Abstract
Background Children and adolescents are significantly tied to their
family's socioeconomic position and living environment. Neighbourhood and
the living environment have been identified as potential risk factors for mental
disorders in this age group.
Aim of the Study The aim of the study was to investigate the distribution
of mental and behavioural disorders (prevalence) and the provision of mental
health services for children and adolescents aged 0–19 years in the city of
Cologne. In particular, the study aimed to examine the association of these
factors with area deprivation and the availability of mental health services
covered by statutory health insurance. Finally, possible spatial variations in
these aspects were analysed.
Method Claims data of children and adolescents aged 0 to 19 years included
in four statutory health insurance of the year 2021 were analysed. A deprivation
index using data on the level of the ZIP code area was calculated. Analyses were
carried out descriptively, using ordinary least squares (OLS) and geographically
weighted regression (GWR).
Results The prevalence of mental and behavioural disorders in children and
adolescents varied across ZIP code areas, with higher rates in the northern,
southern, and eastern parts of the city. The results indicated that the use of
services by male children and adolescents with a prevalent diagnosis of mental
and behavioural disorders was higher in areas with a higher density of
healthcare providers. However, prevalence was on the whole lower in areas with a
higher density of healthcare providers. In addition, the density of health care
providers was higher in the city centre with comparatively lower
deprivation.
Conclusion These results indicate inadequate access to care for children
and young people outside the city centre. However, due to the heterogeneity of
the population in these areas, this study provides only preliminary insights.
Data with a finer geographic resolution are needed for further research in order
to analyse the association further.
Keywords Mental health - healthcare utilization - children and adolescents - deprivation
