Kindergarten and health inequalities in childhood

学龄前年龄被认为是健康方面社会经济不平等的关键发展时期。除了家庭作为社会化的主要媒介之外，幼儿园是这一人生阶段社会化的最重要媒介，在德国，幼儿园的入学率超过93%。幼儿园的背景和组成特征是否与健康结果相关，如果是，哪些相关，迄今为止几乎没有进行过实证研究。以前的研究主要集中在幼儿园出勤本身的影响或评估特定的健康促进计划在特定的幼儿园。次级方案2的总体目标是调查个人决定因素的作用以及幼儿园的组成和背景特征，以解释社会经济健康不平等和学龄前儿童的健康。根据研究单位的概念框架，次级方案2将解决以下研究问题：1. 个人决定因素是否有助于解释学前儿童的健康和健康不平等，以及个人层面的哪些因素对解释该年龄段的健康和健康不平等表现出最强的相对贡献。2. 幼儿园的哪些组成和背景特征与学龄前儿童的健康和健康不平等有关？3. 社会经济地位与健康之间的关联是否受幼儿园环境的组成和背景特征的介导或调节？根据对最新证据的范围审查，SP2将使用两个二级数据集（学前干预研究PRINS和德国国家教育小组研究NEPS）。PRINS数据集收集了52所幼儿园的数据，包括n= 1，134名儿童的一般健康和健康行为的详细（部分纵向）数据以及幼儿园的全面背景和组成数据。此外，PRINS是全球为数不多的数据集之一，也是德国唯一一个使用加速度计客观评估学龄前儿童身体活动的数据集。NEPS数据集是一项具有全国代表性的多队列序列设计研究。有关组别包括来自约250所幼稚园的2，949名儿童，其后每年分六次进行调查。综合数据不仅包括健康结果，还包括关于幼儿园背景和组成的数据。基于总体概念模型，次级方案2将提供新的经验证据，说明幼儿园作为机构背景与个人健康结果和健康不平等之间的关联。因此，次级方案2将填补德国在社会学、流行病学和公共卫生领域研究生命过程对生命早期健康不平等的影响方面的空白。

Preschool age is considered to be a crucial developmental period for socioeconomic inequalities in health. Besides the family as the primary agent of socialisation, kindergartens are the most important agent of socialisation at this stage of life with an attendance rate of more than 93% in Germany. The questions of whether contextual and compositional characteristics of kindergartens are associated with health outcomes, and if so, which ones, have hardly been empirically studied to date. Previous research has focussed mostly on the effect of kindergarten attendance per se or evaluated particular health promotion programmes within specific kindergartens. SP2 aims at closing this research gap.The overall aim of SP2 is to investigate the role of individual determinants as well as compositional and contextual characteristics of kindergartens to explain socioeconomic health inequalities and health in pre-schoolers. Following the conceptual framework of the research unit, SP2 will address the following research questions:1. Do individual determinants contribute to the explanation of health and health inequalities in pre-school children, and which factors at the individual level show the strongest relative contribution for the explanation of health and health inequalities in this age group.2. Which compositional and contextual characteristics of kindergartens are associated with health and health inequalities in preschool children? 3. Is the association between socioeconomic position and health mediated or moderated by compositional and contextual characteristics of the kindergarten context above and beyond individual-level determinants? Based on a scoping review of the most recent evidence, SP2 will use two secondary datasets (the PRe-school Intervention Study PRINS and the German National Educational Panel Study NEPS. Collected in 52 kindergartens, the PRINS dataset includes very detailed (and partly longitudinal) data of n=1,134 children for general health and health behaviour as well as comprehensive contextual and compositional data of the kindergartens. Moreover, PRINS is one of the few datasets worldwide and the only one in Germany that assessed physical activity in pre-schoolers objectively using accelerometry. The NEPS dataset is a nation-wide representative study with multi-cohort sequence design. The relevant cohort comprises 2,949 children from about 250 kindergartens, surveyed in six subsequent annual waves. The comprehensive data include not only health outcomes but also data on kindergarten context and composition. Based on the overarching conceptual model, SP2 will provide new empirical evidence for the association between kindergartens as institutional contexts and individual health outcomes and health inequalities. SP2 will thus close a gap in research on life course influences on health inequalities in very early life at the interface of sociology, epidemiology and public health in Germany.