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      Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents?

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          Abstract

          Objective

          Social support is assumed to be a protective social determinant of health. The aim of this cross-sectional study was to explore whether social support from the father, mother and friends mediates or moderates the association between socioeconomic position and self-rated health among adolescents.

          Methods

          The sample consisted of 1,863 secondary school students from the Kosice region in Slovakia (mean age 16.85; 53.3% females, response rate 98.9%). We assessed the mediation and moderation effects of social support from the mother, father and friends on the relation between socioeconomic position and self-rated health, performing binary logistic regression models. Socioeconomic position was measured by parents’ education, the family affluence scale and financial strain.

          Results

          Social support from the father mediated the association between family affluence and self-rated health among both males and females and the association between financial strain and self-rated health among males only. No moderating effect of social support on socioeconomic differences in self-rated health was found.

          Conclusion

          Father involvement seems to have the potential to mediate socioeconomic differences in health during adolescence.

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          Most cited references29

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          Self-rated health and mortality: a review of twenty-seven community studies.

          We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
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            Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice.

            S. Geyer (2006)
            Education, income, and occupational class are often used interchangeably in studies showing social inequalities in health. This procedure implies that all three characteristics measure the same underlying phenomena. This paper questions this practice. The study looked for any independent effects of education, income, and occupational class on four health outcomes: diabetes prevalence, myocardial infarction incidence and mortality, and finally all cause mortality in populations from Sweden and Germany. Sweden: follow up of myocardial infarction mortality and all cause mortality in the entire population, based on census linkage to the Cause of Death Registry. Germany: follow up of myocardial infarction morbidity and all cause mortality in statutory health insurance data, plus analysis of prevalence data on diabetes. Multiple regression analyses were performed to calculate the effects of education, income, and occupational class before and after mutual adjustments. Sweden (all residents aged 25-64) and Germany (Mettman district, Nordrhein-Westfalen, all insured persons aged 25-64). Correlations between education, income, and occupational class were low to moderate. Which of these yielded the strongest effects on health depended on type of health outcome in question. For diabetes, education was the strongest predictor and for all cause mortality it was income. Myocardial infarction morbidity and mortality showed a more mixed picture. In mutually adjusted analyses each social dimension had an independent effect on each health outcome in both countries. Education, income, and occupational class cannot be used interchangeably as indicators of a hypothetical latent social dimension. Although correlated, they measure different phenomena and tap into different causal mechanisms.
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              Socio-economic differentials in peripheral biology: cumulative allostatic load.

              This chapter focuses on evidence linking socio-economic status (SES) to "downstream" peripheral biology. Drawing on the concept of allostatic load, we examine evidence linking lower SES with greater cumulative physiological toll on multiple major biological regulatory systems over the life course. We begin by reviewing evidence linking lower SES to poorer trajectories of aging in multiple, individual physiological systems, followed by evidence of the resulting cumulative, overall burdens of physiological dysregulation seen among those of lower SES. The role of cumulative physiological dysregulation in mediating SES gradients in morbidity and mortality is then examined. We conclude with discussion of the question of interactions between SES (and other such environmental factors) and genetic endowment, and their potential consequences for patterns of physiological activity--an area of research that appears poised to contribute significantly to our understanding of how social conditions "get under the skin" to affect health and aging.
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                Author and article information

                Contributors
                ferdinand.salonna@upjs.sk
                Journal
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                SP Birkhäuser Verlag Basel (Basel )
                1661-8556
                1661-8564
                13 September 2011
                13 September 2011
                June 2012
                : 57
                : 3
                : 609-617
                Affiliations
                [1 ]Graduate School Kosice Institute for Society and Health, P.J. Safarik University, Kosice, Slovakia
                [2 ]Department of Educational Psychology and Health Psychology, Faculty of Arts, P.J. Safarik University, Kosice, Slovakia
                [3 ]Department of Health Psychology, Medical Faculty, Institute of Public Health, P.J. Safarik University, Kosice, Slovakia
                [4 ]Institute of Mathematics, P.J. Safarik University, Kosice, Slovakia
                [5 ]Department of Social Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
                Article
                300
                10.1007/s00038-011-0300-6
                3359452
                21912942
                71bb01fa-01ca-4e39-9f4b-1aa016887165
                © The Author(s) 2011
                History
                : 3 January 2011
                : 16 August 2011
                : 29 August 2011
                Categories
                Original Article
                Custom metadata
                © Swiss School of Public Health 2012

                Public health
                socioeconomic status,health,self-rated health,adolescents,social support
                Public health
                socioeconomic status, health, self-rated health, adolescents, social support

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