Introduction and objective:
Health-related quality of life (HRQL) should be used more extensively in monitoring the health of school-aged children. The presented study aimed to evaluate trends in KIDSCREEN-10 indices, considering mean scores and the level of social inequalities.

Material and methods:
3,937 children aged 13 participated in three Health Behavior in School-aged Children (HBSC) cross-sectional surveys conducted in Poland between 2010–2018. Subgroups were distinguished according to gender, health status, and three social factors (family affluence, neighbourhood social capital, and local deprivation).

The average KIDSCREEN-10 index value was equal to: 22.36±4.54; 25.41±6.75; and 24.74±6.53 in 2010, 2014, and 2018,respectively. However, in 2018 no deterioration was recorded in boys, in poorer families or in regions with high social capital. The improvement in HRQL in 2014 was accompanied by an increase in disparities in health status and family wealth, as well as a decrease in disparities in local deprivation. An especially high increase in Glass index values was recorded for neighbourhood social capital (increasing from 0.542 in 2010 to 0.938 in 2018). The multivariate general linear model revealed the main effect of the year of the study, gender, chronic disease status, and the three social factors, as well as six significant 2-way interactions.

Changes in the well-being of adolescents should be tracked over time using HRQL indices with proven psychometric properties. The level of social inequalities faced by young people should be included in policies and when designing interventions. The relevant initiatives should be targeted at different populations in order to properly address the needs of different groups of children and adolescents.

Fisher JR, Cabral de Mello M. Using the World Health Organization’s 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings. Int J Ment Health Syst. 2011;(1)16;5:23.
While AE, Heery E, Sheehan AM, et al. Health-related quality of life of young people with long-term illnesses before and after transfer from child to adult healthcare. Child Care Health Dev. 2017;43(1):144–151.
Haverman L, Limperg PF, Young NL, et al. Paediatric health-related quality of life: what is it and why should we measure it? Arch Dis Child. 2017;102(5):393–400.
Bakas T, McLennon SM, Carpenter JS, et al. Systematic review of health-related quality of life models. Health Qual Life Outcomes. 2012;6;10:134.
Wallander JL, Koot HM. Quality of life in children: A critical examination of concepts, approaches, issues, and future directions. Clin Psychol Rev. 2016; 45:131–43.
Haraldstad K, Wahl A, Andenas R, et al. A systematic review of quality of life research in medicine and health sciences. Qual Life Res. 2019; 28(10):2641–2650.
Rajmil L, Herdman M, Fernandez de Sanmamed MJ, et al. Kidscreen Group. Generic health-related quality of life instruments in children and adolescents: a qualitative analysis of content. J Adolesc Health. 2004;34(1):37–45.
Ravens-Sieberer U, Herdman M, Devine J, et al. The European KIDSCREEN approach to measure quality of life and well-being in children: development, current application, and future advances. Qual Life Res. 2014;23(3):791–803.
Ravens-Sieberer U, Gosch A, Rajmil L, et al. The KIDSCREEN-52 quality of life measure for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries. Value Health. 2008;11:645–658.
Befus EG, Helseth S, Molland E, et al. Use of KIDSCREEN health-related quality of life instruments in the general population of childrenand adolescents: a scoping review. Health Qual Life Outcomes. 2023; 20;21(1):6.
Magiera A, Pac A. Determinants of Quality of Life among Adolescents in the Małopolska Region, Poland. Int J Environ Res Public Health. 2022;19:8616.
Ottova V, Erhart M, Rajmil L, et al. Overweight and its impact on the health-related quality of life in children and adolescents: results from the European KIDSCREEN survey. Qual Life Res. 2012;21(1):59–69.
Silva N, Pereira M, Otto C, et al. Do 8-to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires. Qual Life Res. 2019;28:1725–1750.
Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Glob Health Action. 2015;24;8:27106.
Erhart M, Ottova V, Gaspar T, et al. Measuring mental health and well-being of schoolchildren in 15 European countries using the KIDSCREEN-10 Index. Int. J. Public Health. 2009;54:160–166.
Rajmil L, Herdman M, Ravens-Sieberer U, et al. Socioeconomic inequalities in mental health and health-related quality of life (HRQOL) in children and adolescents from 11 European countries. Int J Public Health. 2014;59:95–105.
Martin G, Inchley J, Humphris G, et al. Assessing the psychometric and ecometric properties of neighborhood scales using adolescent survey data from urban and rural Scotland. Popul Health Metr. 2017;15.
Bourdieu P. The forms of capital. In: Richardson J, editor. The Handbook of Theory: Research for the Sociology of Education. New York: Greenwood Press; 1986. pp. 241–258.
Ahlborg MG, Nyholm M, Nygren JM, et al. Current Conceptualization and Operationalization of Adolescents’ Social Capital: A Systematic Review of Self- Reported Instruments. Int J Environ Res Public Health. 2022; 24;19(23):15596.
Kurani S, Webb L, Cadet K, et al. Area-level deprivation and adverse childhood experiences among high school students in Maryland. BMC Public Health. 2022;23;22(1):811.
Jang SJ, Johnson BR. Neighborhood disorder, individual religiosity, and adolescent use of illicit drugs: A test of multilevel hypotheses. Criminology. 2001;39:109–144.
Sitaresmi MN, Indraswari BW, Rozanti NM, et al. Health-related quality of life profile of Indonesian children and its determinants: a community-based study. BMC Pediatr. 2022;22.
Currie C, Nic Gabhainn S, Godeau E. International HBSC Network Coordinating Committee. The Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) study: origins, concept, history and development 1982–2008. Int J Public Health. 2009;54 Suppl 2:131–9.
Inchley J, Currie D, Cosma A, et al. editors. Health Behaviour in School-aged Children (HBSC). Study Protocol: Background, Methodology and Mandatory Items for the 2017/18 Survey; Child and Adolescent Health Research Unit: St. Andrews, UK, 2018.
Mazur J, Dzielska A, Małkowska-Szkutnik A. Health and Health Behaviours of 17-Year-Old Students against the Changes in the Second Decade of Life; Warszawa, Poland: Instytut Matki i Dziecka; 2020. Available online: (accessed on 27 December 2022). (In Polish).
Ravens-Sieberer U, Erhart M, Rajmil L, et al. Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Qual Life Res. 2010;19:1487–1500.
Kleszczewska D, Porwit K, Boberova Z, et al. Adolescent Health Literacy and Neighbourhood Features: HBSC Findings from Czech Republic, Poland, and Slovakia. Int J Environ Res Public Health. 2021;18:7388.
Mazur J, Sentenac M, Brooks F, et al. Burden of chronic health conditions in adolescence measured by school surveys. Dev Period Med. 2013;17:157–164.
Sentenac M., Santos T, Augustine L, et al. Chronic health conditions and school experience in school-aged children in 19 European countries. Eur Child Adolesc Psychiatry. 2022;1–11.
Huang L, Freed GL, Dalziel K. Children With Special Health Care Needs: How Special Are Their Health Care Needs? Acad Pediatr. 2020; 20(8):1109–1115.
Torsheim T, Cavallo F, Levin KA, et al. Psychometric Validation of the Revised Family Affluence Scale: a Latent Variable Approach. Child Indic Res. 2016;9:771–784.
Cavallo F, Dalmasso P, Ottova-Jordan V, et al. Trends in life satisfaction in European and North-American adolescents from 2002 to 2010 in over 30 countries. Eur J Public Health. 2015;25:80–82.
Ottová-Jordan V, Smith OR, Gobina I, et al. Trends in multiple recurrent health complaints in 15-year-olds in 35 countries in Europe, North America and Israel from 1994 to 2010. Eur J Public Health. 2015;2:24–7.
Hobza V, Maracek M, Hamrik Z. Organized Sport Activities of 11 to 15-Year-Old Adolescents: Trends from 2010–2018 and Socioeconomic Context. Int J Environ Res Public Health. 2022;19:6074.
Chatelan A, Lebacq T, Rouche M, et al. Long-term trends in the consumption of sugary and diet soft drinks among adolescents: a cross-national survey in 21 European countries. Eur J Nutr. 2022;6: 2799–2813.
Kjeld SG, Lund L, Madsen KR, et al. Trends in Use of Alcohol and Cigarettes among Danish Adolescents, 2002–2018: Exclusive and Dual Use. Int J Environ Res Public Health. 2022;19:3490.
Cosma A, Walsh SD, Chester KL, et al. Bullying victimization: time trends and the overlap between traditional and cyberbullying across countries in Europe and North America. Int J Public Health. 2020;65:75–85.
Ottova-Jordan V, Smith ORF, Augustine L, et al. Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level. Eur J Public Health. 2015;25:83–89.
Patton GC, Sawyer SM, Santelli JS. et al. Our Future: A Lancet Commission on adolescent health and wellbeing. Lancet. 2016:1–57.
Ow N, Appau A, Matout M, et al. What is QOL in children and adolescents with physical disabilities? A thematic synthesis of pediatric QOL literature. Qual Life Res. 2021;30:1233–1248.
Askari MS, Rutherford CG, Mauro PM, et al. Structure and trends of externalizing and internalizing psychiatric symptoms and gender differences among adolescents in the US from 1991 to 2018. Soc Psychiatry Psychiatr Epidemiol. 2022;57:737–748.
Waverijn G, Heijmans M, Groenewegen PP. Neighbourly support of people with chronic illness; is it related to neighbourhood social capital? Soc Sci Med. 2017;173:110–117.
Martin-Storey A, Bizier-Lacroix R, Temcheff C, et al. Understanding Youth Perceptions of Neighborhood Disorder: The Role of Conduct Problems. J Youth Adolesc. 2021;50:952–964.
Pinchak NP, Swisher RR. Neighborhoods, Schools, and Adolescent Violence: Ecological Relative Deprivation, Disadvantage Saturation, or Cumulative Disadvantage? J Youth Adolesc. 2022;51:261–277.
King C, Huang X, Dewan NA. Continuity and change in neighborhood disadvantage and adolescent depression and anxiety. Health Place. 2022;73.
Vidal C, Jun HJ, Latkin C. The Effects of Social Rank and Neighborhood and School Environment on Adolescent Depression and Suicidal Ideation: A Structural Equation Modeling Approach. Child Psychiatry Hum. Dev. (ahead of print).
Choi JK, Teshome T, Smith J. Neighborhood disadvantage, childhood adversity, bullying victimization, and adolescent depression: A multiple mediational analysis. J Affect Disord. 2021;279:554–562.
KIDSCREEN Group. The KIDSCREEN questionnaires—Quality of life questionnaires for children and adolescents—Handbook. 2016. Lengerich: Papst Science Publisher.
Carrillo-Alvarez E, Andrés A, Riera-Romaní J, et al. The association between social capital indicators and psychological distress in Catalan adolescents. Front Psychol. 2022;17;13:964689.
Mazur J, Szkultecka-Dębek M, Dzielska A et al. What does the Cantril Ladder measure in adolescence? Arch Med Sci. 2018;14(1):182–189.
De Looze M, van Dorsselaer S, Stevens GWJM, et al. The decline in adolescent substance use across Europe and North America in the early twenty-first century: A result of the digital revolution? Int J Public Health. 2019;64(2):229–240.
Ayllón E, Moyano N, Lozano A, et al. Parents’ Willingness and Perception of Children’s Autonomy as Predictors of Greater Independent Mobility to School. Int J Environ Res Public Health. 2019;28;16(5):732.
Riazi NA, Wunderlich K, Yun L, et al. Social-Ecological Correlates of Children’s Independent Mobility: A Systematic Review. Int J Environ Res Public Health. 2022;19,1604.
Lamu AN, Olsen JA. The relative importance of health, income and social relations for subjective well-being: An integrative analysis. Soc Sci Med. 2016;152:176–85.
Mackenbach JP. Re-thinking health inequalities. Eur J Public Health. 2020;30(4):615.
Ravens-Sieberer U, Kaman A, Erhart M, et al. Quality of life and mental health in children and adolescents during the first year of the COVID-19 pandemic: results of a two-wave nationwide population-based study. Eur Child Adolesc Psychiatry. 2022;12:1–14.
Rasmussen M, Damsgaard MT, Morgen CS, et al. Trends in social inequality in overweight and obesity among adolescents in Denmark 1998–2018. Int J Public Health. 2020;65:607–616.
Zhang Y, Mavoa S, Zhao J, et al. The association between green space and adolescents’ mental well-being: a systematic review. Int J Environ Res Publ Health. 2020;17(18):6640.
Brons ME, Bolt GS, Helbich M, et al. Independent associations between residential neighbourhood and school characteristics and adolescent mental health in the Netherlands. Health Place. 2022;74:102765.
Sigmund E, Badura P, Sigmundová D, et al. Methodological Aspects of Trend Studies and Development of the HBSC Study in the Czech Republic. Cent Eur J Public Health. 2017;Suppl 1:S4–S9.
Schnohr CW, Molcho M, Rasmussen M, et al. Trend analyses in the health behaviour in school-aged children study: methodological considerations and recommendations. Eur J Public Health. 2015; Suppl 2:7–12.
Currie C, Morgan A. A bio-ecological framing of evidence on the determinants of adolescent mental health – A scoping review of the international Health Behaviour in School-Aged Children (HBSC) study 1983–2020. SSM Popul Health. 2020;12:100697.
Kołłątaj B, Kołłątaj WP, Cipora E, et al. Research priorities in the domain of disability – correlation between health and social characteristics. A Polish example. Ann Agric Environ Med. 2022;27;29(4):463–470.