Evolution of health inequalities among adolescents based on gender and socioeconomic status over 16 years (2002 to 2018): results of the study on health behaviors of school-aged children

Introduction. Monitoring health inequalities supports policies to reduce these inequalities early in life. The purpose of our study was to examine changes in inequalities in six health domains by gender and socioeconomic status. Methodology. Data were obtained from five quadrennial cycles of the Health Behaviour in School-Aged Children (HBSC) survey conducted in Canada (pooled sample: 94 887 participants). Differences in health by socioeconomic status (based on material deprivation) and gender were assessed using relative indices and inequality slopes in six health domains: daily physical activity, overweight, frequent physical symptoms, frequent psychological symptoms, low life satisfaction, and self-rated fair or poor health. Results. Over 16 years, the self-reported health status of Canadian adolescents has gradually deteriorated in four health domains, with the steepest declines in the lowest socioeconomic group. Differences by socioeconomic status became more pronounced in terms of being overweight, having physical symptoms, having low life satisfaction, and having fair or poor health. Gender differences also deepened. Girls' health status was worse than boys' in all domains except overweight, and gender differences increased over time in physical symptoms, psychological symptoms, and low life satisfaction. Conclusion. Inequalities related to gender and socioeconomic status are persistent and growing among adolescents in Canada. Action is needed to address the material and social factors that contribute to health inequalities during adolescence.