1
|
Rigó M, Weyers S. Child Motor Development before and after the COVID-19 Pandemic: Are There Social Inequalities? CHILDREN (BASEL, SWITZERLAND) 2024; 11:936. [PMID: 39201871 PMCID: PMC11353027 DOI: 10.3390/children11080936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/25/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND COVID-19 pandemic has influenced all children's motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. METHODS Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). RESULTS Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018-6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2-10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. CONCLUSION Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children.
Collapse
Affiliation(s)
| | - Simone Weyers
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany;
| |
Collapse
|
2
|
De Simone P, Germani G, Lai Q, Ducci J, Russo FP, Gitto S, Burra P. The impact of socioeconomic deprivation on liver transplantation. FRONTIERS IN TRANSPLANTATION 2024; 3:1352220. [PMID: 38993752 PMCID: PMC11235234 DOI: 10.3389/frtra.2024.1352220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/13/2024] [Indexed: 07/13/2024]
Abstract
Despite global expansion, social disparities impact all phases of liver transplantation, from patient referral to post-transplant care. In pediatric populations, socioeconomic deprivation is associated with delayed referral, higher waitlist mortality, and reduced access to living donor transplantation. Children from socially deprived communities are twice as much less adherent to immunosuppression and have up to a 32% increased incidence of graft failure. Similarly, adult patients from deprived areas and racial minorities have a higher risk of not initiating the transplant evaluation, lower rates of waitlisting, and a 6% higher risk of not being transplanted. Social deprivation is racially segregated, and Black recipients have an increased risk of post-transplant mortality by up to 21%. The mechanisms linking social deprivation to inferior outcomes are not entirely elucidated, and powered studies are still lacking. We offer a review of the most recent evidence linking social deprivation and post-liver transplant outcomes in pediatric and adult populations, as well as a literature-derived theoretical background model for future research on this topic.
Collapse
Affiliation(s)
- Paolo De Simone
- Liver Transplant Program, University of Pisa Medical School Hospital, Pisa, Italy
- Department of Surgical, Medical, Molecular Pathology and Intensive Care, University of Pisa, Pisa, Italy
| | - Giacomo Germani
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Quirino Lai
- General Surgery and Organ Transplantation Unit, La Sapienza University of Rome, Rome, Italy
| | - Juri Ducci
- Liver Transplant Program, University of Pisa Medical School Hospital, Pisa, Italy
| | - Francesco Paolo Russo
- Department of Surgery, Gastroenterology, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Stefano Gitto
- Internal Medicine and Liver Unit, Department of Experimental and Clinical Medicine, University Hospital Careggi, University of Florence, Florence, Italy
| | - Patrizia Burra
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
- Department of Surgery, Gastroenterology, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| |
Collapse
|
3
|
Ikomi C, Baker-Smith CM. Where a child lives matters: neighborhood deprivation and pediatric obesity. Curr Opin Pediatr 2024; 36:3-9. [PMID: 38001559 DOI: 10.1097/mop.0000000000001317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
PURPOSE OF REVIEW This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality between neighborhood deprivation, race, ethnicity, and pediatric obesity. We conclude by proposing several potential solutions to disparities in pediatric obesity related to neighborhood deprivation. RECENT FINDINGS Neighborhood deprivation, independent of individual socioeconomic status, is a risk factor for pediatric obesity. The obesogenic characteristics of high deprivation neighborhoods (e.g., lack of safe spaces to be active, easy access to fast food) and the psychological aspects of residing within high deprivation neighborhoods may also contribute to this risk. Intervention strategies and policies designed to address neighborhood related risk for pediatric obesity are needed. SUMMARY Pediatric obesity is a growing problem of complex etiology. Neighborhood risk factors should be considered when assessing risk burden and when designing intervention strategies.
Collapse
Affiliation(s)
- Chijioke Ikomi
- Division of Endocrinology
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Carissa M Baker-Smith
- Center for Cardiovascular Research and Innovation, Nemours Cardiac Center, Nemours Children's Health, Wilmington, Delaware
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| |
Collapse
|
4
|
Sakhi H, Beaumier M, Couchoud C, Prezelin-Reydit M, Radenac J, Lobbedez T, Morin D, Audard V, Chatelet V. Social deprivation and kidney failure due to an undiagnosed nephropathy. Nephrol Dial Transplant 2023; 39:133-140. [PMID: 37580138 DOI: 10.1093/ndt/gfad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND In France, kidney diseases of undetermined origin account for 5%-20% of all causes of end-stage kidney disease. We investigated the impact of social disadvantage on the lack of aetiological diagnosis of nephropathies. METHODS Data from patients who started dialysis in France between 1 January 2017 and 30 June 2018 were extracted from the French Renal Epidemiology and Information Network registry. The social deprivation of each individual was estimated by the European Deprivation Index (EDI) defined by the patient's address. Logistic regression was used to perform mediation analysis to study the potential association between social deprivation and unknown nephropathy. RESULTS Of the 7218 patients included, 1263 (17.5%) had unknown kidney disease. A total of 394 (31.4%) patients in the unknown kidney disease belonged to the most deprived quintile of the EDI [fifth quintile (Q5)], vs 1636 (27.5%) patients in the known kidney disease group. In the multivariate analysis, unknown kidney disease was associated with Q5 (odds ratio 1.40, 95% confidence interval 1.12-1.74, P = .003). Mediation analysis did not identify any variables (e.g. obesity, initiation of dialysis in emergency, number of visits to the general practitioner and nephrologist before initiation of dialysis, date of first nephrology consultation) that mediated the association between social deprivation and nephropathy of unknown origin. CONCLUSIONS Our results show that, compared with nondeprived subjects, individuals experiencing social deprivation have a higher risk of unknown nephropathy at dialysis initiation. However, mediation analysis did not identify any variables that explained the association between social deprivation and nephropathy of unknown origin.
Collapse
Affiliation(s)
- Hamza Sakhi
- Assistance Publique des Hôpitaux de Paris (AP-HP), Department of Nephrology, Dialysis and Transplantation, CHU Necker, Paris, France
| | - Mathilde Beaumier
- Centre Universitaire des maladies rénales, CHU de Caen Normandie, Caen, France
- Unit INSERM 1086 ANTICIPE, centre de lutte contre le cancer François Baclesse, Caen, France
| | - Cécile Couchoud
- REIN Registry, Biomedecine Agency, Saint-Denis-La-Plaine, France
| | - Mathilde Prezelin-Reydit
- Maison du Rein AURAD Aquitaine, Gradignan, France
- Université de Bordeaux, INSERM, CIC1401-EC, Bordeaux, France
| | - Jennifer Radenac
- Filière ORKiD (Orphan Rare Kidney Disease), CHU de Montpellier, Montpellier, France
| | - Thierry Lobbedez
- Centre Universitaire des maladies rénales, CHU de Caen Normandie, Caen, France
- Unit INSERM 1086 ANTICIPE, centre de lutte contre le cancer François Baclesse, Caen, France
| | - Denis Morin
- Filière ORKiD (Orphan Rare Kidney Disease), CHU de Montpellier, Montpellier, France
- Department of Pediatric Nephrology and Endocrinology, CHU de Montpellier, Montpellier, France
| | - Vincent Audard
- Filière ORKiD (Orphan Rare Kidney Disease), CHU de Montpellier, Montpellier, France
- AP-HP, Department of Nephrology and Transplantation, Henri Mondor Hospital University, Centre de Référence Maladie Rare « Syndrome Néphrotique Idiopathique », Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
- Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Valérie Chatelet
- Centre Universitaire des maladies rénales, CHU de Caen Normandie, Caen, France
| |
Collapse
|
5
|
Baker-Smith CM, Yang W, McDuffie MJ, Nescott EP, Wolf BJ, Wu CH, Zhang Z, Akins RE. Association of Area Deprivation With Primary Hypertension Diagnosis Among Youth Medicaid Recipients in Delaware. JAMA Netw Open 2023; 6:e233012. [PMID: 36920393 PMCID: PMC10018318 DOI: 10.1001/jamanetworkopen.2023.3012] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/30/2023] [Indexed: 03/16/2023] Open
Abstract
Importance The association between degree of neighborhood deprivation and primary hypertension diagnosis in youth remains understudied. Objective To assess the association between neighborhood measures of deprivation and primary hypertension diagnosis in youth. Design, Setting, and Participants This cross-sectional study included 65 452 Delaware Medicaid-insured youths aged 8 to 18 years between January 1, 2014, and December 31, 2019. Residence was geocoded by national area deprivation index (ADI). Exposures Higher area deprivation. Main Outcomes and Measures The main outcome was primary hypertension diagnosis based on International Classification of Diseases, Ninth Revision and Tenth Revision codes. Data were analyzed between September 1, 2021, and December 31, 2022. Results A total of 65 452 youths were included in the analysis, including 64 307 (98.3%) without a hypertension diagnosis (30 491 [47%] female and 33 813 [53%] male; mean [SD] age, 12.5 (3.1) years; 12 500 [19%] Hispanic, 25 473 [40%] non-Hispanic Black, 24 565 [38%] non-Hispanic White, and 1769 [3%] other race or ethnicity; 13 029 [20%] with obesity; and 31 548 [49%] with an ADI ≥50) and 1145 (1.7%) with a diagnosis of primary hypertension (mean [SD] age, 13.3 [2.8] years; 464 [41%] female and 681 [59%] male; 271 [24%] Hispanic, 460 [40%] non-Hispanic Black, 396 [35%] non-Hispanic White, and 18 [2%] of other race or ethnicity; 705 [62%] with obesity; and 614 [54%] with an ADI ≥50). The mean (SD) duration of full Medicaid benefit coverage was 61 (16) months for those with a diagnosis of primary hypertension and 46.0 (24.3) months for those without. By multivariable logistic regression, residence within communities with ADI greater than or equal to 50 was associated with 60% greater odds of a hypertension diagnosis (odds ratio [OR], 1.61; 95% CI 1.04-2.51). Older age (OR per year, 1.16; 95%, CI, 1.14-1.18), an obesity diagnosis (OR, 5.16; 95% CI, 4.54-5.85), and longer duration of full Medicaid benefit coverage (OR, 1.03; 95% CI, 1.03-1.04) were associated with greater odds of primary hypertension diagnosis, whereas female sex was associated with lower odds (OR, 0.68; 95%, 0.61-0.77). Model fit including a Medicaid-by-ADI interaction term was significant for the interaction and revealed slightly greater odds of hypertension diagnosis for youths with ADI less than 50 (OR, 1.03; 95% CI, 1.03-1.04) vs ADI ≥50 (OR, 1.02; 95% CI, 1.02-1.03). Race and ethnicity were not associated with primary hypertension diagnosis. Conclusions and Relevance In this cross-sectional study, higher childhood neighborhood ADI, obesity, age, sex, and duration of Medicaid benefit coverage were associated with a primary hypertension diagnosis in youth. Screening algorithms and national guidelines may consider the importance of ADI when assessing for the presence and prevalence of primary hypertension in youth.
Collapse
Affiliation(s)
- Carissa M. Baker-Smith
- Cardiovascular Research and Innovation Program, Nemours Cardiac Center, Nemours Children’s Health, Wilmington, Delaware
| | - Wei Yang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mary J. McDuffie
- Center for Community Research and Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark
| | - Erin P. Nescott
- Center for Community Research and Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark
| | | | - Cathy H. Wu
- Data Science Institute, University of Delaware, Newark
| | - Zugui Zhang
- Institute for Research in Equity and Community Health, Christiana Care Health Services, Inc, Newark, Delaware
| | - Robert E. Akins
- Center for Pediatric Clinical Research and Development, Nemours Children’s Health, Wilmington, Delaware
| |
Collapse
|
6
|
Weyers S, Rigó M. Child health and development in the course of the COVID-19 pandemic: are there social inequalities? Eur J Pediatr 2023; 182:1173-1181. [PMID: 36604347 PMCID: PMC9816013 DOI: 10.1007/s00431-022-04799-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
COVID-19 pandemic lockdowns and closures have influenced all children's health and development (HAD). We aimed to examine whether this differs by social circumstances. We hypothesised that socially disadvantaged children experienced more pronounced deterioration in their HAD compared with better-off children. In our trend study, we included five cohorts of school enrolment medical screening (school entrance 2018-2022) in the city of Dusseldorf, Germany. To compensate for selection bias due to the limited number of examinations in pandemic months, we chose the first 800 examinations of each cohort. We computed predicted prevalences of overweight, coordination and language problems as indicators of HAD. Neighbourhood deprivation, single-parent families and non-German nationality were used as indicators of social disadvantage. All groups of children experienced a deterioration in their HAD. Its magnitude is comparable between children with different social circumstances. For instance, between 2018 and 2021, prevalence of overweight increased from 19.2 to 24.2% in children from deprived neighbourhoods, and from 8.1 to 16.5% in children from well-off neighbourhoods. Prevalence of language problems (prepositions) increased from 49.9 to 72.1% among non-German children, and from 14.4 to 39.1% among German children. Conclusion: Results only partly confirmed our hypothesis. However, since the pre-pandemic prevalences of HAD problems among disadvantaged children were already higher, further deterioration - regardless of its magnitude - has led to their particularly poor situation. For those children, overweight and language development should be priorities of prevention. Generally, important settings for child HAD such as kindergartens or leisure facilities should remain open in future pandemics. What is known: • The COVID-19 pandemic has had a negative impact on general child health and development. • Before the pandemic, social inequalities in child health and development were a common phenomenon. What is new: • Children in all social groups experienced a deterioration in their health and development over the course of the pandemic. • Over the course of the pandemic, children from deprived neighbourhoods have demonstrated a particularly high prevalence of overweight. Language problems are particularly prevalent among non-German children.
Collapse
Affiliation(s)
- Simone Weyers
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
| | - Mariann Rigó
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| |
Collapse
|
7
|
Laporte R, Babe P, Jouve E, Daguzan A, Mazoue F, Minodier P, Noel G, Urbina D, Gentile S. Developing and Validating an Individual-Level Deprivation Index for Children's Health in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16949. [PMID: 36554830 PMCID: PMC9816939 DOI: 10.3390/ijerph192416949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/01/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Deprivation generates many health inequalities. This has to be taken in account to enhance appropriate access to care. This study aimed to develop and validate a pediatric individual-level index measuring deprivation, usable in clinical practice and in public health. METHODS The French Individual Child Deprivation Index (FrenChILD-Index) was designed in four phases: item generation then reduction using the literature review and expert opinions, and index derivation then validation using a cross-sectional study in two emergency departments. During these last two phases, concordance with a blinded evaluation by an expert enabled us to determine thresholds for two levels of moderate and severe deprivation. RESULTS The generation and reduction phases retained 13 items. These were administered to 986 children for the derivation and validation phases. In the validation phase, the final 12 items of the FrenChILD-Index showed for moderate deprivation (requiring single specific care for deprived children) a sensitivity of 96.0% [92.6; 98.7] and specificity of 68.3% [65.2; 71.4]. For severe deprivation (requiring a multidisciplinary level of care), the sensitivity was 96.3% [92.7; 100] and specificity was 91.1% [89.2; 92.9]. CONCLUSIONS The FrenChILD-Index is the first pediatric individual-level index of deprivation validated in Europe. It enables clinical practice to address the social determinants of health and meet public health goals.
Collapse
Affiliation(s)
- Remi Laporte
- Permanence d’Accès aux Soins de Santé Mère-Enfant, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
- Equipe de Recherche EA 3279 “Santé Publique, Maladies Chroniques et Qualité de Vie”, Faculté de Médecine, Aix Marseille University, 13005 Marseille, France
- Service d’Accueil des Urgences Pédiatriques, Hôpital Nord, APHM, 13005 Marseille, France
| | - Philippe Babe
- Permanence d’Accès aux Soins de Santé Pédiatrique, Hôpitaux Pédiatriques de Nice CHU-Lenval, 06200 Nice, France
- Service d’Accueil des Urgences Pédiatriques, Hôpitaux Pédiatriques de Nice CHU-Lenval, 06200 Nice, France
| | - Elisabeth Jouve
- Service d’Evaluation Medicale, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Alexandre Daguzan
- Equipe de Recherche EA 3279 “Santé Publique, Maladies Chroniques et Qualité de Vie”, Faculté de Médecine, Aix Marseille University, 13005 Marseille, France
- Service d’Evaluation Medicale, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| | - Franck Mazoue
- Equipe de Recherche EA 3279 “Santé Publique, Maladies Chroniques et Qualité de Vie”, Faculté de Médecine, Aix Marseille University, 13005 Marseille, France
| | - Philippe Minodier
- Service d’Accueil des Urgences Pédiatriques, Hôpital Nord, APHM, 13005 Marseille, France
| | - Guilhem Noel
- Service d’Accueil des Urgences Pédiatriques, Hôpital Nord, APHM, 13005 Marseille, France
| | - Diego Urbina
- Service d’Accueil des Urgences Pédiatriques, Hôpital Nord, APHM, 13005 Marseille, France
| | - Stephanie Gentile
- Equipe de Recherche EA 3279 “Santé Publique, Maladies Chroniques et Qualité de Vie”, Faculté de Médecine, Aix Marseille University, 13005 Marseille, France
- Service d’Evaluation Medicale, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
| |
Collapse
|
8
|
Mazzocchi A, De Cosmi V, Milani GP, Agostoni C. Health and Sustainable Nutritional Choices from Childhood: Dietary Pattern and Social Models. ANNALS OF NUTRITION AND METABOLISM 2022; 78 Suppl 2:21-27. [PMID: 35679841 DOI: 10.1159/000524860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of diet in the pediatric age for optimal development, achievement, and maintenance of a healthy status is well recognized. Increasing attention is nowadays also paid to reducing the burden of human nutrition on the planet's health for present and future generations. SUMMARY Beyond environmental sustainability, the transition to diets rich in animal and processed foods contributes to an overall unhealthy nutritional status leading to an increased prevalence of obesity- and diet-related noncommunicable diseases. Childhood overweight and obesity are a growing public health crisis worldwide. The aim of this narrative review was to summarize evidence of the nutritional status and dietary habits in children and the link with environmental sustainability. KEY MESSAGE Optimizing nutrition in infancy and establishing healthy lifestyles from the preschool years might help to reduce the risk of overweight, and all the disorders related, respecting the sustainability dimension.
Collapse
Affiliation(s)
- Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy,
| | - Valentina De Cosmi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gregorio P Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pediatric Unit, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pediatric Intermediate Care Unit, Milan, Italy
| |
Collapse
|
9
|
Hoffmann S, Tschorn M, Michalski N, Hoebel J, Förstner BR, Rapp MA, Spallek J. Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany. Health Place 2022; 75:102794. [PMID: 35364469 DOI: 10.1016/j.healthplace.2022.102794] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration. METHOD We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high). RESULTS Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation. CONCLUSION Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.
Collapse
Affiliation(s)
- Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany
| | - Mira Tschorn
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany; Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Niels Michalski
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Bernd R Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Michael A Rapp
- Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany; Social and Preventive Medicine, Department of Sports and Health Sciences, Intra-faculty Unit "Cognitive Sciences", Faculty of Human Science, University of Potsdam, Potsdam, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Germany; Faculty of Health Sciences Brandenburg, Research Area Services Research and e-Health, University of Potsdam, Potsdam, Germany.
| |
Collapse
|