De Clercq Bart, Abel Thomas, Moor Irene, Elgar Frank J, Lievens John, Sioen Isabelle, Braeckman Lutgart, Deforche Benedicte
Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Academical Hospital, 4K3, De Pintelaan, 185, Ghent, Belgium.
Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Eur J Public Health. 2017 Apr 1;27(2):279-286. doi: 10.1093/eurpub/ckw236.
Current explanations of health inequalities in adolescents focus on behavourial and economic determinants and rarely include more meaningful forms of economic, cultural, and social capital. The aim of the study was to investigate how the interplay between capitals constitutes social inequalities in adolescent healthy food intake.
Data were collected in the 2013/14 Flemish Health Behavior among School-aged Children (HBSC) survey, which is part of the international WHO HBSC survey. The total sample included 7266 adolescents aged 12-18. A comprehensive set of 58 capital indicators was used to measure economic, cultural and social capital and a healthy food index was computed from a 17-item food frequency questionnaire (FFQ) to assess the consumption frequency of healthy food within the overall food intake.
The different forms of capital were unequally distributed in accordance with the subdivisions within the education system. Only half of the capital indicators positively related to healthy food intake, and instead 17 interactions were found that both increased or reduced inequalities. Cultural capital was a crucial component for explaining inequalities such that social gradients in healthy food intake increased when adolescents participated in elite cultural practices ( P < 0.05), and were consequently reduced when adolescents reported to have a high number of books at home ( P < 0.05).
A combination of selected resources in the form of economic, cultural and social capital may both increase or reduce healthy food intake inequalities in adolescents. Policy action needs to take into account the unequal distribution of these resources within the education system.
目前对青少年健康不平等现象的解释主要集中在行为和经济决定因素上，很少涉及更具意义的经济、文化和社会资本形式。本研究的目的是调查各种资本之间的相互作用如何构成青少年健康食品摄入量方面的社会不平等。
数据收集于2013/14年佛兰德学龄儿童健康行为（HBSC）调查，该调查是世界卫生组织国际HBSC调查的一部分。总样本包括7266名12 - 18岁的青少年。使用一套全面的58项资本指标来衡量经济、文化和社会资本，并根据一份包含17项内容的食物频率问卷（FFQ）计算健康食品指数，以评估在总体食物摄入量中健康食品的消费频率。
不同形式的资本根据教育系统内的细分情况分布不均。只有一半的资本指标与健康食品摄入量呈正相关，相反，发现有17种相互作用会增加或减少不平等现象。文化资本是解释不平等现象的关键因素，当青少年参与精英文化活动时，健康食品摄入量的社会梯度会增加（P < 0.05），而当青少年报告家中有大量书籍时，这种梯度会相应降低（P < 0.05）。
经济、文化和社会资本形式的特定资源组合可能会增加或减少青少年健康食品摄入量方面的不平等现象。政策行动需要考虑这些资源在教育系统内的不平等分布情况。
