Lifestyle, health and social class in adolescence

The paper considers mechanisms for indirect health selection in adolescence, as part of the explanation for health inequalities between social groups. Aspects of adolescent lifestyles are identified as potentially important factors for the production of class based differences in adult health status. Survey data from a Scottish longitudinal study of adolescent socialization and lifestyles are utilized in order to locate such health lifestyle factors within the wider contexts of the individual's personal and social environment at this stage of the life cycle. Relationships and attitudes to family, school and peers in middle adolescence at 15-16 years of age are first examined, and distinctive patterns of integration within these contexts are identified. The inter-connections between these broader aspects of lifestyle, social class and individual health behaviours are then examined. Mid-adolescent patterns of social integration are found to have a clear structural basis, and most importantly, they anticipate social position in later adolescence at 17-18 years of age. It is also found that such patterns of integration into the family, peer and school contexts are linked to subsequent health related behaviours and to self assessed health in later adolescence, and that these links are independent of the young person's social class background. Thus, we conclude that behavioural--cultural lifestyle factors, when these are located within a broader social context, provide a clear and plausible mechanism for indirect health selection in adolescence.