Preschool children's health and its association with parental education and individual living conditions in East and West Germany.
Preschool children's health and its association with parental education and individual living conditions in East and West Germany.
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DOI：
10.1186/1471-2458-6-312
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发表时间：
2006-12-28
影响因子：
4.5
通讯作者：
Ranft U
中科院分区：
文献类型：
--
作者：
du Prel X;Krämer U;Behrendt H;Ring J;Oppermann H;Schikowski T;Ranft U
健康方面的社会不平等现象在全球都存在，是一个重大的公共健康问题。本研究的重点是一个系统的调查之间的关联的健康指标，生活条件和父母的教育水平作为指标的社会地位的6岁儿童生活在西部和东部德国在统一后的十年。研究了观察到的父母教育和健康指标之间的关联。在德国东部和西部预定地区，所有进入小学的男孩和女孩都被邀请参加1991年至2000年期间进行的一系列横断面调查。28，888名德国儿童的父母教育信息被纳入分析。调查内容包括父母文化程度、个人生活状况、传染病和过敏症的症状和诊断。在研究当天，皮肤科医生诊断为特应性湿疹，抽血测定过敏原特异性免疫球蛋白E，测量身高和体重，并在亚组中进行肺功能检查。采用回归分析的方法，探讨了健康指标与父母的文化程度和儿童的生活条件之间的关系。性别、城乡居住地和调查年份用于控制混杂因素。平均答复率在东德国为83%，在西德国为71%。健康指标和父母教育之间的密切联系。受教育程度较高的父母比受教育程度较低的父母报告了更多的诊断和症状。受过高等教育的父母的孩子也更容易对草花粉或屋尘螨过敏，但出生体重较高，气道阻力较低，6岁时超重较少。此外，大多数健康指标与一个或多个生活条件显著相关，如独生子女生活、室内空气不佳、住房条件潮湿、母亲怀孕期间吸烟或居住在忙碌道路附近。在调查当天的总肺活量和特应性湿疹的患病率是唯一的健康指标，这些指标没有显示出与任何预测变量的关联。尽管生活条件存在很大差异，而且有证据表明，一些不良健康结果与不良生活条件直接相关，但只有少数指标表明社会弱势儿童的健康状况较差。在德国的两个地区，超重水平增加，气道阻力增加，仅在德国东部，与受过高等教育的父母相比，受教育程度较低的儿童身高降低。在德国东部和西部德国，较高的气道症状患病率与潮湿的住房条件有关，出生体重较低、身高降低和6岁时气道阻力增加与母亲在怀孕期间吸烟有关。后者在很大程度上解释了教育组之间出生体重和气道阻力的差异。
Social inequalities in health exist globally and are a major public health concern. This study focus on a systematic investigation into the associations between health indicators, living conditions and parental educational level as indicator of the social status of 6-year-old children living in West and East Germany in the decade after re-unification. Explanations of observed associations between parental education and health indicators were examined. All boys and girls entering elementary school and living in predefined areas of East and West Germany were invited to participate in a series of cross-sectional surveys conducted between 1991 and 2000. Data of 28,888 German children with information on parental education were included in the analysis. Information about educational level of the parents, individual living conditions, symptoms and diagnoses of infectious diseases and allergies were taken from questionnaire. At the day of investigation, atopic eczema was diagnosed by dermatologists, blood was taken for the determination of allergen-specific immuno-globulin E, height and weight was measured and lung function tests were done in subgroups. Regression analysis was applied to investigate the associations between the health indicators and parental educational level as well as the child's living conditions. Gender, urban/rural residency and year of survey were used to control for confounding. Average response was 83% in East Germany and 71% in West Germany. Strong associations between health indicators and parental education were observed. Higher educated parents reported more diagnoses and symptoms than less educated. Children of higher educated parents were also more often sensitized against grass pollen or house dust mites, but had higher birth weights, lower airway resistance and were less overweight at the age of six. Furthermore, most of the health indicators were significantly associated with one or more living conditions such as living as a single child, unfavourable indoor air, damp housing condition, maternal smoking during pregnancy or living near a busy road. The total lung capacity and the prevalence of an atopic eczema at the day of investigation were the only health indicators those did not show associations with any of the predictor variables. Despite large differences in living conditions and evidence that some poor health outcomes were directly associated with poor living conditions, only few indicators demonstrated poorer health in social disadvantaged children. These were in both parts of Germany increased levels of overweight, higher airway resistance and, in East Germany only, reduced height in children with lower educated parents compared to those of higher education. In both East and West Germany, higher prevalence of airway symptoms was associated with a damp housing condition, and lower birth weight, reduced height and increased airway resistance at the age of six were associated with maternal smoking during pregnancy. The latter explained to a large extent the difference in birth weight and airway resistance between the educational groups.
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影响因子：
--
作者：
WILLIAMS, HC;STRACHAN, DP;HAY, RJ
通讯作者：
HAY, RJ
影响因子：
1.8
作者：
du Prel, Xianming;Kraemer, Ursula;Ranft, Ulrich
通讯作者：
Ranft, Ulrich
影响因子：
7.7
作者：
Mielck, A;Reitmeir, P;Wjst, M
通讯作者：
Wjst, M
影响因子：
10.3
作者：
Schäfer, T;Krämer, U;Ring, J
通讯作者：
Ring, J
影响因子：
5.2
作者：
HELMERT, U;SHEA, S
通讯作者：
SHEA, S