Territorial and social inequalities in mental distress and self-perceived health among schooled adolescents: a cross-sectional study in central Catalonia and Barcelona


Por: González-Casals, H, Vives-Cases, C, López, MJ, Sanz-Barbero, B, Pérez, K, Perez, G, Cortés-Albaladejo, M, Serral, G, Barceló, MA, Ruiz-Pérez, I, Mateo-Rodríguez, I, Cabrera-León, A, Bosque-Prous, M, Folch, C, Espelt, A

Publicada: 2 jul 2025
Resumen:
BackgroundDespite being generally considered healthy, adolescence is a crucial period where health behaviours are established, which can impact future well-being. Factors such as social determinants, psychosocial variables, and risk behaviours play significant roles in determining general and mental health, with important gender differences. This article aims to study social inequalities in the prevalence of mental distress and poor self-perceived health of 14 to 18-year-old students schooled in Central Catalonia and Barcelona in the 2021-2022 academic year, separately for boys and girls.MethodsCross-sectional study using data from two surveys that monitor health and health behaviours in Central Catalonia (DESKcohort) and in Barcelona (FRESC survey) during the year 2021-2022. The final sample included 7,309 adolescents (51.8% were girls). Prevalence of mental distress and poor self-perceived health status were estimated stratifying by sex and according to different social determinants of health (independent variables): axes of inequality, psychosocial variables, and health behaviours. Poisson regression models with robust variance were calculated to analyse potential associations with independent variables.ResultsSex differences were observed, with girls having more than twice as much mental distress (42.0% vs. 18.7%, p < 0.001) and poorer self-perceived health status (15.6% vs. 6%, p < 0.001), compared to boys. Behavioural factors were more strongly linked to self-perceived health status than to mental distress. Axes of inequality, bullying victimization and problematic internet use were associated to both mental distress and poor self-perceived health status for boys and girls.ConclusionsAdolescents' overall health is associated to factors such as gender, sexual orientation, migration status, socioeconomic position, bullying victimization, and problematic internet use. This study underscores the importance of taking a holistic approach when developing preventive and promotion strategies for adolescent health, addressing different levels of intervention while focusing on the most vulnerable populations.

Filiaciones:
González-Casals, H:
 Ctr Estudis Epidemiol Infecc Transmissio Sexual i, Dept Salut Generalitat Catalunya, Carretera Canyet S-N, Badalona 08916, Spain

 Inst Invest Germans Trias i Pujol IGTP, Badalona, Spain

 Univ Oberta Catalunya, Fac Hlth Sci, Res Grp Epidemiol & Publ Hlth, Rambla Poblenou 156, Barcelona 08018, Spain

 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

Vives-Cases, C:
 Univ Alicante, Dept Community Nursing Prevent Med & Publ Hlth, Hist Sci, Carretera San Vicente Raspeig S N, Alicante 03690, Spain

 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

López, MJ:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Agencia Salut Publ Barcelona ASPB, Placa Lesseps 1, Barcelona 08023, Spain

 Univ Pompeu Fabra, Dept Fac Med Ciencies vida, Carrer Doctors Aiguader, 80, Barcelona 08003, Spain

 Inst Recerca Sant Pau IR ST PAU, St Quinti 77-79, Barcelona 08041, Spain

Sanz-Barbero, B:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Natl Sch Hlth, Inst Salud Carlos 3, Madrid, Spain

Pérez, K:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Agencia Salut Publ Barcelona ASPB, Placa Lesseps 1, Barcelona 08023, Spain

 Inst Recerca Sant Pau IR ST PAU, St Quinti 77-79, Barcelona 08041, Spain

Perez, G:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Agencia Salut Publ Barcelona ASPB, Placa Lesseps 1, Barcelona 08023, Spain

 Univ Pompeu Fabra, Dept Fac Med Ciencies vida, Carrer Doctors Aiguader, 80, Barcelona 08003, Spain

 Inst Recerca Sant Pau IR ST PAU, St Quinti 77-79, Barcelona 08041, Spain

Cortés-Albaladejo, M:
 Agencia Salut Publ Barcelona ASPB, Placa Lesseps 1, Barcelona 08023, Spain

 Inst Recerca Sant Pau IR ST PAU, St Quinti 77-79, Barcelona 08041, Spain

Serral, G:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Agencia Salut Publ Barcelona ASPB, Placa Lesseps 1, Barcelona 08023, Spain

 Inst Recerca Sant Pau IR ST PAU, St Quinti 77-79, Barcelona 08041, Spain

Barceló, MA:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Univ Girona, Res Grp Stat Econometr & Hlth GRECS, Girona, Spain

Ruiz-Pérez, I:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Inst Invest Biosanit Ibs GRANADA, Granada, Spain

 Escuela Andaluza Salud Publ, Cuesta Observ 4, Granada, Spain

Mateo-Rodríguez, I:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Escuela Andaluza Salud Publ, Cuesta Observ 4, Granada, Spain

Cabrera-León, A:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Inst Invest Biosanit Ibs GRANADA, Granada, Spain

 Escuela Andaluza Salud Publ, Cuesta Observ 4, Granada, Spain

Bosque-Prous, M:
 Univ Oberta Catalunya, Fac Hlth Sci, Res Grp Epidemiol & Publ Hlth, Rambla Poblenou 156, Barcelona 08018, Spain

 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Univ Autonoma Barcelona UAB, Dept Psychobiol & Methodol Hlth Sci, Res Grp Epidemiol & Publ Hlth, C de Ca nAltayo S-N, Bellaterra 08193, Spain

Folch, C:
 Ctr Estudis Epidemiol Infecc Transmissio Sexual i, Dept Salut Generalitat Catalunya, Carretera Canyet S-N, Badalona 08916, Spain

 Inst Invest Germans Trias i Pujol IGTP, Badalona, Spain

 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

Espelt, A:
 Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Av Monforte de Lemos 3-5,Pabellon 11 Planta 0, Madrid 28029, Spain

 Univ Autonoma Barcelona UAB, Dept Psychobiol & Methodol Hlth Sci, Res Grp Epidemiol & Publ Hlth, C de Ca nAltayo S-N, Bellaterra 08193, Spain
ISSN: 14712458





BMC PUBLIC HEALTH
Editorial
BMC, CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 25 Número: 1
Páginas:
WOS Id: 001522060800006
ID de PubMed: 40604585
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