Umweltstress, Sozialstatus und Verhaltensauffälligkeiten bei Kindern und Jugendlichen im KiGGS

Abstract

One aspect of the German Health Interview and Examination Survey for Children and Adole-scents (KiGGS 2003-2006, Principal publication 2007) was to investigate the relationship between social status and health. Socio-economic status, often expressed as an index (e.g. Ducan’s SEI or Winkler’s Index), is known to correlate with health outcomes like behavioural problems. We constructed a new index that en-capsulated not only economic and social but also environmental stressors (ESES), using data of the German Health Interview and Examination Survey for Children and Adolescents. Different factors were selected to account for socio-economic stress (low parental education, low household income, low occupational status of the householder), domestic stress (living in large cities, exposure to tobacco smoke at home, crowded housing, mouldy walls), and prenatal stress (maternal smoking during pregnancy, drinking alcohol during pregnancy). Prior to the calculation of ESES, the different factors were multiplied by weights which were estimated by multivariate linear regression on a number of health outcomes. ESES was then used to predict emotional and social problems (SDQ scores). The resulting ORs were compared with those obtained for an established socio-economic index (SEI). ESES was superior to SEI as it could more clearly identify children and adolescents with emotional or social problems. Different types of stressors (i.e. socio-economic stress, domestic stress and prenatal stress) contributed independently to emotional and social problems.