[Type of school, social capital and subjective health in adolescence].

OBJECTIVES: Social capital is increasingly acknowledged as a central determinant of health. While several studies among adults have shown the importance of social capital for the explanation of social inequalities in health, few comparable studies exist which focus on adolescents. The study examines the role of social capital in different social contexts for the explanation of health inequalities in adolescence.

METHODS: Data were obtained from the 'Health Behaviour in School-aged Children (HBSC)' study in North Rhine-Westphalia from 2006. The sample includes data of 4323 11-15-year-old students. To analyse the role of social capital in the contexts family, school, friends and neighbourhood for inequalities in self-rated health and psychosomatic complaints, logistic regression models were calculated. The socioeconomic position of the adolescents was measured by type of school.

RESULTS: Adolescents from general schools reported higher prevalences of fair/poor self-rated health and repeated psychosomatic complaints than pupils from grammar schools. Social capital in all 4 contexts (family, school, friends, and neighbourhood) was associated with both health indicators, independent of gender. In the separate analysis the variables for social capital showed a comparable explanatory contribution and reduced the odds ratios of self-rated health by 6-9%. The contribution for psychosomatic complaints was slightly higher with 10-15%. The only exception was social capital among friends which showed no effect for both health indicators. In the joint analysis the variables for social capital explained about 15% to 30% of health inequalities by school type.

CONCLUSIONS: The results show that, already in adolescence, inequalities in subjective health can be partly explained through socioeconomic differences in the availability of social capital. The settings family, neighbourhood and school provide ideal contexts for preventive actions and give the opportunity to directly address the high-risk group of students from general schools.