, economic reforms were implemented with a de-collectivisation and return to family farming. China has been much criticized for its targetdriven population control programs, and for failing to take into account women's own perceptions of their health needs. It has also been argued that the family planning programs have resulted in undesirable social and economic consequences, such as increased discrimination against girls due to the strong preference for sons. Objectives: The overall aim was to analyse the reproductive patterns among women of different birth groups in one rural county, Yunnan Province, in context of successive birth policies and economic reforms and discuss these in relation to gender relationships. Methods: A cluster random sample of aged 15-64 at the time of the survey (2000) was selected in Huaning, one poor rural county in Yunnan province. The study population was women aged 15 to 64 years at the time of the survey in 2000. Thus, the older women in the study population entered reproductive age at the time of the foundation of the People's Republic of China in 1949. The total data set consists of 1336 women. Pre-coded questionnaires were used including background data, details on marriage, pregnancy histories, abortion, and contraceptive use. Quantitative analysis, such as life-table technique and causation analysis have been made. Main Findings: The childbearing patterns have changed in the direction of postponement of first marriage, a decreased interval between first marriage and first birth, a significant lengthening of birth intervals between first and second child, and a dramatic decline of third and higher birth orders. Abortion had become virtually universal for women with two children, regardless the sex of previous children. During the period 1988-2000, the reported sex ratio at birth rose to an average of 110 for all parities combined, which is considerably above the normal ratio. The IUD was the far most common method of family planning also after the birth of the second child, regardless the sex of the previous child. Conclusions: The timing and magnitude of the transformation of child bearing patterns and adoption of small family size follow closely the requirements of the successive family planning policies, especially from the mid 1980s and onwards. The family planning policies have, in demographic terms, successfully limited population growth, at the same time has the sex ratio at birth increased gradually since the implementation of these policies

Varför har den psykiska ohälsan ökat bland barn och unga i Sverige under perioden 1985–2014?

SammanfattningDenna artikel redovisar huvudresultaten från Folkhälsomyndighetens undersökning av faktorer som skulle kunna förklara den ökade förekomsten av psykosomatiska symtom bland barn och unga i Sverige. Rapporten bygger på analyser av svenska data från studien Skolbarns hälsovanor (1985/86−2013/14), trenddata från olika källor och vetenskaplig litteratur.Sammanfattningsvis tycks brister i skolans funktion, indikerat av de sjunkande skolprestationerna och den utbredda skolstressen, tillsammans med förändringar på arbetsmarknaden troligen ha bidragit till utvecklingen av psykosomatiska symtom bland unga. Däremot tycks inte faktorer inom familjen eller ekonomisk utsatthet i absoluta termer hos barnfamiljer, ha påverkat utvecklingen av psykosomatiska symtom bland barn och unga.På grund av ämnenas komplexitet och begränsat vetenskapligt underlag är det osäkert i vilken utsträckning faktorer som ökad individualisering, ökad öppenhet kring psykisk ohälsa, lägre krav på barnen, medikalisering av barndomen och digital medieanvändning har påverkat utvecklingen.AbstractThis article presents the main findings from the Swedish Public Health Agency's study of factors that could explain the increase of psychosomatic symptoms among children and young people in Sweden. The report is based on analyses of Swedish data from the international study Health Behaviour in School-aged Children, HBSC (1985/86−2013/14), trend data from various sources and scientific literature.In summary, deteriorated school functioning indicated by declining school performance and widespread school stress, together with the changes in the labour market, have probably contributed to the development of psychosomatic symptoms among young people. Factors within the family do not appear to have influenced the development of psychosomatic symptoms among children and adolescents, neither financial vulnerability in absolute terms among families.Due to the complexity of the subjects and limited scientific evidence, it is uncertain to what extent factors such as increased individualization, increased openness about mental ill health, lower demands on children, medicalisation of childhood and digital media use have affected the development.Key words:Psychosomatic symptoms, psychosomatic problems, mental ill health, children, adolescents, Sweden, school, labour marke

Socioeconomic inequalities in adolescent mental health in the Nordic countries in the 2000s - A study using cross-sectional data from the Health Behaviour in School-aged Children study

Abstract Background Adolescents in Sweden experience more mental health problems and lower mental well-being than adolescents in other Nordic countries. According to the literature, one possible explanation may be differences in income inequality. The at-risk-of-poverty rate varies significantly across the Nordic countries, and the highest rate is found in Sweden. The aims of the study were to examine socioeconomic inequalities in subjective health complaints and life satisfaction among adolescents in the Nordic countries during 2002 − 2018 and to explore whether subjective health complaints and life satisfaction were related to income inequality in terms of the at-risk-of-poverty rate at the country level. Methods Data regarding 15-year-olds from the Health Behaviour in School-aged Children study from five survey rounds (2002 − 2018) were used (n = 41,148). The HBSC Symptoms Checklist and Cantril’s ladder were used as measures of subjective health complaints and life satisfaction, respectively. The Family Affluence Scale, the Perceived Family Wealth item and the at-risk-of-poverty rate in each country were used as measures of individual-level socioeconomic conditions and country-level income inequality. Statistical methods involved ANOVA, multiple linear regressions and multilevel regression analyses. Results Absolute and relative socioeconomic inequalities in both subjective health complaints and life satisfaction were found in all countries. Sweden showed average socioeconomic inequalities, Iceland the largest and Denmark the smallest. Country-level income inequality in terms of the at-risk-of-poverty rate was associated with a higher prevalence of subjective health complaints and lower levels of life satisfaction in all countries. Conclusion Socioeconomic inequalities in adolescent mental health and well-being persisted in Nordic countries in the 2000s. Increasing income inequality may have contributed to higher levels of SHC and lower LS in Sweden compared to the other Nordic countries. Policies improving families’ socioeconomic conditions and reducing income inequality at the country level are needed to improve and reduce inequalities in mental health and well-being among adolescents

Sexual jokes at school and students life satisfaction : findings from the 2017/18 Swedish Health Behaviour in School-aged Children study

Objective In a previous study we demonstrated that the occurrence of sexual jokes in the class was associated with higher levels of psychological health complaints. Building on and extending these findings, the aim of the current study was to examine if exposure to sexual jokes at the student and at the class level was inversely associated with students life satisfaction. Data were derived from the 2017/18 Swedish Health Behaviour in School-aged Children (HBSC) study, with students aged 11, 13 and 15 years (n = 3710 distributed across 209 classes). Exposure to sexual jokes at the student level was captured by one item. Exposure to sexual jokes at the class level was calculated by aggregating this measure. The Cantril ladder was used to operationalise life satisfaction. Two-level logistic regression analyses were performed. Results Students who were exposed to sexual jokes at school were less likely to report high life satisfaction (OR 0.38, 95% CI 0.27-0.53). An inverse association was found between the class proportion of students who were exposed to sexual jokes and students likelihood of reporting high life satisfaction, whilst adjusting for exposure to sexual jokes at the student level (OR 0.98, 95% CI 0.97-0.9994). The findings highlight the importance of promoting a school climate without sexual harassment.Funding Agencies|Public Health Agency of Sweden [SU FV-6.1.2-1511-19]; Stockholm University</p

Psychosocial Working Conditions in School and Life Satisfaction among Adolescents in Sweden: A Cross-Sectional Study

Poor psychosocial working conditions in school have consistently been shown to be associated with adverse health among adolescents. However, the relationships between school demands, teacher support, and classmate support and positive aspects of health have not been explored to the same extent. The aim of this study was to examine differences in psychosocial working conditions in school and in life satisfaction by gender and by grade, and to investigate the association between psychosocial working conditions in school and life satisfaction among boys and girls, and among students in different grades. Data from the Swedish Health Behavior in School-Aged Children (HBSC) study of 2017/18 were used, consisting of 3614 students in Grades 5, 7, and 9 (~11, 13, and 15 years). Psychosocial working conditions in school were captured by indices of perceived school demands, teacher support, and classmate support. Life satisfaction was measured by the 11-step Cantril’s ladder (using cutoffs at &gt;5 and &gt;8, respectively). Whereas girls reported higher school demands than boys, higher levels of teacher and classmate support were reported by boys. Students in lower grades reported lower school demands but higher levels of teacher and classmate support compared with students in higher grades. Boys and students in lower grades were more likely to report high life satisfaction compared with girls and students in higher grades. Results from binary logistic regression analyzes showed that school demands were inversely associated with life satisfaction, and that higher levels of teacher support and classmate support were associated with high life satisfaction. These results were found for both boys and girls, and for students in all grades. The findings indicate that schools have the potential to promote positive health among students

Associations between dietary behaviours and the mental and physical well-being of Swedish adolescents.

AimsThis study aims to investigate the association between dietary behaviours, overweight/obesity, and mental health and well-being among Swedish adolescents.MethodsData from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey of 3692 adolescents aged ≈11, ≈13, and ≈15 years was analysed. We evaluated the prevalence and association of dietary behaviours, characterised by daily intake of fruits and vegetables, consumption of sugar-sweetened beverages (SSBs) and sweets once per week, and daily consumption of family meals and breakfast, with socioeconomic and demographic factors. Multivariate logistic regression models (adjusted and unadjusted) were then used to examine the relationship between dietary behaviours, overweight/obesity, and mental health and well-being including psychosomatic complaints, life satisfaction, and school-related pressure.ResultsBoys were more likely to eat breakfast and have meals together with their family than girls, but their fruit and vegetable intake was lower compared to girls. Adolescents with lower socioeconomic status (low family affluence, families perceived 'not well-off' and two unemployed parents), single-parent households and twoforeign born parents were more likely to engage in poorer dietary behaviours. Daily breakfast, family meals, fruit and vegetable intake were positively associated with mental health and well-being. Specifically, daily family meals were linked to higher life satisfaction, fewer psychosomatic complaints, and reduced school-related pressure. Breakfast emerged as a beneficial dietary habit, associated with higher life satisfaction, and a lower likelihood of psychosomatic complaints, school-related pressure, and overweight/obesity. Fruit and vegetable consumption was consistently associated with better mental health and well-being while associations between SSBs and sweets were mixed.ConclusionsImproving mental health and well-being, along with tackling the rising rates of mental illness and challenges related to overweight/obesity in adolescents constitute key public health priorities. Implementing policies that promote the intake of fruits and vegetables, reducing the consumption of SSBs and sweets, and emphasizing the value of having breakfast and sharing family meals could offer a cost-effective public health intervention