Research Findings: Age - Youth: Social patterning of health Summary Papers

Health inequalities: what’s going on in youth?

Around the time of the Black Report in the early 1980s health statistics obscured the stage of youth altogether, combining younger (early) youth with children and older (later) youth with adults.   Since the youth-adult transition stage appeared to be ignored, we questioned the assumption made in Black Report that health inequalities permeate all ages.  We followed the youngest cohort of the Twenty-07 Study from age 15 (when first interviewed in 1987) to age 21 and asked questions about health, family life, life at school, leisure patterns, health-related behaviours like exercise, diet, smoking and drug use, and about their attitudes and concerns.  We found that in early youth, around the time of secondary education, there is less evidence of class differences in health than at any other point in the life-course, including the earlier period of childhood, and that health is more strongly linked to where young people are heading than where they came from.

West, P. and H. Sweeting (1996). "Health inequalities: what's going on in youth?" Health Education 5: 14-20.
 

 
Lack of class variation in health in adolescence

We have previously shown, using a wide range of health measures, that there is little evidence of consistent class gradients in health in adolescence.  This paper explored the possibility that those findings were an artefact of the ‘Head of Household (HoH) occupational measure of social class used in the earlier analysis.  We therefore investigated seven indicators of health among the 1970s cohort of the Twenty-07 Study when they were 15 year olds (i.e. self-reported long standing illness, self-assessed health, accidents, height, blood pressure, respiratory function and psychological well-being) using six different occupationally-based and five non-occupationally based measures of socio-economic status.  Our findings supported conclusions of the earlier paper that adolescence is characterised by little or no class differences in most indicators of health.

Macintyre, S. and P. West (1991). "Lack of class variation in health in adolescence: an artefact of an occupational measure of social class?" Social Science and Medicine 32: 395-402.
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Social class in youth and health

In attempts to explain health inequalities highlighted in the 1980s ‘Black Report’ little attention has previously been given to the pattern of social class gradients throughout the life course.  The assumption that youth, like any other stage, is characterised by class differences in health was questioned.  Using 3 indicators - mortality, chronic illness and self-reported health, there would appear to be little or no class differences in youth.  However, it has been suggested that mortality and, to a lesser extent, chronic illness are inappropriate measures of health in youth, and a wider range of measures is required to establish true physical and mental health in youth.

This project aimed to increase the knowledge of the issue of inequalities – or not – in health in youth by collecting a wide range of information about physical and mental health of the 1970s cohort of the Twenty-07 Study, when they were 15 year olds.  We wanted to find out if youth is characterised by a relative equality on a much greater range of measures than has been collected in previous research. 

We found evidence was unsupportive of class differences in the total number of non-fatal accidents in both males and females.  Class gradients were found to exist in males but not females who rated their own health as “Good”, with 61% of males from non-manual class rating their health as “Good” compared to 48% of males in manual classes.  In terms of the most prevalent symptoms and/or illness experienced we found that more similarities existed between social classes that differences, particularly for headaches, skin conditions, sleep problems and asthma.  However, gender would appear to have a greater significance than class on number of symptoms/illnesses reported.  Females report more colds/flu/throat infections, headaches, weight problems, anxiety/depression, and sickness than males across each social class.  Mental health and well-being was not found to be class differentiated in either males or females.  We found little evidence of class differences for physical measures except in height for both sexes.

Findings from the 1950s cohort from the Twenty-07 study allowed a direct comparison with the youth cohort on an almost identical range of health measures.  Marked social class gradients among 35 year olds were found in respect of self-rated health, symptoms experienced, body mass index and respiratory function.  Our findings support the idea that youth is characterised by little or no class differentiation in health and that significant inequalities emerge within a relatively short space of time in the transition from youth to adulthood.  Possible explanations suggest inequalities may be masked in youth or too early to be observed by factors such as further education, employment, workplace environments, health-related behaviours (smoking, drinking etc) or that they may be era-specific.  To gain a better understanding of possible explanations we need to compare data collected from the 1970s cohort in 1987, when they were 15, with that collected in 2007, as they reach the age of 35. 

West, P., S. Macintyre, et al. (1990). "Social class and health in youth: findings from the West of Scotland Twenty-07 Study." Social Science and Medicine 30: 665-673.