Psychosocial factors influence social inequalities in health-related quality of life among children and adolescents

Viviane Richard, Elsa Lorthe, Roxane Dumont, Andrea Loizeau, Hélène Baysson, Stephanie Schrempft, María-Eugenia Zaballa, Julien Lamour, Rémy P. Barbe, Klara M. Posfay-Barbe, Idris Guessous & Silvia Stringhini, for the SEROCoV-KIDS group.
Psychosocial factors mediate social inequalities in health-related quality of life among children and adolescents.BMC Public Health, 29 October 2024, doi: 10.1186/s12889-024-20393-0.

Abstract

Context: The aim of this analysis was to assess the role played by psychosocial and behavioural factors in mediating social inequalities in health-related quality of life (HRQoL) among children and adolescents.

Methods: Cross-sectional data were extracted from the SEROCoV-KIDS cohort study, randomly selected in Geneva, Switzerland. Associations between socio-economic conditions (parents' highest level of education, household financial situation) and HRQoL, psychosocial factors (parent-child relationship, school difficulties, friends, extracurricular activities) and behavioural factors (screen time, physical activity, time spent in green spaces, sleep duration), as well as associations between psychosocial and behavioural factors and HRQoL, were assessed using generalised estimating equations. Counterfactual mediation analyses were carried out to test the links between socio-economic conditions and HRQoL.

Results: Out of 965 children and 816 adolescents, those experiencing disadvantaged financial conditions were more likely to have low HRQoL (adjusted odds ratio [aOR]: 3.80; 95% confidence interval [CI]: 1.96-7.36 for children and aOR: 3.66; 95% CI: 2.06-6.52 for adolescents). Psychosocial characteristics contributed to 25% (95% CI: 5-70%) and 40% (95% CI: 18-63%) of the financial disparities in HRQoL in children and adolescents, respectively. Health behaviours were weakly related to socio-economic conditions and did not contribute to financial differences in HRQoL.

Conclusions: These results provide empirical evidence of mechanisms explaining socio-economic disparities in children's HRQoL and could inform targeted interventions aimed at reducing health inequalities.

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