Persistent Social Inequality in Adolescent Health Indicators 1991–2022: Trend Study From Denmark

Objectives: To examine trends in socioeconomic inequality in adolescent health over
three decades, across fifteen health indicators: overweight, underweight, headache,
stomachache, backpain, emotional symptoms, difficulties falling asleep, loneliness, low
life satisfaction, low self-rated heath, smoking, drunkenness, physical inactivity, low
vegetable intake, and inadequate toothbrushing.
Methods: The Health Behaviour in School-aged Children (HBSC) study in Denmark
included nine identical surveys of 11–15-year-olds from 1991 to 2022, n = 35,423. For
each health indicator, we measured absolute and relative socioeconomic inequality by
prevalence differences and odds ratios between low and high socioeconomic groups.
Results: There was socioeconomic inequality in thirteen health indicators, e.g., the OR
(95% CI) for overweight in low vs. high socioeconomic groups was 2.22 (1.95–2.49). This
social inequality persisted across health indicators throughout the study period with two
deviations: Underweight was not associated with socioeconomic background and
drunkenness was persistently most prevalent in higher socioeconomic groups.
Conclusion: The political efforts to reduce socioeconomic inequality in health seems to
have failed. It is important to improve monitoring of adolescent health and implement
improved policies to tackle socioeconomic inequality in adolescent health.