title: [Unequal living conditions and health chances in preschool children: support protective factors - limit risk factors].
abstract: Manifestations of an aggravation of social antagonisms and increased reports about childhood poverty and child abuse have unleashed a broad debate about the situation of children in risk-laden circumstances. More and more children are affected by relative poverty and disadvantage. An increase in the number children under 15 who receive social assistance can also be registered in Bremen, this share even increased to 60% in especially burdened districts. Against this background, the Bremen Health Department used a socio-spatial analysis to determine whether the utilisation of health examinations and the social and cultural participation chances of preschool children differed according to their living conditions. To this end, selected data from the school entrance examinations from 1998 to 2005 were analysed in regard to their relevance for the participation chances in different child-related dimensions of the life situation. Contradictory developments could be found, both in the dimension of the utilisation of health examinations and in the dimension of social and cultural participation chances. Children from disadvantaged neighbourhoods exhibited a lower utilisation of health examinations and less chances for social and cultural participation than children from more well-to-do residential areas. Trend calculations for the years 1998 to 2005 show an increasing discrepancy between children from disadvantaged and those from well-to-do neighbourhoods. Disadvantaged life situations - with the danger of increasing exclusion - appear to be establishing themselves in Bremen. The resources of children and families for dealing with risk-laden life situations have to be strengthened. Effective and long-lasting prevention approaches have to be developed and implemented at the local level. Kindergartens and schools could serve as centres for community networking strategies. Integrated concepts for action in the respective social areas are necessary to protect children and guarantee them fair chances despite disadvantaged living conditions.
authors.affiliation: Gesundheitsamt Bremen, Horner Str. 60-70, 28203 Bremen. elisabeth.horstkotte@gesundheitsamt.bremen.de
authors.forename: E
authors.initials: E
authors.lastname: Horstkotte
authors.forename: E
authors.initials: E
authors.lastname: Zimmermann
mesh_terms: D002654:Child Care / Q000706:statistics & numerical data*; D002675:Child, Preschool / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000706:statistics & numerical data*