Subjective health, symptom load and quality of life of children and adolescents in Europe

Objectives: To examine cross-cultural differences in the prevalence of school children's subjective health types and the pattern of socio-demographic and socio-economic differences. Methods: Within the cross-sectional Health Behaviour in School-aged Children 2005/2006 Survey 200,000 school children aged 11, 13 and 15 answered a general health item, the Cantrill life satisfaction ladder and a subjective health complaints checklist. ANOVA and multilevel logistic regression models were conducted. Results: Overall, 44% of the respondents reported multiple recurrent health complaints, only poor to fair general health, low life satisfaction or a combination of these. Older adolescents (OR: 1.1-1.6) and girls (OR: 1.2-1.4) reported more health problems, the gender difference increased with age (OR: 1.3-1.6). Low socio-economic status was also associated with health problems (OR: 1.4-2.3). Sizeable cross-national variation in the prevalence of health types and the impact of the above mentioned factors were observed, yet the main pattern of impact could be confirmed cross-culturally. Conclusions: Increasing social and gender role pressure with growing age, as well as restricted access to material resources and psychosocial strains are discussed as potential explanations for the observed health inequalities.