The use of composite indices and subjective measures to evaluate socioeconomic position, taking into account the effect of inequalities on adolescent health-related behaviors, can contribute to understanding the effect of inequalities on health during adolescence. The aim of this study was to examine the direct and indirect contribution of objective and subjective socioeconomic factors in a broad range of health and lifestyles outcomes. The data come from a representative sample of adolescents (N = 15,340; M age = 13.69) of the Health Behavior in School-aged Children study in Spain. Structural equation modeling was used for data analysis. A global index for evaluating objective socioeconomic position predicted both health and healthy lifestyles. Subjective socioeconomic status mediated the relationship between objective socioeconomic position and health but did not have a significant effect on healthy lifestyles when objective indicators were considered. Lastly, fit indices of the multiple-mediator model—including the direct effect of objective socioeconomic position on health and its indirect effects through the subjective perception of wealth and lifestyles—explained 28.7% of global health variance. Interventions aimed at reducing the impact of health inequalities should address, in addition to material deprivation, the psychological and behavioral consequences of feeling poor.

Purpose: The aim of this study was to describe the well-being and mental health of Spanish adolescents by gender identity using a nationally representative sample. Methods: The sample comprised 1212 15–18-year-old adolescents who participated in the 2018 Spanish edition of the international Health Behaviour in School-aged Children study. Of the total sample, 90 were identified as binary transgender adolescents, 213 as nonbinary transgender adolescents, and 909 as cisgender adolescents (selected through a matching process from an original sample of 17,375 cisgender adolescents). Comparisons of frequencies and means (chi-square, t-test, and analysis of variance) were used to analyze self-reported health, life satisfaction, health-related quality of life (HRQOL), psychosomatic complaints, and sense of coherence (SOC). Results: Nonbinary transgender adolescents reported the lowest levels of perceived excellent health (p < 0.001), the highest frequency of psychological complaints (p < 0.001) and physical complaints (p < 0.05), and a lower SOC (p < 0.05) compared with both cisgender and binary transgender adolescents. Likewise, nonbinary transgender adolescents reported lower levels of life satisfaction (p < 0.001) and HRQOL (p < 0.001) than cisgender adolescents. Conclusions: The differences found between binary and nonbinary transgender youth highlight the diversity within the transgender community. Both research and intervention programs should consider the unique experiences within the transgender community to adapt sensitively to their needs.

The Family Affluence Scale (FAS) is a widely used and validated instrument to measure adolescents’ socioeconomic status (SES). It is plausible that the COVID-19 pandemic and resulting social and economic changes have affected the capacity of the six-item FAS-III to measure adolescent SES, particularly the holiday and computer items. Using data from 247,503 adolescents from 16 European countries participating in the Health Behaviour in School-aged Children (HBSC) study before (2013/14 and 2017/18) and during (2021/22) the pandemic, the present study aims to fill this gap. Findings showed that although the internal consistency of the scale decreased during the pandemic, related to the functioning of the computer and especially the holiday item, it was still acceptable in all countries. Furthermore, measurement invariance analysis showed that during the pandemic the item thresholds of the computer and particularly the holiday item deviated from the thresholds of these items before the pandemic. However, all item factor loadings were comparable to the factor loadings before the pandemic. In addition, during the pandemic the computer and holiday item and their correlations with health-related outcomes were mostly still in the expected direction. Removing these items from the scale yielded comparable or decreased scale criterion validity as compared to the original FAS-III scale in most countries. These findings inform future research that although mean differences in family affluence levels before and during the pandemic should be interpreted with caution, it is a suitable tool to study (changes in) socioeconomic health inequalities among adolescents during the pandemic.

Civic engagement plays a positive role in adolescent wellbeing, as well as being the basis for maintaining a democratic society. This research analyzed how perceived support from developmental contexts contributes to adolescent civic engagement –assessed through their expectations of future sociopolitical participation–, mediated by sense of unity, and differences according to sex, age, and socioeconomic status. The sample included 3,715 participants (13–18 years old) from the 2019OPINA Barometerwho were selected using multistage random sampling stratified by conglomerates. The measures assessed sex, age, family, friends, classmates, and teacher support, the expectations of future sociopolitical participation, and sense of unity. Socioeconomic status was assessed by the Family Affluence Scale (FAS). Data analysis was conducted using descriptive statistics, mean comparisons, and structural equation models using bootstrapping and measurement invariance. Results showed developmental contexts to significantly affect expected sociopolitical participation only through the mediator role of the sense of unity. In addition, peer support (both friends and classmates) showed a stronger direct influence on sense of unity –and indirect influence on the expectations of future sociopolitical participation– than family and teachers. The model was invariant across sex, age, and FAS. This research highlights that a sense of unity, derived from feeling part of a larger dependable structure, is crucial for establishing behaviors in the interest of the common good, and that this social connectedness is learned in the most immediate developmental contexts, specifically, that of peers.