In a large-scale study, scientists at the Robert Koch Institute have been researching the health of children and adolescents in Germany for years. New evaluations show in particular how often minors are plagued by pain, what role migration background and family income play for health and at what age children are at particular risk of accident.
Details on how the study on the health of children and adolescents in Germany (KiGGS) is carried out can be found here.
Constant too fat
The positive news in advance: A majority of children in Germany has a normal weight. However, 7.6 percent of 3- to 17-year-olds are underweight, 15.4 percent are overweight or even obese.
Neither boys nor girls have significantly changed the proportion of children who are too fat or too thin between the two KiGGS surveys, the researchers write. The scientists studied several thousand children - now in three studies in the periods from 2003 to 2006, 2009 to 2012 and 2014 to 2017
Many children and adolescents have repeated pain
"Did you or did your child have the following pain in the last three months?" The researchers asked this question either to the children themselves, if they were at least 11 years old or their guardians. The answer could be either "no", "yes, one-time" or "yes, repeated" - only those who stated that the pain had occurred repeatedly were counted.
The results show that pain is common in children (3 to 10 years):
- About every fifth girl and every sixth boy had a headache several times in the past quarter,
- every third girl and every fourth boy stomach ache.
- Back pain suffered 4.9 percent of girls and 4.5 percent of boys.
In adolescence (11 to 17 years) headache and back pain become more common:
- Around 45 percent of the girls and almost 29 percent of the boys repeatedly suffered from headaches, according to the survey.
- Around 28 percent of girls and 20 percent of boys had recurrent back pain.
Compared with the data from the years 2003 to 2006, children and adolescents were more likely to experience pain in the current survey.
Sports club for all!
The World Health Organization (WHO) recommends that children and adolescents should be physically active for at least one hour each day. However, this goal reaches only a quarter of 3- to 17-year-olds in Germany. Even children are sitting too much.
Correspondingly, the verdict on motor performance fails: According to the researchers, it is stagnating at a low level.
For the study, children and adolescents had to complete some tasks, standing for about a minute on a narrow block on one leg, counting the number of floor contacts.
Participants who did sport in a club, were not overweight and whose parents had a high socioeconomic status, performed better in the tests.
Whether a child is active in sport is related to their parents' income: only 11 percent of children from high-income households are physically inactive, and 18.4 percent are in middle-income families. Among the children of low-income parents, 28 percent do not practice sports.
From the point of view of scientists, more should be done to ensure that, in particular, children from low-income families, overweight children and girls are more likely to join sports clubs. Because all children should have access to regular sports, writes the research team.
Eating Disorders - a serious girl problem
To find out if children showed symptoms of an eating disorder, researchers asked them five questions, such as, "Do you feel too fat while others find you too thin?" "Do you give yourself when you feel uncomfortably full?" or "Are you worried because sometimes you can not stop eating?" When children answered "yes" to at least two of the questions, the researchers rated it as an indication of an eating disorder.
In the evaluation, every fifth child aged 11 to 17 showed signs of eating disorder. Girls were affected more than twice as often:
- 27.9 percent of the girls showed signs of an eating disorder.
- For the boys, it was 12.1 percent.
Among other things, the risk of an eating disorder increased when children were living in a low-cohesive family, had emotional problems or were less familiar with their abilities to master challenging situations.
Also critical was when the young people felt too fat or too thin. "Body dissatisfaction, especially against the background of adolescent physical changes, is a major risk factor for the development of eating disorders, especially in girls," the study said.
Migration background: does not make you healthier or sicker
A good third of minors in Germany have a migration background. This "does not make you sicker or healthier", writes the research team. In their search for volunteers, the researchers paid particular attention to activating families with a migration background, for example by inviting letters in the native language assumed to be the name, for example Turkish or Russian.
The surveys show that these parents assess the health status of their children a little more often than mediocre or poorly, as do parents without a migration background. In addition, the children, especially the girls, more often overweight.
However, the study also shows that families with a migrant background are more likely to have low income, lower education and lower occupational status - and this is associated with their poorer health status. Therefore, the researchers consider it insufficient to use the migration background alone as an explanation.
In summary, the researchers say that the vast majority of children and adolescents in Germany grow up healthy, whether with or without a migration background.
Risk of child poverty
One fifth of children and adolescents in Germany live in poverty - and this is often reflected in their health and health behavior.
In the study, parents were asked to rate their children's overall health status. Only 1.6 percent of children in high-income families are mediocre to poor. In low-income families, 8 percent are children.
Among other things, mental disorders are much more common in children and adolescents growing up in poor conditions.
If the parents have little money, the children also eat less healthy, do less exercise and are more likely to be overweight. It is all the more important to reach these families with health programs.
Accidents: care for 11 to 12 year olds
Be it poisoning, falls or collisions - accidents are among the most common causes of child health problems in Germany. Around 16.5 percent of the children and adolescents had to be treated for an injury the year before the survey. Nearly five percent were even three times or more after an accident at the doctor, it says in the study.
Boys were injured much more frequently, with the proportion at 18.6 percent; the girls were 14.3 percent. It could also be the fault of society, the researchers write. According to this, boys are socialized differently from girls and may be slowed down less often by their parents.
Almost one in eight children had to stay in the hospital for at least one night due to his injuries, and one to six year olds were affected much more frequently.
Older children tend to injure themselves more often than young people, the risk reaches its peak at eleven to twelve years. The type of accidents also changes with age. In the case of children under the age of ten, falls are still the most common cause of accidents, and among the 11 to 17 year olds, clashes play an increasingly frequent role. In addition, with age increases the risk of being injured by the overload of individual body parts - such as by kinking or dislocations.
Number of Type 1 diabetics is increasing.
Type 1 diabetes occurs when the immune system destroys the insulin-producing cells in the pancreas. Sufferers have to inject insulin for a lifetime. According to the latest data, the incidence of the disease in children and adolescents increases. While in the survey from 2003 to 2006 a total of 0.1 percent of 11 to 13-year-olds were affected, in the current KiGGS study 0.7 percent of the children in this age group were affected. In the adolescents aged 14 to 17, the proportion of type 1 diabetics rose from 0.2 to 0.8 percent. How the increase is explained, this study can not answer.
Although the study does not differentiate between type 1 and 2 diabetes, the researchers assume that the vast majority of adolescents have type 1 diabetes. Because type 2 is mainly due to an unhealthy lifestyle and rarely occurs before the 40th year of life. According to current estimates, less than 0.02 percent of 11- to 18-year-olds have Type 2 diabetes, less than 2 in 10,000 children.
Chickenpox becomes rarer
Since 2004, the Standing Vaccination Commission has recommended that children should be vaccinated against chickenpox. Before the vaccine was introduced, around 85 percent of children fell ill until the age of six.
The study documents how the disease has become rarer since the vaccine was introduced. In the 2003 to 2006 baseline survey, 68.4 percent of parents said that their child has had chickenpox. In the next round between 2009 and 2012 it was 51.4 percent - in the latest survey only 32.5 percent.
