title: Individual socio-demographic factors and perceptions of the environment as determinants of inequalities in adolescent physical and psychological health: the Olympic Regeneration in East London (ORiEL) study.
abstract: BACKGROUND
  Populations living in urban areas experience greater health inequalities as well as higher absolute burdens of illness. It is well-established that a range of social and environmental factors determine these differences. Less is known about the relative importance of these factors in determining adolescent health within a super diverse urban context.
  
  
  METHODS
  A cross-sectional sample of 3,105 adolescent participants aged 11 to 12 were recruited from 25 schools in the London boroughs of Newham, Tower Hamlets, Hackney and Barking & Dagenham. Participants completed a pseudo-anonymised paper-based questionnaire incorporating: the Warwick-Edinburgh Mental Well-being Scale used for assessing positive mental well-being, the Short Moods and Feelings Questionnaire based on the DSM III-R criteria for assessment of depressive symptoms, the Youth-Physical Activity Questionnaire and a self-assessment of general health and longstanding illness. Prevalence estimates and unadjusted linear models estimate the extent to which positive well-being scores and time spent in physical/sedentary activity vary by socio-demographic and environmental indicators. Logistic regression estimated the unadjusted odds of having fair/(very)poor general health, a long standing illness, or depressive symptoms. Fully adjusted mixed effects models accounted for clustering within schools and for all socio-demographic and environmental indicators.
  
  
  RESULTS
  Compared to boys, girls had significantly lower mental well-being and higher rates of depressive symptoms, reported fewer hours physically active and more hours sedentary, and had poorer general health after full adjustment. Positive mental well-being was significantly and positively associated with family affluence but the overall relationship between mental health and socioeconomic factors was weak. Mental health advantage increased as positive perceptions of the neighbourhood safety, aesthetics, walkability and services increased. Prevalence of poor health varied by ethnic group, particularly for depressive symptoms, general health and longstanding illness suggesting differences in the distribution of the determinants of health across ethnic groups.
  
  
  CONCLUSIONS
  During adolescence perceptions of the urban physical environment, along with the social and economic characteristics of their household, are important factors in explaining patterns of health inequality.
authors.affiliation: Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London, EC1M 6BQ, UK. n.r.smith@qmul.ac.uk.
authors.forename: Neil R
authors.initials: NR
authors.lastname: Smith
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. daniel.lewis@lshtm.ac.uk.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lewis
authors.affiliation: Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London, EC1M 6BQ, UK. amanda.fahy@qmul.ac.uk.
authors.forename: Amanda
authors.initials: A
authors.lastname: Fahy
authors.affiliation: Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK. s.eldridge@qmul.ac.uk.
authors.forename: Sandra
authors.initials: S
authors.lastname: Eldridge
authors.affiliation: Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK. s.j.c.taylor@qmul.ac.uk.
authors.forename: Stephanie J C
authors.initials: SJ
authors.lastname: Taylor
authors.affiliation: Institute for Research in Child Development, School of Psychology, University of East London, Stratford Campus, Water Lane Stratford, London, E15 4NO, UK. d.g.moore@uel.ac.uk.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Moore
authors.affiliation: Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London, EC1M 6BQ, UK. c.clark@qmul.ac.uk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.affiliation: Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London, EC1M 6BQ, UK. s.a.stansfeld@qmul.ac.uk.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Stansfeld
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. steven.cummins@lshtm.ac.uk.
authors.forename: Steven
authors.initials: S
authors.lastname: Cummins
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008131:London; D008297:Male; D008603:Mental Health; D012111:Residence Characteristics / Q000706:statistics & numerical data; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health