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EV0741

Social determinants and mental health: a multiyear comparative community-based study of adolescents in Tuscany, Italy

SOCIAL DETERMINANTS AND MENTAL HEALTH: A POPULATION-BASED STUDY WITH A MULTI-YEAR COMPARISON AMONG ADOLESCENTS IN TUSCANY, ITALY

Migrant background emerges as the social determinant most strongly associated with mental health among adolescents in Tuscany, while the increase in psychological distress after 2018 shows only a partial decline in 2025.

The aim is to assess the relationship between mental health and three complementary social determinants of health (geographical location, migrant background, and parental education) among adolescents in Tuscany. An anonymous structured questionnaire administered every three years since 2005 to secondary school students aged 14–19 was used; 4,927 participants completed the questionnaire in 2025, and the trend analysis covering the period since 2015 was based on an average of 20,000 respondents. Indicators included peer relationships, academic achievement, digital device use, alcohol, illicit drug and tobacco use, psychological distress (Kessler K6), self-harm behaviors, sleep problems, eating disorder risk (SCOFF), and current psychological treatment; cross-tabulations and Poisson regression were used to calculate incidence rate ratios (IRRs) for the 2025 data. In 2025, first-generation (FG) and second-generation (SG) migrant adolescents reported poorer mental health, poorer peer relationships and academic achievement, and lower access to treatment, whereas substance use was less common in these groups. No significant differences by geographical location were found for any indicator (p>0.05), except that adolescents living in inland areas had lower scores for attitudes toward smoking and lower rates of psychological treatment. Parental education was positively associated with academic achievement (p<0.01) and negatively associated with digital device use (p<0.05). Temporal trends showed that the increase in psychological distress after 2018 had only partially subsided by 2025. The authors consider this consistent with the lasting impact of COVID-19 on adolescent mental health, identify migrant background as the determinant most strongly associated with mental health, and state that these preliminary findings call for greater diversification of regional and national prevention planning.

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