An examination of adolescent mental well being and the ‘Glasgow Effect’

Background There is a growing body of literature examining the existence of a negative ‘Glasgow effect’ on health. Previously, the poor health of Glasgow was believed to be due to high levels of poverty, however more recent studies investigating adult health outcomes have shown an effect over and above that of deprivation.
Objectives The aim of this study was to examine the existence of a ‘Glasgow effect’ in mental well-being and subjective health of an adolescent sample.
Study Design Data from the 2006 Health Behaviour in School-Aged Children cross-sectional survey were analysed.
Methods Data were modelled using multilevel logistic modelling and MCMC estimation methods for outcome measures: happiness, confidence, feeling left out, self-rated health and multiple health complaints (MHC), and multilevel linear modelling and REML estimation for outcome measures: life satisfaction and health-related quality of life (KIDSCREEN-10). The models were further adjusted for family affluence (FAS) and family status, as proxy measures of SES.
Results The proportion of pupils reporting being very happy, always confident and never left out were greater among Glasgow pupils than the rest of Scotland, as were mean life satisfaction and KIDSCREEN scores. Frequencies of MHC and subjective health were not significantly different in Glasgow from the Rest of Scotland. With the exception of life satisfaction, similar results were observed following the modelling procedures, adjusting for age, sex, grade, school type (state or private), and effect sizes increased further after adjustment for FAS and family status. The odds of a Glasgow pupil being very happy, for example, were 1.48 (1.19, 1.83) those of a pupil outside Glasgow. After adjustment for FAS and family status, the odds were 1.59 (1.28, 1.98). Life satisfaction was not associated with Glasgow before adjustment for FAS and family status, although after adjustment, adolescents scored on average 0.18 higher (on a scale of 0-10) than those from elsewhere in Scotland, significant at the 91% level. An interaction term between Glasgow and grade was not significant for any of the outcomes although there was some suggestion that a negative Glasgow effect on self-rated health was emerging by S4.
Conclusion The ‘Glasgow effect’ may not be all bad. The findings suggest that during adolescence mental well-being is more prevalent in Glasgow relative to the rest of Scotland and that this is especially the case after adjustment for family affluence. Further research is recommended to investigate the Glasgow effect during this life stage.