Education system stratification and health complaints among school-aged children. (January 2019)

• Record Type: Journal Article
• Authors: Högberg, Björn; Strandh, Mattias; Petersen, Solveig; Johansson, Klara
• Is Part Of: Social science & medicine. Volume 220(2019)
• Page Start: 159
• Page End: 166
• Publication Date: 2019-01
• Subjects: Health complaints -- Health inequalities -- Education systems -- Schools -- Children -- Adolescents -- Multilevel -- Comparative research; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2018.11.007
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Research shows that the school environment is an important social determinant of health among children and adolescents. However, we know virtually nothing of the health consequences of national education systems and policies, for example the stratification of pupils by academic ability. This study aimed to investigate if education system stratification is related to self-reported psychological and somatic health complaints of pupils aged 11 to 15, and social inequalities in such health complaints. Survey data from the Health Behaviors of School-aged Children (HBSC) survey, covering 33 countries and more than 180 000 pupils in primary and lower secondary school, were used. Multilevel models showed that education system stratification was not associated with the average levels of health complaints of pupils, but cross-level interaction effects showed that stratification moderated the relationship between social background and health complaints, such that inequalities in health complaints were smaller in countries with more stratified systems. Moreover, this moderating effect was mediated by the school learning environment and social relations in school. Specifically, social inequalities in school pressure, academic self-concept, school climate, and school satisfaction were smaller in more stratified education systems, which in turn accounted for smaller inequalities in health complaints in these countries. Highlights: Education system stratification is important for school environments. Stratification is not related to average levels of health complaints of pupils. Stratification moderates the association between social background and health. Moderated effects are mediated by school learning and social environments.