title: Glasgow smiles better: an examination of adolescent mental well-being and the 'Glasgow effect'.
abstract: BACKGROUND
  The existence of a negative 'Glasgow effect' on health has been much disputed. Previously, Glasgow's poor health was believed to be due to high levels of poverty. However, more recent studies investigating adult health outcomes have shown an effect over and above that of deprivation.
  
  
  OBJECTIVE
  To examine the existence of a 'Glasgow effect' on mental well-being and subjective health of an adolescent sample.
  
  
  METHODS
  Data from the 2006 Health Behaviour in School-Aged Children cross-sectional survey were analyzed.
  
  
  METHODS
  Data were modelled using multilevel logistic and linear modelling for the following outcomes: happiness, confidence, feeling left out, self-rated health, multiple health complaints (MHC), life satisfaction and health-related quality of life (KIDSCREEN-10). The models were further adjusted for family affluence and family status, as proxy measures of socio-economic status.
  
  
  RESULTS
  The proportions of pupils that reported being very happy, always confident and never left out were greater among pupils in Glasgow compared with pupils in the rest of Scotland, as were mean life satisfaction and KIDSCREEN scores. Frequencies of MHC and subjective health were not significantly different in Glasgow compared with the rest of Scotland. Similar results were observed following the modelling procedures, adjusting for age, sex, grade and school type (state or independent), for all outcomes other than life satisfaction, and effect sizes increased further after adjustment for family affluence and family status. The odds of a pupil in Glasgow being very happy, for example, were 1.48 [credible interval (CI) 1.19-1.83] those of a pupil outside Glasgow. After adjustment for family affluence and family status, the odds were 1.59 (CI 1.28-1.98). An interaction term between Glasgow and grade was not significant for all mental well-being outcomes, although there was some suggestion that a negative Glasgow effect on self-rated health is emerging by Secondary 4.
  
  
  CONCLUSIONS
  The Glasgow effect may not be all bad. The findings suggest that mental well-being is more prevalent in Glasgow compared with the rest of Scotland during adolescence. Further research is recommended to investigate the Glasgow effect during this life stage.
authors.affiliation: Child and Adolescent Health Research Unit, University of St Andrews, Medical and Biological Sciences Building, Fife KY16 9TF, UK. kl1@st-andrews.ac.uk
authors.forename: K A
authors.initials: KA
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006240:Happiness; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D000297:Psychology, Adolescent; D011788:Quality of Life; D012606:Scotland; D012923:Social Class