Socioeconomic status, health, and health behaviours of school-aged adolescents : the psychosocial mechanisms of social capital

  • Evelyn Aboagye ADDAE

Student thesis: PhD Thesis (Lingnan)

Abstract

Psychosocial social capital is advocated as a protective health asset and a non-monetary safety net that protect adolescents’ developmental outcomes against effects of socioeconomic inequalities. This study utilised advanced mixed research methods, and socioecological and health asset approaches to offer evidence on social capital’s psychosocial mechanisms and pathways through which socioeconomic status (SES) affects adolescents’ health and health behaviours. This is to offer appropriate policy and practice proposals in Ghana. The quantitative and qualitative studies respectively employed a multi-stage stratified cross-sectional survey data of 2,068 and 54 in-school Ghanaian adolescents (13-18yrs) in focus group discussions. Various univariate and bivariate (cross-tabulation-Chi square, Spearman correlation) statistical analyses, bootstrapping mediation, and moderation analysis using structural equation modelling techniques in SPSS-AMOS (controlling for sociodemographic factors (SDFs)), and qualitative content analysis were completed. Bivariate analyses revealed significant associations among SES, social capital, health, and health behaviour outcomes as well as variations in health and health behaviours by SES, social capital, and SDFs. From regression analyses in mediation models, SES positively predicted satisfaction with self-confidence (SSC) and physical activity (PA) but not self-rated health (SRH), multiple health/psychosomatic symptoms (MHPS), and multiple health risks behaviour (MHRB) after accounting for social capital’s effects. Again, the measures of social capital comprising family sense of belonging (FSB), family autonomy support (FAS), family control (FC), perceived social support from family (PSS-Fa), community sense of belonging (CSB), school sense of belonging (SSB), school autonomy support (SAS), and peer-based social network (PSN) showed significant varying effects on SRH, MHPS, SSC, MHRB, and PA. Moreover, social capital (FSB, FAS, FC, PSS-Fa, CSB, and PeerR) mediated the relationship between the adolescents’ SES and SRH, SSC, MHPS, PA, and MHRB. Furthermore, a moderation model revealed social capital (CSB, PSS-Fa) as a moderator in the relationship between SES and SRH, PA, and MHRB. The qualitative findings also confirmed that, indeed, psychosocial social capital offers protective mechanisms against SES’ effects on adolescents’ health and health behaviours. Explicitly, parent-child relationship, FSB, PSS-Fa, FAS, FC, peer relationships, peer social support, CSB, community autonomy support and community social support were reported as protective health assets for promoting especially poor adolescents’ health outcomes (happiness, perceived meaning in life) and health behaviours. Generally, findings from both methods assert that SES and psychosocial social capital are vital social determinants of school-aged adolescents’ health and health behaviours. Psychosocial social capital is revealed to empower adolescents to build resilience against SES’ effects. The family, peers, and community contexts offer the most crucial protective health assets and non-monetary safety nets against SES’ effects on Ghanaian adolescents’ health status, mental health, and health-promoting and risk behaviours. This study offers original research and theoretical contributions for the application of social capital as a component/complement in policies targeting young people’s socioeconomic conditions, health, and health behaviours such as Ghana’s Child and Family Welfare Policy and National Health Policy. Social well-being and empowerment at the family, school, peers, and community level should be acknowledged in integrative and inclusive social approaches addressing multidimensional poverty, health, and health behaviours of Ghanaian young people.
Date of Award29 Aug 2022
Original languageEnglish
Awarding Institution
  • Lingnan University
SupervisorStefan KÜHNER (Supervisor) & Gizem ARAT (Co-supervisor)

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