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Health and health risk behaviour of adolescents-Differences according to family structure. Results of the German KiGGS cohort study.

ABSTRACT: This study's aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003-2006, follow-up: 2009-2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents' health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.Because the direct effects of family structure on adolescents' health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents' health, prevention programmes and interventions should be directed towards the parent-adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.

SUBMITTER: Rattay P

PROVIDER: S-EPMC5841741 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Health and health risk behaviour of adolescents-Differences according to family structure. Results of the German KiGGS cohort study.

Rattay Petra P von der Lippe Elena E Mauz Elvira E Richter Felicitas F Hölling Heike H Lange Cornelia C Lampert Thomas T

PloS one 20180307 3

<h4>Objective</h4>This study's aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.<h4>Methods</h4>We used longitudinal data fr ...[more]

PMID: 29513693

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Project description:BackgroundThe well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account.MethodsThe sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014-2017). Sex-and age-specific BMI (kg/m2) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses.Results18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = -.14, standard error [SE] = .03, p < .001, and obesity: β = -.16, SE = .03, p < .001; girls with overweight: β = -.09, SE = .04, p = .011, and obesity: β = -.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = -.10, SE = .04, p = .002) and parent-related well-being (β = -.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers.ConclusionHRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.

Project description:To investigate the prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication and its associations with socioeconomic status (SES), health-related behaviour and living conditions. Observational cross-sectional study. Germany. Representative population-based sample of non-institutionalised youth aged between 0 and 17 years (n=17 450) and examined between 2003 and 2006. Prevalence and spectrum of ADHD medication (Anatomical Therapeutic Chemical (ATC) code N04BA) measured by standardised computer-assisted personal interview (CAPI) on drug use. The overall prevalence of ADHD medication (stimulants including atomoxetine) was 0.9% (95% CI 0.7% to 1.1%). Boys used these drugs (1.5%, 1.2% to 1.8%) five times more than girls 0.3% (0.2% to 0.5%). The highest prevalence rates were for boys aged 6-10 years (2.3%, 1.7% to 3.1%S) and 11-13 (2.7%, 2.0% to 3.7%). Boys from families with no immigration background used ADHD medication almost 6 times as frequently as boys with an immigration background (1.7% vs 0.3%). Multivariate analysis (binary logistic regression) showed boys (OR 5.16, 95% CI 3.15 to 8.47), 11-year-olds to 13-year-olds (2.24, 1.28 to 3.49), children in large cities (2.18, 1.13 to 4.22), children with no immigration background (3.06, 1.34 to 6.99), and children with only a good (vs excellent) parent-rated health status (1.91, 1.18 to 3.08) being more likely to be using ADHD medication. A visit to the doctor in the last month or last quarter was associated with a higher probability for ADHD medication (3.18, 1.29 to 7.95 and 3.59, 1.45 to 8.90, respectively). Results show prevalence rates of ADHD medication use for the German child and adolescent population that are considerably lower than published prevalence rates from the USA, but comparable with those of western European and Scandinavian countries. Lower use rates in rural versus urban regions may point to differential healthcare access. The inverse association of ADHD medication use with immigration status suggests potentially restricted access to healthcare services for immigrants or may reflect culture-specific differences in attitudes towards symptoms of ADHD.

Project description:BackgroundThe positive association between parental socio-economic position (PSEP) and health among adolescents may be partly explained by physical activity behaviour. We investigated the associations between physical activity, aerobic fitness and PSEP in a population based sample of German adolescents.Methods5,251 participants, aged 11-17 years, in the German Health Interview and Examination Survey for Children and Adolescents 2003-2006 (KiGGS) underwent a sub-maximal cycle ergometer test and completed a questionnaire obtaining information on physical activity and media use. The associations between physical activity, media use, aerobic fitness and PSEP were analysed with multivariate logistic regression models for boys and girls separately. Odds ratios (ORs) of PSEP (education, occupation and income) on the outcomes were calculated adjusted for age, region, and other influencing factors.ResultsParental education was more strongly associated with the outcome variables than parental occupation and income. After adjusting for age and region, a higher parental education level was associated with better aerobic fitness - with an OR of 1.5 (95% CI 1.2-1.9) for girls whose parents had secondary education and 1.9 (1.4-2.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 1.3 (1.0-1.6) and 1.6 (1.2-2.1), respectively. Higher parental education level was associated with lower media use: an OR of 2.1 (1.5-3.0) for girls whose parents had secondary education and 2.7 (1.8-4.1) for girls whose parents had primary education compared to girls whose parents had tertiary education. The corresponding ORs for boys were 1.5 (1.2-1.9) and 1.9 (1.5-2.5), respectively. Higher parental education level was associated with a higher physical activity level only among girls: an OR of 1.3 (1.0-1.6) for girls whose parents had secondary education and 1.2 (0.9-1.5) for girls whose parents had tertiary education compared to girls whose parents had primary education. The corresponding ORs for boys were 0.9 (0.8-1.2) and 0.8 (0.6-1.0), respectively.ConclusionsAdolescents of parents with low SEP showed a lower level of aerobic fitness and higher levels of media use than adolescents of parents with higher SEP. Health-promotion interventions need to reach adolescents of parents with low PSEP and stimulate physical activity.

Project description:AimChildren and adolescents with low socioeconomic status (SES) suffer from mental health problems more often than their peers with high SES. The aim of the current study was to investigate the direct and interactive association between commonly used indicators of SES and the exposure to stressful life situations in relation to children's mental health problems.MethodsThe prospective BELLA cohort study is the mental health module of the representative, population-based German National Health Interview and Examination Survey for children and adolescents (KiGGS). Sample data include 2,111 participants (aged 7-17 years at baseline) from the first three measurement points (2003-2006, 2004-2007 and 2005-2008). Hierarchical multiple linear regression models were conducted to analyze associations among the SES indicators household income, parental education and parental unemployment (assessed at baseline), number of stressful life situations (e.g., parental accident, mental illness or severe financial crises; 1- and 2-year follow-ups) and parent-reported mental health problems (Strength and Difficulties Questionnaire; 2-year follow-up).ResultsAll indicators of SES separately predicted mental health problems in children and adolescents at the 2-year follow-up. Stressful life situations (between baseline and 2-year follow-up) and the interaction of parental education and the number of stressful life situations remained significant in predicting children's mental health problems after adjustment for control variables. Thereby, children with higher educated parents showed fewer mental health problems in a stressful life situation. No moderating effect was found for household income and parental employment. Overall, the detected effect sizes were small. Mental health problems at baseline were the best predictor for mental health problems two years later.ConclusionsChildren and adolescents with a low SES suffer from multiple stressful life situations and are exposed to a higher risk of developing mental health problems. The findings suggest that the reduction of socioeconomic inequalities and interventions for families with low parental education might help to reduce children's mental health problems.

Dataset Information

Health and health risk behaviour of adolescents-Differences according to family structure. Results of the German KiGGS cohort study.

Publications

Health and health risk behaviour of adolescents-Differences according to family structure. Results of the German KiGGS cohort study.

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