University Consortium of Seinäjoki, Seinäjoki Technology and Innovation Centre,, University of Tampere, School of Health Sciences, Kampusranta 9C, Seinäjoki FIN-60320, Finland.
BMC Public Health. 2013 Aug 2;13:711. doi: 10.1186/1471-2458-13-711.
Our interest was in how health behaviours in early and late adolescence are related to educational level in adulthood. The main focus was in the interplay between school career and health behaviours in adolescence. Our conceptual model included school career and health-compromising (HCB) and health-enhancing (HEB) behaviours as well as family background. Two hypotheses were tested: 1) the primary role of school career in shaping educational level in adulthood (an unsuccessful school career in adolescence leads to HCB and not adopting HEB and to low educational level in adulthood); 2) the primary role of health behaviours (HCB and not adopting HEB in adolescence leads to a school career with low education in adulthood).
Mailed surveys to 12 to18 year-old Finns in 1981-1991 (N=15,167, response rate 82%) were individually linked with the Register of Completed Education and Degrees (28 to 32-year-olds). We applied structural equation modeling to study relations of latent variables (family SEP, family structure, school career, HCB, HEB) in adolescence, to the educational level in adulthood.
Standardized regression coefficients between school career and health behaviours were equally strong whether the direction was from school career to HEB (0.21-0.28 for 12-14 years; 0.38-0.40 for 16-18 years) or from HEB to school career (0.21-0.22; 0.28-0.29); and correspondingly from school career to HCB (0.23-0.31; 0.31-0.32) or from HCB to school career (0.20-0.24; 0.22-0.22). The effect of family background on adult level of education operated mainly through school career. Only a weak pathway which did not go through school career was observed from behaviours to adult education.
Both hypotheses fitted the data showing a strong mutual interaction of school achievement and adoption of HCB and HEB in early and late adolescence. Both hypotheses acknowledged the crucial role of family background. The pathway from health behaviours in adolescence to adult education runs through school career. The interplay between behaviours and educational pathways in adolescence is suggested as one of the mechanisms leading to health inequalities in adulthood.
我们的兴趣在于青少年早期和晚期的健康行为如何与成年后的教育水平相关。主要重点是青春期的学校生涯和健康行为之间的相互作用。我们的概念模型包括学校生涯和健康损害（HCB）和健康促进（HEB）行为以及家庭背景。我们测试了两个假设：1）学校生涯在塑造成年后教育水平方面的主要作用（青春期学业不成功导致 HCB 和不采用 HEB，并导致成年后教育水平低）；2）健康行为（青春期的 HCB 和不采用 HEB）的主要作用导致成年后接受低教育水平的学校生涯。
1981-1991 年，我们向芬兰 12 至 18 岁的青少年邮寄调查问卷（N=15167，回应率 82%），并将其与完成教育和学位登记处（28 至 32 岁）进行个人匹配。我们应用结构方程模型来研究青春期潜在变量（家庭社会经济地位、家庭结构、学校生涯、HCB、HEB）与成年后教育水平之间的关系。
无论从学校生涯到 HEB（12-14 岁时为 0.21-0.28；16-18 岁时为 0.38-0.40）还是从 HEB 到学校生涯（0.21-0.22；0.28-0.29）的方向，学校生涯与健康行为之间的标准化回归系数都同样强；从学校生涯到 HCB（0.23-0.31；0.31-0.32）或从 HCB 到学校生涯（0.20-0.24；0.22-0.22）的情况也是如此。家庭背景对成人教育水平的影响主要通过学校生涯运作。只观察到一条从行为到成人教育的弱途径，且不经过学校生涯。
两个假设都符合数据，表明青少年早期和晚期的学业成绩和 HCB 和 HEB 的采用之间存在强烈的相互作用。两个假设都承认家庭背景的关键作用。青春期健康行为到成人教育的途径是通过学校生涯。青春期行为和教育途径的相互作用被认为是导致成年期健康不平等的机制之一。
