Date Published: March 13, 2019
Publisher: Public Library of Science
Author(s): Franziska Reiss, Ann-Katrin Meyrose, Christiane Otto, Thomas Lampert, Fionna Klasen, Ulrike Ravens-Sieberer, Kenji Hashimoto.
Children and adolescents with low socioeconomic status (SES) suffer from mental health problems more often than their peers with high SES. The aim of the current study was to investigate the direct and interactive association between commonly used indicators of SES and the exposure to stressful life situations in relation to children’s mental health problems.
The prospective BELLA cohort study is the mental health module of the representative, population-based German National Health Interview and Examination Survey for children and adolescents (KiGGS). Sample data include 2,111 participants (aged 7–17 years at baseline) from the first three measurement points (2003–2006, 2004–2007 and 2005–2008). Hierarchical multiple linear regression models were conducted to analyze associations among the SES indicators household income, parental education and parental unemployment (assessed at baseline), number of stressful life situations (e.g., parental accident, mental illness or severe financial crises; 1- and 2-year follow-ups) and parent-reported mental health problems (Strength and Difficulties Questionnaire; 2-year follow-up).
All indicators of SES separately predicted mental health problems in children and adolescents at the 2-year follow-up. Stressful life situations (between baseline and 2-year follow-up) and the interaction of parental education and the number of stressful life situations remained significant in predicting children’s mental health problems after adjustment for control variables. Thereby, children with higher educated parents showed fewer mental health problems in a stressful life situation. No moderating effect was found for household income and parental employment. Overall, the detected effect sizes were small. Mental health problems at baseline were the best predictor for mental health problems two years later.
Children and adolescents with a low SES suffer from multiple stressful life situations and are exposed to a higher risk of developing mental health problems. The findings suggest that the reduction of socioeconomic inequalities and interventions for families with low parental education might help to reduce children’s mental health problems.
Socioeconomic inequalities are an important topic in politics, social sciences and public health research. Families with a low socioeconomic status (SES) are deprived in multiple ways and suffer from a higher number of stressors related to finances, social relations, employment situations and health complaints than those with a high SES [1, 2]. These socioeconomic inequalities affect not only parents’ but also children’s lives. For instance, children with low SES often have worse access to education and social participation than their peers with high SES . Moreover, children with low SES suffer more often from health problems than children with high SES . Results from a time-series analysis of 34 countries from 2002 to 2010 showed that inequalities between socioeconomic groups increased in many domains of adolescent health; thereby, adolescents with a low SES are more affected by psychological and physical symptoms .
The present study was the first to investigate the direct and interactive association between single indicators of SES and stressful life situations in relation to mental health problems in children and adolescents using data from a large population-based sample from Germany. All indicators of low SES as well as a high number of stressful life situations were associated with more mental health problems in children and adolescents. As a main finding of the study, only number of stressful life situations and the interaction between parental education and number of stressful life situations remained significant in predicting children’s mental health problems at the 2-year follow-up after adjustment for fundamental variables. Nonetheless, existing children’s mental health problems at baseline was the strongest predictor of mental health problems at the 2-year follow-up.