School as a determinant for health outcomes – a structural equation model analysis

Ulrike Ravens‐Sieberer (Department of Psychosomatics in Children and Adolescents, University Medical Center Hamburg‐Eppendorf, Hamburg, Germany)
John Freeman (Faculty of Education, Duncan McArthur Hall, Queen's University, Kingston, Canada)
Gyongyi Kokonyei (National Institute of Child Health, Major Department of Child Health, Department of Epidemiology, Budapest, Hungary)
Christiane A. Thomas (Department of Psychosomatics in Children and Adolescents, University Medical Center Hamburg‐Eppendorf, Hamburg, Germany)
Michael Erhart (Department of Psychosomatics in Children and Adolescents, University Medical Center Hamburg‐Eppendorf, Hamburg, Germany)

Health Education

ISSN: 0965-4283

Publication date: 19 June 2009

Abstract

Purpose

The purpose of this paper is to investigate whether students' perceptions of their school environment and their adjustment to school are associated with health outcomes across gender and age groups.

Design/methodology/approach

Data from the cross‐sectional international Health Behavior in School‐aged Children Survey of the year 2002 (n=162 306) were analyzed. A structural equation model (LISREL) specified social school climate and school demands influencing, school adjustment (achievement and liking of school). The latter aspects were assumed to influence the health outcomes general health item, life satisfaction and multiple psychosomatic symptoms. Analyses were repeated across gender and age (11, 13 and 15 years).

Findings

The specified LISREL model fitted the data well on the entire sample as well as for age and gender subgroups (RMSEA=0.043‐0.054). Overall, girls' general perceived health and life satisfaction seemed to be more strongly affected by the school environment than boys'. Age affected the goodness of fit of the model and reduced the strength of the relationship between school pressure and school adjustment. In all subgroups, the relationship between better school perceptions and better subjective health and life satisfaction were supported by the analyses.

Research limitations/implications

Reported findings are limited to the cross‐sectional study design which precludes causal inferences. Further research using longitudinal data is warranted to confirm the findings.

Practical implications

Relationships between school environment and school adjustment and health‐related outcomes revealed the relative importance of school social climate and demands for school adjustment and through the latter in determining subjective health and life satisfaction. School social climate is a target for promoting health and well‐being of children and adolescents.

Originality/value

Complex statistical analyses employing structural equation modelling confirmed findings on the importance of school aspects for child and adolescents in a huge data set.

Keywords

Citation

Ravens‐Sieberer, U., Freeman, J., Kokonyei, G., Thomas, C.A. and Erhart, M. (2009), "School as a determinant for health outcomes – a structural equation model analysis", Health Education, Vol. 109 No. 4, pp. 342-356. https://doi.org/10.1108/09654280910970910

Download as .RIS

Publisher

:

Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited

To read the full version of this content please select one of the options below

You may be able to access this content by logging in via Shibboleth, Open Athens or with your Emerald account.
To rent this content from Deepdyve, please click the button.
If you think you should have access to this content, click the button to contact our support team.