Abstract
Background: While the graded relationship between socio-economic status (SES) and health risk behaviour in adulthood has been the subject of intense research, far less is known about the magnitude and the pattern of social inequalities in healthrelated behaviours among adolescents and the scarce evidence that does exist is inconsistent and partly contradictory. Knowledge about the existence of such an early life-course relationship between socio-economic differences and healthrisk behaviours is, however, important as it would constitute a particular challenge for health policy and health promotion. The purpose of the present study is to examine socio-economic differences in adolescent alcohol use as well as changes in the relationship between 1994 and 2006 in Germany.
Methods: Data were obtained from the ‘Health Behaviour in School-aged Children’ Study conducted in the largest federal state of Germany, North Rhine Westphalia in 1994, 1998, 2002 and 2006. The analysis is based on N = 15724 11 to 15-year-old students from all four types of the very segmented and hierarchical German school system. Socio-economic differences in weekly alcohol use and lifetime prevalence of drunkenness were studied, in relation to both parental SES (family affluence) and students’ own SES (type of school attended). Time trends for the percentages of regular alcohol consumers
and for repeated drunkenness for different SES groups were estimated with the help of logistic regression models.
Results: While rates of at least weekly alcohol use as well as repeated drunkenness in 11- to 15-year-old German students have increased steadily from 1994 to 2002, the last years have witnessed a reversal of this trend. In 2006, prevalence rates of alcohol use and drunkenness decreased to or fell even below the levels of 1994 (10.8% to 9.2% for weekly alcohol consumption in boys and 8.1% to 4.9% in girls). These trends were largely independent of socio-economic status as measured by family affluence and type of school attended. Findings for drunkenness, particularly in boys, however, showed that independent of point in time, family affluence and type of school each did make
a difference, however, in different directions. While the odds for having been drunk at least 2–3 times increased with family affluence, they decreased with increase of school status. Thus, the odds of having been drunk were almost twice as high for male students attending the lowest status school type as
compared to those attending the highest status schools (gymnasium) [OR = 1.89; CI = 1.32–2.71].
Conclusions:
The reversal in alcohol consumption trends seems to reflect changing social norms within adolescent subcultures, but also recent changes in alcohol pricing in Germany and possibly effects of an increase in preventive efforts. The partly divergent findings for the social status indicates family affluence and school type suggest differing mediating mechanisms underlying the separate dimensions, i.e. affordability versus educational background and peer group norms. Subgroups such as boys attending the lower status types of school still exhibit
high rates of problem drinking, i.e. drunkenness and seem to warrant particular prevention efforts.
Methods: Data were obtained from the ‘Health Behaviour in School-aged Children’ Study conducted in the largest federal state of Germany, North Rhine Westphalia in 1994, 1998, 2002 and 2006. The analysis is based on N = 15724 11 to 15-year-old students from all four types of the very segmented and hierarchical German school system. Socio-economic differences in weekly alcohol use and lifetime prevalence of drunkenness were studied, in relation to both parental SES (family affluence) and students’ own SES (type of school attended). Time trends for the percentages of regular alcohol consumers
and for repeated drunkenness for different SES groups were estimated with the help of logistic regression models.
Results: While rates of at least weekly alcohol use as well as repeated drunkenness in 11- to 15-year-old German students have increased steadily from 1994 to 2002, the last years have witnessed a reversal of this trend. In 2006, prevalence rates of alcohol use and drunkenness decreased to or fell even below the levels of 1994 (10.8% to 9.2% for weekly alcohol consumption in boys and 8.1% to 4.9% in girls). These trends were largely independent of socio-economic status as measured by family affluence and type of school attended. Findings for drunkenness, particularly in boys, however, showed that independent of point in time, family affluence and type of school each did make
a difference, however, in different directions. While the odds for having been drunk at least 2–3 times increased with family affluence, they decreased with increase of school status. Thus, the odds of having been drunk were almost twice as high for male students attending the lowest status school type as
compared to those attending the highest status schools (gymnasium) [OR = 1.89; CI = 1.32–2.71].
Conclusions:
The reversal in alcohol consumption trends seems to reflect changing social norms within adolescent subcultures, but also recent changes in alcohol pricing in Germany and possibly effects of an increase in preventive efforts. The partly divergent findings for the social status indicates family affluence and school type suggest differing mediating mechanisms underlying the separate dimensions, i.e. affordability versus educational background and peer group norms. Subgroups such as boys attending the lower status types of school still exhibit
high rates of problem drinking, i.e. drunkenness and seem to warrant particular prevention efforts.
| Original language | English |
|---|---|
| Journal | European Journal of Public Health |
| Volume | 17 |
| Issue number | Suppl 2 |
| Pages (from-to) | 132 |
| ISSN | 1101-1262 |
| DOIs | |
| Publication status | Published - 1. Jan 2007 |