title: Welfare state regimes, health and health inequalities in adolescence: a multilevel study in 32 countries.
abstract: Comparative research on health and health inequalities has recently started to establish a welfare regime perspective. The objective of this study was to determine whether different welfare regimes are associated with health and health inequalities among adolescents. Data were collected from the 'Health Behaviour in School-aged Children' study in 2006, including 11- to 15-year-old students from 32 countries (N = 141,091). Prevalence rates and multilevel logistic regression models were calculated for self-rated health (SRH) and health complaints. The results show that between 4 per cent and 7 per cent of the variation in both health outcomes is attributable to differences between countries. Compared to the Scandinavian regime, the Southern regime had lower odds ratios for SRH, while for health complaints the Southern and Eastern regime showed high odds ratios. The association between subjective health and welfare regime was largely unaffected by adjusting for individual socioeconomic position. After adjustment for the welfare regime typology, the country-level variations were reduced to 4.6 per cent for SRH and to 2.9 per cent for health complaints. Regarding cross-level interaction effects between welfare regimes and socioeconomic position, no clear regime-specific pattern was found. Consistent with research on adults this study shows that welfare regimes are important in explaining variations in adolescent health across countries.
authors.affiliation: Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle, Germany. m.richter@medizin.uni-halle.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Richter
authors.forename: Katharina
authors.initials: K
authors.lastname: Rathman
authors.forename: Saoirse
authors.initials: S
authors.lastname: Nic Gabhainn
authors.forename: Alessio
authors.initials: A
authors.lastname: Zambon
authors.forename: William
authors.initials: W
authors.lastname: Boyce
authors.forename: Klaus
authors.initials: K
authors.lastname: Hurrelmann
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D014943:Global Health; D015438:Health Behavior; D054624:Health Status Disparities; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D038622:Internationality; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012044:Regression Analysis; D012650:Self Disclosure; D057566:Self Report; D012923:Social Class; D012946:Social Welfare; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires