Relative socio-economic position and meaning and purpose in life in adolescents: An intangible cost of social inequalities.

Having a sense of meaning in life supports adolescent health but is affected by experiences of wealth or poverty. We examined its associations with relative advantage (RA) and relative deprivation (RD) in a sample of Canadian adolescents (n = 17,634) using survey data from the Health Behaviour in School-aged Children study. We calculated RA and RD using all other schoolmates as reference groups in 238 schools. Descriptively, RA was associated with greater meaning and purpose and RD was associated with less. Regression-based estimates of prevalence ratios (PR) revealed more nuanced patterns. RD was associated with less of a sense of meaning and purpose in females and gender-diverse youth only. RA was associated with a reduced risk of low meaning and purpose in females (PR 0.77; 95 % CI: 0.61 to 0.98), with similar trends in males and gender diverse students that did not achieve significance. Although the association was not pronounced at the ecological (school) level, the negative associations with RD were stronger in more unequal schools. To illustrate, in schools of high wealth inequality, RD was most strongly associated with having low meaning and purpose in females (PR 1.59; 95 % CI: 1.20 to 2.11) and gender diverse adolescents (PR 1.97, 95 % CI: 0.90 to 4.33), with no statistically significant effect in males. These patterns reveal the salience of proximal socioeconomic reference cues for adolescents and offer new insights into why inequalities in health and wellbeing are so challenging to address in youth populations. They also underscore the importance of both socioeconomic position and wealth distribution within school settings, providing impetus for thought and change.