Intersectional inequality in perceived health during adolescence and early adulthood

Abstract Background Research on intersectional inequalities in wellbeing over the life course remains scarce. This study assessed inequalities in perceived health from adolescence to early adulthood across multiple social background characteristics. Methods Data from 2548 participants in the 1986 Northern Finland Birth Cohort (NFBC1986) during the 16- and 33-year surveys were included. We employed a novel approach, the Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA), to investigate social intersectional inequality in perceived health. The intersectional social strata were formed across dimensions of sex, family type, parental education, parental income, and the number of close friends, all measured during adolescence. Results Girls without close friends and with varying family characteristics (family type, parental education, and income) were less likely to report higher health ratings during adolescence and adulthood (variance partitioning coefficient (%) of 3.72 with a 95% credible interval of 1.62 - 6.91). Notably, girls from low-income families who did not live with two parents experienced the steepest decline in perceived health from adolescence to adulthood. In contrast, girls from higher-income, two-parent families experienced an increase in perceived health during this time. The variation observed across social strata was primarily explained by additive main effects, as indicated by a substantial (93.75%) proportional change in variance, with no significant intersectional interactions identified. Conclusions Our findings have significant implications for future research and policy by identifying disadvantaged groups (i.e., those who experienced lower perceived health from adolescence to early adulthood), such as girls and boys from low-income families who lack close friends. This helps in developing targeted wellbeing interventions throughout the life course. Key messages • Health inequalities vary significantly across social strata during adolescence and early adulthood. • Girls and boys from low-income families who lack close friends report lower health ratings.