Waldhauer Julia, Kuntz Benjamin, Lampert Thomas
Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Apr;61(4):374-384. doi: 10.1007/s00103-018-2704-4.
Social inequalities in health can already be found among children and adolescents to the disadvantage of socially deprived population groups. This paper aims to detect, whether differences in subjective health, mental health and health behavior among young people are due to the secondary school type attended and whether these associations exist independently of the family's socioeconomic position (SEP).
The data basis was the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012). Data of 11- to 17-year-old girls and boys (n = 4665) who attend different types of secondary schools in Germany were analyzed. The dependent variables were self-rated health, findings of the Strengths and Difficulties Questionnaire (SDQ) for the detection of psychological abnormalities, as well as self-reported information regarding leisure sport, tobacco, and alcohol consumption. Prevalence and odds ratios (ORs) based on logistic regressions are shown.
For the majority of the examined indicators, it can be shown that adolescents in lower secondary schools are more likely to report worse self-rated health and mental problems and engage in unhealthy behavior than peers in grammar schools ("Gymnasium"). The differences decrease after controlling for family's SEP but mostly remain statistically significant. Adolescents who don't attend grammar schools are most strongly disadvantaged in terms of inattention/hyperactivity for both gender (OR: 2.29 [1.70-3.08]), smoking among girls (2.91 [1.85-4.57]) and physical inactivity (no leisure sport) among boys (OR: 2.71 [1.85-3.95]).
Unequal health opportunities should be viewed in relation to people's living conditions. For adolescents, school constitutes an important setting for learning, experience, and health. The results indicate divergent needs of school-based health promotion and prevention regarding differences among gender and type of school.
健康方面的社会不平等现象在儿童和青少年中就已存在，对社会弱势群体不利。本文旨在探究年轻人在主观健康、心理健康和健康行为方面的差异是否归因于所就读的中学类型，以及这些关联是否独立于家庭社会经济地位（SEP）而存在。
数据来源于德国儿童和青少年健康访谈与检查调查（KiGGS第一轮，2009 - 2012年）。对德国不同类型中学的11至17岁的女孩和男孩（n = 4665）的数据进行了分析。因变量包括自我评估健康状况、用于检测心理异常的长处与困难问卷（SDQ）结果，以及关于休闲运动、烟草和酒精消费的自我报告信息。呈现基于逻辑回归的患病率和比值比（OR）。
对于大多数被检查指标而言，可以看出初中学生比文理中学（“Gymnasium”）的同龄人更有可能报告较差的自我评估健康状况和心理问题，并从事不健康行为。在控制家庭SEP后，差异有所减小，但大多仍具有统计学意义。未就读文理中学的青少年在注意力不集中/多动方面，无论男女都处于最不利地位（OR：2.29 [1.70 - 3.08]）；女孩吸烟方面（2.91 [1.85 - 4.57]）；男孩缺乏体育活动（无休闲运动）方面（OR：2.71 [1.85 - 3.95]）。
应结合人们的生活条件来看待不平等的健康机会。对于青少年来说，学校是学习、体验和健康的重要场所。结果表明，基于学校的健康促进和预防在性别和学校类型差异方面存在不同需求。
