The international Family Affluence Scale (FAS): charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities

Candace Currie; Aixa Y Alemán-Díaz; Lucia Bosáková; Margreet de Looze

doi:10.1016/j.ssmph.2023.101599

The international Family Affluence Scale (FAS): charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities

Candace Currie^*, Aixa Y Alemán-Díaz, Lucia Bosáková, Margreet de Looze

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

In the absence of suitable indicators of adolescent socioeconomic status, the Family Affluence Scale (FAS) was first developed in Scotland 25 years ago. Since then, it has been adapted for use in the Health Behaviour in School-Aged Children (HBSC) Study to research inequalities in adolescent health in Europe and North America. FAS has also been used as an indicator of adolescent socioeconomic status in research studies outside of HBSC, worldwide. There has been a need for FAS to evolve and change its component items over time in order to take into account social and technological changes influencing the families of adolescents. This paper uniquely charts the development of FAS describing the methodological work carried out to validate the measure internationally and over time. It also presents an overview of the body of evidence on adolescent health inequalities produced over years from the HBSC Study and other research studies. Interviews conducted with policy stakeholders reveal that the evidence from FAS-related HBSC work has influenced their strategic work to raise awareness of inequalities and make the case for action to address these. Finally, the future of FAS is discussed with respect to its continual evolution in the context of technological, environmental and social change.

Original language	English
Article number	101599
Number of pages	8
Journal	Social Science & Medicine
Volume	25
DOIs	https://doi.org/10.1016/j.ssmph.2023.101599
Publication status	Published - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors

Funding

We conducted semi-structured interviews (Bernard, 2006; Leech, 2002) with a select group of policy makers with experience working with HBSC data to triangulate findings from the reviews of evidence and to begin to understand the role and strategic use of the FAS in the policy world. We used a short introduction and a set of prompt questions to stimulate discussion with participants about their organizational experience with using HBSC data on FAS-related health inequalities (see Appendix 1). We interviewed four policy makers at international agencies that work with data on children and adolescent health (Baker & Edwards, 2012). We approached one participant at the Organisation for Economic Co-operation and Development (OECD), one participant at the United Nations International Children's Emergency Fund (UNICEF), and two participants at the World Health Organisation (WHO). These three international agencies were utilising many data sources for their strategic work and had collaborated with the HBSC Study in relation to the use of its data. This qualitative work gave a snapshot on the views of policy makers and provides the basis for more detailed, systematic and wide-ranging work in the future to understand the impact of FAS in policy work.

Funders	Funder number
United Nations International Children's Emergency Fund
Forskningsrådet för Arbetsliv och Socialvetenskap

Keywords

Adolescent health
Family affluence scale (FAS)
Family material deprivation
Global health indicators
HBSC study
Indicator development
Policy impact
Socioeconomic inequalities

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title = "The international Family Affluence Scale (FAS): charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities",

abstract = "In the absence of suitable indicators of adolescent socioeconomic status, the Family Affluence Scale (FAS) was first developed in Scotland 25 years ago. Since then, it has been adapted for use in the Health Behaviour in School-Aged Children (HBSC) Study to research inequalities in adolescent health in Europe and North America. FAS has also been used as an indicator of adolescent socioeconomic status in research studies outside of HBSC, worldwide. There has been a need for FAS to evolve and change its component items over time in order to take into account social and technological changes influencing the families of adolescents. This paper uniquely charts the development of FAS describing the methodological work carried out to validate the measure internationally and over time. It also presents an overview of the body of evidence on adolescent health inequalities produced over years from the HBSC Study and other research studies. Interviews conducted with policy stakeholders reveal that the evidence from FAS-related HBSC work has influenced their strategic work to raise awareness of inequalities and make the case for action to address these. Finally, the future of FAS is discussed with respect to its continual evolution in the context of technological, environmental and social change.",

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author = "Candace Currie and Alem{\'a}n-D{\'i}az, {Aixa Y} and Lucia Bos{\'a}kov{\'a} and {de Looze}, Margreet",

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The international Family Affluence Scale (FAS): charting 25 years of indicator development, evidence produced, and policy impact on adolescent health inequalities

Abstract

Bibliographical note

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Keywords

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