Original article
Gender Differences and Predictors of Self-Rated Health Development Among Swedish Adolescents

https://doi.org/10.1016/j.jadohealth.2010.06.005Get rights and content

Abstract

Purpose

The purpose of the study was to evaluate the development of self-rated health among boys and girls during adolescence.

Methods

Longitudinal cohort study, involving 1,046 Swedish adolescents from the seventh (12–13 years old) to the ninth grade. Self-rated health (well-being) and health-related empowerment were measured using a questionnaire.

Results

In the seventh as well as in the ninth grade, the proportion of adolescents reporting a good health was lower in girls than in boys. In general, girls showed lower health-related empowerment as compared with boys and this difference remained between both the grades. In boys and girls belonging to both grades, a high empowerment score was related to a high self-rated health. For both boys and girls, self-rated health declined between the seventh and ninth grade. In girls, the proportion rating their health as “very good” declined from 47 % to 30%, and in boys the same proportion declined from 56% to 46%, indicating an increasing gender difference. Only a minor proportion of adolescents (16% of the boys and 13% of the girls) reported an improvement. A high self-rated health in grade nine was, in girls, predicted by positive school experiences in seventh grade and, in boys, by a good mood in the family.

Conclusion

During adolescence, girls reported lower self-rated health than boys and this gender difference increased over the years. High empowerment is related to high self-rated health, and positive school experiences and a good mood in the family seem to be important predictors of a positive development of self-rated health.

Section snippets

Participants and procedures

The study was approved by the Research Ethics Committee of the Medical Faculty, Umeå University. Three Swedish municipalities were chosen, representing varying numbers of inhabitants, geographical areas, and levels of education among parents. Educational level of parents was considered a proxy for different levels of SES of the family [22]. Using data from Statistics Sweden, the schools for students in the seventh to the ninth grades were classified according to the educational level of the

Results

Background characteristics of the cohort at the start of the study showed that 49.7% of the population were boys and 50.3% were girls; 22.2% were 12-year-olds, 74.7% were 13-year-olds, and 3.1% were 14-year-olds; 93.5% adolescents were born in Sweden and 4.5% outside Europe; 50.6% had at least one parent with college or university education; and 56.8% lived in a city.

The distribution of self-rated health in the seventh grade was significantly different between boys and girls, with girls rating

Discussion

The general high level of self-rated health, especially among the boys, found in this study, is in line with results from the 41-country HBSC study, where a great majority of adolescents reported excellent or good health [1]. Swedish 13–15-year olds score somewhat better on self-rated health than that rated as average in the HBSC study [1]. Reports from epidemiological studies of adolescents often focus on the minority with less than good health. From a public health point of view,

Acknowledgments

The authors thank the participating adolescents and schools. The study received financial support from Center for Clinical Research Dalarna, Swedish National Institute of Public Health, Sparbanksstiftelsen Dalarna, Swedish Cancer Society, and Umeå University.

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