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Longitudinal Associations Between Parental SES and Adolescent Health-Related Quality of Life Using Growth Curve Modeling

Abstract

We evaluate how two aspects of socioeconomic status, parental objective and subjective social status, are associated with health-related quality of life in three racial/ethnic groups during pre- to mid-adolescent development, using growth curve modeling. In a longitudinal cohort study, 4,048 Black, Latinx, or White adolescents were assessed in 5th, 7th and 10th grade. Objective social status (OSS) was based on parent-reported highest household educational attainment and total household income, and subjective social status (SSS) was measured with the MacArthur Scale, through which parents indicated their social standing in reference to community and national norms. Adolescents completed the Pediatric Quality of Life Inventory to measure their physical and psychosocial health-related quality of life. Based on growth curve modeling of the intercept, adolescents whose parents have higher OSS levels reported better health-related quality of life, whereas parental SSS was not associated with adolescent health-related quality of life in 5th grade. These findings were largely consistent across racial/ethnic groups. Based on growth curve modeling of the developmental slopes (or growth curves), higher objective social status was associated with a slower positive growth of health-related quality of life from 5th to 10th grade, which was largely consistent across racial/ethnic groups. The opposite appeared for parental SSS and physical health-related quality of life, and only for Latinx, where higher parental perceived social status was associated with an acceleration of positive change. Family income and education may influence health-related quality of life at the start of adolescence, but its effect appears to diminish as youth mature. However, in Latinx youth, parents’ perceived social status may continue to influence improvement in their physical health-related quality of life as they mature.

Highlights

  • Socioeconomic status (SES) is known to influence health throughout the lifespan, but the potentially different influence from different components of SES during adolescent development is unknown.

  • Parental income and education level are positively associated with health-related quality of life (HRQOL) for youth in 5th grade.

  • However, the role of parental income and education fades as adolescents mature, generally consistently across racial/ethnic groups.

  • Yet, in Latinx adolescents, parents’ perceived social status may continue to influence improvement in their physical HRQOL as they mature.

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Acknowledgements

This work was funded by the Centers for Disease Control and Prevention, Prevention Research Centers (Cooperative Agreements CCU409679, CCU609653, CCU915773, U48DP000046, U48DP000057, U48DP000056, U19DP002663, U19DP002664, and U19DP002665). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. The contributions made to this research by study participants in the Birmingham, Houston, and Los Angeles areas, other Healthy Passages™ investigators; field teams at each site; and the CDC Division of Adolescent and School Health are gratefully acknowledged.

Author Contribution

K.W.K. performed the statistical computation and S.D. verified the analytical methods and provided further calculations. K.W.K. wrote the manuscript in consultation with J.L.W. and S.D. M.N.E. and M.A.S. contributed to the original data collection, discussed the results, and contributed to the final document. J.L.W. supervised this study.

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Correspondence to Jan L. Wallander.

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Kim, K.W., Wallander, J.L., Depaoli, S. et al. Longitudinal Associations Between Parental SES and Adolescent Health-Related Quality of Life Using Growth Curve Modeling. J Child Fam Stud 30, 1463–1475 (2021). https://doi.org/10.1007/s10826-021-01970-y

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Keywords

  • Adolescence
  • Health-related quality of life
  • Socioeconomic status
  • Race
  • Ethnicity