Social Inequalities in Mental Health and Health-Related Quality of Life in Children in Spain
ABSTRACT To assess mental health and health-related quality of life (HRQoL) of children and adolescents in Spain and to investigate the existence of a social gradient in mental health and HRQoL.
Within the Spanish National Health Survey (2006), the parents' version of the Strengths and Difficulties Questionnaire was administered to a population aged 4 to 15 years, and the parents' version of the modified KIDSCREEN-10 Index was given to a population aged 8 to 15 years. Sociodemographic data and information on family structure, socioeconomic status, health status, and discrimination were collected. Regression models were developed to analyze associations of socioeconomic status with mental health and HRQoL.
A total of 6414 children and adolescents aged 4 to 15 years participated. Mean Strengths and Difficulties Questionnaire score was 9.38 (SD, 5.84) and mean KIDSCREEN-10 Index score (n = 4446) was 85.21 (SD, 10.73). Children whose mothers had a primary school education (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.29-1.46) or a secondary education (OR: 1.21; 95% CI: 1.14-1.29) presented poorer mental health than those whose mothers had a university degree. Children from disadvantaged social classes (IV-V) showed slightly poorer HRQoL scores (OR: 0.98; CI: 0.97-0.99) than the remaining children.
There is a social gradient in the mental health of children and young adolescents in Spain. No social gradient was found for HRQoL, although children from families of disadvantaged social classes had slightly worse HRQoL scores than their counterparts from more advantaged classes.
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ABSTRACT: To analyse changes in the family living conditions of children in Catalonia between 2006 and the 2010-2012 period, and to study associations between these changes and health outcomes. A before-after analysis of two cross-sectional surveys. Population younger than 15 years of age from Catalonia, Spain. Representative samples of children in the 2006 Catalan Health Survey (ESCA), baseline, before the crisis; n=2200) and the first four waves of ESCA 2010-2012 (after start of the crisis, n=1967). Overweight/obesity, health behaviour, mental health and health-related quality of life (HRQOL). Logistic regression and multiple linear regression models were used to analyse the influence of changes in family conditions on outcome measures, including interaction terms to describe the potential influence of the study period on the results. The percentage of unemployed families rose from 9.1% (2006) to 20.6% (2010-2012), with inequalities by level of education. Overweight/obesity increased from 18.4% (95% CI 16.5% to 20.4%) to 26.9% (24.6% to 29.2%) in 2010-2012, and inequalities related to maternal education and employment status persisted. Eating habits have improved in 2010-2012 in disadvantaged families (ie, junk food consumption improved in families with a maternal primary education level; beta (B)=2.85; 0.83 to 4.88, for the survey interaction by primary education level). An improvement in HRQOL was found in the second survey (B=6.07; 4.15 to 7.99), although children whose mothers had a primary education showed poorer HRQOL scores in this survey than in 2006 (B=-4.14; -7.17 to -1.12). Although some health-related behaviour improved during the study period, childhood obesity increased and inequalities in HRQOL appeared. Policy measures that fight against these inequalities should be urgently implemented to avoid their negative impact on the health of future generations of Catalans.BMJ Open 08/2013; 3(8):e003286. DOI:10.1136/bmjopen-2013-003286 · 2.27 Impact Factor
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ABSTRACT: In recent years, there has been a change in the health and disease spectrum among children and adolescents, with an increase in mental health problems and a shift from acute to chronic illness. In this phase, the health-related quality of life (HRQoL) has increased in importance as a dimension of subjective health. The aim of this study is to describe the HRQoL of children and adolescents measured with the internationally standardized screening instrument KIDSCREEN-10. In the follow-up of the KiGGS study in 2009-2012 (KiGGS Wave 1), 2,567 parents of children aged 7-10 years and 4,878 adolescents aged 11 years or older completed the KIDSCREEN-10 questionnaire. In all, 94% of parents of 7- to 10-year-old girls and boys estimate the HRQoL of their children to be "very good" or "good." Of the 11- to 17-year-old adolescents, 96 % report their HRQoL as "very good" or "good." Somatic diseases and pain as well as mental health problems and a low social status are included in the HRQoL in only a limited way. Potential differences in HRQoL by social status were not confirmed in multivariate models. The HRQoL of the examined children and adolescents is predominantly very good or good. Interventions to improve the HRQoL of children and adolescents with diseases and psychopathological problems are necessary, regardless of their social status.Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 07/2014; 57(7):798-806. DOI:10.1007/s00103-014-1978-4 · 1.42 Impact Factor
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ABSTRACT: The diagnosis of Legg-Calvé-Perthes disease (LCPD) has a considerable influence on the daily life of the patients with restrictions in their leisure time activities. This might influence their mood. Until now this aspect of the disease has been neglected. Therefore the objective of the study was to evaluate the health related quality of life (HRQoL) of children with severe LCPD who had an extensive surgery with pelvic/femoral osteotomy. The KIDSCREEN-10 and the modified Modified Harris Hip Score (mHHS) -questionnaire were administered to 17 children (16 boys and 1 girl) aged 5 to 11 years at the time of surgery. Analyses of mHHS were made preoperatively and at the time of the follow-up examination at least 2 years postoperatively. KIDSCREEN-analyses were made postoperatively. The follow-up results were compared to an age-matched normal control group. Correlations were computed between KIDSCREEN-10 and mHHS pre- and post-operatively. The postoperative calculated KIDSCREEN-10-T-value [70.2 (SD 12.7)] was higher than the mean T-value of the control-group [56.6 (SD 10.4)]. The mHHS improved from 54.4 (SD 19.9) to a score of 99.5 (SD 1.5) postoperatively. A strong correlation was found between the preoperative mHHS and the postoperative KIDSCREEN-10-T-value (Spearman's-rho 0.67, P=0.003). After containment improving surgery and a mean follow-up period of 4.2 years the HRQoL-status is even better compared with a healthy age-matched control group. As well an excellent clinical function could be achieved.Orthopedic Reviews 10/2014; 6(4):5567. DOI:10.4081/or.2014.5567