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That's what friends are for: adolescent peer social status, health-related quality of life and healthcare costs.

ABSTRACT: Social connections at all stages of life are essential for physical and mental well-being. Of particular importance are social relationships during adolescence that shape adult health behaviors and health outcomes.The aim of this study was to estimate the association between adolescent peer status in school and later-life quality-adjusted life-years (QALYs) and healthcare costs.This study used social network and health outcomes data from Wave I (ages 12-18 years) and Wave III (ages 18-24 years) of the US National Longitudinal Study of Adolescent Health (n = 10,578) to compare QALYs and healthcare costs (in 2012 US$) by adolescent peer status in US schools. Generalized linear models controlled for school fixed effects, individual and family characteristics, and US census block neighborhood effects. Non-parametric bootstrapping accounted for residual skewness in QALYs and healthcare costs. Net monetary benefit (NMB) was calculated by converting adjusted 5-year QALYs into US$ values and subtracting 5-year healthcare costs. NMB was then compared across quintiles of adolescent peer status in school at Wave I.Results obtained from non-parametric bootstrapping indicate that adolescents with higher peer status in school experience significantly better health and lower healthcare costs over the next 5 years. At US$50,000 per QALY, adolescents with 8 or more friends achieved NMB of US$214,300 (95 % CI 212,800-215,800) over a 5-year span, in comparison to adolescents with 0-1 friends, who attained US$209,900 (95 % CI 207,900-211,700) NMB. This difference translates into approximately US$4,440 (95 % CI 2,036-6,825) per socially disengaged adolescent in additional health costs and/or reduced QALYs over 5 years.The study calls for randomized controlled trials targeting adolescent peer group structures in schools as a means to promote better health and lower healthcare costs in adulthood.

SUBMITTER: Mundt MP

PROVIDER: S-EPMC3972808 | biostudies-literature | 2014 Apr

REPOSITORIES: biostudies-literature

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That's what friends are for: adolescent peer social status, health-related quality of life and healthcare costs.

Mundt Marlon P MP Zakletskaia Larissa I LI

Applied health economics and health policy 20140401 2

<h4>Background</h4>Social connections at all stages of life are essential for physical and mental well-being. Of particular importance are social relationships during adolescence that shape adult health behaviors and health outcomes.<h4>Objective</h4>The aim of this study was to estimate the association between adolescent peer status in school and later-life quality-adjusted life-years (QALYs) and healthcare costs.<h4>Methods</h4>This study used social network and health outcomes data from Wave ...[more]

PMID: 24531987

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Project description:ObjectiveThis study aimed to determine the association between adolescent socioeconomic status (father's education and adolescent subjective socioeconomic status) and adult quality of life and the mediation roles of adult socioeconomic status, social capital and lifestyle (physical activity and exposure to smoke) among the "Tehran University of Medical Sciences Employees Cohort (TEC) Study" participants.MethodData of 4455 participants were derived from the Tehran University of Medical Sciences Employees Cohort (TEC) Study. In this study, the World Health Organization quality of life-BREF, the World Bank's Integrated and the International Physical Activity Questionnaire were used. Data were analyzed with structural equation modeling using SPSS Amos 24.0 program.ResultsThe mean age of the participants was 42.31 years (SD: 8.37) and most of the subjects were female (60.7%). Correlation analysis results revealed that, quality of life had a significant and positive association with adolescent subjective socioeconomic status (r = 0.169, p < 0.01) and father's education (r = 0.091, p < 0.01). A mediation model testing the direct relationship between adolescent socioeconomic status and adult socioeconomic status and quality of life, showed a positive relationship between adolescent subjective socioeconomic status (β = 0.229, p < 0.001) and father's education (β = 0.443, p < 0.001) with adult socioeconomic status. Adult socioeconomic status was positively related to quality of life (β = 0.205, p < 0.001). Adult socioeconomic status mediated the relationship between adolescent subjective socioeconomic status (β = 0.047, p < 0.01) and father's education (β = 0.091, p < 0.01) with quality of life. While adult socioeconomic status fully mediated the relationship between the father's education and quality of life, it partially mediated the adolescent subjective socioeconomic status-quality of life association. Other variables such as social capital and lifestyle did not have mediator role in a mediation model.ConclusionThis study provides the evidence for the role of adult socioeconomic status as a partial mediator between adolescent subjective socioeconomic status and quality of life. Therefore, there are several unknown mediators other than adult socioeconomic status that need to be explored in future studies.

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Dataset Information

That's what friends are for: adolescent peer social status, health-related quality of life and healthcare costs.

Publications

That's what friends are for: adolescent peer social status, health-related quality of life and healthcare costs.

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