Health in Adolescence
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- Jonas Willemsen
- 7 jaren geleden
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1 Health in Adolescence An Empirical Study of Social Inequality in Health, Health Risk Behaviour and Decision Making Styles
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3 Rijksuniversiteit Groningen Health in Adolescence An Empirical Study of Social Inequality in Health, Health Risk Behaviour and Decision Making Styles Proefschrift ter verkrijging van het doctoraat in de Medische Wetenschappen aan de Rijksuniversiteit Groningen op gezag van de Rector Magnificus, dr. F. van der Woude, in het openbaar te verdedigen op woensdag 27 mei 1998 des namiddags te 4.15 uur door Jolanda Tuinstra geboren op 7 oktober 1966 te Lemmer
4 Promotores Prof dr D Post Prof dr WJA van den Heuvel Co-promotor Dr JW Groothoff
5 Promotiecommissie Prof dr LJ Gunning-Schepers Prof dr RB Minderaa Prof dr JL Peschar
6 1998 Groningen Ontwerp Extra Bold, Groningen Omslag ontwerp en opmaak Edzard Krol Druk Stichting Drukkerij C. Regenboog, Groningen ISBN Financial support by the Netherlands Heart Foundation and the Dr. L.A. Bumastichting for the publication of this thesis is gratefully acknowledged.
7 Voorwoord Twee dingen had ik duidelijk voor ogen toen ik in 1993 begon aan mijn AIO-onderzoek. Mijn proefschrift zou een Nederlandstalig boek worden. Daarnaast zou ik me vier jaar lang, een eindeloze tijd, kunnen verdiepen in één onderwerp. Maar vier jaren bleken allesbehalve eindeloos, ze zijn al voorbij. En dat ene onderwerp was veel omvattender dan ik dacht. Ook het Nederlandstalige boek pakte anders uit. Voor me ligt nu een bundeling van Engelstalige artikelen. Daar viel niet aan te ontkomen, besefte ik al snel, en ik ben er nog blij mee ook. Dat is vooral te danken aan een aantal mensen die mij tijdens het onderzoek enorm hebben geholpen. Ik wil hen daarvoor hartelijk bedanken. Doeke Post en Wim van den Heuvel hebben als promotores het geheel in goede banen geleid. Dankzij hen werden op passende momenten keuzes gemaakt. Bovendien gaven zij mij het vertrouwen dat wat ik deed de moeite waard was en zou gaan lukken. Johan Groothoff was als co-promotor altijd zeer betrokken bij mijn onderzoek. Ik heb het bijzonder gewaardeerd dat ik op ieder moment bij hem binnen kon lopen. Aan onze regelmatige en inspirerende besprekingen bewaar ik goede herinneringen, vooral ook aan de 'heenen-weer-vragen'. De GGD-en, Groningen Stad en Ommelanden, Noord-Friesland, Regio IJssel Vecht en Zuid-Oost Drenthe werkten mee aan de uitvoering van het onderzoek. Vijf mensen wil ik graag noemen, Annet Baltissen, Jan van Beek, Dick Brethouwer, Onno Sijperda en Aaltje Tjoelker. Zij waren sterk betrokken bij het onderzoek, dachten mee, en hebben de toegang tot de scholen mogelijk gemaakt. Behalve de scholen wil ik ook en vooral de leerlingen bedanken voor hun medewerking. Ik stond versteld van hun animo en gedrevenheid om de vragenlijst in te vullen. Liesbeth Hoekstra, Jacco Kip, Jeanette Meeuwesen, Joke Noordhof, Vidya Rama en Folkert Veentjer hebben allemaal geholpen met het maken, vullen en bijhouden van het databestand. Ik heb het erg op prijs gesteld dat zij in korte tijd de stapels vragenlijsten wisten om te toveren tot een bestand waarop en waarmee ik kon rekenen.
8 Eric van Sonderen gaf mij methodologische adviezen en hielp bij verschillende analyses. Vooral de evaluatie van de ADMQ in hoofdstuk 7 was een leuke en leerzame exercitie. Geke Dijkstra, Ria Molanus, Adelita Ranchor, Renzo Tuinsma en Paul van der Wijk lazen in verschillende stadia teksten van mijn artikelen of hoofdstukken. Zij leverden een waardevolle bijdrage aan zowel de inhoud, als de formuleringen. Ze wezen op mijn cirkelredeneringen en tegenstrijdigheden, en halveerden het aantal 'howevers'. I would like to thank Patrick West for at least two reasons. Firstly, for his kind hospitality and the interesting discussions we had during my stay in Glasgow. Secondly, for his recommendation of Helen Sweeting and Tony Glendinning as reviewers of some of the chapters. Without him, I would not have been able to thank Helen Sweeting and Tony Glendinning for their constructive comments on chapter 1, 2, and 9. Despite the extremely tight schedule, they were most cooperative. Mijn collega's van Sociale Geneeskunde bedank ik voor de plezierige en stimulerende sfeer om in te werken. Ellen Tuinstra en Geke Dijkstra wil ik bedanken, omdat zij zulke bijzondere paranimfen zijn. Ook bedank ik mijn ouders, Fred en Jet, die mij op zoveel uiteenlopende manieren geholpen hebben. En dan tot slot natuurlijk Edzard. Tijdens het hele AIO-onderzoek was hij voor mij van onschatbare waarde, bedankt! Jolanda Tuinstra, Groningen, april 1998.
9 Contents Introduction to the Study 11 Data Source 25 The Prevalence of Self-Reported Health Problems in Male and Female Dutch Adolescents 35 Socioeconomic Health Differences in Male and Female Adolescents in the Netherlands 47 Self-esteem, Chronic Illness and the Influence of Socioeconomic Status in Young People 59 Socioeconomic Differences in Health Risk Behaviour in Adolescence: Do They Exist? 69 Reliability, Validity and Structure of the Adolescent Decision Making Questionnaire among Adolescents in the Netherlands 83 The Role of Decision Making Styles and Socioeconomic Status in Adolescent Health Risk Behaviour: a Test of Differential Vulnerability 97 Summary, General Discussion and Implications 109 Samenvatting 131 Appendices 145 References 147
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