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Social Status as a Teen Predicts Health as an Adult

Research finds those at the top of the pecking order fared the best

TUESDAY, Sept. 29 (HealthDay News) -- For those middle-aged folks who cringe at the memory of their adolescence, new Swedish research suggests that social standing as a teenager has long-term health consequences.

And in a related study, British scientists have found that children whose mothers work outside the home are more likely to engage in unhealthier lifestyles -- including eating less healthy foods and getting less exercise -- than kids whose mothers are at home.

Both studies appear online Sept. 29 in the Journal of Epidemiology and Community Health.

"I think that the results highlight the importance of recognizing that school is not only about performance and grades, but equally so about the social interplay between children," said study author Ylva Almquist, a sociologist at the Centre for Health Equity Studies in Stockholm.

The researchers studied data from 14,000 children who participated in the Stockholm Birth Cohort Study, which tracked the long-term health of Swedes born between 1953 and 2003. Specifically, Almquist and her team examined levels of popularity, power and status reported by study participants who were in sixth grade in 1966.

Using that information as a personality baseline, the team then examined the students' health records during a 30-year-period from 1973 and 2003, focusing on hospital discharge records. Researchers noted that the students who reported lower levels of social acceptance as young teens tended to have a higher risk of serious health issues as adults; the same was true for males and females.

Specifically, the study found that:

  • Children who were the least popular and powerful at school were more than four times as likely to require hospital treatment for hormonal, nutritional and metabolic diseases as their most popular and powerful classmates.
  • They were more than twice as likely to develop mental health and behavioral problems, including suicide attempts and self-harm.
  • They were more than five times as likely to be admitted for unintentional poisoning.
  • They were also significantly more likely to develop drug and alcohol dependency problems, and nine times more likely to develop heart disease.

Almquist said she is not sure why low social status has such noticeable and long-term health consequences, but there are theories.

"Most likely it is a combination of various aspects," she said. "Our hypothesis is that lower peer status is linked to less social support, influence and integration, which could result in a more negative self-image and self-confidence. This could in turn influence the child's future ambitions, expectations and choices. For example, health behaviors such as smoking may be a relevant explanation as to why peer status influences ischemic heart disease. Stress and coping abilities may also be potentially important aspects."

Kiti Freier Randall, a pediatric neurodevelopmental psychologist from California, said there is a growing body of evidence pointing to the negative consequences of social isolation.

"Our experience of low power and status affects our self-esteem," she said. "How you feel about yourself affects your health. In many ways, we are hardwired to connect with others."

Stress physically harms the body, said Freier Randall, who added that people who feel bad often try to comfort themselves with potentially self-destructive behaviors, such as smoking, over-eating and substance abuse.

Freier Randall was also intrigued with the British study that looked at the behavioral impact of mothers working outside the home. To her, the issue is less about moms, who often have no choice but to work, than about the lack of overall adult supervision of young people, especially after school.

"Kids need to have activities with adults who care," she said.

More information

The U.S. Centers for Disease Control and Prevention has more on the long-term impact of childhood trauma through its Adverse Childhood Experiences Study.

SOURCES: Ylva Almquist, M.Sc., Centre for Health Equity Studies, Stockholm, Sweden; University College London; Kiti Freier Randall, Ph.D., pediatric neurodevelopmental psychologist, California; Sept. 29, 2009, Journal of Epidemiology and Community Health, online

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