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Adolescent mental health and earnings inequalities in adulthood: evidence from the Young-HUNT Study
  1. Miriam Evensen1,
  2. Torkild Hovde Lyngstad2,
  3. Ole Melkevik1,
  4. Anne Reneflot1,
  5. Arnstein Mykletun1
  1. 1Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
  2. 2Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
  1. Correspondence to Miriam Evensen, Division of Mental Health, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, Oslo 0403, Norway; miev{at}


Background Previous studies have shown that adolescent mental health problems are associated with lower employment probabilities and risk of unemployment. The evidence on how earnings are affected is much weaker, and few have addressed whether any association reflects unobserved characteristics and whether the consequences of mental health problems vary across the earnings distribution.

Methods A population-based Norwegian health survey linked to administrative registry data (N=7885) was used to estimate how adolescents' mental health problems (separate indicators of internalising, conduct, and attention problems and total sum scores) affect earnings (≥30 years) in young adulthood. We used linear regression with fixed-effects models comparing either students within schools or siblings within families. Unconditional quantile regressions were used to explore differentials across the earnings distribution.

Results Mental health problems in adolescence reduce average earnings in adulthood, and associations are robust to control for observed family background and school fixed effects. For some, but not all mental health problems, associations are also robust in sibling fixed-effects models, where all stable family factors are controlled. Further, we found much larger earnings loss below the 25th centile.

Conclusions Adolescent mental health problems reduce adult earnings, especially among individuals in the lower tail of the earnings distribution. Preventing mental health problems in adolescence may increase future earnings.

  • Social and life-course epidemiology

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  • Twitter Follow Miriam Evensen at @miriamevensen

  • Contributors ME planned the study, performed the statistical analyses and wrote the paper. THL contributed to the interpretation of results, commented on drafts and details in the research design. AR and OM contributed to the interpretation of results and commented on drafts. AM contributed to planning of the study, interpretation of results and commented on drafts. All authors have approved the final draft of the manuscript.

  • Funding The research is funded by a grant from the Norwegian Research Council (grant 213744).

  • Competing interests None declared.

  • Ethics approval The Regional Committee for Medical Research Ethics in Norway approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.