González-Casals Helena, Vives-Cases Carmen, López María José, Sanz-Barbero Belén, Pérez Katherine, Perez Gloria, Cortés-Albaladejo Mònica, Serral Gemma, Barceló Maria A, Ruiz-Pérez Isabel, Mateo-Rodríguez Inmaculada, Cabrera-León Andrés, Bosque-Prous Marina, Folch Cinta, Espelt Albert
Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Carretera de Canyet, s/n, Badalona, 08916, Spain.
Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona, Spain.
BMC Public Health. 2025 Jul 2;25(1):2246. doi: 10.1186/s12889-025-23515-4.
Despite being generally considered healthy, adolescence is a crucial period where health behaviours are established, which can impact future well-being. Factors such as social determinants, psychosocial variables, and risk behaviours play significant roles in determining general and mental health, with important gender differences. This article aims to study social inequalities in the prevalence of mental distress and poor self-perceived health of 14 to 18-year-old students schooled in Central Catalonia and Barcelona in the 2021-2022 academic year, separately for boys and girls.
Cross-sectional study using data from two surveys that monitor health and health behaviours in Central Catalonia (DESKcohort) and in Barcelona (FRESC survey) during the year 2021-2022. The final sample included 7,309 adolescents (51.8% were girls). Prevalence of mental distress and poor self-perceived health status were estimated stratifying by sex and according to different social determinants of health (independent variables): axes of inequality, psychosocial variables, and health behaviours. Poisson regression models with robust variance were calculated to analyse potential associations with independent variables.
Sex differences were observed, with girls having more than twice as much mental distress (42.0% vs. 18.7%, p < 0.001) and poorer self-perceived health status (15.6% vs. 6%, p < 0.001), compared to boys. Behavioural factors were more strongly linked to self-perceived health status than to mental distress. Axes of inequality, bullying victimization and problematic internet use were associated to both mental distress and poor self-perceived health status for boys and girls.
Adolescents' overall health is associated to factors such as gender, sexual orientation, migration status, socioeconomic position, bullying victimization, and problematic internet use. This study underscores the importance of taking a holistic approach when developing preventive and promotion strategies for adolescent health, addressing different levels of intervention while focusing on the most vulnerable populations.
尽管青春期通常被认为是健康的，但它是一个确立健康行为的关键时期，这些行为会影响未来的幸福感。社会决定因素、心理社会变量和风险行为等因素在决定总体健康和心理健康方面发挥着重要作用，且存在重要的性别差异。本文旨在研究2021 - 2022学年在加泰罗尼亚中部和巴塞罗那上学的14至18岁学生中，心理困扰患病率和自我感觉健康状况不佳方面的社会不平等情况，分别针对男孩和女孩进行研究。
采用横断面研究，使用2021 - 2022年期间在加泰罗尼亚中部（DESK队列）和巴塞罗那（FRESC调查）监测健康和健康行为的两项调查数据。最终样本包括7309名青少年（51.8%为女孩）。根据性别以及不同的健康社会决定因素（自变量）：不平等轴、心理社会变量和健康行为，对心理困扰患病率和自我感觉健康状况不佳进行分层估计。计算具有稳健方差的泊松回归模型，以分析与自变量的潜在关联。
观察到性别差异，与男孩相比，女孩的心理困扰发生率高出两倍多（42.0%对18.7%，p < 0.001），自我感觉健康状况较差（15.6%对6%，p < 0.001）。行为因素与自我感觉健康状况的关联比与心理困扰的关联更强。不平等轴、受欺凌受害情况和有问题的互联网使用与男孩和女孩的心理困扰以及自我感觉健康状况不佳均相关。
青少年的整体健康与性别、性取向、移民身份、社会经济地位、受欺凌受害情况和有问题的互联网使用等因素有关。本研究强调在制定青少年健康预防和促进策略时采取整体方法的重要性，在关注最脆弱人群的同时应对不同层面的干预。
