New dak children and youth report shows serious differences between urban and rural areas and di

March, presented, from state and federal governments expect. Also, in the context of the truly dreadful debate about today's health care costs and their causes. From the "Health Report" of the city of Leipzig we know some of these figures. But the federal comparison or the one between city. country leads to some hefty aha-effects. Because Saxony's children are sick more often.

Neurodermatitis, asthma, hay fever – in Saxony almost every third child is chronically ill (30 percent). There are major differences between urban and rural children. These are two findings from the new DAK-Gesundheit children and youth report, for which the health insurer collected insurance data from around 15.000 children in the Free State of Saxony. According to the study, nine out of ten boys. Girls visit a doctor or hospital at least once a year. And it shows that schoolchildren already suffer from morbid obesity and back pain. As a consequence, DAK-Gesundheit now wants to expand its prevention campaign "fit4future" – a joint initiative with the Cleven Foundation for more exercise, healthy nutrition and stress management.

Saxony deviates negatively from the national average

On behalf of DAK-Gesundheit, the University of Bielefeld conducted a comprehensive study of the health and care situation of boys and girls in Saxony. The representative study with billing data from 2016 provides the first systematic analyses of the incidence of disease in children.

"We want to better understand the health situation of children and bring them more into the political discussion," says Christine Enenkel, head of the DAK regional office in Saxony.

New dak children and youth report shows serious differences between city and country and di

Saxony's deviations from the national average. Graphic: DAK

In Saxony, almost every third child is physically chronically ill. Boys are affected slightly more often than girls. The Children and Adolescents Report evaluates 14 different diseases that can potentially take a chronic course. Neurodermatitis and asthma are the most common, followed by hay fever and inflammations of the gastrointestinal tract.

"These are diseases that can have a significant impact on everyday life for children and parents," emphasizes Christine Enenkel. Chronic ailments are more common in Saxony than the national average. This is mainly due to neurodermatitis (plus 48 percent). Hay fever (up 34 percent). Depression (down 13 percent), on the other hand, is diagnosed less frequently in the Free State than in Germany as a whole.

Consequence of lack of exercise: Even children have back pain and knee problems

Respiratory diseases rank #1 overall among the most common types of childhood illnesses. More than half (61.8 percent) of all boys and girls in Saxony suffer from a flu-like infection or acute bronchitis at least once a year. These are followed in frequency by infectious diseases, skin diseases, eye diseases and mental health problems. Musculoskeletal problems such as back pain or knee problems also occur already in young people. From the age of twelve, more than one in four young people have a corresponding diagnosis at least once a year.

"This is alarming," Enenkel points out, "because early musculoskeletal problems can result in severe back problems in adulthood."

Another condition associated with physical inactivity is morbid obesity. Across all age groups, just under four percent are affected, and 5.2 percent in the ten to 14 age group.

New dak children and youth report shows serious differences between city and state and di

How parents' education affects children's disease rates. Graphic: DAK

Children in Saxony are comparatively sicker than the national average. Although the same diseases dominate as at the national level, the proportion of children affected is higher in many disease areas.

"The Children and Young People's Report now provides robust analyses of the regional incidence of certain diseases compared with the national average," explains Julian Witte of Bielefeld University, the study's author. " The study, commissioned by DAK-Gesundheit, is the first continuous and cross-disease analysis of such regional billing data from a statutory health insurer."

City children have caries and depression more often

The Children and Youth Report for Saxony also shows that city children are ill differently than their peers from the countryside: city children suffer more frequently from viral diseases (plus 43 percent), dental caries (plus 38 percent) or depression (plus 22 percent). Rural children, on the other hand, are more likely to have hay fever (plus 20 percent).

"Our report proves that the difference between urban and rural children in terms of health is greater than thought," emphasizes Christine Enenkel. However, this is not reflected in the expenditures of the health insurance funds: these are comparably high overall. However, there are differences in the individual areas of care. "The difference is highest in the area of pharmaceuticals: in 2016, we spent an average of 187 euros for each city child, and 207 euros for each rural child, i.e. eleven percent more."

New dak children and youth report shows serious differences between urban and rural and di

How the number of illnesses among children differs between urban and rural areas. Graphic: DAK

This is particularly due to more prescriptions for antibiotics among rural children. For city children, on the other hand, per capita spending on outpatient doctor visits was ten percent higher.

Parents' educational background also influences children's medical history

The above-mentioned results for urban and rural children also have something to do with the different findings from educationally disadvantaged and educationally close families. The study also explicitly confirms this. For example, when it comes to tooth decay – triggered, of course, by far too many sugar products in the diet and negligent dental care. Findings: Children from families with parents without educational qualifications, who are also more often affected by poverty, are up to 278 percent more likely to have dental caries than children from homes with high educational qualifications.

The same applies to morbid overweight (obesity): the deviation is 247 percent. For physical developmental disorders, the figure is 45 percent; for behavioral disorders (for example, ADHD), it is also 45 percent; for allergies, 34 percent; and for asthma, 31 percent.

Children from families with a lower level of educational attainment therefore take too little exercise, apparently consume far too much diverse media in front of which they sit still, and eat far too much sweetened (convenience) food.

If preventive measures are taken, the children affected can often be spared a lifetime of suffering.

In total, DAK-Gesundheit spent around 15.2 million euros on the treatment of children in Saxony in 2016. Of this, more than half went to clinics (37 percent). Physicians in private practice (25 percent). Pharmaceuticals accounted for just under one-fifth of all costs, and remedies and aids together accounted for 17 percent. Rehab services had the lowest share at two percent. Per child, this corresponds to an average expenditure of 1.024 euros per year. However, the distribution of spending varied widely, with only three percent of all children and adolescents accounting for half of total spending.

On the basis of the report, DAK-Gesundheit now intends to further optimize the existing supply of. In addition, the health insurance company intends to intensify its prevention activities at daycare centers and schools. This is how the prevention campaign "fit4future" with the Cleven Foundation for more exercise, healthy nutrition and stress management is to be expanded. The program is currently running at 105 primary and special schools in Saxony with more than 16.000 pupils and is to be launched shortly in day-care centers as well as in secondary schools.

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