TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany T2 - Health & Place N2 - 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. KW - Health inequalities KW - Spatial analysis KW - Regional deprivation KW - Rurality KW - Developmental delay KW - Children Y1 - 2022 UR - https://www.sciencedirect.com/science/article/pii/S1353829222000557 U6 - https://doi.org/10.1016/j.healthplace.2022.102794 SN - 1353-8292 VL - 75 ER - TY - GEN A1 - Tschorn, Mira A1 - Schulze, Susanne A1 - Förstner, Bernd R. A1 - Holmberg, Christine A1 - Spallek, Jacob A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe T2 - Aging & Mental Health N2 - Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent–child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent–child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders. KW - Hazardous alcohol use KW - older adults KW - middle-aged adults KW - Europe KW - drug and alcohol abuse KW - cross-national/international studies KW - environmental factors/housing/rural-urban factors KW - epidemiology KW - mental health Y1 - 2022 UR - https://www.tandfonline.com/doi/epub/10.1080/13607863.2022.2076208?needAccess=true U6 - https://doi.org/10.1080/13607863.2022.2076208 SN - 1364-6915 VL - 27 (2023) IS - 5 SP - 1001 EP - 1010 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Regionale sozioökonomische Deprivation, Ruralität und kindliche Entwicklung: Analyse von Daten der Schuleingangsuntersuchung des Bundeslandes Brandenburgs T2 - 17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK N2 - Einleitung Die gesundheitliche Entwicklung von Kindern wird neben der sozioökonomischen Position (SEP) der Familie auch von Merkmalen der Lebensumgebung geprägt. Ruralität oder regionale sozioökonomische Deprivation werden als mögliche unabhängige Einflussgrößen postuliert, ohne dass bisher ausreichende empirische Ergebnisse vorliegen. In dieser Studie wurde untersucht, ob regionale sozioökonomische Deprivation und Ruralität unabhängig von familiärer SEP mit der Entwicklung von Kindern assoziiert sind. Methoden Daten des Sozialpädiatrischen Entwicklungsscreenings im Rahmen der Einschulungsuntersuchungen aus dem Jahr 2018/2019 in Brandenburg (n=22.801 Kinder) wurden verknüpft mit Daten zur regionalen Bevölkerungsdichte (Ruralität) sowie mit dem German Index of Socioeconomic Deprivation (regionale Deprivation). Mittels gemischter Modelle wurde der Zusammenhang einer Allgemeinen Entwicklungsverzögerung (AEV) mit Ruralität und mit regionaler Deprivation analysiert (OR=Odds Ratio (95% Konfidenzintervall)), wobei für familiäre SEP (hoch, mittel, niedrig) adjustiert und nach Geschlecht (M=Mädchen, J=Jungen) stratifiziert wurde. Ergebnisse Kinder mit hoher familiärer SEP zeigten geringere Chancen einer AEV als Kinder mit mittlerer familiärer SEP (ORM=4,26(3,14-5,79); ORJ=3,46(2,83-4,22)) und niedriger familiärer SEP (ORM=16,58(11,90-23,09); ORJ=12,79(10,13-16,16)). Größere regionale Deprivation war unabhängig von familiärer SEP und Ruralität mit AEV assoziiert (ORM=1,35(1,13-1,62); ORJ=1,20(1,05-1,39)). Neben familiärer SEP und regionaler Deprivation zeigte Ruralität keine Assoziation mit AEV. Schlussfolgerung Neben der familiären SEP wirkt sich die regionale sozioökonomische Deprivation auf Entwicklungsverzögerungen von Kindern aus. Sozialepidemiologie und Public Health sollten daher neben den individuellen sozioökonomischen Voraussetzungen auch die regionalen sozioökonomischen Bedingungen als Determinante der gesundheitlichen Entwicklung über den Lebenslauf berücksichtigen. Y1 - 2022 UR - https://www.researchgate.net/publication/364213456_Regionale_soziookonomische_Deprivation_Ruralitat_und_kindliche_Entwicklung_Analyse_von_Daten_der_Schuleingangsuntersuchung_des_Bundeslandes_Brandenburgs ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Do regional characteristics predict developmental delay? Analyses of German school entry examination T2 - European Journal of Public Health N2 - Background Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP. Methods The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP. Results Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP. Conclusions In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP. KW - regional characteristics KW - developmental delay KW - school entry examination KW - Germany Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.342/6766047?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.342 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - Soziale Ungleichheiten in der frühkindlichen Sprachentwicklung während der COVID-19-Pandemie im Bundesland Brandenburg T2 - German Medical Science N2 - Einleitung: Die Entwicklung von Kindern unter sechs Jahren hängt nicht nur von ihren individuellen Eigenschaften ab, sondern auch von den sozialen Umständen, in denen sie leben [1]. Es besteht ein Forschungsbedarf zu möglichen Veränderungen der frühkindlichen Sprachentwicklung aufgrund sozialer Ungleichheiten während der COVID-19 Pandemie. Diese Studie [2] beschreibt die Prävalenz der Verzögerung in der Sprachentwicklung von Kindern bei der Einschulung und deren Zusammenhänge mit a) der sozioökonomischen Position der Familie (SEP), b) der Muttersprache und c) der Jahre des Kindergartenbesuchs vor und während der Pandemie. Methoden: Verwendet wurden Daten der Schuleingangsuntersuchung im Land Brandenburg aus drei aufeinanderfolgenden Kohorten 5–7-jähriger Kinder (2018|19: n=19.299; 2019|20: n=19.916; 2020|21: n=19.698). Der öffentliche Gesundheitsdienst erfasst routinemäßig die Sprachentwicklung mit validierten Instrumenten des ‘Sozialpädiatrischen Entwicklungsscreenings für Schuleingangsuntersuchungen‘ [3]. Deskriptive bivariate und multivariate Querschnittsanalysen [OR, 95%CI] untersuchten die Sprachentwicklungsverzögerung [SE ja|nein] mit SEP [niedrig|mittel|hoch], deutscher Muttersprache [ja|nein] und den Jahren des Kindergartenbesuchs [<4|≥4]. Die Analysen wurden stratifiziert nach SEP wiederholt. Ergebnisse: Die SE Prävalenz sank über die Jahre insgesamt (21,1%2018|19; 19.2%2019|20; 18,8%2020|21) sowie bei Kindern mit hoher SEP (14,3%2018|19; 13,0%2020|21) und mit deutscher Muttersprache (20,2%2018|19; 17,8%2020|21). Bei Kindern mit niedrigem SEP stieg die SE Prävalenz über die Jahre (42,4%2018|19; 43,4%2020|21) und bei Kindern mit nicht-deutscher Muttersprache blieb sie konstant (36,0%2018|19, 35,5%2020|21). Die Chancen für eine SE unterscheiden sich dementsprechend nach SEP (2018|19: ORniedrig|hoch=4,41;3,93-4,94; 2020|21: ORniedrig|hoch=5,12;4,54-5,77) und Muttersprache (2018|19: ORnicht-deutsch|deutsch=2,22;1,86-2,66; 2020|21: ORnicht-deutsch|deutsch=2,54;2,19-2,95). Die Jahre des Kindergartenbesuchs trugen nicht zu Unterschieden in der SE Prävalenz bei. Schlussfolgerung: Soziale Ungleichheiten bei der SE Prävalenz aufgrund der SEP und der Muttersprache nahmen während der Pandemie leicht zu. Für Familien mit sozioökonomischen Nachteilen sind Risiko- und Schutzfaktoren für SE der Kinder während der Pandemie unklar. Weitere Forschung sollte in Längsschnittbeobachtungen die Auswirkungen der COVID-19 Pandemie auf die frühe Kindheit vertiefend betrachten. Literatur 1. Hoff E, Ribot KM. Language Development: Influence of Socio-Economic Status. In: Wright JD, editor. International encyclopedia of the social & behavioral sciences. Second edition. Amsterdam, Boston, Heidelberg, London, New York, Oxford, Paris, San Diego, San Francisco, Singapore, Sydney, Tokyo: Elsevier; 2015. p. 324–8. 2. Hoffmann S, Tschorn M, Spallek J. Social inequalities in early childhood language development during the COVID-19 pandemic: a descriptive study with data from three consecutive school entry surveys in Germany. Int J Equity Health. 2024;23(1):2. 3. Daseking M, Oldenhage M, Petermann F, Waldmann HC. Die Validität der Sprachskala des SOPESS unter Berücksichtigung der Erstsprache [Social Pediatric Screening of Developmental Status for School Entry (SOPESS): Validity in the Domain of Speech and Language]. Gesundheitswesen 2009;71(10):663–8. KW - Gesundheitliche Ungleichheit KW - Kinder KW - Sozioökonomische Position Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:0183-24gmds6030 UR - https://www.egms.de/static/en/meetings/gmds2024/24gmds603.shtml ER - TY - GEN A1 - Tschorn, Mira A1 - Arntz, Fabian A1 - Hoffmann, Stephanie A1 - Wölke, Maxi A1 - Cohrdes, Caroline A1 - Spallek, Jacob A1 - Rapp, Michael T1 - Regionale sozioökonomische Deprivation und Gesundheit bei Kindern und Jugendlichen T2 - 53rd DGPs Congress / 15th ÖGP Conference, September 16 - 19, 2024, Wien/Vienna, Abstract-Band N2 - Hintergrund: Von Geburt an sind die Gesundheit und die psychomotorische Entwicklung eng mit der familiären sozioökonomischen Lebenssituation verbunden. Wir stellen Ergebnisse aus unseren Studien vor, in denen wir den Zusammenhang sozioökonomischer Deprivation mit verschiedenen Outcomes aus dem Bereich Entwicklung und psychische Gesundheit untersuchen. Methoden: Anhand linearer gemischter Modelle und Mehrebenenmodelle wird untersucht, ob ein zusätzlicher Zusammenhang regionaler sozioökonomischer Deprivation auf die Outcomes Einschulalter, globale Entwicklungsverzögerung und psychische Gesundheit über den Effekt individueller sozioökonomischer Faktoren hinaus besteht. Die vorgestellten Analysen beziehen sich auf die EMOTIKON Studie (171.916 Drittklässler aus 533 Schulen in 11 Kohorten aus Brandenburg von 2011 bis 2019), Daten der Schuleingangsuntersuchung im Bundesland Brandenburg (Vollerhebung des Vorschuljahrgangs 2018/2019, N=22.801) sowie die KiGGS Kohorte (bevölkerungsrepräsentative Stichprobe am Robert Koch-Institut, N=17.641 Kinder von 0-17 Jahre zur Baseline in 2003-2006). Regionale Deprivation wird mittels des German Index of socioeconomic Deprivation (GISD, Robert Koch-Institut) operationalisiert. Für einzelne Analysen wird zudem der Einfluss der drei GISD Subfaktoren Einkommen, Bildung und Beruf auf die untersuchten Faktoren berichtet. Globale Entwicklungsverzögerung wurde standardisiert mittels des SOPESS (Sozialpädiatrisches Entwicklungsscreening für Einschulungsuntersuchungen) im Rahmen der Schuleingangsuntersuchungen erhoben, psychische Auffälligkeiten wurden in der KiGGS Studie anhand des Strengths and Difficulties Questionnaire (SDQ) erhoben. Ergebnisse: Die Ergebnisse deuten darauf hin, dass die regionale Deprivation am Wohn- bzw. Schulort der Kinder einen Einfluss auf das Einschulalter und die globale Entwicklungsverzögerung hat und dass dieser Einfluss über den Effekt der individuell familiären sozioökonomischen Bedingungen hinaus besteht. Außerdem werden erste Ergebnisse der Analysen der KiGGS Kohorte vorgestellt. Y1 - 2024 UR - https://dgps2024.univie.ac.at/fileadmin/user_upload/k_dgps2020/Abstractband_13092024.pdf UR - https://dgps2024.univie.ac.at/program/ SP - 1493 EP - 1494 CY - Wien ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - Did social inequalities in child development change during the COVID-19 pandemic in Germany? T2 - European Journal of Public Health N2 - Background Early childhood development (aged <6 years) is dependent on the social conditions in which children live and strongly affect their life course trajectory. This study describes changes in social inequalities in language development during the COVID-19 pandemic based on data from the legally prescribed school entry examination in the German federal state of Brandenburg. The aim is to inform public health interventions for individuals at risk of long-term health inequalities. Methods Secondary data from three cohorts of 5-7-year-olds were used [n = 19,2992018|19; n = 19,9162019|20; n = 19,6982020|21]. Language development was assessed as delayed compared to peers [LD yes/no], measured by public health services using validated instruments. Descriptive bivariate and multivariate analyses [OR, 95%CI] examined language delay [%] with social inequalities defined by (1) an index composed of parents’ reported education and occupation [SEP low|high], (2) ‘German native language’ [yes|no] and (3) ‘years of kindergarten attendance’ [<4|≥4]. Results Overall, the proportion of LD decreased over the years (21.1%2018|19; 19.2%2019|20; 18.8%2020|21), both among children from families with high SEP (14.3%2018|19; 13.0%2020|21) and from German-speaking families (20.2%2018|19; 17.8%2020|21). LD rates among children increased with low SEP (42.4%2018|19; 43.4%2020|21) and remained constant with a non-German native language (36.0%2018|19; 35.5%2020|21). The probability for LD differed only for SEP (2018|19: ORlow|high=4.4, 3.93-4.94; 2020|21: ORlow|high=5.12, 4.54-5.77) and for native language (2018|19: ORnon-German|German=2.22, 1.86-2.66; 2020|21: ORnon-German|German=2.54, 2.19-2.95). Conclusions Social inequalities in language development based on SEP and native language increased slightly during the pandemic compared to the pre-pandemic period. Research should examine the effects of the pandemic on early development as well as protective and risk factors on a longitudinal basis. Y1 - 2024 UR - https://academic.oup.com/eurpub/article/34/Supplement_3/ckae144.079/7844119 U6 - https://doi.org/10.1093/eurpub/ckae144.079 VL - 34 IS - Supplement 3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Spallek, Jacob T1 - Social inequalities in early childhood language development during the COVID-19 pandemic : a descriptive study with data from three consecutive school entry surveys in Germany T2 - International Journal for Equity in Health N2 - Background Social health inequalities are still of great public health importance in modern societies. The COVID-19 pandemic may have affected social inequalities in people's health due to containment measures. As these measures particularly affected children, they might have been particularly vulnerable to increased social inequalities. The aim of the study was to describe health inequalities during the pandemic based on language delay (LD) in children in order to inform public health interventions for a population at risk of long-term health and education inequalities. Methods Data of 5–7 year old children from three consecutive school entry surveys in the German federal state of Brandenburg were used, including data compulsorily collected before the pandemic (2018/2019: n = 19,299), at the beginning of the pandemic (2019/2020: n = 19,916) and during the pandemic (2020/2021: n = 19,698). Bivariate and multivariate binary regression analyses [OR, 95% CI] cross-sectionally examined the relationship between the prevalence of LD [yes/no] and social inequalities, operationalized by family socioeconomic position [SEP low/middle/high], migration background [native-German language/non-native German language] and length of kindergarten attendance [< 4 years/ ≥ 4 years]. Factors contributing to inequality in LD were examined by socioeconomic stratification. Results Cross-sectionally, LD prevalence has decreased overall (2018/2019: 21.1%, 2019/2020: 19.2%, 2020/2021: 18.8%), and among children from both high SEP and native German-speaking families. As LD prevalence increased among children from families with low SEP and remained stable among non-native German speakers, social inequalities in LD prevalence increased slightly during the pandemic i) by low SEP (2018/2019: OR = 4.41, 3.93–4.94; 2020/2021: OR = 5.12, 4.54–5.77) and ii) by non-German native language (2018/2019: OR = 2.22, 1.86–2.66; 2020/2021: OR = 2.54, 2.19–2.95). During the pandemic, both migration background and kindergarten attendance determined LD prevalence in the high and middle SEP strata. However, the measured factors did not contribute to LD prevalence in children from families with low SEP. Conclusion Social inequalities in LD increased due to opposing trends in prevalence comparing low and high SEP families. To promote health equity across the life course, early childhood should be of interest for tailored public health actions (e.g. through targeted interventions for kindergarten groups). Further analytical studies should investigate determinants (e.g., parental investment). Y1 - 2024 U6 - https://doi.org/10.1186/s12939-023-02079-y SN - 1475-9276 VL - 23 IS - 2 SP - 1 EP - 13 PB - BioMed Central CY - London ER -