ARCHIVED: Chapter 2: Young people in Canada: their health and well-being – Socio-Economic Inequalities
Social inequalities are associated with a variety of indicators including perceived health, mortality, morbidity, and psychosomatic illness (Machenbach, Kunst and Cavelaars, 1997; Kennedy, Kawachi, and Prothrow-Stith, 1998). Some inequalities, such as gender, race, and disability, represent basic life conditions and disparities in life chances.
Socio-economic inequalities are increasing throughout the world (Atkinson, Rainwater, and Smeeding, 1995) and include factors such as income, wealth, education, and prestige (Currie, Samdal, Boyce, and Smith, 2001). Although these socio-economic aspects have been associated with the well-being of children and adults, their impact on adolescents has been controversial (Bergman and Scott, 2001). For example, the relationship between socioeconomic variables and family functioning has demonstrated varying results (Baer, 1999), as is shown in Chapter 3 (The Home) of this report.
Within the HBSC study, measures of socioeconomic status (SES) comprised parent occupation and family income as measured by material wealth, perceived family wealth, and poverty (in the form of hunger). The family affluence scale (FAS) was used as a measure to capture students' reports of their families' assets and material wealth (Currie, Todd, and Platt, 1997; Mullan and Currie, 2000).
This chapter examines aspects of social inequalities assessed by family affluence and other measures of socio-economic status and gives an account of the association between family affluence and youth health outcomes.
Socio-Economic Status - Parent Occupation
Since many youth cannot accurately report family income (Duncan and Brooks-Gunn, 2000), youth socio-economic status is commonly measured instead in terms of the type of employment held by parents. The study asked students to identify their parents' type of occupations; if parents were not employed, students were requested to give the reason for this economic inactivity.
Approximately 90 percent of students across Grades 6 to 10 reported having fathers who were employed. Nearly one-third of those fathers held professional jobs, and just over one-third had skilled occupations, such as plumbers, electricians, and law enforcement officers (Figure 2.1). Only one-third of unemployed fathers were actually described as seeking employment, with 41 percent of students indicating that their fathers' economic inactivity was due to illness, retirement, or being a student and only 12 percent stating that their fathers were taking care of others full-time in the home (Figure 2.2).
The employment status of mothers was also questioned. About 80 percent of students reported that their mothers were employed. Mothers' patterns of occupation (Figure 2.3) indicated that a significant proportion of this population (28 percent) could be categorized within the semi-skilled workers category, 21 percent in second-level professional positions, and fewer in the skilled workers positions (8 percent) relative to fathers' occupation patterns. Students reported far more often that their mothers were unemployed because they were taking care of others in the home than for any other reason (Figure 2.4).
Socio-Economic Status - Income
Abernathy, Webster, and Vermeulen's examination of the American National Population Health Survey data in 2002 shows that significant relationships exist between income and youth health. While children and adolescents are aware of socio-economic inequality (Jensen and Jensen, 2002), few studies examine the relationships between socio-economic inequality and adolescent health (Currie, Todd, and Platt 1997; Abernathy, Webster, and Vermeulen, 2002).
Family income level represents one important indicator of socio-economic status. The HBSC study asked students about their perception of the wealth of their families. Figure 2.5 illustrates that a little over one-half of Canadian students perceived their families to be well off or quite well off, although this number decreased for older students, perhaps as they gained a better understanding of their family's financial limitations. Further, boys were slightly more likely than girls to report that their families were well off or quite well off.
The study also gathered information about basic poverty by asking students how often they went to bed hungry for lack of food in the house. Figure 2.6 illustrates that a significant proportion of students, especially younger ones, sometimes went to bed hungry. For example, 17 percent of Grade 6 students, compared with 10 percent of student in Grade 10, reported that they sometimes went to bed hungry. Those who indicated that they always or often went to bed hungry were in a smaller minority.
Students were also asked questions about their families' material assets and disposable wealth as a proxy for family income. Figure 2.7 reveals that only about 10 percent of students reported not having their own bedroom, and the overall percentage of students who had their own bedroom increased between Grade 6 and Grade 10. Figure 2.8 shows that almost three-quarters of adolescents stated that their families owned two or more vehicles. About 4 percent of students' families did not own a vehicle. A family's ability to afford vacations was measured by asking how often students had been on holiday with their families within the previous year (Figure 2.9). Younger adolescents were more likely to report that they had travelled more than twice within the previous year. However, older students may have stayed at home and so did not report such family trips.
Computer ownership was also investigated as an indicator of family affluence. Figure 2.10 illustrates that about one-half of students reported that their families owned one computer; 41 percent of youth said that their families owned two or more computers. In addition, about 85 percent of students across all grades stated that they had access to the Internet at home (data not shown).
The four measures of wealth - (a) having own bedroom; (b) car, van, or truck ownership; (c) going on holiday/vacation; and (d) computer ownership - were scaled to create a family affluence scale (FAS) (Currie, Samdal, Boyce, and Smith, 2001; Mullan and Currie, 2000). Adolescents were placed into four categories of affluence, as indicated in Figure 2.11. Family affluence was fairly stable across grades, with over 60 percent of students having a middle to high FAS score, and very few students reporting a low FAS score.
Abernathy, Webster and Vermeulen (2002) suggest that SES variables, such as family affluence measures, correlate well with certain adolescent health outcomes, such as life satisfaction and self-reported health. Relationships between family affluence and these health outcomes are presented in Figures 2.12 and 2.13.
A clear positive association exists between family affluence and important outcomes at all grade levels. As sutdents' family affluence increased, so did the proportion of students who reported high life satisfaction. Similarly, there is a clear gradient between family affluence and excellent self-reported health.
- Approximately 10 percent of students' fathers and 20 percent of their mothers were not employed.
- A range of 50 to 60 percent of students reported that their families were well off, although this proportion decreased in older grades.
- Between 9 and 17 percent of students reported at least sometimes going to bed hungry because of lack of food at home.
- Almost 95 percent of students' families owned at least one computer.
- Family affluence was positively related to life satisfaction and self-reported health.
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