The family is of exceptional and lifelong importance to the health of adolescents. Family structure has been linked to children’s and adolescents’ health and well-being; a nuclear family has been shown to be indicative of better health outcomes as compared with a single-parent family or a step-family. Family climate is rarely included in studies on children’s and adolescents’ health and well-being, albeit findings have indicated it is importance. Using data from n = 6838 students aged 12–13 years from the German National Educational Panel Study, this study shows that stronger familial cohesion and better a parent-child relationship are associated with better self-rated health, higher life satisfaction, more prosocial behavior, and less problematic conduct, and that these associations are stronger than those for family structure. Surveys on young people’s health are encouraged to include family climate above and beyond family structure alone.
IntroductionAs trend studies have shown, health inequalities by income and occupation have widened or remained stable. However, research on time trends in educational inequalities in health in Germany is scarce. The aim of this study is to analyse how educational inequalities in health evolved over a period of 21 years in the middle-aged population in Germany, and whether the trends differ by gender.MethodsData were obtained from the German Socio-Economic Panel covering the period from 1994 to 2014. In total, n=16 339 participants (106 221 person years) aged 30–49 years were included in the study sample. Educational level was measured based on the ‘Comparative Analysis of Social Mobility in Industrial Nations’ (CASMIN) classification. Health outcomes were self-rated health (SRH) as well as (mental and physical) health-related quality of life (HRQOL, SF-12v2). Absolute Index of Inequality (Slope Index of Inequality (SII)) and Relative Index of Inequality (RII) were calculated using linear and logarithmic regression analyses with robust SEs.ResultsSignificant educational inequalities in SRH and physical HRQOL were found for almost every survey year from 1994 to 2014. Relative inequalities in SRH ranged from 1.50 to 2.10 in men and 1.25 to 1.87 in women (RII). Regarding physical HRQOL, the lowest educational group yielded 4.5 to 6.6 points (men) and 3.3 to 6.1 points (women) lower scores (SII). Although educational level increased over time, absolute and relative health inequalities remained largely stable over the last 21 years. For mental HRQOL, only few educational inequalities were found.DiscussionThis study found persistent educational inequalities in SRH and physical HRQOL among adults in Germany from 1994 to 2014. Our findings highlight the need to intensify efforts in social and health policies to tackle these persistent inequalities.
This study aimed to examine the knowledge of mothers of children with congenital heart disease as well as the association of cardiological factors and maternal characteristics with maternal understanding. Mothers of 135 children (≤2 years old) were interviewed to assess maternal knowledge of infective endocarditis (IE) using the Hannover Inventory of Parental Knowledge of Congenital Heart Disease. Two subscales, endocarditis and risk factors, were used. Cardiological data as well as maternal characteristics were collected. Two-thirds of the mothers achieved only low scores, answering 0-20 % of the questions correctly (endocarditis = 64.4 %; risk factors = 71.1 %). Mothers with higher education recalled the correct definition of IE (P = 0.001) and the importance of dental hygiene (P = 0.004) more often. Mothers with only one child were more likely to know the most typical symptom (P = 0.007). The severity of the heart disease and the requirement of endocarditis prophylaxis did not influence maternal understanding. Yet, mothers assessing the heart disease as severe showed better knowledge (typical symptom P = 0.021; importance of dental hygiene P = 0.007). If mothers learned the diagnosis before their child's birth, they remembered relevant information more often. Mothers receiving information by the medical staff and from the Internet showed better knowledge (definition P = 0.014; importance of dental hygiene P = 0.001). Due to low levels of knowledge, more efforts must be put into the education of mothers. Educational programs should take maternal characteristics into account, providing written material and thereby keeping the instruction of lower-educated persons in mind. Furthermore, education should be focused on mothers of children requiring IE prophylaxis.
ObjectiveWe aim to investigate the effect of income and housing satisfaction on self-rated health in different life stages.DesignA population-based panel study (German Socio-Economic Panel).ParticipantsThe final sample consisted of 384 280 observations from 50 004 persons covering the period between 1994 and 2016.Outcome measuresAverage marginal effects were calculated based on fixed effects regressions to obtain the effect of changes in income and housing satisfaction on changes in self-rated health for each year of age. Self-rated health was assessed on a 5-point scale, with higher values indicating better health.ResultsChanges in income and housing satisfaction showed a small association with changes in self-rated health. The association was stronger for income, where it also varied considerably in different life stages. The average marginal effects for income satisfaction varied between 0.02 and 0.05 in men and 0.02 and 0.04 in women and peaked between the ages of 55–60. For housing satisfaction, average marginal effects ranged from 0.02 to 0.04 (men) and from 0.02 to 0.03 (women).ConclusionHigher satisfaction with housing and income was associated with better self-rated health. Therefore, studies on the social determinants of health should not only focus on objective material conditions but also on how individuals perceive and evaluate their situation.
Background Socioeconomic position (SEP) in different life stages is related to health-related quality of life (HRQoL). Yet, research on the relevance of life course processes is scarce. This study aims to analyse the association between accumulation of disadvantages, social mobility and HRQoL. Methods Analyses were conducted using population-averaged panel-data models and are based on data from the German Socio-Economic Panel 2002–14, including retrospective biographical information, comprising 25 473 observations from 8666 persons. Intergenerational and intragenerational mobility included the occupational positions in childhood (parental position), first job and middle age. Accumulation of disadvantages was measured using an accumulation index. HRQoL was assessed using the Mental and Physical Component Summary Scores of the SF12v2. Results Accumulation of disadvantages was the main predictor for the Physical Component Summary in mid-age. Men and women in a stable low SEP or with a steep downward mobility showed the least favourable physical HRQoL. This holds for intergenerational and intragenerational mobility. Mental HRQoL did not seem to be associated with accumulation or social mobility. Conclusion The results show that physical HRQoL is related to social mobility and accumulation of (dis-)advantages. Further research is needed thoroughly analysing this association.
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