Subproject 2 Kindergarten and health inequalities in childhood

Preschool age is considered to be a crucial developmental period for socioeconomic inequalities in health. Besides the family as the primary agent of socialisation, kindergartens are the most important agent of socialisation at this stage of life with an attendance rate of more than 93% in Germany. The questions of whether contextual and compositional characteristics of kindergartens are associated with
health outcomes, and if so, which ones, have hardly been empirically studied to date.

Previous research has focused mostly on the effect of kindergarten attendance per se or evaluated particular Health promotion programmes within specific kindergartens. SP2 aims at closing this research gap. The overall aim of SP2 is to investigate the role of individual determinants as well as compositional and contextual characteristics of kindergartens to explain socioeconomic health inequalities and health in pre-schoolers.

Following the conceptual framework of the research unit, SP2 will address the following research questions:

  1. Do individual determinants contribute to the explanation of health and health inequalities in pre-school children, and which factors at the individual level show the strongest relative contribution for the explanation of health and health inequalities in this age group.
  2. Which compositional and contextual characteristics of kindergartens are associated with health and health inequalities in preschool children?
  3. Is the association between socioeconomic position and health mediated or moderated by compositional and contextual characteristics of the kindergarten context above and beyond individual-level determinants?

Based on a scoping review of the most recent evidence, SP2 will use two secondary datasets (the PRe-school Intervention Study PRINS and the German National Educational Panel Study NEPS. Collected in 52 kindergartens, the PRINS dataset includes very detailed (and partly longitudinal) data of n=1,134 children for general health and health behaviour as well as comprehensive contextual and compositional data of the kindergartens. Moreover, PRINS is one of the few datasets worldwide and the only one in Germany that assessed physical activity in pre-schoolers objectively using accelerometry. The NEPS dataset is a nation-wide representative study with multi-cohort sequence design. The relevant cohort comprises 2,949 children from about 250 kindergartens, surveyed in six subsequent annual waves. The comprehensive data include not only health outcomes but also data on kindergarten context and composition. Based on the overarching conceptual model, SP2 will provide new empirical evidence for the association between kindergartens as institutional contexts and individual health outcomes and health inequalities. SP2 will thus close a gap in research on life course influences on health inequalities in very early life at the interface of sociology, epidemiology and public health in Germany.



Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University

  • Sven Schneider, apl. Prof. Dr.
  • Jennifer Hilger-Kolb, M.Sc.
  • Raphael Herr, Dr.
  • Katharina Diehl, PD Dr.