Accumulative processes in health inequalities: the socioeconomic causes and consequences of mental and physical health comorbidity in adolescence

该研究项目通过调查青春期抑郁症状和高体重指数(BMI)共病的原因和后果，调查了健康和社会结果方面的累积不平等。在包括英国在内的许多经济发达国家，儿童超重或肥胖等高BMI的比例一直在上升，人们普遍担心抑郁症等心理健康问题也在增加。青少年幸福感的这些重要方面往往是同时发生的，也可能是共同发展的。它们还与许多童年社会因素有关，如家庭社会经济环境和经历负面生活事件。重要的是，青春期的健康和幸福反过来会影响学业成绩和后来的社会经济机会。抑郁症状和BMI之间的强烈联系表明，精神和身体健康问题可能会累积，这可能会产生比任何特定健康或幸福领域的困难更严重的后果。在这个研究项目中，我将使用两项关于青少年的纵向研究和一项关于成年人的大型基因信息横断面研究，以了解不平等是如何发展的。该项目的理论框架基于累积(非)优势理论，该理论认为，生活中不同领域的劣势可能会产生比各部分之和更大的后果。这些分析应用了先进的统计学方法来描述青春期抑郁症状和BMI之间的关系，以及它们共同患病的社会预测因素，并估计它们对未来结果的影响强度。该项目解决了以下研究问题：--早期社会经济环境如何预测青春期抑郁症状和高BMI的共病？-童年不良生活事件的数量和严重程度是否预测了共病，并解释了家庭背景的一些影响？-共病抑郁症状和高BMI的社会决定因素和性别模式是否发生了队列变化？-抑郁症状和高BMI是否相互作用，影响学校成绩和教育抱负？--抑郁症状和高BMI一起预测成年后的教育、收入和与配偶生活是否比两者中的任何一个都更强烈？该项目将研究抑郁症状和高BMI之间的相互作用。由于健康和社会因素之间的密切联系以及对一系列学科知识的潜在贡献，BMI与社会环境之间存在着跨学科的方法。承担这个项目将使我进一步发展成为一名独立的学者，并使我能够与政策制定者和利益相关者建立有影响力的联系。该项目加深了我们对累积劣势的早期驱动因素和早期投资对福祉的益处的理解，将有助于广泛政策领域的政策制定者以及旨在改善青少年福祉并最终解决生活机会不平等问题的卫生和社会服务专业人员。

The research project investigates accumulative inequalities in health and social outcomes through investigating the causes and consequences of the comorbidity of depressive symptoms and high body mass index (BMI) in adolescence. Rates of high BMI such as being overweight or obese have been increasing in children in many economically developed countries including the UK, and there has been widespread concern that mental health problems such as depression have also been on the rise. These important aspects of adolescent wellbeing often co-occur and can develop together. They are also associated with numerous childhood social factors such as family socioeconomic circumstances and experiencing negative life events. Importantly, adolescent health and wellbeing can in turn influence school achievement and later socioeconomic opportunities. The strong links between depressive symptoms and BMI indicate that mental and physical health problems may accumulate, which can have even greater consequences than difficulties in any specific area of health or wellbeing on their own.In this research project, I will use two longitudinal studies on adolescents and one large genetically informed cross-sectional study of adults to understand how inequalities develop. The theoretical framework of the project is based on accumulative (dis)advantage theory, which suggests that disadvantage in different areas of life may interact with consequences bigger than the sum of its parts. The analyses apply advanced statistical methods to characterise the relationship between depressive symptoms and BMI across adolescence, the social predictors of their comorbidity, and to estimate the strength of their effects on later outcomes. The project addresses the following research questions:- How do early-life socioeconomic circumstances predict the comorbidity of depressive symptoms and high BMI in adolescence?- Does the number and severity of adverse life events in childhood predict the comorbidity and explain some of the influence of family background?- Have there been cohort changes in the social determinants and gender-specific patterns of comorbid depressive symptoms and high BMI?- Do depressive symptoms and high BMI interact to impact school grades and educational aspirations?- Do depressive symptoms and high BMI together predict education, income and living with a spouse in adulthood more strongly than either separately?The project will study the interaction of depressive symptoms, BMI and social circumstances with an interdisciplinary approach, because of the close links between health and social factors and the potential contribution to knowledge in a range of disciplines. Undertaking the project will further my development into an independent academic and enable me to build impactful connections with policy-makers and stakeholders. Advancing our understanding of the early drivers of accumulative disadvantage and the benefits of early investments to wellbeing, the project will be useful for policy-makers in a wide range of policy areas and professionals in health and social services aiming to improve adolescent wellbeing and, ultimately, to address inequalities in life chances.