Analysis of comprehensive community-based health promotion approaches for children : Health prospects in disadvantaged neighborhoods in Germany's Ruhr area

The "Growing up Healthy" research consortium investigated comprehensive community-based approaches to health promotion aimed at children in the cities of Moers and Oberhausen in Germany's Ruhr area. The aim of this paper is to analyze municipal policies as well as institutional and sociospatial conditions for comprehensive community-based approaches under the following research questions: What is the implementation level of comprehensive community-based health promotion from the perspective of a) key community actors; b) administrators from day care centers, family centers, and primary schools? How do they assess the health prospects of disadvantaged families and families with migration background? In the course of a local stocktaking, expert interviews were conducted with key community actors and administrators from day care centers, family centers, and primary schools (n = 34). Needs for development exist, particularly in the intersectoral coordination of prevention policies as well as in adequate mandating by municipal policymakers. The major hurdles faced by preschools and schools are an ailing or absent infrastructure and insufficient resources. The challenges faced by professionals in disadvantaged neighborhoods are immense: poverty, integration, and inclusion. Comprehensive community-based health promotion is still in its infancy. An explicit legal mandate including the commitment to provide funding does not exist. There are clear indications that children's health prospects vary widely according to urban neighborhood and educational institutions. It is becoming evident that preschools and schools require need-based funding.