Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitaetsplatz 1, 01968, Senftenberg, Germany.
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
BMC Public Health. 2022 Feb 17;22(1):338. doi: 10.1186/s12889-022-12603-4.
By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children's health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries.
This review followed the methodology of "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". To identify German and English scientific peer-reviewed literature published from January 1, 2000, to December 19, 2019, the following search term blocks were linked with the logical operator "AND": (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus.
The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent-child conflicts) are identified to have mediating or moderating effects. While families' living conditions (i.e., TVs in children's bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities.
Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children's health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.
通过解释健康不平等的发展，生态社会理论强调了儿童所处的社会环境的重要性。儿童早期最重要的环境是家庭，因为家庭通过各种特征深刻地影响着儿童的健康。这些特征包括家庭过程、家庭结构/规模和生活条件，并与家庭的社会经济地位（SEP）密切相关。尽管已知 SEP 导致儿童早期的健康不平等，但家庭特征对健康不平等的影响仍不清楚。本研究旨在综合现有研究，探讨高收入国家儿童早期家庭特征对社会经济健康不平等（HI）的中介和调节作用。
本研究遵循“系统评价和荟萃分析扩展的首选报告项目”的方法。为了确定 2000 年 1 月 1 日至 2019 年 12 月 19 日期间德国和英语科学同行评议文献，使用以下搜索词块与逻辑运算符“AND”连接：（1）家庭结构/规模、过程、生活条件，（2）不平等、差异、多样性，（3）收入、教育、职业，（4）健康，（5）幼儿。搜索涵盖了电子数据库 PubMed、PsycINFO 和 Scopus。
搜索结果为 7089 条记录。经过标题/摘要和全文筛选，只有 10 篇同行评议文章被纳入综合分析，这些文章分析了家庭特征对儿童早期 HI 的影响。家庭过程（即规则/描述性规范、压力、父母屏幕时间、父母-子女冲突）被确定为具有中介或调节作用。虽然家庭生活条件（即儿童卧室中的电视）被认为是中介因素，但家庭结构/规模（即单亲家庭、家庭中孩子的数量）似乎调节了健康不平等。
家庭特征导致儿童早期的健康不平等。结果总体上支持家庭压力和家庭投资模型。然而，关于家庭健康素养在儿童健康结果（如口腔健康、炎症参数、体重和身高）的广泛范围内的作用以及从出生开始贯穿整个生命过程的健康不平等的发展，仍存在知识空白。
