Perceptions of School Safety and Teachers' Responses in the Context of Appearance-Based Bullying: A Short-Term Longitudinal Study.

Social inequalities in morbidity and mortality have long been central to public health research and policy [–]. Socioeconomic status (SES) is an indicator of social position within the social hierarchy and a key social determinant of health [–]. A substantial body of research has documented that individuals with low-SES (hereafter referred to as “social disadvantage” [] have higher mortality and morbidity than their more advantaged counterparts [–]. For example, a multicohort life-course study in the United States reported a 1.28-fold higher mortality risk among adults of social disadvantage, and a 1.25-fold higher hazard among young adult women []. In Germany, data from the Gutenberg Health Cohort Study showed that social disadvantage was associated with a 1.86-fold higher risk of all-cause mortality []. Mortality also varies by sex. Globally, men have a 1.6-times higher mortality risk than women []. Mortality differences might stem from behavioural, sociocultural and biological variations, including differential exposure to occupational hazards, gendered behavioural norms, and sex-specific hormonal regulation and disease susceptibility []. Men more often engage in high-risk behaviours like tobacco and heavy alcohol use, and hazardous risks, reinforced by cultural expectations of masculinity []. Women, by contrast, experience higher rates of physical inactivity and obesity, influenced by gender norms []. Such patterns underscore the need to examine social disadvantage and mortality through a sex specific lens. Furthermore, socioeconomic trajectories differ by sex. Men and women differ in labour-market (employment) participation [], occupational risk [, ], and caregiving and domestic roles [, ]. These structural differences may influence the accumulation and timing of social disadvantage for women and men. Furthermore, from an intersectional perspective, biological processes, as well as gendered social roles and cultural norms, would be potential sources of differences in social disadvantage and mortality []. Yet, despite strong theoretical foundations, empirical evidence on sex differences in the accumulation of social disadvantage across the adult life-course and their mortality associations remains understudied, including in Germany [].