Socioeconomic differences in emotional symptoms among adolescents in the Nordic countries: recommendations on how to present inequality.
OBJECTIVE
This comparative study examines absolute and relative socioeconomic differences in emotional symptoms among adolescents using standardised data from five Nordic countries and gives recommendations on how to present socioeconomic inequality.


METHODS
The Health Behaviour in School-aged Children (HBSC) international cross-sectional study from 2005/2006 provided data on 29,642 11-15-year-old adolescents from nationally random samples in Denmark, Finland, Iceland, Norway and Sweden. The outcome was daily emotional symptoms. Family Affluence Scale (FAS) was used as indicator of socioeconomic position. We applied four summary measures of inequality: Prevalence Difference, Odds Ratio, Slope Index of Inequality and Relative Index of Inequality, and presented the socioeconomic inequality by a graphical illustration of the prevalence of emotional symptoms, the size of the FAS groups and the summary indices of inequality in each country.


RESULTS
The prevalence of emotional symptoms ranged from 8.1% in Denmark to 13.2% in Iceland. There were large country variations in the size of the low FAS-group ranging from 2% in Iceland to 12% in Finland. The largest absolute and relative socioeconomic inequalities were found in Iceland and the smallest in Finland for girls and in Denmark for boys.


CONCLUSIONS
Emotional symptoms were more common among nordic adolescents from low affluence families this association appeared in the study of both absolute and relative inequality. A comprehensive presentation of socioeconomic inequality should include the prevalence of the health outcome, the size of the socioeconomic groups, and the regression line representing the summary indices of inequality.
National Institute of Public Health, University of Southern Denmark linn@niph.dk.
Line
L
Nielsen
National Institute of Public Health, University of Southern Denmark.
Mogens Trab
MT
Damsgaard
National Institute of Public Health, University of Southern Denmark.
Charlotte
C
Meilstrup
National Institute of Public Health, University of Southern Denmark.
Pernille
P
Due
National Institute of Public Health, University of Southern Denmark.
Katrine Rich
KR
Madsen
National Institute of Public Health, University of Southern Denmark.
Vibeke
V
Koushede
National Institute of Public Health, University of Southern Denmark.
Bjørn Evald
BE
Holstein
D000293:Adolescent; D000342:Affective Symptoms / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D012959:Socioeconomic Factors
Adolescents; Child health; Emotional Symptoms; Epidemiologic Methods; Measures of Inequality; Mental Health; Nordic countries; Public Health; Socioeconomic Inequality