The Moderating Effect of Social Skills and Social Support on the Association Between Poverty Ratio and Health Promotion Behaviors in Adolescence.

Eating and exercise habits established in adolescence are associated with immediate and long-term health outcomes. These habits may be influenced by adolescents' socioeconomic status (SES), such that low SES households often experience inequitable access to nutritious foods and opportunities for exercise. Emerging evidence suggests that social factors, such as social skills and social support may support adolescents' health behavior engagement. Thus, this study tested if social factors might be a viable target for interventions to reduce SES disparities in health behavior among adolescents. Using data from the Future of Families and Child Wellbeing Study, we examined (1) if household SES is associated with adolescents' self-reported frequency of healthy eating and exercise, and (2) if social factors (e.g., social skills, connectedness, social support) mitigate the negative association between SES and each health behavior. Regression analyses revealed that adolescents in lower SES households reported fewer days of healthy eating and exercise. Social skills and support were positively associated with exercise for all adolescents, but did not reduce the SES disparity. Social skills and support were only associated with healthy eating for adolescents with higher SES, but connectedness was associated with healthy eating for all adolescents. Even so, connectedness did not reduce the SES difference in healthy eating. These findings suggest that high quality social relationships and social skills may have a significant but small positive effect on health behavior for adolescents in low SES households, and that systemic change is needed to achieve health equity and improve health outcomes for all adolescents.