The Impact of Migration Background on the Health Outcomes of Preschool Children: Linking a Cross-Sectional Survey to the School Entrance Health Examination Database in Bavaria, Germany

Aim of the study This study investigated the impact of migration background on the health outcomes of preschool children from families of various social status levels. Methods During the school entrance health examination (Schuleingangsuntersuchung (SEU)) from October 2012 to August 2013, the parents of 5052 preschool children (62% response rate) participated in a cross-sectional health survey within the framework of health-monitoring units (Gesundheits-Monitoring-Einheiten (GME)) in Bavaria, Germany. They were handed a self-administered questionnaire with questions relating to the language spoken at home and other socio-demographic characteristics. By applying the record linkage method, 3747 participants were correctly linked to the corresponding data of the SEU. Based on the merged dataset, 4 definitions of migration background were explored regarding demographic indicators, the parents’ mother tongue, and the language spoken at home. The association between migration background and health outcomes of preschool children was analyzed using multivariable logistic regression models separately. The risk estimates were presented for the study population and stratified into high, medium, and low social status. The models were repeated for each of the 4 migration background variables. Results The results show significant associations between migration background and health outcomes of preschool children (except in pronunciation). A migration background had the strongest impact on the development of word/sentence formation disorder. Compared to non-migrant preschool children, migrant children had twice the chances for full vaccination coverage (OR [95% CI]: 2.4 [1.9–3.1]) but only half the chance to participate in all health examinations from U1 to U9 (0.5 [0.4–0.6]). These children were also at two-fold increased risk to be overweight/obese (2.2 [1.7–2.8]). Moreover, preschool children with double-sided migration from medium social status families faced the highest risk for word/sentence formation disorder (9.5 [5.6–16.1] with SEU definition and 23.3 [10.3–52.6] with GME definition of a migration background). Conclusions Future prevention programs at the preschool level should focus on children with double-sided migration from medium social status families. With respect to social and cultural integration, the definition of migration background based on the language spoken at home should be appropriate for future SEUs.