The Role of Health Service Regions in Children’s Subjective Well-Being: A Cross-Sectional Study

This study aims to examine the relationship between sociodemographic characteristics and subjective well-being among school-aged children and to reveal differences in this relationship across family health center (FHC) regions. The sample consisted of 2135 secondary school students aged 11-14 years living in 22 family FHC regions in three central districts (A, B, C) of a city in Türkiye. Data was collected using a sociodemographic characteristics questionnaire and the Children’s Subjective Well-Being Index (CWEBI). Individual-level variables (age, number of siblings, mother's and father's working status, perceived economic situation, mother's education, father's education and regional-level variables (perceived neighborhood economic status, district) were created, and data analysis was performed using a Multilevel Linear Mixed Model (HLM). While a negative school environment characterized 50% of FHC regions, 36.4% exhibited more adverse conditions in terms of material deprivation, neighborhood characteristics, and personal well-being. Additionally, 12.5% of FHC regions showed negative features in family relationships, and 9.0% showed negative features in peers relationship. Participants' subjective well-being differed significantly across the FHCs in which the school was located. Furthermore, the HLM results indicated significant variation in subjective well-being levels across FHC regions, after controlling for sociodemographic and residential characteristics. The number of siblings, the family's perceived economic status, perceived neighborhood economic status, and the neighbourhood's district were associated with components of subjective well-being. Children's subjective well-being was associated with individual and regional risk factors, and, for all indicators except material deprivation, this relationship differed across study regions.