A Multi-Level Analysis of Social Support and Socio-Economic Status As Related to Adolescent Health and Psychological Wellbeing

Purpose: Health disparities among US youths based on socio-economic status have been well documented. To promote healthy development for all youths, it is critical for social workers to understand factors contributing o poor health. Grounded in Ecological Theory, this study explores how social support, school engagement, and socio-economic factors relate to physical health problems and psychological wellbeing among adolescents who are diverse in terms of race/ethnicity and family income. We also explore whether social supports and socio-economic factors have interdependent relationships with dependent variables. For example, we assess whether social support relates to health problems and wellbeing differently for students from higher and lower income families. 

Methods: This study is a secondary analysis of 19,767 diverse middle and high school students who completed the School Success Profile (SSP). A large proportion of the sample are students of color and those from low-income families. The SSP is a 220 item self-report questionnaire that assesses health and wellbeing, as well as supports and stressors across four social environment domains: neighborhood, school, family, and peers. Multilevel linear regression models were performed, with students serving as Level 1 and schools as Level 2. HLM was applied it provide more accurate standard error estimates by accounting for the fact that students are nested within schools.

Results: Males, African American and Hispanic youths, youths from higher income families (not eligible for free or reduced price lunch), those reporting more support from parents, friends, neighbors, and teachers, youths reporting more school engagement, and those with better grades are significantly less likely to report physical health problems. The results for wellbeing are similar, with males, African Americans, youths from higher income families, youths with more support from parents, friends, neighbors, and teachers, youths more engaged in school, and youths with better grades are significantly more likely to report better psychological wellbeing. In addition, a significant interaction effect indicated that the relationship between teacher support and the dependent variables depends on family income. Among students reporting the lowest levels of teacher support, students from lower income families report fewer health problems and better wellbeing than other students. However, higher income students have better outcomes than lower income students when teacher support is perceived as average or better.

Conclusions and Implications: Youths from all racial/ethnic groups and family income levels benefit from social support from parents, peers, neighbors, and teachers. However, these relationships are complex. The protective relationship between teacher support and outcomes is stronger for students from higher income families. In this study, African American and Hispanic students reported fewer health problems than other racial and ethnic groups, and African American students reported better wellbeing than all other groups. This finding, considered alongside research on the benefits of racially integrated schools, suggests a need for more research examining whether students of color may be more likely to experience positive health and wellbeing in the context of more diverse school environments, such as those included in the present study.