[Do parental resources mediate between social inequality and health-related quality of life of children?].
OBJECTIVE
The present study examines the influence of socioeconomic position and the family's living conditions on children's self-reported quality of life. The aim is to analyse to what extent these relationships are mediated by maternal parenting resources (coping strategies, psychological health and maternal self-efficacy).


METHODS
We used data from 691 children (aged 8 - 12 years) and their mothers, collected in mother-child rehabilitation centres in Germany. The children's quality of life was measured by the KID-KINDL (self-report). Maternal parenting resources were measured by the SVF-60 (coping strategies), the SCL-K-9 (psychological health) and the FKE-K (maternal self-efficacy). Analyses of variance were used for estimating the effects of social factors on children's self-reported quality of life and on parenting resources. The relationship between children's quality of life and maternal parenting resources was assessed by computing correlation measures. The mediating effects of parenting resources on relationships between social factors and children's quality of life were estimated by means of multiple regression.


RESULTS
Overall girls and boys showed high quality of life levels. A social gradient was only found for girls. The most significant influence was shown by receiving social welfare (t-test, p=0.000), flat size (VA, p=0.011) and single motherhood (t-test, p=0.011). The influence depends on the type of indicator for family living conditions as well as on specific dimensions of quality of life. Overall the influence of living conditions on the quality of life was small. Probably this is due to the sample being drawn from a clinical population. A social gradient was also found for maternal parenting resources: Psychological health as well as maternal self-efficacy were significantly different depending on whether families received social welfare or not (t-test, p=0.000; p=0.001). Single mothers showed more negative coping strategies and lower psychological health and maternal self-efficacy (t-test, each with p=0.002). Maternal parenting resources were substantially correlated with quality of life (boys: r (Max)=0.28**; girls: r (Max)=0.24**). They had mediating effects on the relationship between social factors and quality of life of girls. This may be explained by a direct effect of socioeconomic conditions and by an indirect effect of maternal parenting resources.


CONCLUSIONS
Our findings emphasise the importance of gender-specific analyses dealing with health inequality in childhood. Socialisation was found to be relevant for the transmission of health inequality between generations. The results emphasise the need for programmes directed towards promoting parental resources for deprived mothers.
Arnhold-Kerri
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Medizinische Soziologie, Medizinische Hochschule Hannover. Arnhold-Kerri.Sonja@mh-hannover.de
Sperlich
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D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000706:statistics & numerical data*; D011788:Quality of Life; D012923:Social Class; D055815:Young Adult