Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample
2.2. Procedure
2.3. Measures
2.4. Socially Marginalized and Vulnerable Groups
2.5. Health Outcomes (Age 28)
2.6. Statistical Analysis
3. Results
3.1. Physical Health Outcomes
3.2. Mental Health and Substance Use Outcomes
3.3. Groups Analysis
4. Discussion
5. Strengths and Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Combined Sample | Victorian Sample | Washington State Sample | |
---|---|---|---|
Demographics (baseline) | |||
Age, mean (SD) | 25.2 (0.48) | 25.1 (0.46) | 25.3 (0.46) |
Sex, n (%) | |||
Female | 907 (53.1%) | 457 (52.8%) | 450 (53.5%) |
Male | 800 (46.9%) | 409 (47.2%) | 391 (46.5%) |
Family socioeconomic status, mean (SD) | 2.01 (0.43) | 1.96 (0.48) | 2.07 (0.37) |
Race and ethnicity—Victoria | |||
Aboriginal or Torres Strait Islander | 10 (1.0%) | ||
African | 7 (0.7%) | ||
Asian | 51 (5.3%) | ||
Australian | 880 (90.6%) | ||
Spanish/Hispanic/Latinx | 4 (0.4%) | ||
Pacific islander | 9 (0.9%) | ||
Other | 10 (1.0%) | ||
Race and ethnicity—Washington State | |||
Asian | 36 (3.7%) | ||
American Indian/Native American or Alaskan Native | 46 (4.9%) | ||
Black or African American | 32 (3.4%) | ||
Latinx | 95 (10.2%) | ||
Multiracial | 66 (7.1%) | ||
Native Hawaiian or other Pacific Islander | 15 (1.6%) | ||
White | 643 (68.9%) | ||
Social marginalization and vulnerability (Age 25) | |||
Homelessness | |||
Yes | 89 (5.2%) | 36 (4.2%) | 53 (6.3%) |
No | 1608 (94.8%) | 823 (95.8%) | 785 (93.7%) |
ACEs, mean (SD) | 1.46 (2.03) | 1.31 (1.87) | 1.61 (2.17) |
Sexual identity, n (%) | |||
LGBT | 329 (19.4%) | 163 (19.0%) | 166 (20.0%) |
Not LGBT | 1363 (80.6%) | 697 (81.0%) | 666 (80.0%) |
Financial insecurity, mean (SD) | 0.83 (1.07) | 0.81 (1.12) | 0.84 (1.02) |
Justice system involvement, n (%) | |||
Yes | 172 (15.7%) | 103 (12.0%) | 69 (29.6%) |
No | 921 (84.3%) | 757 (88.0%) | 164 (70.4%) |
Health outcomes (Age 28) | |||
Perceived health status, mean (SD) | 2.61 (0.94) | 2.64 (0.96) | 2.57 (0.92) |
Chronic illness, n (%) | |||
Yes | 458 (29.0%) | 253 (31.9%) | 205 (26.0%) |
No | 1124 (71.0%) | 541 (68.1%) | 583 (74.0%) |
Serious injury, n (%) | |||
Yes | 86 (5.4%) | 36 (4.5%) | 50 (6.3%) |
No | 1502 (94.6%) | 761 (95.5%) | 741 (93.7%) |
Disability or ongoing medical problems resulting from serious injury, n (%) | |||
Yes | 55 (3.5%) | 21 (2.6%) | 34 (4.3%) |
No | 1529 (96.5%) | 775 (97.4%) | 754 (95.7%) |
Self-reported depression and anxiety symptoms, n (%) | |||
None | 875 (55.4%) | 425 (53.4%) | 450 (57.4%) |
Mild | 301 (19.1%) | 163 (20.5%) | 138 (17.6%) |
Moderate | 193 (12.2%) | 96 (12.1%) | 97 (12.4%) |
Severe | 211 (13.4%) | 112 (14.1%) | 99 (12.6%) |
Diagnosed mood disorder, n (%) | |||
Yes | 319 (20.2%) | 165 (20.7%) | 154 (19.7%) |
No | 1260 (79.8%) | 631 (79.3%) | 629 (80.3%) |
Diagnosed anxiety disorder, n (%) | |||
Yes | 325 (20.6%) | 160 (20.1%) | 165 (21.1%) |
No | 1254 (79.4%) | 636 (79.9%) | 618 (78.9%) |
Diagnosed substance use disorders, n (%) | |||
Yes | 45 (2.8%) | 8 (1.0%) | 37 (4.7%) |
No | 1534 (97.2%) | 788 (99.0%) | 746 (95.3%) |
Poor Perceived Health Status | Chronic Illness | Serious Injury | Disability or Ongoing Medical Problems Resulting from Serious Injury | |||||
---|---|---|---|---|---|---|---|---|
b (SE) | p | OR (SE) | p | OR (SE) | p | OR (SE) | p | |
Social marginalization and vulnerability | ||||||||
Homelessness | −0.10 (0.11) | 0.358 | 0.95 (0.27) | 0.853 | 1.50 (0.67) | 0.367 | 0.70 (0.52) | 0.632 |
ACEs | 0.05 (0.01) | <0.001 | 1.14 (0.03) | <0.001 | 1.10 (0.06) | 0.083 | 1.12 (0.06) | 0.049 |
LGBT | 0.26 (0.07) | <0.001 | 1.14 (0.17) | 0.373 | 0.75 (0.24) | 0.365 | 0.63 (0.27) | 0.281 |
Financial insecurity | 0.14 (0.03) | <0.001 | 1.13 (0.06) | 0.033 | 1.15 (0.11) | 0.164 | 1.15 (0.17) | 0.338 |
Justice system involvement | 0.06 (0.10) | 0.515 | 1.41 (0.29) | 0.097 | 1.89 (0.69) | 0.082 | 1.82 (0.84) | 0.196 |
Demographic factors | ||||||||
Age | 0.09 (0.06) | 0.167 | 1.15 (0.15) | 0.298 | 1.02 (0.27) | 0.928 | 1.22 (0.30) | 0.426 |
Male | −0.02 (0.06) | 0.771 | 0.89 (0.11) | 0.345 | 1.42 (0.34) | 0.14 | 1.25 (0.35) | 0.434 |
Nonwhite | −0.15 (0.08) | 0.072 | 0.75 (0.13) | 0.094 | 1.02 (0.34) | 0.946 | 0.83 (0.35) | 0.653 |
Washington State | −0.08 (0.06) | 0.155 | 0.68 (0.08) | 0.002 | 1.34 (0.34) | 0.242 | 1.47 (0.47) | 0.232 |
Family SES ^ | −0.31 (0.06) | <0.001 | 0.90 (0.12) | 0.428 | 0.55 (0.13) | 0.012 | 1.17 (0.39) | 0.627 |
Self-Reported Depression and Anxiety Symptoms | Diagnosed Mood Disorder | Diagnosed Anxiety Disorder | Diagnosed Substance Use Disorder | |||||
---|---|---|---|---|---|---|---|---|
b (SE) | p | OR (SE) | p | OR (SE) | p | OR (SE) | p | |
Social marginalization and vulnerability | ||||||||
Homelessness | 0.10 (0.12) | 0.429 | 0.79 (0.25) | 0.461 | 1.16 (0.36) | 0.63 | 1.39 (0.72) | 0.525 |
ACEs | 0.11 (0.01) | <0.001 | 1.32 (0.04) | <0.001 | 1.24 (0.04) | <0.001 | 1.26 (0.08) | <0.001 |
LGBT | 0.37 (0.07) | <0.001 | 2.14 (0.33) | <0.001 | 1.79 (0.28) | <0.001 | 1.67 (0.64) | 0.186 |
Financial insecurity | 0.16 (0.03) | <0.001 | 1.37 (0.09) | <0.001 | 1.26 (0.08) | <0.001 | 1.57 (0.19) | <0.001 |
Justice system involvement | 0.17 (0.10) | 0.087 | 0.61 (0.17) | 0.075 | 1.17 (0.31) | 0.538 | 3.75 (1.88) | 0.008 |
Demographic factors | ||||||||
Age | 0.06 (0.06) | 0.372 | 0.97 (0.16) | 0.826 | 0.77 (0.12) | 0.093 | 0.58 (0.25) | 0.211 |
Male | −0.13 (0.06) | 0.026 | 0.60 (0.09) | <0.001 | 0.37 (0.06) | <0.001 | 1.07 (0.39) | 0.86 |
Nonwhite | −0.18 (0.08) | 0.028 | 0.52 (0.12) | 0.003 | 0.59 (0.13) | 0.013 | 0.65 (0.32) | 0.377 |
Washington State | −0.13 (0.06) | 0.024 | 0.92 (0.14) | 0.573 | 0.99 (0.14) | 0.953 | 4.21 (1.80) | 0.001 |
Family SES ^ | −0.06 (0.07) | 0.346 | 1.30 (0.21) | 0.105 | 1.48 (0.23) | 0.012 | 1.14 (0.51) | 0.778 |
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Heerde, J.A.; Merrin, G.J.; Le, V.T.; Toumbourou, J.W.; Bailey, J.A. Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study. Int. J. Environ. Res. Public Health 2023, 20, 1711. https://doi.org/10.3390/ijerph20031711
Heerde JA, Merrin GJ, Le VT, Toumbourou JW, Bailey JA. Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study. International Journal of Environmental Research and Public Health. 2023; 20(3):1711. https://doi.org/10.3390/ijerph20031711
Chicago/Turabian StyleHeerde, Jessica A., Gabriel J. Merrin, Vi T. Le, John W. Toumbourou, and Jennifer A. Bailey. 2023. "Health of Young Adults Experiencing Social Marginalization and Vulnerability: A Cross-National Longitudinal Study" International Journal of Environmental Research and Public Health 20, no. 3: 1711. https://doi.org/10.3390/ijerph20031711