The social gradients in mental health and psychosocial well-being from adolescence to midlife and the mediating role of parenting practices: a national cohort study

Research investigating social inequalities in mental health and well-being across the life course is scarce. Moreover, a comprehensive examination of underlying pathways linking early life disadvantage to subsequent mental health inequalities is needed. This nationally representative prospective cohort study in Norway followed 3072 individuals from adolescence (mean age 15 years, 1992) to midlife (43 years, 2020). Using latent growth curve modeling, we examined the magnitude and life course development of social gradients in self-reported internalizing problems (symptoms of depression and anxiety), externalizing problems (problematic alcohol use and conduct problems), and psychosocial well-being (loneliness and self-esteem). Family disadvantage in adolescence was assessed by parental educational attainment and living situation. Parenting practices, including behavioral monitoring, warmth, educational investment, social support, and psychological overcontrol, were examined as mediators. Results showed that living with both biological parents was consistently linked with better mental health and psychosocial well-being, with these advantages persisting into midlife. In contrast, lower parental educational attainment was associated with deteriorated psychosocial well-being and externalizing problems during adolescence, but these inequalities diminished with age. Importantly, individuals from advantaged families experienced more nurturing, supportive, and involved parenting, which accounted for a substantial portion of observed mental health disparities during adolescence. Altogether, our findings highlight the importance of early social disadvantage for mental health and well-being across the life course, underscoring the critical role of parenting practices in shaping these trajectories.