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

Date Published: 2023-05-12

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.

Introduction:
The foundations for socioeconomic inequality and later-life disease are established as early as in utero. If the expectant mother lives in deprived circumstances, this can lead to children being born prematurely or with low birthweight, which are both risk factors for diseases in later life [1,2,3]. Growing up in poverty is associated with poor physical and mental health [4,5], as well as impaired cognitive development [6] and poor educational achievement [7]. Even if socioeconomic circumstances improve in later…

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