The neighbourhood is an essential arena for adolescents’ health development and research suggests that perceived neighbourhood insecurity (PNI) is associated with socio-economic status and self-rated health. The present study explored the distribution of adolescents’ PNI and its association with psychosomatic health complaints across districts. It also examined gender differences and whether family socio-economic position, foreign background and previous exposure to crime could explain part of the association. Data came from classroom-surveys within Stockholm municipality’s 14 districts in 2010, 2012 and 2014 (n=10,291). Linear and logistic multilevel regression models were applied. Results showed that the average level of PNI varied considerably between districts and were strongly connected to its socio-demographic composition. However, individual characteristics in terms of family background and previous exposure to crime only explained a minor part of the variation in PNI across districts. Girls reported more insecurity than boys in all districts. Gender differences in PNI decreased in absolute numbers, but increased in relative numbers, as the overall ‘neighbourhood safety’ increased. Between-district differences in health were minor, but PNI was still a strong predictor of individual-level health, especially for boys. Furthermore, the predictive power of PNI on health was stronger in districts perceived as safer.

Psychosomatic health, including sleep, is important for adolescent well-being and daily functioning. Sleep difficulties are more seldom studied per se and whether there is socio-demographic variation in sleep difficulties among adolescents in Sweden is less known. The overall aim of the present study was to examine the frequency and social distribution of sleep difficulties among adolescents in Sweden. The child supplements of the Survey of Living Conditions, a Swedish nationally representative sample of ages 10-18, from years 2002 and 2003 were used (n=2531). Information from adolescents was linked to information from parents in a cross-sectional study design. Based on logistic regression analyses, variation in sleep difficulties was present according to gender, age, family structure, family economy, parent’s unemployment and residential area. No systematic sleep inequality by social class was found in the present study. The main results showed that adolescent girls, older age groups of adolescents, adolescents living in reconstituted families, living in families with a lack of cash margin, having unemployed parents and living in big cities reported sleep difficulties to a greater extent. Social factors, together with biological, psychological and cultural factors interact in explaining the variation in sleep difficulties.

Family and school are the two major socialization agents for young people with important implications for their social, psychological and cognitive development. This thesis aimed to investigate the extent to which family conditions in terms of parental attachment and support (PAS) and school conditions in terms of participation and teacher support were associated with adolescents’ psychosomatic health. The thesis also explored whether school participation and support (SPS) could compensate for the potentially negative health implications of experiencing poor relational support at home. Association patterns according to gender and grade were also investigated. Data were derived from a classroom survey of all ninth and eleventh-grade students carried out in Stockholm 2006 (n=9,560). Results from linear regression analyses showed that both PAS and SPS were negatively associated with psychosomatic complaints. Gender and grade differences were also noted in respect to PAS and SPS as well as in the interaction between them. The study failed to find a compensatory function of school characteristics for less advantaged students, but modifying effects were nevertheless found. Students with a combination of high PAS and low SPS had worse health than expected, thus indicating that poor condition in school modifies the positive health effect of PAS in a negative way.

Aim: The aim of the study was to explore the association between school pressure and psychosomatic health complaints and the potentially moderating effect of physical activity in a Swedish cohort of adolescents.Method: Cross-sectional data from the Swedish Health Behavior in School-aged Children (HBSC) survey of 2017/2018 was used, with participants aged 11-15 (n=3,745). The exposure was school pressure, which was measured with one question. The outcome was psychosomatic complaints, with information on the frequency of eight complaints which was added to an index. Physical activity was measured with one question. Covariates were gender, grade, and family affluence. First, Cross-tabulations with Chi squared tests were performed to examine patterns related to the exposure variable, school pressure and the covariates as well, and one- way ANOVA was used to explore the bivariate association between school pressure and psychosomatic complaints. Next, linear regression analyses were conducted to examine the association between school pressure and psychosomatic health complaints, with adjusted models including age, gender, familial socioeconomic status, and physical activity. Moderation was examined with a multiplicative interaction term which was evaluated with a Wald test, as well as with a combined variable of both school pressure and physical activity.  Results: The results suggest that higher levels of school pressure were significantly associated with higher levels of psychosomatic health complaints. The association persisted even after the adjustment for covariates. The interaction analyses did not present any moderating effect of physical activity. However, the combined variable analysis showed indications of a buffering effect: for students in the high school pressure group, those with low physical activity had more psychosomatic health complaints than those with high physical activity, the difference being statistically significant.  Conclusion: This study helps further the knowledge on how adolescents’ experiences of school pressure is associated with psychosomatic health complaints and how physical activity can buffer against this association. Suggestions on future research and important study strengths and limitations were discussed.

Mental health problems have increased among adolescents in Sweden and research suggests that contextual matters could be of importance over and beyond individual socio-demographic characteristics. One such social context is school, where both the student composition of the school and its support can influence student health. This study explored the distribution of psychosomatic health complaints (PHC) and perceived teacher support (PTS) as well as the association between PTS and PHC, across school segregated profiles. It also examined gender differences in these distributions and associations. The study design was cross-sectional, and data came from classroom-surveys within Stockholm municipality of ninth grade students in 2014 (n=4904). Linear regression analyse was applied. Results showed that average levels of PHC varied across school segregation profiles for girls, while PTS varied for both gender. PTS was negatively associated with PHC for all students, while the strength of association varied across school profiles to the benefit of students in the most privileged schools. Gender differences in these associations was also observed. Conclusions were that school context, based on the student composition of the school, and its provided support was linked to psychosomatic health complaints among students in Stockholm and that gender played a role in understanding pathways in these associations.