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. 2021 Nov;69(5):774-781.
doi: 10.1016/j.jadohealth.2021.06.013. Epub 2021 Jul 15.

Using Latent Class Analysis to Explore Complex Associations Between Socioeconomic Status and Adolescent Health and Well-Being

Emily Lowthian  1 , Nicholas Page  2 , G J Melendez-Torres  3 , Simon Murphy  4 , Gillian Hewitt  2 , Graham Moore  4
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Using Latent Class Analysis to Explore Complex Associations Between Socioeconomic Status and Adolescent Health and Well-Being

Emily Lowthian et al. J Adolesc Health. 2021 Nov.

Abstract

Purpose: Research demonstrates a strong socioeconomic gradient in health and well-being. However, many studies rely on unidimensional measures of socioeconomic status (SES) (e.g. educational qualifications, household income), and there is often a more limited consideration of how facets of SES combine to impact well-being. This paper develops a multidimensional measure of SES, drawing on family and school-level factors, to provide more nuanced understandings of socioeconomic patterns in adolescent substance use and mental well-being.

Methods: Data from the Student Health and Wellbeing Survey from Wales, UK was employed. The sample compromised 22,372 students and we used latent class analysis to identify distinct groups using three measures of SES. These classes were then used to estimate mental well-being, internalizing symptoms, and substance use.

Results: The five-class solution offered the best fit. Findings indicated distinct classes of families as follows: "nonworking," "deprived working families," "affluent families in deprived schools," "lower affluence," and "higher affluence." There was a clear relationship among the classes and mental well-being, internalizing symptoms, smoking, and cannabis use; alcohol was the exception to this.

Conclusions: The identification of these classes led to a fuller understanding of the health and well-being effects of SES, showing clearer patterning in health behaviors that often is not captured in research. The implications for adolescent health and well-being are discussed, including considerations for future research.

Keywords: Latent class analysis; Mental health; Socioeconomic status; Substance use.

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Figures

Figure 1
Figure 1
Mental well-being and internalizing symptoms means and standard error bars for each class.
Figure 2
Figure 2
Proportions of classes who have used tobacco, alcohol, or cannabis.
Figure 3
Figure 3
Proportions of classes who use tobacco regularly, or have used cannabis or been drunk in the last 30 days.
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