Health  Vol.4 No.10 , October 2012
How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden
Abstract: Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at schools, participation and psychosomatic problems. Methods: Pupils in grades 6 - 9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex; culture or ethnicity; disability; religion beliefs; sexual preferences; and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z = d/s(d) was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z = d/s (d) was > ± 2 SD, -2.59 for boys and -39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effect was stronger in girls than in boys. There is a need for school health promotion programs focusing on participation in terms of democratic processes, communication and cooperation in the classroom.
Cite this paper: Carlerby, H. , Viitasara, E. , Knutsson, A. and Gadin, K. (2012) How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden. Health, 4, 866-872. doi: 10.4236/health.2012.410132.

[1]   Hagquist, C. (2010) Discrepant trends in mental health complaints among younger and older adolescents in Sweden: An analysis of WHO data 1985-2005. Journal of Adolescent Health, 46, 258-264. doi:10.1016/j.jadohealth.2009.07.003

[2]   Karvonen, S., Vikat, A. and Rimpel?, M. (2005) The role of school context in the increase in young people’s health complaints in Finland. Journal of Adolescents, 28, 1-16. doi:10.1016/j.adolescence.2004.05.006

[3]   Srabstein, J. and Piazza, T. (2008) Public health, safety and educational risks associated with bullying behaviors in American adolescents. International Journal of Adolescent Medicine and Health, 20, 223-233. doi:10.1515/IJAMH.2008.20.2.223

[4]   Sellstr?m, E. and Bremberg, S. (2006) Is there a “school effect” on pupils outcomes? A review of multilevel studies. Journal of Epidemiology and Community Health, 60, 149-155. doi:10.1136/jech.2005.036707

[5]   Carlerby, H., Viitasara, E., Knutsson, A. and G?din, K.G. (2012) How bullying involvement is associated with the distribution of parental background and with subjective health complaints among swedish boys and girls. Springer Netherlands, Dordrecht.

[6]   Eliasson, M., Laflamme, L. and Isaksson, K. (2005) Verbal abuse, gender and wellbeing at school. International Journal of Adolescent Medicine and Health, 17, 367-378. doi:10.1515/IJAMH.2005.17.4.367

[7]   The Swedish National Agency for Education (2009) Discriminated, harassed, offended? Childs, pupil’s and students perceptions of discrimination and harassment. Fritzes, Stockholm.

[8]   G?din, G.K. and Hammarstr?m, A. (2005) A possible contributor to the higher degree of girls reporting psychological symptoms compared with boys in grade nine? European Journal of Public Health, 15, 380-385.

[9]   Gustafsson, J.E., Westling, A.M., Alin ?kerman, B., Eriksson, C., Eriksson. L., Fischbein, S. et al., (2010) School, learning and mental health: A systematic review. The Royal Swedish Academy of Sciences, The Health Committee, Stockholm.

[10]   Neto, F. (2009) Predictors of mental health among adolescents from immigrant families in Portugal. Journal of Family Psychology, 23, 375-385. doi:10.1037/a0015831

[11]   Pascoe, E.A. and Smart Richman L. (2009) Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135, 531-554. doi:10.1037/a0016059

[12]   Williams, D.H., Neighbors, H.W. and Jackson J.S. (2003) Originally published as: Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200-208. doi:10.2105/AJPH.93.2.200

[13]   Wamala, S., Bostrom, G. and Nyqvist, K. (2007) Perceived discrimination and psychological distress in Sweden. British Journal of Psychiatry, 190, 75-76. doi:10.1192/bjp.bp.105.021188

[14]   SFS 2008:567. The Discrimination Act. Svensk f?rfattnings-samling. Stockholm.

[15]   SFS 2010:800. The Education Act. Svensk f?rfattnings-samling. Stockholm.

[16]   Mayer, M.J. (2010) Structural analysis of 1995-2005 school crime supplement datasets: Factors influencing students’ fear, anxiety, and avoidant behaviors. Journal of School Violence, 9, 37-55. doi:10.1080/15388220903153496

[17]   Witkowska, E. and Menckel, E. (2005) Perceptions of sexual harassment in Swedish high schools: Experiences and school environment problems. European Journal of Public Health, 15, 78-85. doi:10.1093/eurpub/cki119

[18]   Landau, S., Milich, R., Harris, M.J. and Larson, S.E. (2001) You really don’t know how much it hurts: Children’s and preservice teachers’ reaction to childhood teasing. School Psychology Review, 30, 329-343.

[19]   Natvig, G., Albrektsen, G. and Qvarnstr?m, U. (2003) Methods of teaching and class participation in relation to perceived social support and stress: Modifiable factors for improving health and wellbeing among students. Educational Psychology, 23, 261-274. doi:10.1080/0144341032000060101

[20]   Ahlstr?m, B. (2010) Student participation and school success: A study about participation, grades and bullying among 9th grade students in Sweden. Education Inquiry, 1, 97-115.

[21]   Voelkl, K.E. (1995) School warmth, student participation, and achievement. Journal of Experimental Education, 63, 127-139. doi:10.1080/00220973.1995.9943817

[22]   Hermerén, G.R. (2011) Good research practice. The Swedish Research Council’s Expert Group on Ethics, Swedish Research Council, Stockholm.

[23]   Hagquist, C. (2006) Health inequalities among adolescents—The impact of academic orientation and parents’ education. European Journal of Public Health, 17, 21-26. doi:10.1093/eurpub/ckl087

[24]   Carlerby, H., Viitasara, E., Knutsson, A. and Gillander G?din, K. (2011) Subjective health complaints among boys and girls in the Swedish HBSC study: Focussing on parental foreign background. International Journal of Public Health, 56, 457-464. doi:10.1007/s00038-011-0246-8

[25]   Hagquist, C. (2008) Psychometric properties of the psychosomatic problems scale: A rasch analysis on adolescent data. Social Indicator Research, 86, 511-523. doi:10.1007/s11205-007-9186-3

[26]   Ahlstr?m, B. (2009) Bullying and social objectives: A study of prerequisites for success in swedish schools. Ph.D. Thesis, Ume? University, Ume?.

[27]   Vinnerljung, B., Hjern, A., Ringb?ck Weitoft, G., Franzén, E. and Estrada, F. (2007) Children and young people at risk. International Journal of Social Welfare, 16, 163-202. doi:10.1111/j.1468-2397.2007.00520.x

[28]   Pallant, J. (2007) SPSS Survival manual. McGraw Hill, Open University Press, Berkshire.

[29]   Baron, R. and Kenny, D. (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. doi:10.1037//0022-3514.51.6.1173

[30]   Stiles, B., Liu, X. and Kaplan, H. (2000) Relative deprivation and deviantadaptations: The mediating effects of negative self-feelings. Journal of Research in Crime and Delinquency, 37, 64-90. doi:10.1177/0022427800037001003

[31]   G?din, G.K. and Hammarstr?m, A. (2003) Do changes in the psychosocial school environment influence pupils’ health development? Results from a three-year follow-up study. Scandinavian Journal of Public Health, 31, 169-177. doi:10.1080/14034940210134121

[32]   Fryer, R.G., Kahn. L., Levitt S.D. and Spenkuch, J.L. (2008) The plight of mixed race adolescents. The Review of Economics and Statistics, 94, 621-634. doi:10.3386/w14192

[33]   Pridemore, P. (2000) Children’s participation in development for school health. Compare, 30, 103-113. doi:10.1080/030579200109888

[34]   Wyn, J., Chaill, H., Holdsworth R., Rowling, L. and Carson, S. (2000) Mind matters, a whole-school approach promoting mental health and wellbeing. Australian and New Zealand Journal of Psychiatry, 34, 594-601. doi:10.1080/j.1440-1614.2000.00748.x

[35]   G?din, G.K., Weiner, G. and Ahlgren, C. (2011) School health promotion to increase empowerment, gender equality and pupil participation: A focus group study of a Swedish elementary school initiative. Scandinavian Journal of Educational Research, 1-17. doi:10.1080/00313831.2011.621972

[36]   Connell, R. (2009) Gender. Polity Press, Cambridge.

[37]   MacLean, A, Sweeting, H. and Hunt, K. (2010) “Rules” for boys, “guidelines” for girls: Gender differences in symptom reporting during childhood and adolescence. Social Science of Medicine, 70, 597-604. doi:10.1016/j.socscimed.2009.10.042