Socioeconomic inequalities in mental health and health-related quality of life (HRQOL) in children and adolescents from 11 European countries

To assess the presence and magnitude of social inequalities in mental health and health-related quality of life (HRQOL) in the population aged 8-18 years in 11 European countries. Cross-sectional surveys were carried out in representative samples of children/adolescents (8-18 years) from the participating countries of the KIDSCREEN project. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and HRQOL by means of the KIDSCREEN-10. Socioeconomic status (SES) was assessed using the Family Affluence Scale and parental level of education. The association between health outcomes and SES was analyzed with the regression-based relative index of inequalities (RII) and population attributable risk. A total of 16,210 parent-child pairs were included. The SDQ showed inequalities in mental health according to family level of education in all countries (RII = 1.45; 1.37-1.53). The RII for HRQOL was 2.15 (1.79-2.59) in the whole sample, with less consistent results by age and country. Socioeconomic inequalities in mental health were consistently found across Europe. Future research should clarify the causes of these inequalities and define initiatives which prevent them continuing into adulthood.