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. 2023 May 12;10(5):865.
doi: 10.3390/children10050865.

Segregated by Wealth, Health, and Development: An Analysis of Pre-School Child Health in a Medium-Sized German City

Karoline Wagner  1 , Andreas Wienke  1 , Christine Gröger  2 , Jan-Henning Klusmann  3 , Amand Führer  1
Affiliations

Segregated by Wealth, Health, and Development: An Analysis of Pre-School Child Health in a Medium-Sized German City

Karoline Wagner et al. Children (Basel). .

Abstract

The School Entry Examination (SEE) can be used to identify children with current health issues, developmental delays, and risk factors for later diseases. This study analyzes the health status of preschool children in a German city with considerable socio-economic differences among its quarters. We used secondary data from SEEs 2016-2019 from the entire city (8417 children), which we divided into quarters with low (LSEB), medium (MSEB), and high socioeconomic burden (HSEB). In HSEB quarters, 11.3% of children were overweight as opposed to 5.3% in LSEB quarters. In HSEB quarters, 17.2% of children had sub-par cognitive development in contrast to 1.5% in LSEB quarters. For overall sub-par development, LSEB quarters had a prevalence of 3.3%, whereas, in HSEB quarters, 35.8% of children received this result. Logistic regression was used to determine the influence of the city quarter on the outcome of overall sub-par development. Here, considerable disparities among HSEB and LSEB quarters remained after adjustment for parents' employment status and education. Pre-school children in HSEB quarters showed a higher risk for later disease than children in LSEB quarters. The city quarter had an association with child health and development that should be considered in the formulation of interventions.

Keywords: Germany; Health Inequities; Social Determinants of Health; child; child health; health status disparities; preschool; socioeconomic factors.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Prevalence of an overall developmental score below the cut-off value.
Figure 2
Figure 2
Prevalence of overweight at the time of the SEE across Halle.
Figure 3
Figure 3
Prevalence of children not having undergone the recommended U8 pediatric check-up.
See this image and copyright information in PMC

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