COVID-19 Associated Contact Restrictions in Germany: Marked Decline in Children's Outpatient Visits for Infectious Diseases without Increasing Visits for Mental Health Disorders.

Children have a low risk for severe COVID-19 infections, but indirect consequences of the pandemic may affect their health. We evaluated nationwide data on children's outpatient visits before and during the first wave of the COVID-19 pandemic in Germany. Data from the National Association of Statutory Health Insurance Physicians for all children with statutory health insurance and at least one physician's office visit between January 2019 and June 2020 were evaluated for total visits and selected diagnoses for the 2nd quarter of 2019 (8.29 million children, controls) and the 2nd quarter of 2020 (8.5 million, pandemic). Outpatient visits per child fell by 18% during the first wave of the pandemic. Outpatient visits associated with diagnosed infections fell markedly by 51%, particularly for children up to age 5 years for gastroenteritis (73%), otitis media (71%), and streptococcal angina (78%). Outpatient visits for diagnosed chronic physical disorders (diabetes, celiac disease, and hay fever) and mental and behavioral disorders showed little change. Reduced contact between children appears to markedly reduce infection transmission. Infection risks in educational settings should be attenuated after the pandemic through targeted education and counseling and appropriate relationship prevention measures to improve quality of life and opportunities for children and to reduce stress and lost work time for parents.

Parental well-being in times of Covid-19 in Germany.

We examine the effects of Covid-19 and related restrictions on individuals with dependent children in Germany. We specifically focus on the role of day care center and school closures, which may be regarded as a "disruptive exogenous shock" to family life. We make use of a novel representative survey of parental well-being collected in May and June 2020 in Germany, when schools and day care centers were closed but while other measures had been relaxed and new infections were low. In our descriptive analysis, we compare well-being during this period with a pre-crisis period for different groups. In a difference-in-differences design, we compare the change for individuals with children to the change for individuals without children, accounting for unrelated trends as well as potential survey mode and context effects. We find that the crisis lowered the relative well-being of individuals with children, especially for individuals with young children, for women, and for persons with lower secondary schooling qualifications. Our results suggest that public policy measures taken to contain Covid-19 can have large effects on family well-being, with implications for child development and parental labor market outcomes.

Obesity and skill attainment in early childhood.

This paper investigates the association between obesity and skill attainment in early childhood (aged 2-3 years). Data from the German Socio-Economic Panel Study are used to estimate models of developmental functioning in four critical areas (verbal skills, activities of daily living, motor skills, and social skills) as a function of various measures of weight (including body mass index and obesity) controlling for a rich set of child, parent, and family characteristics. The findings indicate that, among boys, obesity is associated with reduced verbal skills, social skills, motor skills, and activities of daily living. Among girls, obesity is associated with reduced verbal skills. Further investigations show that the correlations exist even for those preschool children who spend no time in day care, which implies that the correlations cannot be due solely to discrimination by teachers, classmates, or day care providers.

Relations Among Maternal Life Satisfaction, Shared Activities, and Child Well-Being.

Maternal well-being is assumed to be associated with well-being of individual family members, optimal parenting practices, and positive developmental outcomes for children. The objective of this study was to examine the interplay between maternal well-being, parent-child activities, and the well-being of 5- to 7-year-old children. In a sample of N = 291 mother-child dyads, maternal life satisfaction, the frequency of shared parent-child activities, as well as children's self-regulation, prosocial behavior, and receptive vocabulary were assessed using several methods. Data were collected in a special study of the Socio-Economic Panel Study (SOEP), a representative longitudinal survey of private households in Germany. Using structural equation modeling, significant positive direct and indirect relations between maternal life satisfaction, frequency of shared parent-child activities, children's self-regulation, prosocial behavior, and receptive vocabulary were found. The more satisfied the mother was, the more she shared activities with her child and the more the child acted prosocially. Furthermore, the higher the frequency of shared parent-child activities, the higher the child scored in all three analyzed indicators of children's well-being: self-regulation, prosocial behavior, and receptive vocabulary. The current study supports the assumption of maternal well-being as the basis of positive parenting practices and child well-being.

The intergenerational transmission of health in early childhood--evidence from the German Socio-Economic Panel study.

Children's physical health problems have clear and lasting impacts on a variety of later life outcomes, as a growing body of research has shown. Furthermore, problems such as obesity, motor impairment, and chronic diseases entail high social costs, particularly when childhood health problems carry over into adulthood. This study examines intergenerational relationships between parent and child health based on data from the German Socio-Economic Panel (SOEP), in particular the recently introduced Mother and Child Questionnaires. Using various health measures, including anthropometric measures, information on health disorders, and "self-rated" health measures, we find significant relationships between parental and child health during the first three years of life. Overall, our results suggest that when controlling for parental income, education, and family composition, parents with poor health are more likely to have children with poor health. However, there are significant differences between health measures and age groups. For some health measures, our results suggest an increasing health gradient by age.

Pollution exposure and child health: evidence for infants and toddlers in Germany.

This paper examines the impact of outdoor pollution and parental smoking on children's health from birth until the age of three years in Germany. We use representative data from the German Socio-Economic Panel (SOEP), combined with five air pollution levels. These data were provided by the Federal Environment Agency and cover the years 2002-2007. Our work makes two important contributions. First, we use European data to replicate and extend an important US study by following the effects of pollution exposure and parental smoking on child health during the first four years of life. Second, we have health measures not only for infants but for toddlers as well. For infants, as well as for two- to three-year-olds, we are able to account for time-invariant and unobserved neighborhood and maternal characteristics. Our results suggest a significantly negative impact of some pollutants on infant health. High exposure to CO prior to birth causes, on average, a 289g lower birth weight. With respect to toddler health, we find that disorders and in particular those as bronchitis and respiratory illnesses are affected particularly by O3 levels.