There are social inequalities in health – poor and less educated adults experi- ence worse health and shorter life spans than richer and better educated adults. These inequalities are also observed in youth, where adolescents with a low so- cial position have fewer chances in life and inferior living conditions compared with adolescents with a high social position. Health-related behaviour is usually established during late childhood and adolescence, and risk behaviour might continue in adult life, so that social disparities in lifestyle manifest themselves later in life as social inequalities in morbidity and mortality rates. But how to decrease social inequalities in health remains relatively unexplored. Therefore, we find it highly relevant to investigate how social inequalities in adolescents’ health can be reduced. Social inequalities in health have long been recognised and during the last decades this has attracted keen attention in the Danish research and policy arenas; however, the attention has not led to greater equity in health. In this master thesis we focus on social inequalities in adolescent’s health and the possibilities of reducing the inequity by health-promoting interventions in school. The thesis consists of three sections. In the first section we begin by exploring the term social equity in health, the causes of the inequalities, and the political strategies. The second section deals with youth and health behaviour and it has a qualitative and quantitative approach. Through focus group interviews with adolescents in the 9th grade, we got an insight into how adolescents experience their daily life and health. The aim of the quantitative analysis was to explore social inequalities in health among Danish adolescents and for that purpose we used data from the Danish Youth Cohort, a national representative study including more than 5000 students carried out in 2004-2007. In our analysis we used three different categories to measure social position: Fam- ily Affluent Scale (FAS), parents’ education and parents’ attachment to the labour market, and we included a broad range of health measures. The third section deals with health-promoting interventions in school and the potential of the interventions to diminish the social inequalities in health. This section is based on interviews with school principals and on a case study of two large healthpromoting interventions – “Tackling” and “The Health-Promoting School” – which have been carried out in a number of Danish schools. The thesis concludes that social inequalities in health among adolescents is a major problem that calls for action. It further concludes that health-promoting interventions in school can contribute to the reduction of social inequalities in health. The conclusion can be summarised into the following points: It is not always clear what is meant by the terms social, equity and health, and the picture of social variations in health that can be observed depends on the measurement of these terms. Therefore, the definition of social equity in health has important consequences for what inequities and political solutions that emerge. In this thesis we define social inequity in health as a systematic relation between social positions and inequalities in health. Our analysis show large social inequalities in health behaviour (smoking, diet and physical activity) and well-being (self-reported health, bullying and wellbeing at school) among Danish adolescents. The inequity is primarily manifested as a social gradient that runs right across society, so that even middleclass adolescents have poorer health behaviour and well-being than adolescents at the top of the social hierarchy. The school provides an important arena for preventing social inequalities in health, as the school reaches adolescents from all social groups of society. But to be an ideal field for prevention, more political will and financial support is needed. To tackle social inequalities, health-promoting interventions must have an inclusive approach to avoid stigmatisation and they should deal with health topics that will benefit those in poorer social circumstances the most. Furthermore, interventions have to be tailored to suit the Danish school system, which is charged with numerous responsibilities besides health concerns and suffers from a lack of resources. A range of social, environmental and cultural determinants contribute to the socially determined inequalities in health. Therefore a multisectoral and multifaceted approach is needed to tackle the problem. Health-promoting interventions in school can be a part of the solution.
|Uddannelser||TekSam - miljøplanlægning, (Bachelor/kandidatuddannelse) Kandidat|
|Udgivelsesdato||1 aug. 2008|
- Social ulighed i sundhed