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. 2025 Feb;34(2):549-561.
doi: 10.1007/s11136-024-03834-6. Epub 2024 Nov 20.

Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study

Eva-Grethe Befus  1   2 , Eirin Mølland  3 , Sølvi Helseth  4   5 , Thomas Westergren  4   6 , Eirik Abildsnes  7 , Milada Hagen  4   5 , Sandra Nolte  8   9 , Kristin Haraldstad  4
Affiliations

Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study

Eva-Grethe Befus et al. Qual Life Res. 2025 Feb.

Abstract

Purpose: Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children.

Method: The present study included mother-reported health assessments for 621 children aged 5-7 years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression.

Results: Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11 years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL.

Conclusion: Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.

Keywords: (4–6) Health-related quality of life; Children; KIDSCREEN-27 proxy version; Mental health; Socioeconomic status; Strength and difficulties questionnaire proxy version.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no competing interests. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki [63]. The data were obtained from already established data (the Starting Right™ project), and the data security and storage routines were organized according to the General Data Protection Regulation [64]. The study was judged as not being under the Norwegian jurisdiction of medical and health research by The Regional Committee for Medical Research Ethics in Southeast Norway (2018/1610). The study procedures were recommended by the Norwegian Centre for Research Data (Number: 630027) and approved by the Ethics Board, Faculty of Health and Sport Sciences and the university research director (April 5, 2019) at the University of Agder. All experiments were performed according to the relevant guidelines and regulations. Consent to participate: Written informed consent was obtained from parents through the online solution for the distribution of health assessments. Consent to publish: Not applicable.

Figures

Fig. 1
Fig. 1
Boxplots representing the distribution of KIDSCREEN-27-scores in the full sample for each subscale. Box = 25th and 75th percentile, line = median, bars = min and max values
See this image and copyright information in PMC

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