Health inequalities among adolescents and young people : an analysis of the UK censuses and the Scottish Longitudinal Study

The aim of this PhD was to examine health inequalities among young people by utilising data from the UK censuses and Scottish Longitudinal Study (SLS), applying Fundamental Cause Theory (FCT) and Social Determinants of Health approach (SDH) as a theoretical framework. The body of work presented in this portfolio thesis comprises four research papers. First, a systematic review of qualitative studies indicated that young people’s survey health ratings are influenced by physical factors such as health problems and behaviours. However, health is a holistic concept formed through interactions between contextual, physical, social, and mental dimensions. Studies included in the review also showed that young people can be exposed to health-harming structural factors which will likely shape their long-term health outcomes. The second paper used data from the 2001, 2011, and 2021 UK censuses and provided robust evidence of consistent socioeconomic (SE) patterning of self-reported general health (SRH) across two decades and three cohorts of 10–24-year-olds. The third study examined associations between three measures of SE position and SRH, showing how disability attenuates these relationships. The fourth study utilised data from the SLS to examine changes in SRH status between 2001 and 2011. Overall, this research demonstrates that UK censuses provide robust evidence on health inequalities among 10-24-year-olds. Across three census periods, a consistent SE gradient of SRH was evident, with those from lower SE backgrounds reporting poorer health compared to their peers from more advantaged backgrounds. In line with the FCT and an SDH approach, this research shows that young people’s health is shaped by structural factors beyond their control, placing them at unequal starting points in their health trajectories.