No abstract

A social index derived from examinations of prospective first graders is used for health reporting in the Federal State of Brandenburg. The Brandenburg social index consists of data from the medical examinations, which contain social anamnesis questions. Based on parents' education and employment, the social index is computed for each child and finally each child is assigned to a group of lower, middle or higher socioeconomic status. The simply made social index is not only used for analysing health and social inequalities but also for analysing the social situation and trends of young families. Social index data for prospective first graders have ben collected since 1994. Thus, the social index is part of the social reporting in Brandenburg. The present article illustrates with examples how the index is used. Finally, it is mentioned that the Brandenburg government uses the social index to control finances in the language promotion for kindergarteners in day-care centres.

The epidemiological analysis of childrens' injuries should be the starting point for age- and environment-specific and product-related interventions. Intervention strategies should take into account parents' ethnic background as well as potential language barriers.

In 1998, 31 children (<15 years) (N=655) died through falls, in most cases by falling from a building (n=8). Around 700,000 children are estimated to have required medical treatment for falls, approx. 120,000 of them being hospitalized. Fall injuries show an age- and environment-specific accident pattern. Most of the falls among infants and toddlers are from changing tables, children's beds, high chairs and stairs. Among school-age children, falls occur most frequently at school (during break and physical education lessons) and during leisure activities (skating, cycling). These facts should form the basis for prevention measures targeting behaviour and health conditions.

Routine well-child visits, implemented as a means of secondary prevention and covered by health insurance, lead to early identification of disorders and abnormalities in child development."Guiding principles for children" (by the G-BA) have determined the content of the eleven examinations, ranging from U1 immediately after birth to J1 in adolescence; eight of them take place within the first four years of age. Since cases of child maltreatment, neglect, or abuse became public in 2007, almost all German federal states have established mandatory examination and notification processes in the new child welfare surveillance programs. First results in the German federal states (six of which are exemplarily illustrated) point out that mandatory requirements have collectively increased the frequency of medical check-ups in children, especially starting from four years of age and most significantly in families with social disadvantages (young/single parents, immigrant background, uneducated or socially disadvantaged families), which have so far been difficult to reach. Subsequently, provision of primary prevention (vaccinations and health promotion advice) by pediatricians has also increased. As a sole instrument for the complete identification of threats for children's welfare, however, systems inviting and reminding parents about check-ups are only of limited benefit.