Peer-reviewed article
Who Uses Services Overall and Within High-Need Families? Social Inequalities in Access to Early Support Services in Southern Germany.
Herrmann S, Nehring I, Mall V, Friedmann A ·
Summary
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Abstract
Objectives Reducing inequalities in early childhood support is a central public health and prevention challenge because services are most effective when families with high psychosocial burden can access them. This study examined a potential need-access gap in Early Support Services (Frühe Hilfen) in Southern Germany by analysing overall service use and use within a subgroup of highly burdened parents. Materials and methods Cross-sectional data from the Junge Familien in Bayern (JuFaBY) cohort of families with young children were used. High need was defined as membership in the highest cut-off category of the Eltern-Belastungs-Inventar (EBI), indicating clinically significant parenting stress. Multivariable logistic regression models with robust standard errors were estimated, adjusting for socio-economic position, family structure, parental mental health, parenting behaviour difficulties, child health, childcare hours, labour status, survey year and non-linear child age effects. Results In the full sample (N = 20 216), Early Support use was positively associated with several need indicators, including parenting stress, parenting behaviour difficulties, single parenthood and chronic child illness. A socio-economic gradient was also observed: Lower household income was associated with higher uptake, while higher parental education was associated with higher use. In the high-need subgroup (N = 3232), income differences attenuated, but disparities by parental education and migration proxy persisted. Conclusion Early Support Services appear broadly need-responsive, while selective access barriers may remain among families with high support needs. In particular, educational and migration-related differences in uptake within highly burdened families indicate potential inequalities in access despite comparable levels of need.