CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China.
JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Soc Psychiatry Psychiatr Epidemiol. 2024 Dec;59(12):2189-2201. doi: 10.1007/s00127-024-02649-7. Epub 2024 Apr 4.
Despite evidence on socioeconomic inequalities in psychosocial well-being of adolescents under the COVID-19 pandemic, the explanatory factors and their potential variations across contexts remained understudied. Hence, this cross-regional study compared the extent of inequalities and the mediating pathways across Hong Kong, Mainland China, and the Netherlands.
Between July 2021 and January 2022, 25 secondary schools from diverse socioeconomic background were purposively sampled from Hong Kong, Zhejiang (Mainland China), and Limburg (the Netherlands). 3595 junior students completed an online survey during class about their socioeconomic position, psychosocial factors, and well-being. Socioeconomic inequalities were assessed by multiple linear regressions using the Slope Index of Inequality (SII), whereas the mediating pathways through learning difficulty, overall worry about COVID-19, impact on family' financial status, resilience, trust in government regarding pandemic management, and adaptation to social distancing were examined by mediation analyses moderated by regions.
The adverse psychosocial impact of COVID-19 was stronger in the Netherlands and Hong Kong compared with Mainland China. The greatest extent of socioeconomic inequalities in the change in psychosocial well-being was observed among students in the Netherlands (SII = 0.59 [95% CI = 0.38-0.80]), followed by Hong Kong (SII = 0.37 [0.21-0.52]) and Mainland China (SII = 0.12 [0.00-0.23]). Learning difficulty and resilience were the major mediators in Mainland China and Hong Kong, but to a lesser extent in the Netherlands.
Socioeconomic inequalities in psychosocial well-being were evident among adolescents under the pandemic, with learning difficulty and resilience of students as the key mediators. Differences in the social contexts should be considered to better understand the variations in inequalities and mediating pathways across regions.
尽管有证据表明，在 COVID-19 大流行下，青少年的心理社会福祉存在社会经济不平等，但解释因素及其在不同背景下的潜在变化仍未得到充分研究。因此，本跨区域研究比较了香港、中国大陆和荷兰的不平等程度和中介途径。
在 2021 年 7 月至 2022 年 1 月期间，从不同社会经济背景的 25 所中学中，有针对性地抽取了香港、浙江（中国大陆）和林堡（荷兰）的 3595 名初中生，在课堂上完成了一项关于其社会经济地位、心理社会因素和幸福感的在线调查。使用不平等斜率指数（SII），通过多元线性回归评估社会经济不平等，通过中介分析检验学习困难、对 COVID-19 的总体担忧、对家庭财务状况的影响、适应力、对政府大流行管理的信任以及适应社会距离的中介途径，这些途径受到地区的调节。
与中国大陆相比，COVID-19 对青少年的心理社会影响在荷兰和香港更为严重。社会经济地位变化对心理社会福祉影响的社会经济不平等程度最大的是荷兰的学生（SII=0.59[95%CI=0.38-0.80]），其次是香港（SII=0.37[0.21-0.52]）和中国大陆（SII=0.12[0.00-0.23]）。学习困难和适应力是中国大陆和香港的主要中介因素，但在荷兰的作用较小。
在大流行期间，青少年的心理社会福祉存在社会经济不平等，学生的学习困难和适应力是关键的中介因素。应该考虑社会背景的差异，以更好地理解不同地区不平等和中介途径的变化。
