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“Lean on me”: An international comparison of social support, subjective social status, and adolescent health

Title:

“Lean on me”: An international comparison of social support, subjective social status, and adolescent health

Fairbank, Eloïse ORCID: https://orcid.org/0009-0009-5135-1541 (2025) “Lean on me”: An international comparison of social support, subjective social status, and adolescent health. PhD thesis, Concordia University.

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Abstract

Perceived social support and subjective social status (SSS) are key social determinants of child and adolescent health. However, little is known about the extent to which they relate to one another or interact to influence health outcomes among youth. Additionally, the role of broader social context in shaping these associations remains underexplored. This dissertation addressed these research gaps via four manuscripts:

Manuscript 1 summarized the association between perceived social support and SSS in youth via meta-analysis. A small, positive association (r = .15) was found, consistent across support sources, measurement tools, and levels of cultural individualism. Stronger associations were observed in countries with lower income inequality. However, substantial heterogeneity remained.

Manuscript 2 investigated the associations between perceived social support and SSS among early adolescents using data from the 2013/4 Health Behaviour in School-aged Children (HBSC) Survey. It addressed limitations from Manuscript 1 and replicated findings of a small, positive association between social support and SSS. This association was robust regardless of demographic adjustment and moderation. Country-level income inequality, cultural individualism, and power distance were not significant moderators.

Manuscript 3 assessed the interactive effects of social support and SSS on self-reported health using the HBSC dataset. Higher social support buffered against the negative health effects of SSS for self-rated health, general health symptoms, life satisfaction, breakfast consumption, and substance use (but not physical activity).

Manuscript 4 examined country-level economic and cultural moderators of the buffering effect of social support against SSS on self-reported health outcomes and lifestyle behaviours. High social support was generally more protective against SSS in countries with higher GDP, lower income inequality, and more collectivistic, egalitarian cultures; direction varied across health measures.

Taken together, results of this dissertation offer novel insights about the associations between social support, SSS, and adolescent health across countries. Importantly, our findings point to the interactions between individual- and country-level social determinants of health. Specifically, individual social support and SSS interact to impact health, which is further moderated by country-level economic and cultural indicators. Results can be used to inform culturally sensitive biopsychosocial models of health among adolescents.

Divisions:Concordia University > Faculty of Arts and Science > Psychology
Item Type:Thesis (PhD)
Authors:Fairbank, Eloïse
Institution:Concordia University
Degree Name:Ph. D.
Program:Psychology
Date:23 June 2025
Thesis Supervisor(s):McGrath, Jennifer J.
Keywords:social support, subjective social status, child, adolescent, health, income inequality, economy, culture
ID Code:995987
Deposited By: Eloïse Fairbank
Deposited On:04 Nov 2025 17:34
Last Modified:04 Nov 2025 17:34

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