What can the 2001, 2011 and 2021 UK censuses tell us about health inequalities among young people? A cross-sectional study using censuses from England, Wales, and Scotland

Abstract

Background Health inequalities are avoidable and unjust differences in people’s health across population groups. The WHO has estimated that up to 70% of premature deaths among adults are related to behaviours initiated in adolescence. However, evidence on health inequalities among adolescents is scarce compared to that among adults and younger children. This study examined the association between self-rated health and a family’s socioeconomic position in young people (10-24-year-olds). Methods The outcome variable is the single question of self-reported general health. The study population included young people aged 10 to 24 years. We analysed 2001, 2011 and 2021 census microdata from England and Wales and 2001 and 2011 data from Scotland. We used descriptive methods to determine differences in general health status by sociodemographic variables and logistic regression analysis to calculate the odds of reporting poor health according to the National Statistics Socio-economic Classification of the family reference person. Logistic regression models controlled for the effects of age, gender, household deprivation, and UK region. Results Compared to young people from the households where the reference person belonged to the managerial or professional occupational group, all other groups except those self-employed in 2001 had greater odds of reporting poor health. These differences were statistically significant (p < 0.001). The odds were highest among young people from households where the reference person had never worked or was long-term unemployed: 2.7 times in 2001, 3.1 times in 2011 and 3.6 times in 2021. The odds of reporting poor health increased with age and were greater among girls than among boys. Young people from households that were deprived in the dimensions of education or housing had greater odds of reporting poor health than did those from nondeprived groups. Conclusions Health inequalities in the self-reported health of 10–24-year-olds can be observed using UK census data. We observed a similar social gradient of self-reported poor health across the 2001, 2011 and 2021 datasets; as disadvantage increased, the share of young people with fair or poor health increased.