The social determinants of adolescent health
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The Social Determinants of Adolescent Health
Introduction to Social Determinants of Adolescent Health
Adolescent health is significantly influenced by a variety of social determinants that operate at multiple levels, including personal, family, community, and national contexts. These determinants shape health behaviors and outcomes, which can have lasting effects into adulthood. Understanding these factors is crucial for developing effective interventions to improve adolescent health globally.
National Wealth, Income Inequality, and Education Access
One of the strongest determinants of adolescent health worldwide is the structural context, including national wealth, income inequality, and access to education. These factors create a framework of opportunities and constraints that shape the health trajectories of young people. Countries with higher national wealth and lower income inequality tend to provide better health outcomes for adolescents by ensuring access to quality education and healthcare services1.
Family and Community Influences
Safe and supportive family environments are critical for adolescent health. Family cohesion, parental well-being, and effective parenting styles are significant mediators of the relationship between socioeconomic status and adolescent health outcomes. For instance, parental well-being and family cohesion have been shown to explain a substantial portion of the health inequalities observed among adolescents from different socioeconomic backgrounds4. Additionally, community-level factors such as safe neighborhoods and supportive schools play a crucial role in promoting healthy behaviors and reducing risks1 4.
Peer Influence and Social Networks
Peers significantly influence adolescent health behaviors through social network processes. Health behaviors such as smoking, drinking, and physical activity often cluster within social networks due to homophilic social selection and social influence. Adolescents in denser social networks tend to exhibit lower levels of harmful behaviors, highlighting the protective role of positive peer relationships2. Popularity within these networks can also impact health behaviors, with more popular adolescents often engaging in behaviors that enhance their social status2.
Mental Health and Adverse Childhood Experiences
Mental health issues such as anxiety and depression are prevalent among adolescents and are strongly associated with various social determinants. Adverse childhood experiences (ACEs) and experiences of racism are particularly impactful, significantly increasing the likelihood of mental health challenges. Interventions targeting these specific determinants may be more effective in mitigating mental health issues among adolescents3.
Socioeconomic Position and Health Inequalities
Socioeconomic position, including factors like income, education, and occupational status, is a critical determinant of self-rated health among adolescents. Familial determinants such as parental stress, smoking, and physical activity mediate the relationship between socioeconomic status and health outcomes. These mediators are particularly influential for female adolescents, where family practices can explain a large portion of health inequalities4.
Health Lifestyles and Behavioral Clusters
Adolescents' health behaviors often cluster into distinct lifestyles, influenced by their social determinants. For example, clusters such as "substance consumers" and "active students" exhibit different health behaviors and are shaped by their family, school, and peer environments. Understanding these clusters can help in designing targeted health promotion activities that address the specific needs and risks of different adolescent groups7.
Addressing Social Determinants in Healthcare
Incorporating social determinants into routine adolescent healthcare is essential for addressing health inequities. Medical homes that connect adolescents to community resources and utilize multidisciplinary teams can effectively address social needs and improve health outcomes. Screening tools and referral programs should be developed and evaluated to ensure they meet the unique needs of adolescents5.
Conclusion
The social determinants of adolescent health are multifaceted and operate at various levels, from national policies to family dynamics and peer influences. Addressing these determinants requires comprehensive strategies that include improving access to education and healthcare, fostering supportive family and community environments, and targeting specific risk factors such as ACEs and racism. By understanding and addressing these social determinants, we can improve the health and well-being of adolescents globally.
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Most relevant research papers on this topic
Adolescence and the social determinants of health
Adolescent health is strongly influenced by structural factors, national wealth, income inequality, access to education, safe and supportive families, schools, and supportive peers.
Literature Review
Rigorous Journal
Highly CitedPeer social network processes and adolescent health behaviors: A systematic review.
Denser adolescent peer social networks are associated with lower levels of harmful behavior, suggesting social network processes play a significant role in adolescent health behaviors.
Systematic ReviewRigorous JournalHighly CitedSocial determinants of mental health and adolescent anxiety and depression: Findings from the 2018 to 2019 National Survey of Children’s Health
Interventions targeting adverse childhood experiences and racism may be more effective in mitigating mental health challenges associated with social determinants of mental health in adolescents.
Observational StudyRigorous JournalSocioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study
Family practices, particularly parental well-being, play a significant role in explaining the association between socioeconomic disadvantage and poorer health in adolescents.
Observational StudyRigorous JournalAddressing social determinants of health in the adolescent medical home
Adolescent medical homes should incorporate social determinants of health into routine healthcare, utilizing multidisciplinary team members and screening tools to effectively connect adolescents to resources.
Literature ReviewNew Findings From the Health Behaviour in School-aged Children (HBSC) Survey: Social Media, Social Determinants, and Mental Health.
The latest Health Behaviour in School-aged Children (HBSC) survey highlights the importance of social media, social determinants of health, and mental health in promoting adolescent well-being globally.
Health lifestyles during adolescence: clustering of health behaviours and social determinants in Italian adolescents.
Adolescents can be grouped into four distinct health lifestyle clusters, with associations between health behaviors and social determinants, aiding in designing effective health promotion activities.
Observational StudyCanadian adolescent perceptions and knowledge about the social determinants of health: an observational study of Kingston, Ontario youth
Adolescents in Kingston, Ontario lack knowledge of social determinants of health, with knowledge varying by socioeconomic status, highlighting the need for health curriculum revision to include SDH material.
Observational StudyRigorous JournalSocial determinants in the sexual health of adolescent Aboriginal Australians: a systematic review
Social determinants like access to healthcare, poverty, substance use, educational disadvantage, sociocultural context, gender inequalities, and social disadvantage impact Aboriginal and Torres Strait Islander adolescents' sexual health and risk.
Systematic ReviewRigorous JournalWhere Youth Live, Learn, and Play Matters: Tackling the Social Determinants of Health in Adolescent Sexual and Reproductive Health
Adolescent sexual and reproductive health practitioners should address social determinants of health, including neighborhood, built environment, economic stability, health, healthcare, social context, and education, to improve outcomes.
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