Child health and development in the course of the COVID-19 pandemic: are there social inequalities?

Publisher: Springer Verlag Country of Publication: Germany NLM ID: 7603873 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1076 (Electronic) Linking ISSN: 03406199 NLM ISO Abbreviation: Eur J Pediatr Subsets: MEDLINE

Publication: Berlin : Springer Verlag
Original Publication: Berlin, New York, Springer-Verlag.

Pandemics* ; COVID-19*/epidemiology; Child ; Humans ; Child Health ; Overweight/epidemiology ; Communicable Disease Control ; Socioeconomic Factors

COVID-19 pandemic lockdowns and closures have influenced all children's health and development (HAD). We aimed to examine whether this differs by social circumstances. We hypothesised that socially disadvantaged children experienced more pronounced deterioration in their HAD compared with better-off children. In our trend study, we included five cohorts of school enrolment medical screening (school entrance 2018-2022) in the city of Dusseldorf, Germany. To compensate for selection bias due to the limited number of examinations in pandemic months, we chose the first 800 examinations of each cohort. We computed predicted prevalences of overweight, coordination and language problems as indicators of HAD. Neighbourhood deprivation, single-parent families and non-German nationality were used as indicators of social disadvantage. All groups of children experienced a deterioration in their HAD. Its magnitude is comparable between children with different social circumstances. For instance, between 2018 and 2021, prevalence of overweight increased from 19.2 to 24.2% in children from deprived neighbourhoods, and from 8.1 to 16.5% in children from well-off neighbourhoods. Prevalence of language problems (prepositions) increased from 49.9 to 72.1% among non-German children, and from 14.4 to 39.1% among German children.   Conclusion: Results only partly confirmed our hypothesis. However, since the pre-pandemic prevalences of HAD problems among disadvantaged children were already higher, further deterioration - regardless of its magnitude - has led to their particularly poor situation. For those children, overweight and language development should be priorities of prevention. Generally, important settings for child HAD such as kindergartens or leisure facilities should remain open in future pandemics. What is known: • The COVID-19 pandemic has had a negative impact on general child health and development. • Before the pandemic, social inequalities in child health and development were a common phenomenon. What is new: • Children in all social groups experienced a deterioration in their health and development over the course of the pandemic. • Over the course of the pandemic, children from deprived neighbourhoods have demonstrated a particularly high prevalence of overweight. Language problems are particularly prevalent among non-German children.
(© 2023. The Author(s).)

Viola TW, Nunes ML (2022) Social and environmental effects of the COVID-19 pandemic on children. J Pediatr (98(1)):S4-S12.
Pajek SV, Trajkovic N (2022) Impact of the COVID-19 pandemic on the motor development of schoolchildren in rural and urban environments. Biomed Res Int 2022:8937693. https://doi.org/10.1155/2022/8937693. (PMID: 10.1155/2022/8937693356073019123420)
Chaabane S, Doraiswamy S, Chaabna K, Mamtani R, Cheema S (2021) The impact of COVID-19 school closure on child and adolescent health: a rapid systematic review. Children (Basel, Switzerland) 8(5). https://doi.org/10.3390/children8050415.
Stavridou A, Kapsali E, Panagouli E, Thirios A, Polychronis K, Bacopoulou F, Psaltopoulou T, Tsolia M, Sergentanis TN, Tsitsika A (2021) Obesity in children and adolescents during COVID-19 pandemic. Children (Basel, Switzerland) 8(2):135. https://doi.org/10.3390/children8020135. (PMID: 10.3390/children802013533673078)
Bantel S, Buitkamp M, Wünsch A (2021) Kindergesundheit in der COVID-19-Pandemie: Ergebnisse aus den Schuleingangsuntersuchungen und einer Elternbefragung in der Region Hannover (Child health in the COVID-19 pandemic: results from school entry data and a parent survey in the Hanover region). Bundesgesundheitsbl 64(12):1541–1550. https://doi.org/10.1007/s00103-021-03446-2. (PMID: 10.1007/s00103-021-03446-2)
Bredahl R (2022) Corona-Pandemie: Entwicklungsprobleme bei Schulneulingen nachweisbar. In: Oommen-Halbach A, Weyers S, Griemmert M (eds) Kinder und Jugendliche in der Covid-19-Pandemie. Perspektiven aus Praxis und Wissenschaft. De Gruyter, Berlin, pp 83–90.
Pearce A, Dundas R, Whitehead M, Taylor-Robinson D (2019) Pathways to inequalities in child health. Arch Dis Child 104(10):998–1003. https://doi.org/10.1136/archdischild-2018-314808. (PMID: 10.1136/archdischild-2018-31480830798258)
Pillas D, Marmot M, Naicker K, Goldblatt P, Morrison J, Pikhart H (2014) Social inequalities in early childhood health and development. A European-wide systematic review. Pediatric Research 76:418 EP -. https://doi.org/10.1038/pr.2014.122.
Gur-Arie R, Johnson S, Collins M (2022) Advancing child health and educational equity during the COVID-19 pandemic through science and advocacy. Isr J Health Policy Res 11(1):3. https://doi.org/10.1186/s13584-021-00512-7. (PMID: 10.1186/s13584-021-00512-7349965138739628)
Lemkow-Tovías G, Lemkow L, Cash-Gibson L, Teixidó-Compañó E, Benach J (2022) Impact of COVID-19 inequalities on children: An intersectional analysis. Sociol Health Illn. https://doi.org/10.1111/1467-9566.13557. (PMID: 10.1111/1467-9566.13557361814849538856)
Monnier M, Moulin F, Thierry X, Vandentorren S, Côté S, Barbosa S, Falissard B, Plancoulaine S, Charles M-A, Simeon T, Geay B, Marchand L, Ancel P-Y, Melchior M, Rouquette A, Galera C (2021) Children’s mental and behavioral health, schooling, and socioeconomic characteristics during school closure in France due to COVID-19: the SAPRIS project. Sci Rep 11(1):22373. https://doi.org/10.1038/s41598-021-01676-7. (PMID: 10.1038/s41598-021-01676-7347897838599695)
Ravens-Sieberer U, Erhart M, Devine J, Gilbert M, Reiss F, Barkmann C, Siegel NA, Simon AM, Hurrelmann K, Schlack R, Hölling H, Wieler LH, Kaman A (2022) Child and adolescent mental health during the COVID-19 pandemic: results of the three-wave longitudinal COPSY study. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. https://doi.org/10.1016/j.jadohealth.2022.06.022. (PMID: 10.1016/j.jadohealth.2022.06.02235989235)
Wessely S, Ferrari N, Friesen D, Grauduszus M, Klaudius M, Joisten C (2022) Changes in Motor Performance and BMI of Primary School Children over Time-Influence of the COVID-19 Confinement and Social Burden. IJERPH 19(8). https://doi.org/10.3390/ijerph19084565.
Jenssen BP, Kelly MK, Powell M, Bouchelle Z, Mayne SL, Fiks AG (2021) COVID-19 and changes in child obesity. Pediatrics 147(5). https://doi.org/10.1542/peds.2021-050123.
Wahl S, Kreffter K, Frölich S, Müller-Thur K, Dragano N, Göbels K, Poschkamp T, Schäfer M, Weyers S (2018) Die Schuleingangsuntersuchung als Türöffner für die gesundheitswissenschaftliche Forschung? Eine Analyse zur Studienteilnahme „schwer erreichbarer“ Bevölkerungsgruppen (Is the school entrance examination a door opener for health sciences research?  Analyzing study participation of hard-to-reach groups). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 61(10):1236–1241. https://doi.org/10.1007/s00103-018-2808-x. (PMID: 10.1007/s00103-018-2808-x30191267)
Daseking M, Petermann F, Roske D, Trost-Brinkhues G, Simon K, Oldenhage M (2009) Entwicklung und Normierung des Einschulungsscreenings SOPESS (Development and standardisation of the social-pediatric screening SOPESS). Gesundheitswesen (Bundesverband der Ärzte des Öffentlichen Gesundheitsdienstes (Germany)) 71(10):648–655. https://doi.org/10.1055/s-0029-1239511.
Petermann F (2009) Sozialpädiatrisches Entwicklungsscreening für Schuleingangsuntersuchungen. SOPESS; theoretische und statistische Grundlagen zur Testkonstruktion, Normierung und Validierung. LIGA. NRW, Düsseldorf.
Kromeyer-Hauschild K, Moss A, Wabitsch M (2015) Referenzwerte für den Body-Mass-Index für Kinder, Jugendliche und Erwachsene in Deutschland. Adipositas - Ursachen, Folgeerkrankungen, Therapie 09(03):123–127. https://doi.org/10.1055/s-0037-1618928. (PMID: 10.1055/s-0037-1618928)
Nguyen TH, Götz S, Kreffter K, Lisak-Wahl S, Dragano N, Weyers S (2021) Neighbourhood deprivation and obesity among 5656 pre-school children-findings from mandatory school enrollment examinations. Eur J Pediatr 180(6):1947–1954. https://doi.org/10.1007/s00431-021-03988-2. (PMID: 10.1007/s00431-021-03988-2335768938105223)
Kim Y, Cubbin C, Oh S (2019) A systematic review of neighbourhood economic context on child obesity and obesity-related behaviours.Obes Rev 20(3):420–431. https://doi.org/10.1111/obr.12792. (PMID: 10.1111/obr.1279230515953)
Ohri-Vachaspati P, DeLia D, DeWeese RS, Crespo NC, Todd M, Yedidia MJ (2015) The relative contribution of layers of the social ecological model to childhood obesity. Public Health Nutr 18(11):2055–2066. https://doi.org/10.1017/S1368980014002365. (PMID: 10.1017/S136898001400236525374257)
Wilde JA, Eilander M, Middelkoop BJC (2019) Effect of neighbourhood socioeconomic status on overweight and obesity in children 2–15 years of different ethnic groups. Eur J Pub Health. https://doi.org/10.1093/eurpub/cky277. (PMID: 10.1093/eurpub/cky277)
Geis-Thöne W (2020) Häusliches Umfeld in der Krise: Ein Teil der Kinder braucht mehr Unterstützung. Ergebnisse einer Auswertung des Sozio-oekonomischen Panels (SOEP), IW-Report, Nr. 15, Köln.
Mears M, Brindley P, Maheswaran R, Jorgensen A (2019) Understanding the socioeconomic equity of publicly accessible greenspace distribution: The example of Sheffield, UK. Geoforum 103:126–137. https://doi.org/10.1016/j.geoforum.2019.04.016. (PMID: 10.1016/j.geoforum.2019.04.016)
Mitra R, Moore SA, Gillespie M, Faulkner G, Vanderloo LM, Chulak-Bozzer T, Rhodes RE, Brussoni M, Tremblay MS (2020) Healthy movement behaviours in children and youth during the COVID-19 pandemic: exploring the role of the neighbourhood environment. Health Place 65:102418. https://doi.org/10.1016/j.healthplace.2020.102418. (PMID: 10.1016/j.healthplace.2020.102418328714997455528)
Bhattacharya S, Aggarwal P, Bera OP, Saleem SM, Shikha D, Vallabh V, Juyal R, Singh A (2021) COVID-19 and childhood obesity (CO-BESITY) in the era of new normal life: a need for a policy research. Journal of public health research 10(s2). https://doi.org/10.4081/jphr.2021.2673.
Eales L, Gillespie S, Alstat RA, Ferguson GM, Carlson SM (2021) Children’s screen and problematic media use in the United States before and during the COVID-19 pandemic. Child Dev 92(5):e866–e882. https://doi.org/10.1111/cdev.13652. (PMID: 10.1111/cdev.13652344867218478850)
Pardhan S, Parkin J, Trott M, Driscoll R (2022) risks of digital screen time and recommendations for mitigating adverse outcomes in children and adolescents. J Sch Health 92(8):765–773. https://doi.org/10.1111/josh.13170. (PMID: 10.1111/josh.1317035253225)
Ritterfeld U, Pahnke B, Lüke T (2012) Vergleich der Mediennutzung einsprachig und mehrsprachig aufwachsender Kinder zwischen drei und sechs Jahren. Sprache Stimme Gehör 36(01):e3–e10. https://doi.org/10.17877/DE290R-10343. (PMID: 10.17877/DE290R-10343)
Will AK (2019) The German statistical category “migration background”: Historical roots, revisions and shortcomings. Ethnicities (19(3)):535–557. https://doi.org/10.1177/1468796819833437.
Führer A, Wienke A, Tiller D (2018) Die Schuleingangsuntersuchung als subsidiäre Vorsorgeuntersuchung. Präv Gesundheitsf 71(10):669. https://doi.org/10.1007/s11553-018-0652-3. (PMID: 10.1007/s11553-018-0652-3)
Browne NT, Snethen JA, Greenberg CS, Frenn M, Kilanowski JF, Gance-Cleveland B, Burke PJ, Lewandowski L (2021) When pandemics collide: the impact of COVID-19 on childhood obesity. J Pediatr Nurs 56:90–98. https://doi.org/10.1016/j.pedn.2020.11.004. (PMID: 10.1016/j.pedn.2020.11.00433293199)
Park MH, Falconer C, Viner RM, Kinra S (2012) The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obesity reviews : an official journal of the International Association for the Study of Obesity 13(11):985–1000. https://doi.org/10.1111/j.1467-789X.2012.01015.x. (PMID: 10.1111/j.1467-789X.2012.01015.x22731928)
Towner EK, Clifford LM, McCullough MB, Stough CO, Stark LJ (2016) Treating obesity in preschoolers: a review and recommendations for addressing critical gaps. Pediatr Clin North Am 63(3):481–510. https://doi.org/10.1016/j.pcl.2016.02.005. (PMID: 10.1016/j.pcl.2016.02.005272615466246919)
Nally S, Carlin A, Blackburn NE, Baird JS, Salmon J, Murphy MH, Gallagher AM (2021) The effectiveness of school-based interventions on obesity-related behaviours in primary school children: a systematic review and meta-analysis of randomised controlled trials. Children (Basel, Switzerland) 8(6). https://doi.org/10.3390/children8060489.
Marmot M, Friel S, Bell R, Houweling T, Taylor S, on behalf of the Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 372:1661–1669. https://doi.org/10.1016/S0140-6736(08)61690-6. (PMID: 10.1016/S0140-6736(08)61690-6)

Keywords: Child health inequalities; Language development; Motor development; Overweight

Date Created: 20230105 Date Completed: 20230321 Latest Revision: 20230607

20250114

10.1007/s00431-022-04799-9

36604347