ABSTRACT
OBJECTIVE: Measuring children's health-related quality of life (HRQOL) is of growing importance given increasing chronic diseases. By integrating HRQOL questions into the European GABRIEL study, we assessed differences in HRQOL between rural farm and non-farm children from Germany, Austria, Switzerland and Poland to relate it to common childhood health problems and to compare it to a representative, mostly urban German population sample (KIGGS). METHODS: The parents of 10,400 school-aged children answered comprehensive questionnaires including health-related questions and the KINDL-R questions assessing HRQOL. RESULTS: Austrian children reported highest KINDL-R scores (mean: 80.9; 95 % CI [80.4, 81.4]) and Polish children the lowest (74.5; [73.9, 75.0]). Farm children reported higher KINDL-R scores than non-farm children (p = 0.002). Significantly lower scores were observed in children with allergic diseases (p < 0.001), with sleeping difficulties (p < 0.001) and in overweight children (p = 0.04). The German GABRIEL sample reported higher mean scores (age 7-10 years: 80.1, [79.9, 80.4]; age 11-13 years: 77.1, [74.9, 79.2]) compared to the urban KIGGS study (age 7-10 years: 79.0, [78.7-79.3]; age 11-13 years: 75.1 [74.6-75.6]). Socio-demographic or health-related factors could not explain differences in HRQOL between countries. CONCLUSIONS: Future increases in chronic diseases may negatively impact children's HRQOL.
Subject(s)
Health Status , Quality of Life , Rural Health/standards , Rural Population , Adolescent , Austria , Child , Cross-Sectional Studies , Female , Germany , Health Surveys , Humans , Male , Poland , Surveys and Questionnaires , SwitzerlandABSTRACT
BACKGROUND: Numerous studies report a protective effect of farming against allergic diseases. Some specific underlying exposures contributing to this effect have recently been described in the GABRIEL survey. So far, psycho-social factors have not been included in these analyses. METHODS: In order to assess the potential influence of health-related quality of life (HRQOL) on the protective effect of farming, 8259 school aged children from the European GABRIEL study answered questions concerning farming and allergic diseases, as well as validated questions about HRQOL. RESULTS: Farm children reported higher HRQOL than non farm children. However, HRQOL did not modify the protective effect of farming against allergies. Children with allergic diseases reported significantly lower HRQOL scores suggesting that the higher HRQOL of farm children was in part explained by the lower prevalence of these diseases among farm children. CONCLUSION: Although farm children reported higher HRQOL scores than did non-farm children, HRQOL did not explain the protective effect of farming against allergic diseases. The relationship between allergic diseases and HRQOL is likely bidirectional and needs to be assessed prospectively.
