Unit for Public Health and Statistics (FSE), University Hospital of Linköping, Sweden.
Department of Global Public Health, Karolinska Institutet, Sweden.
Scand J Public Health. 2022 Dec;50(8):1081-1088. doi: 10.1177/14034948221113142. Epub 2022 Sep 8.
The study aimed to analyse the association between neighbourhood- and school-level socio-demographic factors and self-reported mental health among adolescents.
The study population consisted of 3959 adolescents in southern and central Sweden (the KUPOL study), surveyed in the seventh grade (13 years old) and again in the ninth grade (15 years old). Cross-sectional associations were studied between socio-demographic indicators at neighbourhood level (proportion of adults with high education, without employment, of foreign-born residents) and at school level (proportion of students with at least one parent with high education, of students with a foreign background, mean qualification points in ninth grade) and mental health problems. These were assessed through the Strengths and Difficulties Questionnaire (SDQ). We derived odds ratios (OR) and corresponding 95% confidence intervals (CI) of scale scores above the threshold using multilevel logistic regression models.
After adjustment for individual- and family-level socio-demographic factors, there was an indication of higher OR of mental health problems with increasing proportions of foreign-born and residents without employment, especially among girls and in public schools. Stronger associations in the expected direction were found with the internalising subscale. Socio-demographic factors at the school level were not associated with adolescents' mental health, except in private schools, where increasing proportions of students with highly educated parents were significantly associated with SDQ scores under the threshold (OR=0.91; 95% CI 0.85-0.97).
The results indicate that equal living conditions may represent important cues to improve the mental health of adolescents. Longitudinal studies are needed to determine any causality.
本研究旨在分析社区和学校层面的社会人口因素与青少年自我报告的心理健康之间的关联。
研究人群包括瑞典南部和中部的 3959 名青少年（KUPOL 研究），他们在七年级（13 岁）和九年级（15 岁）时接受了调查。采用横断面研究方法，分析了社区层面（受过高等教育的成年人比例、无业人员比例、外国出生居民比例）和学校层面（至少有一位家长受过高等教育的学生比例、有外国背景的学生比例、九年级平均资质分数）的社会人口学指标与心理健康问题之间的关联。采用长处与困难问卷（SDQ）评估心理健康问题。我们使用多水平逻辑回归模型得出了分数高于阈值的比例与心理健康问题之间的比值比（OR）及其相应的 95%置信区间（CI）。
在调整了个体和家庭层面的社会人口学因素后，外国出生人口比例和无业人员比例的增加与心理健康问题的 OR 呈正相关，这在女孩和公立学校中更为明显。与内部化子量表的相关性更强。学校层面的社会人口学因素与青少年的心理健康无关，除了在私立学校中，具有高学历父母的学生比例增加与 SDQ 分数低于阈值显著相关（OR=0.91；95%CI 0.85-0.97）。
研究结果表明，平等的生活条件可能是改善青少年心理健康的重要线索。需要进行纵向研究来确定任何因果关系。
