Inequalities in subjective health complaints in Swedish adolescents: an intersectional approach

Background Health inequality has been defined as the association between individuals’ health and their position in societal hierarchies. Such associations can be used as a starting-point in the search for social determinants of health. With regard to subjective health complaints among adolescents the evidence of socio-economic inequalities has been inconclusive. Inequalities by gender are, in contrast, clear and a female excess emerge or increase during adolescence. The aim of this study is to apply an intersectional approach and analyse differences in health complaints by parental education among girls and boys, taking age into account. Furthermore, data with information from both adolescents and their parents will be used which is ideal since adolescents seldom have correct information on parental education. Methods The data was obtained from a Swedish nationally representative survey (ULF) and its child supplement (Child-ULF) from the years 2007-2011 (n = 5280). Subjective health complaints were reported by adolescents (aged 10-18) and measures indicating psychological (e.g. feeling sad) and somatic complaints (i.e. head- and stomach ache) calculated. Information on education was obtained for one parent and five educational groups distinguished. Binary logistic regression was used and odds ratios with 95% confidence limits computed. Results Among girls, a clear gradient was found. From higher to lower level of parental education the odds ratios for psychological complaints were; 1.00 (ref); 1.07 (0.7-1.6); 1.38 (1.0-2.0); 1.73 (1.3-2.4); 2.05 (1.3-3.3); and for somatic complaints; 1.00 (ref); 1.27 (0.8-1.9); 1.55 (1.1-2.3); 1.69 (1.2-2.4); 2.82 (1.8-4.5). No association was found among boys. Gender differences per se were pervasive and, in ages where female excess is present, substantial within all educational groups. Conclusions The higher burden of subjective health complain