Santé, comportements de santé et violence parmi les immigrants. Rôle des facteurs socioéconomiques chez les adolescents

in Les Déterminants de la santé (2014)

Etudier les problèmes relatifs à la santé (usage de substances, état de santé, symptômes dépressifs, violence physique/verbale et abus sexuel subis, et implication dans la violence) des immigrés européens ... [more ▼]

Etudier les problèmes relatifs à la santé (usage de substances, état de santé, symptômes dépressifs, violence physique/verbale et abus sexuel subis, et implication dans la violence) des immigrés européens et non-européens et le rôle des difficultés socioéconomiques, relationnelles et scolaires. Les problèmes relatifs à la santé sont plus fréquents chez les immigrés européens et non-européens que les français. Ils sont fortement expliqués par les difficultés socioéconomiques, relationnelles et scolaires. Contexte. Cette enquête transversale a été réalisée sur 1559 adolescents des collèges dans le nord-est de la France. Elle est basée sur un auto-questionnaire, rempli en classe sous la surveillance de l’équipe de recherche, concernant le sexe, l’âge, la nationalité, les caractéristiques socioéconomiques (structure familiale, faible éducation parentale (<bac), profession du père et revenu familial insuffisant), consommation durant les 30 derniers jours d’alcool, tabac, cannabis, drogues dures, faible performance scolaire (note moyenne du dernier trimestre < 10/20), mauvais état de santé et faibles relations sociales (échelle de qualité de vie de l’OMS, WHOOoL-Bref), symptômes dépressifs (mesure de Kandel, score>90ème percentile), violence physique/verbales subie, agression sexuelle subie, et implication dans la violence. Les données sont analysées par les modèles de régression logistiques. Résultats. Les problèmes sont fréquents : usage d’alcool (35,2%), tabac (11,2%), cannabis (5,6)%, drogues dures (2,8%), mauvais état de santé (25,8%), symptômes dépressifs (13,3%), être victime de violence physique/verbale (16,2%) ou d’abus sexuel (3,7%) et implication dans la violence (14,6%). Comparés aux français, les immigrés ont un risque accru pour : usage de tabac (odds ratio ajusté sur le sexe et l’âge 2,04), cannabis (2,33), drogues dures (4,18), mauvais état de santé (1,89), violence subie (1,84) et implication dans la violence (1,77). Les situations socioéconomiques expliquaient respectivement 25%, 9%, 13%, 30%, 12% et 39% de ces risques. L’ajout de relations sociales et de la performance scolaire expliquait respectivement 43%, 20%, 29%, 53%, 24% et 61% des risques. Ces problèmes et les contributions des cofacteurs diffèrent beaucoup entre les immigrés européens et non-européens. Conclusions. Les problèmes relatifs à la santé sont plus fréquents chez les immigrés européens et non-européens que les français. Ils sont fortement expliqués par les difficultés socioéconomiques, relationnelles et scolaires. La prévention pour leur intégration sociale devrait traiter ces problèmes. [less ▲]

Associations between quality of life and socioeconomic factors, functional impairments and dissatisfaction with received information and home-care services among survivors living at home two years after stroke onset

in BMC Neurology (2014), 14

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors ... [more ▼]

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors, functional impairments and self-reported dissatisfaction with received information and home-care services among survivors two years after stroke onset. This problem remains partially addressed though optimal information and services may improve survivors' QoL. Methods Stroke-survivors admitted to all hospitals in Luxembourg 18 months or more previously were identified using the only care-expenditure-reimbursement national system database. The clinical diagnosis was confirmed. Ninety four patients aged 65 years and living at home were interviewed to gather socioeconomic characteristics, functional impairments, dissatisfaction with information and home-care services, and QoL (using the Newcastle Stroke-Specific QoL, newsqol) assessing 11 domains. Data were analyzed using multiple linear regression models. Results About 50% of survivors had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Survivors with education (<12th grade) or lower income had low values for most newsqol domains (sex-age-adjusted regression coefficient saRC, i.e. mean difference, between -23 and -8). Patients who were working had better values for pain, mental feelings and sleep domains than did retired people (saRC between -3.9 and 4.2). Various functional impairments were associated with markedly low values of nearly all domains (saRC between -33.5 and -7.5) and motor, language, memory and sensory impairments had the highest impact. The survivors' perceived QoL was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Various QoL domains were strongly related to dissatisfaction with information about stroke and its consequences/changes over time, accuracy of information obtained, help received, coordination between services, and the possibility of receiving help when necessary (saRC reaching -30). Conclusions Stroke-survivors had major alterations in QoL that reflected depressive symptoms, which should be appropriately treated. These findings may help with the development of public policies aiming at improving QoL among stroke survivors. The newsqol could be used routinely to measure the recovery of survivors over time and their needs in terms of information, help and care services [less ▲]

Impacts of socioeconomic, Family, School, Behavioral and Mental Difficulties on Suicide attempts in Youth

in The bio-psycho-social model: the futur of psychiatry (2013)

This study may help participants to recognize factors influencing suicide attempt which have to be assessed/monitored in boys and girls. Purpose: To assess the impacts of socioeconomic factors, alcohol ... [more ▼]

This study may help participants to recognize factors influencing suicide attempt which have to be assessed/monitored in boys and girls. Purpose: To assess the impacts of socioeconomic factors, alcohol/tobacco/cannabis/hard drugs uses, repeating a school-year, sustained physical/verbal violence, sexual abuse, depressive symptoms, and involvement in violence on suicide attempt among boys and girls in early adolescents. Methods: The sample included 1,559 middle-school students from north-eastern France (778 boys and 781 girls, mean age 13.5, SD 1.3), who completed a self-administered questionnaire including gender, birth date, father’s occupation, parents’ education, nationality, income, social supports (9-item scale), and lifetime history reconstruction of parents’ separation/divorce/death, alcohol/tobacco/ cannabis/hard drugs uses, repeating a school-year, sustained physical/verbal violence (20-item scale), sexual abuse, depressive symptoms (Kandel scale), involvement in violence (11-item scale), and suicide attempts. Data were analyzed using Cox regression models. Results: Lifetime suicide attempt affected 7.2% of boys and 12.5% of girls (p<0.001). Among boys, the factors with significant crude hazard ratio cHR were: insufficient income (2.29), alcohol use (2.33), tobacco use (3.76), hard drugs use (4.48), depressive symptoms (3.60), sustained physical/verbal violence (2.72), sexual abuse (4.30), involvement in violence (3.16), and lack of social support (2.64 for score 1-2, 3.08 for score 3+, vs. score 0). Full model including all factors retained only insufficient income (adjusted hazard ratio aHR 2.11), alcohol use (1.99), depressive symptoms (3.29), and involvement in violence (2.64). Among girls, the factors with significant cHR were: parents’ separation/divorce (2.44), insufficient income (2.23), low parents’ education (1.86), repeating a school-year (2.56), alcohol use (2.04), tobacco use (5.19), cannabis use (3.72), hard drugs use (11.65), depressive symptoms (3.51), sustained physical/verbal violence (1.71), sexual abuse (8.09), involvement in violence (2.04), and lack of social support (3.46 for score 1-2, 6.92 for score 3+, vs. score 0). Full model retained only parents’ separation/divorce (aHR 1.56), repeating a school-year (1.98), alcohol use (1.58), tobacco use (3.60), depressive symptoms (1.86), sexual abuse (6.60), and lack of social support (2.62 for score 1-2 and 4.38 for score 3+, vs. score 0). Compared with boys, girls had a significant cHR of 1.74 which decreased to 1.57 when controlling for all covariates (contribution 23%). Conclusion: This study has achieved our objectives to identify a wide range of socioeconomic, family, school, behavioral and mental difficulties generating suicide attempt among boys and girls in early adolescence. Our findings are original. They reported their causal relationships, the knowledge of which may help public policy preventing suicide attempt. [less ▲]

Associations of unhealthy Behaviors and Depressive Symptoms with School Difficulties and Role of Socioeconomics Factors in Early Adolescence

in Pracana, Clara; Silva, Liliana (Eds.) International Psychological Applications Conference and Trends (2013)

Unhealthy behaviors such as alcohol, tobacco, cannabis and hard drugs uses and depressive symptoms are common in early adolescence and they are well known to affect physical, mental and cognitive ... [more ▼]

Unhealthy behaviors such as alcohol, tobacco, cannabis and hard drugs uses and depressive symptoms are common in early adolescence and they are well known to affect physical, mental and cognitive functions. These factors can thus favor persistent school difficulties. Socioeconomic factors are known to favor unhealthy behaviors and depressive symptoms as well as school difficulties. This study assessed the associations of unhealthy and depressive symptoms with learning difficulty, low school performance, and school dropout ideation, and the confounding roles of socioeconomic factors in early adolescence. Design: Cross-sectional study. Methods: The sample included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3), who completed a self-administered questionnaire including gender, birth date, socioeconomic factors (father’s socioeconomic category, family structure, parents’ education, parent death, nationality, family income, and social supports), last-30-day alcohol, tobacco, cannabis and hard drugs uses, depressive symptoms (Kandel scale, score>90th percentile), learning difficulty, low school performance (last-trimester mark <10/20), and school dropout ideation at 16 years (school is compulsory until this age). Learning difficulty was measured using an 8-item scale including lesson comprehension, concentration/lesson learning, keeping up the pace/constraint, relaxing/rest, class atmosphere, home learning atmosphere, teacher pressure, and parent pressure; Cronbach alpha coefficient 0.81, score>90th percentile). The school difficulties were chosen to measure various difficulty levels. Data were analyzed using logistic models to compute gender-age-grade-adjusted odds ratios (OR1) and the contributions of socioeconomic factors. Findings: Learning difficulty, low school performance, and school dropout ideation affected respectively 14.1%, 8.2%, and 3.8% of students. These school difficulties were linked with alcohol use: OR1 1.72 (95%CI 1.26-2.33), 1.51 (1.03-2.21), and 3.43 (1.96-6.01), respectively. Higher OR1 were found for tobacco use: 3.82 (2.64-5.52), 5.81 (3.83-8.82), and 6.31 (3.53-11.28), respectively; cannabis use: OR1 3.61 (2.23-5.86), 4.12 (2.41-7.04), and 6.89 (3.45-13.76), respectively; hard drugs uses: OR1 6.37 (3.41-11.89), 5.05 (2.53-10.08), and 10.85 (4.99-23.55), respectively; and depressive symptoms: OR1 7.21 (5.06-10.27), 1.84 (1.16-2.93), 3.14 (1.64-6.03), respectively. The socioeconomic factors considered explained respectively <4%, 15-37%, 10%-31%, 20%-43%, and 20%-68% of the associations of school difficulties with alcohol, tobacco, cannabis, and hard drugs uses and depressive symptoms. Conclusions: Unhealthy behaviors and depressive symptoms were strongly associated with school difficulties. Socioeconomic factors highly confounded their associations. Public policy to improve school achievement, and thus community participation in adulthood, should focus on unhealthy behaviors and mental disorders, especially among students with socioeconomic difficulties. Causal relationships could not be advanced (study cross-sectional nature). [less ▲]

Failure of school project: the role of social, material, behavioural, physical and mental resources among multi-cultural students.

in Psychosociological Work in Transcultural Contexts (2012)

Youth context require social-material-behavioral-mental resources to realize school achievement and their community participation, but they are lacking or altered for many adolescents. In an early ... [more ▼]

Youth context require social-material-behavioral-mental resources to realize school achievement and their community participation, but they are lacking or altered for many adolescents. In an early adolescence context, this study assessed the associations of these factors with repeating a school year, low school-performance, and quitting-school thinking at 16 years. Methods: Questionnaires were completed by 1559 middle-school adolescents from north-eastern France including: sex, age, family structure, parental education, income, and occupation, WHOQoL (quality of life for 4 domains physical, psychological, social relationship, and environment; <25th percentile value), last-30-day consumption of tobacco/alcohol/ cannabis/hard drug, regular sports/physical activities, victim of violence, sexual abuse, implication in violence, suicidal ideation, social supports, repeating a school year, low summer-term school-performance (<10/20), and quitting-school-thinking. Data were analyzed using logistic models which yield adjusted odds ratios (OR). Results: Repeating a school-year affected 14.7%, low school performance 8.2%, and quitting-school-thinking 3.9%. Repeating a school-year was significantly related to increasing age (OR 2.18), father being a manual worker (2.79 vs. manager/professional), clerk (2.36), craftsman/tradesman/firm-head (1.68), or unemployed (4.65), low WHOQoL-environment (2.29), tobacco use (1.70), and hard drug use (2.35). Low school-performance was linked with increasing age (OR 1.25), father being a manual worker (4.81 vs. manager/professional), clerk (3.30), craftsman/tradesman/firm-head (2.36), or unemployed (5.41), tobacco use (3.95), low WHOQoL-physical (2.27), and low WHOQoL-psychological (1.56). Quitting-school-thinking was associated with being male (OR 4.03), divorced/separated-parents (2.92 vs. intact family), not living with parent(s) (3.45), implication in violence (5.19), sexual abuse (4.11), and suicidal ideation (2.47). Conclusion: Socioeconomic living conditions and physical/mental difficulties have impressive impacts on failure of school project in youth. Public policy aiming at improving school achievement should focus on improvement of environment and living conditions, well-being, and monitoring physical/behavioral/mental difficulties as well as services appropriate to reduce school difficulties. This should promote community participation at adolescence and also at adulthood. [less ▲]

Gender disparities of depressive mood and roles of family factors, school difficulty, violence, and unhealthy behaviours among adolescents

in Social Justice and Democratization (2012)

Nowadays modern societies are to be more competitive and include more non-intact families and living difficulties due to employment and social deprivations. Adolescents may suffer from depressive mood (DM ... [more ▼]

Nowadays modern societies are to be more competitive and include more non-intact families and living difficulties due to employment and social deprivations. Adolescents may suffer from depressive mood (DM) which is common and multi-factorial. This study assessed, among boys and girls, the causal relationships between DM and parent education, nationality, occupation, income, divorce/separation, and death, repeating a school-year, lifetime alcohol/tobacco/cannabis/other drugs uses, victim of violence and sexual abuse, involvement in violence, and lack of social supports (family members/friends). Methods: 1559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3) completed in class a questionnaire including DM (Kandel scale), factors studied, and their occurring/persisting period. Data were analyzed using Cox models taking into account risk factors which came before and persisted until DM occurring. Findings: Lifetime-DM affected 7.6% of boys and 19.1% of girls. Among girls factors with significant crude hazard ratios (HR) were: parent divorce/separation (1.57), insufficient income (1.95), repeating a school-year (1.95), victim of violence (2.99) or sexual abuse (4.96), and lack of supports (4.08 for score 1-2 and 7.74 for score 3+, vs. score 0) while tobacco use was close to significance (1.77). Taking all factors into account retained only repeating a school-year (adjusted HR 1.87), victim of violence (2.50) or sexual abuse (4.02), and lack of supports (3.83 and 7.28). Among boys, the significant factors were: hard-drug use (6.01), victim of violence (2.88), and lack of supports (2.27 and 4.78) while insufficient income (1.75), low parent education (1.60), and victim of sexual abuse (3.58) were close to significance. Full model retained only victim of violence (adjusted HR 2.29) and lack of supports (2.16 and 4.18). Conclusion: Taking chronology in consideration revealed strong gender disparities for DM and its associations with family characteristics, school difficulties, unhealthy behaviours, violence, and social supports that may be prevention targets. [less ▲]

Quality of life social disparities and roles of family and unhealthy behaviours among adolescents.

in Psychology and Health (2011), 26(suppl 2), 147

Adolescents’ quality of life determinants include socioeconomic characteristics and unhealthy behaviours. This study explored WHOQOL social disparities and the roles of family structure, income and ... [more ▼]

Adolescents’ quality of life determinants include socioeconomic characteristics and unhealthy behaviours. This study explored WHOQOL social disparities and the roles of family structure, income and unhealthy behaviours. Methods: 1556 middle-school adolescents from north-eastern France completed a self-administered questionnaire measuring WHOQOL domains and other factors. Data were analysed using multiple regression models. Findings: Significantly lower WHOQOL was found for clerk (gender-age-adjusted regression coefficient r 5.8 (SE 1.1)), manual-worker ( 5.7 (1.5)), unemployed/inactive ( 10.3 (1.5)) and other categories ( 1.3 to 3.2), compared with manager families. Controlling for family structure and income highly reduced the r to 2.45 (1.1), 2.3 (1.5), 5.3 (1.6) and 1.5 to 0.89 (NS), respectively. The disparities remained after further controlling for last-month tobacco/alcohol/cannabis uses and lack of sports-physical activity. Similar findings were found for all physical, psychological, social relationships and environment WHOQOL domains. Discussion: WHOQOL disparities are highly explained by family structure, income and unhealthy behaviours that may be prevention targets. [less ▲]