Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022

Irene Moor; Max Herke; Jenny Markert; Marie Böhm; Franziska Reiß; Ludwig Bilz; Gorden Sudeck; Kristina Winter; HBSC Study Group Germany

doi:10.25646/11876

Trends in health inequalities in childhood and adolescence in Germany: Results of the HBSC study 2009/10 - 2022

J Health Monit. 2024 Mar 4;9(1):79-98. doi: 10.25646/11876. eCollection 2024 Mar.

Authors

Irene Moor¹, Max Herke¹, Jenny Markert¹, Marie Böhm¹, Franziska Reiß², Ludwig Bilz³, Gorden Sudeck^{4

5}, Kristina Winter^{1

6}; HBSC Study Group Germany

Affiliations

¹ Martin Luther University Halle-Wittenberg, Halle (Saale), Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology.
² University Medical Centre Hamburg-Eppendorf, Centre for Psychosocial Medicine, Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Child Public Health Research Section.
³ Brandenburg University of Technology, Cottbus-Senftenberg, Institute of Health.
⁴ Eberhard Karls University of Tübingen, Institute of Sports Science.
⁵ Eberhard Karls University of Tübingen, Interfaculty Research Institute for Sport and Physical Activity.
⁶ Nordhausen University of Applied Sciences, Institute for Social Medicine, Rehabilitation, Sciences and Health Services Research.

PMID: 38559681
PMCID: PMC10977468
DOI: 10.25646/11876

Abstract

Background: Many studies have identified health inequalities in childhood and adolescence. However, it is unclear how these have developed in recent years, particularly since the COVID-19 pandemic.

Methods: Analyses are based on the German data from the international Health Behaviour in School-aged Children (HBSC) study from 2009/10 (n = 5,005), 2013/14 (n = 5,961), 2017/18 (n = 4,347), and 2022 (n = 6,475). A total of 21,788 students aged approximately between 11 and 15 years were included. Socioeconomic status (SES) was assessed using the Family Affluence Scale (FAS). Several health indicators were analysed stratified by gender using bivariate and multivariate analysis methods.

Results: In 2022, there are clear socioeconomic inequalities in life satisfaction, self-rated health, fruit and vegetable consumption, and physical activity. These inequalities remained largely constant or increased between 2009/10 and 2022. Between 2017/18 and 2022, no significant changes in inequalities were found.

Conclusions: Health inequalities are persistent and reduce the chances of growing up healthy. There is no evidence that inequalities in the analysed outcomes have changed during the pandemic period (between 2017/18 and 2022). Rather, the changes in the health indicators seem to affect all adolescents in a similar way.

Keywords: ADOLESCENTS; CHILDREN; COVID-19; GERMANY; HBSC; HEALTH EQUITY; LIFE SATISFACTION; NUTRITION; PHYSICAL ACTIVITY; PREVALENCES; SCHOOLS; SELF-RATED HEALTH; SOCIOECONOMIC STATUS; SURVEY; TREND.

Grants and funding

Only funds from the following institutions (in alphabetical order) were used to conduct the national HBSC study 2022: Brandenburg University of Technology Cottbus-Senftenberg (Prof. Dr. Ludwig Bilz), Fulda University of Applied Sciences (Prof. Dr. Katharina Rathmann, Prof. Dr. Kevin Dadaczynski), Heidelberg University of Education (Prof. Dr. Jens Bucksch), Martin Luther University Halle-Wittenberg (Dr. Irene Moor), Technical University of Munich (Prof. Dr. Matthias Richter), University Medical Center Hamburg-Eppendorf (Prof. Dr. Ulrike Ravens-Sieberer), University of Tübingen (Prof. Dr. Gorden Sudeck). Partial funding was provided for the additional state samples in Saxony-Anhalt and Brandenburg (in Saxony-Anhalt by IKK gesund plus, in Brandenburg by the Ministry of Education, Youth and Sports (MBJS) and the Ministry of Social Affairs, Health, Integration and for Consumer Protection (MSGIV) as well as AOK Nordost).