Longitudinal patterns of adolescent well-being and associations with health-related outcomes in young adulthood: a cohort study using latent growth mixture modelling

BACKGROUND: Adolescence represents a sensitive developmental period that can have lasting consequences for later health. This study investigates long-term patterns of subjective well-being during adolescence and their associations with health-related outcomes in young adulthood. METHODS: Drawing on data from the German National Educational Panel Study (NEPS), we use latent growth mixture modelling (LGMM) to identify distinct trajectories of well-being in a cohort of 8,137 adolescents aged 11 to 21 and relate them to childhood social determinants as antecedents and health-related outcomes in young adulthood. RESULTS: Four distinct classes emerged: a large group with stable high well-being (78.3%), two classes displaying a temporary decrease in subjective well-being earlier around age 15 (11.1%) or later around age 17 (7.8%), and a small catching up group with initially low but improving well-being (2.8%), with the caveat that panel attrition may have limited the identification of an additional persistently adverse trajectory class. Membership in these trajectories was associated with socio-demographic and socio-economic factors. Adolescents from higher-income households and nuclear families were more likely to follow the stable high trajectory, whereas those from single-parent or step-families or attending non-academic schools were more likely to experience early or late drops or belong to the catching up group. Well-being trajectories significantly predicted health-related outcomes in young adulthood (age 22-23), such as self-rated health, body mass index, smoking, and alcohol consumption. The late drop group reported the poorest outcomes, while those in the stable high group reported better overall health and fewer risk behaviours. The catching up group, although initially disadvantaged, approached the levels of their peers, suggesting resilience processes at work. CONCLUSIONS: These findings underscore the importance of adolescence as a sensitive period with lasting implications for health-related outcomes. Supporting adolescent well-being - particularly during critical transition points - may help reduce health inequalities and promote healthier trajectories into adulthood.