Research shows that the school environment is an important social determinant of health among children and adolescents. However, we know virtually nothing of the health consequences of national education systems and policies, for example the stratification of pupils by academic ability. This study aimed to investigate if education system stratification is related to self-reported psychological and somatic health complaints of pupils aged 11 to 15, and social inequalities in such health complaints.

Survey data from the Health Behaviors of School-aged Children (HBSC) survey, covering 33 countries and more than 180 000 pupils in primary and lower secondary school, were used. Multilevel models showed that education system stratification was not associated with the average levels of health complaints of pupils, but cross-level interaction effects showed that stratification moderated the relationship between social background and health complaints, such that inequalities in health complaints were smaller in countries with more stratified systems. Moreover, this moderating effect was mediated by the school learning environmentand social relations in school. Specifically, social inequalities in school pressure, academic self-concept, school climate, and school satisfaction were smaller in more stratified education systems, which in turn accounted for smaller inequalities in health complaints in these countries.

Inequalities in health and well-being are important contemporary public health issues. This article is the first to investigate the institutional causes of inequality in well-being among youth in a comparative perspective. Data from the European Social Survey are used to analyse how educational policies moderate the association between social background and well-being. Multilevel techniques are used to investigate cross-level interactions between social background and educational policies on life satisfaction. Four indicators of inclusive educational policies are analysed: age of tracking, costs of education, enrolment rates, and second-chance opportunities in the educational system. The results show that educational policies indeed moderate the association between social background and well-being: inequalities as measured by the father’s social class are smaller in countries where educational policies are more inclusive. Moreover, the analysis shows that the moderating impact of education policies is mediated by individual-level education, activity status, and income.

Background: Suicide ideation is a health issue affecting adolescents worldwide. There are significant variations in suicide ideation between countries and genders, which have not been fully explained. Research is especially lacking in countries outside Europe and North America. Gender equality has been shown to matter in other aspects of adolescent mental health, such as life satisfaction, but has not been researched in relation to suicide ideation at national level.

Objective: To investigate how national gender inequality is related to self-reported suicide ideation among adolescents, and whether this association differs between boys and girls.

Methods: This is a cross-national, cross-sectional study using individual survey data from the Global School-based Student Health Survey, a survey in Africa, Asia, Latin America and the South Pacific, developed and supported by among others the WHO and the CDC; connecting this to national data: the gender inequality index from the UNDP; controlling for GDP per capita and secondary school enrolment. The data was analysed using a multilevel logistic regression method and included 149,306 students from 37 countries.

Results: Higher national gender inequality, as measured by the gender inequality index, was significantly associated with a higher likelihood of suicide ideation in both girls and boys (odds ratio: 1.38 p-value: 0.015), but for girls and both sexes this was only after adjusting for selection bias due to secondary school enrolment (as well as GDP/capita). Interaction models showed that this association was stronger in boys than in girls.

Conclusions: National gender inequality seems to be associated with higher levels of suicide ideation among adolescents in mainly low- and middle-income countries, especially among boys.

Temporary work is common across Europe, especially among young people. Whether temporary employment is a transitory stage on the road to standard employment, and whether this varies depending on institutional contexts, is controversial. This article investigates variability in transition rates from temporary to permanent employment across Europe, and how this is related to employment protection legislation (EPL) and the vocational specificity of education systems. We utilize harmonized panel data from the European Union Statistics on Income and Living Conditions, covering 18 European countries and including 34,088 temporary workers aged 18–30. The results show that stricter EPL is associated with lower rates of transitions to permanent employment, while partial deregulation, with strict EPL for permanent contracts but weaker EPL for temporary contracts, is associated with higher transition rates. Vocationally specific education systems have higher transition rates, on average. Moreover, the role of EPL is conditional on the degree of vocational specificity.

The aim of this study is to investigate cross-country variability in transition rates from unemployment to further education among young adults, as well as how barriers in educational systems affect these transition rates. Previous research on adult further education has largely neglected the role of policies, and has not taken unemployed people into account.

Two dimensions of educational policies are investigated. (1) Barriers facing prospective students with regard to previous academic achievements (e.g. second chance opportunities); and (2) financial barriers (e.g. high costs). It is hypothesized that low barriers are associated with higher transition rates into education, especially for unemployed young adults with lower levels of education.

The aim is approached by investigating how differences in transition rates across countries are linked to the design of educational policies. Cross-country standardised individual-level panel data from 29 European countries are taken from EU-SILC. Multilevel multinomial models are fitted.

Results show that lower barriers in the education system are associated with higher probabilities that unemployed young adults leave unemployment to re-enter further education, although only partial support is found for the hypothesis that unemployed young adults with lower levels of education gain relatively more from low barriers. Low barriers are sometimes associated with lower transition rates into employment.

This article aims to investigate if education policies moderate the association between unemployment and well-being among young adults. Based on the capability approach, we argue that education policies mitigate the negative effects of unemployment by providing opportunities for education and thus ways to exit unemployment. Education policies can strengthen capabilities, enhance the control that individuals have over their situation, and thereby reduce the stress associated with unemployment. We estimated cross-level interactions between education policies and unemployment status using multilevel methods and data from the European Social Survey. Results showed that policies that increase educational opportunities—such as generous second chance opportunities—were associated with smaller negative effects of unemployment on well-being and that this moderating impact was stronger for young adults with low education. Further analyses show that education policies are also associated with perceived capabilities among unemployed, supporting the proposed mechanism.

The aim of this thesis is to investigate the moderating role of social policies for the association between vulnerable social positions and health and wellbeing. Vulnerable social positions are identified in relation to age-related transition points in to or out of the labour market. Specifically, the focal groups are young adults, on the route to establish themselves in the labour market, and older persons, having just left the labour market, and inequalities by labour market status, class, or gender within these age groups. The thesis moreover aims to contribute to the theoretical development of the comparative health literature, by developing and implementing a theoretical framework for analyzing the role of social policy for the health and wellbeing of vulnerable groups.

Data and methods: The aim is addressed through a cross-country comparative approach, by fitting multilevel regression models on harmonized individual level data from the European Social Survey. Specifically, cross-level interactions between social position and social policies are estimated, with self-reported general health and psychological wellbeing as outcomes. The focal social policies are pension systems and elderly care policies, as well as education policies.

Results and conclusions: Overall, the empirical results showed that public investment in, and public organization of, elderly care was associated with smaller health inequalities by both social class and gender, and that redistributive minimum pensions were associated with smaller inequalities by social class, while more status-maintaining standard pensions were associated with larger gender-based inequalities. Regarding the role of education policies, the analyses showed that inclusive policies – specifically low degree of tracking, generous second chance opportunities, low out-of-pocket costs for, and a larger supply of, education – were associated with smaller inequalities by both social background and employment status. The overall conclusion of the thesis is that redistributive social policies, which distribute essential resources to vulnerable groups, have the potential to reduce inequalities in health and wellbeing between vulnerable and more advantaged groups.

Comparative studies of health inequalities have largely neglected age and ageing aspects, while ageing research has often paid little attention to questions of social inequalities. This article investigates cross-country differences in gradients in self-rated health and limiting long-standing illness (LLSI) in middle-aged and in older people (aged 50–64 and 65–80 years) linked to social class, and degrees to which the social health gradients are associated with minimum pension levels and expenditure on elderly care. For these purposes, data from the European Social Survey (2002–2010) are analysed using multilevel regression techniques. We find significant cross-level interaction effects between class and welfare policies: higher expenditure on elderly care and particularly more generous minimum pensions are associated with smaller health inequalities in the older age group (65–80 years). It is concluded that welfare policies moderate the association between social class and health, highlighting the importance of welfare state efforts for older persons, who are strongly reliant on the welfare state and welfare state arrangements such as pensions and care policies.

The study investigated how social policies moderate the association between gender and health among older people across European countries. The study is the first to take a comprehensive view on the role of social policies in connection with gender inequality in health among older Europeans. The association between gender and poor self-rated health and limiting long-standing illness was investigated in a multilevel framework. Cross-level interaction effects showed that more generous minimum pensions, higher spending on eldercare and a higher degree of eldercare formalisation are associated with relatively better health among women, while more generous standard pensions are associated with relatively better health among men. The conclusion is that policies directed towards older people are not gender neutral; rather they are likely to affect men and women differently. By shaping the distribution of resources as well as of unpaid work, social policies can contribute to either strengthening or weakening the link between gender and health.