@techreport{BozorgmehrHintermeierRazumetal., author = {Bozorgmehr, Kayvan and Hintermeier, Maren and Razum, Oliver and Mohsenpour, Amir and Biddle, Louise and Oertelt-Prigione, Sabine and Spallek, Jacob and Tallarek, Marie and Jahn, Rosa}, title = {SARS-CoV-2 in Aufnahmeeinrichtungen und Gemeinschaftsunterk{\"u}nften f{\"u}r Gefl{\"u}chtete: Epidemiologische und normativ-rechtliche Aspekte}, doi = {10.4119/UNIBI/2943665}, pages = {37}, abstract = {Ziel des Factsheets ist es, das „Ausbreitungspotential" (als kumulatives Inzidenzrisiko) von SARSCoV- 2 in Aufnahmeeinrichtungen und Gemeinschaftsunterk{\"u}nften bei Auftreten eines Falls zu ermitteln, Zusammenh{\"a}nge mit Einrichtungstyp und Strategie des Ausbruchsmanagements zu explorieren und normativ-rechtliche Aspekte zu diskutieren. Zusammengefasst kann gesagt werden: - Das Risiko, mit dem weitere Bewohner*innen nach einem ersten nachgewiesenen Fall von SARS-CoV-2 (mittels PCR) positiv getestet werden ist in Aufnahmeeinrichtungen und Gemeinschaftsunterk{\"u}nften mit durchschnittlich 17\% als hoch einzusch{\"a}tzen, wobei es eine große Varianz zwischen den Einrichtungen gibt. - Eine Kollektivquarant{\"a}ne hat bezogen auf das Infektionsrisiko der unter Quarant{\"a}ne gestellten Bewohner*innen gegen{\"u}ber anderen Strategien keinen messbaren Vorteil. Ist innerhalb der Quarant{\"a}ne eine physische Distanzierung nur bedingt m{\"o}glich, ist von einer Erh{\"o}hung des Infektionsrisikos f{\"u}r die nicht-infizierten Bewohner*innen auszugehen. Studien zur Quarant{\"a}ne unter den vergleichsweisen g{\"u}nstigen Bedingungen von Kreuzfahrtschiffen best{\"a}tigen dies. Es gibt keine Daten dar{\"u}ber, ob die Kollektivquarant{\"a}ne einen gesundheitlichen Nutzen f{\"u}r die Bev{\"o}lkerung außerhalb der Einrichtung bedeutet. Da sie allerdings erhebliche normativ-rechtliche Probleme birgt, ist die Kollektivquarant{\"a}ne nach aktuellem Kenntnisstand zu vermeiden. - Die Unterbringung von Gefl{\"u}chteten sollte grunds{\"a}tzlich coronaschutzkonform erfolgen, d.h. m{\"o}glichst dezentral bzw. bei zentralen Einrichtungen m{\"o}glichst in Einzelunterbringung in kleinen Wohneinheiten, damit bei Auftreten eines Falls eine rasche Ausbreitung vermieden wird und eine ad{\"a}quate Kontaktnachverfolgung m{\"o}glich ist. - Nationale Empfehlungen zum Umgang mit SARS-CoV-2 in Aufnahmeeinrichtungen und Gemeinschaftsunterk{\"u}nften unter Ber{\"u}cksichtigung der bisher vor Ort entwickelten Pr{\"a}ventions- und L{\"o}sungsans{\"a}tze sowie epidemiologischer und normativ-rechtlicher {\"U}berlegungen sind dringend notwendig, um die beteiligten Akteur*innen in ihrem Engagement f{\"u}r die Gesundheit der Bewohner*innen zu unterst{\"u}tzen. Dieses Papier richtet sich an: Politikverantwortliche sowie Akteur*innen der Fl{\"u}chtlingsversorgung und der Wissenschaft.}, language = {de} } @misc{UlrichKohlerFachetal., author = {Ulrich, Hanna-Sophie and Kohler, Emma and Fach, Eva-Maria and Spallek, Jacob and Richter, Matthias and Mlinarić, Martin}, title = {Healthcare needs among unaccompanied minor refugees: a study protocol of a qualitative study explaining access and utilisation across place and gender}, series = {BMJ Open}, volume = {10}, journal = {BMJ Open}, number = {9}, issn = {2044-6055}, doi = {10.1136/bmjopen-2020-038882}, pages = {8}, abstract = {Introduction: Several studies have identified that unaccompanied minor refugees (UMRs) are allegedly 'vulnerable' and belong to a high-risk group in terms of psychological distress and post-traumatic stress disorder due to their preflight, periflight and postflight experiences. Psychosocial care (PSC) is of high importance for UMRs, but little is known about barriers to access and utilisation of PSC across place and gender. The aims of this gender-sensitive qualitative study will be to build on the existing body of literature and to provide qualitative evidence on the contexts and mechanisms of PSC for male and female UMRs in Germany by comparing two German regions. Methods and analysis: Following the study preparing realist review, a qualitative study will be undertaken in Berlin and Central German cities. Approximately 24 experts from the field of PSC and 12 lay UMRs will participate in face-to-face, semistructured interviews. Data will be transcribed and analysed based on the grounded theory research paradigm. Ethics and dissemination: Only participants who have been informed in both German and their native tongue and who have signed a declaration of consent will be included in the study. The study will comply rigorously with German data protection standards. Approval from the Ethical Review Committee at Martin Luther University Halle-Wittenberg, Germany has been obtained and granted. The results of the study will be presented at several conferences and will be published in high-quality, peer-reviewed international journals. The results will display a differentiated picture of the PSC of UMRs in Germany. Such knowledge is a precondition for a 'science of change' that translates explanations into practical recommendations on how to improve healthcare policies.}, language = {en} } @misc{WachtlerHoffmannBlumeetal., author = {Wachtler, Benjamin and Hoffmann, Stephanie and Blume, Miriam and Rattay, Petra and Herr, Raphael and Deindl, Christian and Sundmacher, Leonie and Richter, Matthias and Spallek, Jacob and Lampert, Thomas}, title = {The impact of the family on health inequalities in children - A systematic scoping review}, series = {European Journal of Public Health}, volume = {30}, journal = {European Journal of Public Health}, number = {Supplement_5}, publisher = {Univ. Press}, address = {Oxford}, issn = {1101-1262}, doi = {10.1093/eurpub/ckaa166.898}, pages = {1}, abstract = {Background Health inequalities in school-aged children and adolescents were repeatedly reported across Europe but less is known about the contextual and compositional factors of families that might influence and reproduce those health inequalities. In this systematic scoping review we aim to provide a comprehensive overview of the available international literature on the mediating and moderating influence of the family on health inequalities in children and adolescents in Europe and North America. Methods This review follows the PRISMA guidelines for scoping reviews. After defining the research question a search strategy was developed in cooperation with a scientific librarian and the study protocol was registered. A search of three databases (Pubmed, Scopus, PsycINFO) was conducted to identify relevant literature in English or German published between the year 2000 and 2019. A qualitative data charting process was used to extract the relevant data. Results In total 11.838 records were identified through the multi database search (Pubmed n = 6370, PsycINFO n = 3505, Scopus n = 1963). After elimination of duplicates and records from excluded countries, 8862 abstracts were screened by two researchers independently. Different cluster of evidence of family influences on health inequalities were identified: Parental behaviors and children's obesity, parents' smoking and drinking habits and adolescents' risk behaviors, parenting style and children's common mental disorders, parental resources and children's quality of life. Conclusions There are different aspects of family's contextual and compositional characteristics on health inequalities identifiable in the international literature. These characteristics might be new targets for family-focused health promotion strategies. Key messages: -A systematic scoping review found different family aspects that influence health inequalities in children and adolescents. - The identified family traits are promising targets for family-focused health promotion strategies to reduce health inequalities.}, language = {en} } @misc{MatosFialhoDraganoReuteretal., author = {Matos Fialho, Paula Mayara and Dragano, Nico and Reuter, Matthias and Metzendorf, Maria-Inti and Richter, Bernd and Richter, Matthias and Spallek, Jacob and Diehl, Katharina and Lampert, Thomas and Pischke, Claudia R.}, title = {Health inequalities during school-to-work transitions among young adults: Mapping the evidence}, series = {European Journal of Public Health}, volume = {30}, journal = {European Journal of Public Health}, number = {Supplement_5}, doi = {10.1093/eurpub/ckaa166.278}, pages = {1}, abstract = {Background School-to-work transition is a sensitive period that can have a substantial impact on health over the life course. Previous studies suggest pronounced health inequalities during this period but little is known about the determinants at the individual, meso- and macro-levels. We aim to further elucidate possible health inequalities during school-to-work transitions with a focus on multilevel determinants, e.g. evidence on potential effects of contextual and compositional factors of specific institutions involved. Methods We are currently conducting a scoping review (funded by the German Research Foundation) to map the evidence on the above mentioned topic among young adults (aged 16-24 years), following the methodological framework proposed by Arksey and {\´O}Malley and PRISMA. The literature search was performed in Ovid MEDLINE, Web of Science, ILO and NIOSH, using sensitive search strategy developed by text-analysis. Only articles published between January 2000 - February 2020 and written in English or German are considered. The selection process is conducted following a two-step approach:1) screening of titles and abstracts 2) screening of full-texts by two independent reviewers. Any discrepancies in the selection process are resolved by a third researcher. Preliminary Results Following the five stages of the methodological framework, the scoping review is currently in stage 3 (study selection-screening phase). We found 25,069 potentially relevant articles in our primary search. 15,508 articles remained after the duplicates were removed. Up to now, 8,825 papers were screened of which 7,629 were excluded and 1,176 included which qualified for full-text reading. Complete results of the scoping review will be presented at the conference. Conclusions This scoping review will improve our knowledge about the emergence and development of health inequalities during school-to-work transitions by examining health of individuals in different institutional contexts. Key messages - Improving our knowledge of health inequalities during school-to-work transitions. - the role of determinants at the individual, meso- and macro-levels during this stage will also be examined.}, language = {en} } @misc{SchillingSpallekMauletal., author = {Schilling, Laura and Spallek, Jacob and Maul, Holger and Tallarek, Marie and Schneider, Sven}, title = {Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy}, series = {Maternal and Child Health Journal}, volume = {25}, journal = {Maternal and Child Health Journal}, number = {4}, issn = {1092-7875}, doi = {10.1007/s10995-020-03037-8}, pages = {656 -- 665}, abstract = {Objectives Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-cigarettes among pregnant women. The objective of our current STudy on E-cigarettes and Pregnancy (STEP) was to advance and complement the current knowledge regarding active and passive exposure to tobacco and e-cigarettes before pregnancy and during early and late pregnancy. Methods One element of the STEP study was a quantitative cross-sectional design: A sample of 540 pregnant women recruited at an obstetrician clinic in Hamburg from April 2018 to January 2019 were surveyed once via a standardized questionnaire and provided complete information regarding their consumption of tobacco and e-cigarettes. We performed a descriptive analysis of tobacco and e-cigarette use before pregnancy and during early and late pregnancy, as well as bivariate analysis of these variables with sociodemographic determinants. Passive exposure was assessed by asking the participating pregnant women about the consumption of tobacco and e-cigarettes by their partners, in general, and in their homes. Results Before pregnancy, 20.0\% of the participants used tobacco cigarettes exclusively, 1.3\% used e-cigarettes exclusively, and 6.5\% were dual users. Educational level was significantly associated with tobacco cigarette use (p < 0.001) and dual use (p = 0.047) before pregnancy. During early (late) pregnancy, 8.7\% (2.8\%) used tobacco cigarettes and 0.4\% (0.0\%) used e-cigarettes exclusively. Twenty-point nine percent of women's partners consumed tobacco cigarettes exclusively, 2.7\% consumed e-cigarettes exclusively, and 2.7\% consumed both. A total of 8.5\% (16.7\%) of the partners who consumed tobacco cigarettes exclusively (e-cigarettes exclusively) did so in the women's homes. Conclusions for Practice Among pregnant women, the use of tobacco cigarettes remains prominent before and during pregnancy, while e-cigarette use predominately occurs before pregnancy. Our study shows that pregnant women are frequently exposed to their partners' tobacco and e-cigarette use within their homes. Strategies to reduce such exposure should be further intensified. Significance In the last decade, e-cigarettes have become popular, and e-cigarette use has been increasing, even among pregnant women. However, there is a lack of knowledge concerning the exposure to e-cigarettes before pregnancy and during early and late pregnancy, as well as studies comparing e-cigarettes and tobacco cigarettes. The current study found that active exposure to e-cigarettes before pregnancy is high, while exposure during pregnancy is marginal. In contrast, exposure to tobacco cigarettes before and in early pregnancy is high but decreases during late pregnancy. In addition, the results of our study show that pregnant women are passively exposed to tobacco and e-cigarettes at home. Pregnant women should be advised against exposing themselves, actively or passively, to tobacco and e-cigarette smoke.}, language = {en} } @misc{TallarekBozorgmehrSpallek, author = {Tallarek, Marie and Bozorgmehr, Kayvan and Spallek, Jacob}, title = {Towards inclusionary and diversity-sensitive public health: the consequences of exclusionary othering in public health using the example of COVID-19 management in German reception centres and asylum camps}, series = {BMJ Global Health}, volume = {5}, journal = {BMJ Global Health}, number = {12}, issn = {2059-7908}, doi = {10.1136/bmjgh-2020-003789}, pages = {9}, abstract = {The German government's response to the COVID-19 pandemic has been predominantly considered wellfounded. Still, the practice of mass quarantine in reception centres and asylum camps has been criticised for its discrimination of refugees and asylum seekers. Building on the concept of othering, this article argues that processes of othering are structurally anchored in German asylum regulations and they have further pervaded public health measures against COVID-19. The practice of mass quarantine made the negative consequences of exclusionary othering for public health particularly noticeable. In the light of recent data indicating this measure to be epidemiologically, legally and ethically insufficient, we apply the concept of othering to public health and discuss (1) exclusionary, (2) inclusionary and (3) diversity-sensitive approaches to public health. We finally conclude that a shift of perspective from exclusion to inclusion, from subordination to empowerment and from silencing to participation is urgently required.}, language = {en} } @misc{HerkeMoorWinteretal., author = {Herke, Max and Moor, Irene and Winter, Kristina and Hoffmann, Stephanie and Spallek, Jacob and Hilger-Kolb, Jennifer and Pischke, Claudia R. and Dragano, Nico and Novelli, Anna and Richter, Matthias}, title = {Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review}, series = {BMJ Open}, volume = {10}, journal = {BMJ Open}, number = {12}, issn = {2044-6055}, doi = {10.1136/bmjopen-2020-038999}, pages = {7}, abstract = {Introduction Childhood and adolescence are crucial life stages for health trajectories and the development of health inequalities in later life. The relevance of schools for health and well-being of children and adolescents has long been recognised, and there is some research regarding the association of contextual and compositional characteristics of schools and classes with health, health behaviour and well-being in this population. Little is known about the role of meso-level characteristics in relation to health inequalities. The aim of this scoping review is to retrieve and synthesise evidence about the mediating or moderating role of compositional or contextual characteristics of schools for the association between students' socioeconomic position and health in primary and secondary education. Methods and analysis We will conduct a systematic search of electronic databases in PubMed/Medline, Web of Science and Education Resources Information Center. Studies must meet the following inclusion criteria: (1) The population must be students attending primary or secondary schools in developed economies. (2) The outcomes must include at least one indicator for individual health, health behaviour or well-being. (3) The study must include at least one contextual or compositional characteristic of the school context and one individual determinant of socioeconomic position. (4) The study must also examine the mediating or moderating role of the contextual or compositional characteristic of the school context for the associations between socioeconomic position and health, health behaviour or well-being. (5) The study must be published since 1 January 2000 in English or German language. We will provide a narrative synthesis of findings. Ethics and dissemination We will not collect primary data and only include secondary data derived from previously published studies. Therefore, ethical approval is not required. We intend to publish our findings in an international peer-reviewed journal and to present them at national and international conferences.}, language = {en} } @misc{HintermeierGencerKajikhinaetal., author = {Hintermeier, Maren and Gencer, Hande and Kajikhina, Katja and Rohleder, Sven and Santos-H{\"o}vener, Claudia and Tallarek, Marie and Spallek, Jacob and Bozorgmehr, Kayvan}, title = {SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review}, series = {medRxiv}, journal = {medRxiv}, doi = {10.1101/2020.12.14.20248152}, pages = {27}, abstract = {The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesise the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0.12\% to 2.08\% in non-outbreak settings and from 5.64\% to 21.15\% in outbreak settings. Migrants showed a lower hospitalisation rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.}, language = {en} } @misc{MianiBatramZantvoortWandschneideretal., author = {Miani, C{\´e}line and Batram-Zantvoort, Stephanie and Wandschneider, Lisa and Spallek, Jacob and Razum, Oliver}, title = {Potential of Standard Perinatal Data for Measuring Violation of Birth Integrity}, series = {Frontiers in global women's health}, journal = {Frontiers in global women's health}, number = {1}, issn = {2673-5059}, doi = {10.3389/fgwh.2020.581244}, pages = {8}, abstract = {Background: Measuring the phenomenon of violation of birth integrity (vBI) (e.g., obstetric violence) relies in part on the availability and content of maternity care providers' data. The population coverage and linkage possibilities that these data provide make for a yet untapped potential. Although vBI is a complex phenomenon best measured with dedicated instruments, we argue that maternity care providers' data could contribute to enhance our knowledge of the manifestations and frequency of vBI, and allow for analyses across different sub-groups of the population. Looking into the German standardized perinatal data, we investigate which variables are relevant to vBI-related research, and how complete their reporting is. Methods: First, we analyse state-of-the-art frameworks and recommendations, and, for each vBI-related domain, we search for and list corresponding variables in the perinatal data which could contribute to a better understanding of vBI issues. Second, we use an example and analyse the content of perinatal data obtained between 2013 and 2016 in the context of the BaBi birth cohort study set in Bielefeld, Germany. We use descriptive statistics to assess the completeness of the data. Results: The vBI-related variables can be classified in three main categories: discrimination based on specific patient socio-demographic attributes (e.g., height and weight to calculate BMI before pregnancy, foreign origin), indication for medical interventions (i.e., medicalization-related variables: indication for cesarean sections and induction), and supportive care, in particular the mobilization dimension (e.g., continuous fetal heartbeat monitoring). The data analyses included 876 births, of which 601 were vaginal birth. We found poor reporting on demographic variables in terms of completeness. Medicalization and mobilization variables are better documented, although limited in scope. Conclusions: Putting more emphasis on the completeness of standardized data could increase their potential for vBI-related research. Perinatal data alone are insufficient to assess vBI, but a broader, theory-informed discussion of indicators to be included in standardized datasets would contribute to capturing the different aspects of integrity violation in a more systematic way and expand the evidence-base on different types of vBI.}, language = {en} } @misc{SchillingSpallekMauletal., author = {Schilling, Laura and Spallek, Jacob and Maul, Holger and Schneider, Sven}, title = {Study on E-Cigarettes and Pregnancy (STEP) - Results of a Mixed Methods Study on Risk Perceptionof E-Cigarette Use During Pregnancy}, series = {Geburtshilfe und Frauenheilkunde}, volume = {81}, journal = {Geburtshilfe und Frauenheilkunde}, number = {02}, issn = {0016‑5751}, doi = {10.1055/a-1308-2376}, pages = {214 -- 223}, abstract = {Introduction E-cigarette use during pregnancy is a risk factor for maternal and fetal health. Early studies on animals showed that in utero exposure to e-cigarettes can have negative health outcomes for the fetus. There has been only limited research into the risk perceptions of e-cigarette use during pregnancy. This study was conducted to comprehensively characterize the constructs of risk perceptions with regard to e-cigarette use during pregnancy using an Integrated Health Belief Model (IHBM). Methods Our STudy on E-cigarettes and Pregnancy (STEP)used a mixed methods approach, with the study divided intoan initial qualitative part and a quantitative part. A netno-graphic approach was used for the first part, which consistedof the analysis of 1552 posts from 25 German-language on-line discussion threads on e-cigarette use during pregnancy. Using these qualitative results, a quantitative questionnaire was developed to explore risk perception constructs about e‑cigarette use during pregnancy. This questionnaire was subsequently administered to pregnant women (n = 575) in onehospital in Hamburg, Germany. Descriptive and bivariate analysis was used to examine differences in risk perception ac-cording to participantsʼ tobacco and e-cigarette user status before and during pregnancy. While the study design, methods and sample have been extensively described in our recently published study protocol in the January 2020 issue of Geburtshilfe und Frauenheilkunde, this paper is devoted to apresentation of the results of our mixed methods study. Results Themes related to perceived threats identified in the qualitative study part were nicotine-related health risks and po-tential health risks of additional ingredients. Perceived benefits were possibility and facilitation of smoking cessationand a pre-sumed potential to reduce harm. The subsequent quantitative part showed that nearly all participants (99.3\%) perceivede‑cigarettes which contained nicotine as constituting a threat to the health of the unborn child. The most commonly perceived barrier was health-related (96.6\%), while the most commonly perceived benefit was a reduction in the amount of tobacco cigarettes consumed (31.8\%). We found that partic-ularly perceived benefits varied depending on the partici-pantʼs tobacco and e-cigarette user status. Conclusion When considering future prevention strategies, the potential health risks and disputed effectiveness of e-cigarettes as a tool for smoking cessation need to be taken intoaccount and critically discussed.}, language = {en} } @misc{NovelliSchuettigSpalleketal., author = {Novelli, Anna and Sch{\"u}ttig, Wiebke and Spallek, Jacob and Wachtler, Benjamin and Diehl, Katharina and Moor, Irene and Richter, Matthias and Dragano, Nico and Sundmacher, Leonie}, title = {Correlation of mesolevel characteristics of the healthcare system and socioeconomic inequality in healthcare use: a scoping review protocol}, series = {BMJ Open}, volume = {11}, journal = {BMJ Open}, number = {2}, issn = {2044-6055}, doi = {10.1136/bmjopen-2020-044301}, pages = {7}, abstract = {Introduction Although the impact of macrolevel characteristics of health systems on socioeconomic inequity in health has been studied extensively, the impact of access characteristics on a smaller scale of health systems has received less attention. These mesolevel characteristics can influence access to healthcare and might have the potential to moderate or aggravate socioeconomic inequity in healthcare use. This scoping review aims to map the existing evidence of the association of socioeconomic inequity in healthcare use and mesolevel access characteristics of the health system. Methods and analysis In conducting the scoping review, we follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews. The search will be carried out in four scientific databases: MEDLINE (via PubMed), Web of Science, Scopus and PsycINFO. Main eligibility criteria are inclusion in the analysis of a measure of socioeconomic position, a measure of individual healthcare use and a mesolevel determinant of access to healthcare services. The selection process consists of two consecutive screening stages (first: title/abstract; second: full text). At both stages, two reviewers independently assess the eligibility of studies. In case of disagreement, a third reviewer will be involved. Cohen's kappa will be calculated to report inter-rater agreement between reviewers. Results are synthesised narratively, as a high heterogeneity of studies is expected. Ethics and dissemination No primary data are collected for the presented scoping review. Therefore, ethical approval is not necessary. The scoping review will be published in an international peer-reviewed journal, and findings will be presented on national and international conferences.}, language = {en} } @misc{LueckmannHoebelRoicketal., author = {Lueckmann, Sara Lena and Hoebel, Jens and Roick, Julia and Markert, Jenny and Spallek, Jacob and Knesebeck, Olaf von dem and Richter, Matthias}, title = {Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review}, series = {International journal for equity in health}, volume = {20}, journal = {International journal for equity in health}, issn = {1475-9276}, doi = {10.1186/s12939-020-01375-1}, pages = {19}, abstract = {Background Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries. Methods We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria. Results Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES. Conclusion This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare.}, language = {en} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Inclusionary und diversit{\"a}tssensibles Public Health in der Pandemie}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {1}, issn = {1876-4851}, doi = {10.1515/pubhef-2020-0112}, pages = {22 -- 26}, abstract = {Othering beschreibt die Markierung von Menschen als „anders" oder „nicht zugeh{\"o}rig". Ausgehend von den Konzepten des exclusionary und inclusionary Othering diskutiert dieser Beitrag drei Ans{\"a}tze zu i) exclusionary Public Health, ii) inclusionary Public Health und iii) diversit{\"a}tssensiblem Public Health. Die Implikationen der Ans{\"a}tze werden am Beispiel des Umgangs mit der COVID-19 Pandemie bei schutzsuchenden Menschen in Aufnahmeeinrichtungen und Sammelunterk{\"u}nften in Deutschland aufgezeigt.}, language = {de} } @incollection{SpallekRazum, author = {Spallek, Jacob and Razum, Oliver}, title = {Epidemiologische Erkl{\"a}rungsmodelle f{\"u}r den Zusammenhang zwischen Migration und Gesundheit}, series = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, booktitle = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, editor = {Spallek, Jacob and Zeeb, Hajo}, edition = {1}, publisher = {Hogrefe AG}, address = {Bern}, isbn = {978-3-456-85995-8}, doi = {10.1024/85995-000}, pages = {81 -- 90}, abstract = {Migration beeinflusst die Gesundheit. Ob sich Migration gesundheitlich positiv oder negativ auswirkt, h{\"a}ngt von einer Vielzahl von Faktoren ab, die in verschiedenen Erkl{\"a}rungsmodellen in einen Zusammenhang gebracht werden. Wichtig bei der Beschreibung des Zusammenhangs sind eine zeitliche Komponente und die Einbeziehung der individuellen Lebensl{\"a}ufe der Migrant*innen mit ihren Lebensabschnitten vor, w{\"a}hrend und nach der Migration.}, language = {de} } @incollection{ScholaskeSpallekEntringer, author = {Scholaske, Laura and Spallek, Jacob and Entringer, Sonja}, title = {Intergenerationale {\"U}bertragung von Migrationserfahrungen und fetale Programmierung von Krankheit und Gesundheit}, series = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, booktitle = {Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien}, editor = {Spallek, Jacob and Zeeb, Hajo}, edition = {1}, publisher = {Hogrefe AG}, address = {Bern}, isbn = {978-3-456-85995-8}, pages = {351 -- 368}, abstract = {Gesundheitsdisparit{\"a}ten manifestieren sich in der Nachkommengeneration von Migrant*innen teilweise schon in fr{\"u}hen Lebensjahren. Viele dieser Gesundheits-disparit{\"a}ten werden durch sozio{\"o}konomische Benachteiligung und Akkulturation vermittelt. Anhand des Konzeptes der fetalen Pro-grammierung kann erkl{\"a}rt werden, dass das m{\"u}tterliche Stresserleben - vermittelt {\"u}ber endokrine und immunologische Prozesse - die sp{\"a}tere Gesundheit und Krank-heitsvulnerabilit{\"a}t der Nachkommen bereits in der Schwangerschaft beeinflusst. Es gibt aus der internationalen Forschung zahlreiche Belege daf{\"u}r, dass endokrine und immunologische Prozesse den Zusam-menhang zwischen m{\"u}tterlichen migrationsbezogenen Stressoren und Schwangerschafts-, Geburts- und sp{\"a}teren Gesundheitsoutcomes des Kindes vermitteln. Bei Migrant*innen in Deutschland sind diese Zusammenh{\"a}nge weitestgehend unterforscht.}, language = {de} } @misc{UlrichKohlerSpalleketal., author = {Ulrich, Hanna-Sophie and Kohler, Emma and Spallek, Jacob and Richter, Matthias and Clauß, Daniel and Mlinarić, Martin}, title = {Explaining psychosocial care among unaccompanied minor refugees: a realist review}, series = {European child \& adolescent psychiatry}, volume = {31(2022)}, journal = {European child \& adolescent psychiatry}, number = {12}, issn = {1435-165X}, doi = {10.1007/s00787-021-01762-1}, pages = {1857 -- 1870}, abstract = {Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations.}, language = {en} } @incollection{TallarekMlinarićSpallek, author = {Tallarek, Marie and Mlinarić, Martin and Spallek, Jacob}, title = {Migration - Bedeutung und Implikationen f{\"u}r die Pr{\"a}vention und Gesundheitsf{\"o}rderung}, series = {Springer Reference Pflege - Therapie - Gesundheit}, booktitle = {Springer Reference Pflege - Therapie - Gesundheit}, editor = {Tiemann, Michael and Mohokum, Melvin}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-62426-5}, issn = {2662-6942}, doi = {10.1007/978-3-662-62426-5_28}, pages = {199 -- 211}, abstract = {Die Bev{\"o}lkerungsgruppe der Menschen mit Migrationshintergrund umfasst fast ein Viertel der Gesamtbev{\"o}lkerung in Deutschland und ist h{\"o}chst heterogen. Pauschalisierende Aussagen zum Gesundheitsstatus dieser Gruppe sind daher nicht m{\"o}glich. Menschen mit Migrationshintergrund sind nicht grunds{\"a}tzlich ges{\"u}nder oder kr{\"a}nker als die Mehrheitsbev{\"o}lkerung. Allerdings k{\"o}nnen sie sich aufgrund von Expositionen vor, w{\"a}hrend und nach der Migration in ihren Gesundheitschancen und -risiken von der Mehrheitsbev{\"o}lkerung unterscheiden. Pr{\"a}vention und Gesundheitsf{\"o}rderung sollten daraus resultierende spezifische Bedarfe ebenso ber{\"u}cksichtigen wie die Diversit{\"a}t der Bev{\"o}lkerung insgesamt. Erfolgversprechend ist eine Kombination aus diversit{\"a}tssensiblen, f{\"u}r die Gesamtbev{\"o}lkerung zug{\"a}nglichen Angeboten und migrationsspezifischen Ans{\"a}tzen in besonders risikoreichen Situationen. Kommunale, settingorientierte sowie soziokulturell angepasste Angebote verbessern die Erreichbarkeit der Zielgruppen maßgeblich.}, language = {de} } @misc{ScholaskeSpallekEntringer, author = {Scholaske, Laura and Spallek, Jacob and Entringer, Sonja}, title = {Fetale Programmierung von Gesundheitsdisparit{\"a}ten bei Kindern mit Migrationshintergrund}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {2}, issn = {1876-4851}, doi = {10.1515/pubhef-2021-0015}, pages = {131 -- 134}, abstract = {Kinder von Migrant*innen zeigen bereits in fr{\"u}hen Lebensjahren h{\"a}ufig Gesundheitsdisparit{\"a}ten, die mit m{\"u}tterlicher Gesundheit und migrationsbezogenen Faktoren eng zusammenh{\"a}ngen. Zur Erkl{\"a}rung dieses Ph{\"a}nomens der intergenerationalen Transmission von Gesundheitsdisparit{\"a}ten schlagen wir ein Modell vor, das eine Lebensverlaufsperspektive mit dem Konzept der fetalen Programmierung von Gesundheit und Krankheitsvulnerabilit{\"a}t zusammenbringt.}, language = {de} } @misc{SpallekScholaskeDumanetal., author = {Spallek, Jacob and Scholaske, Laura and Duman, Elif Aysimi and Razum, Oliver and Entringer, Sonja}, title = {Association of maternal migrant background with inflammation during pregnancy - results of a birth cohort study in Germany}, series = {Brain, Behavior, and Immunity}, volume = {Vol. 96}, journal = {Brain, Behavior, and Immunity}, issn = {1090-2139}, doi = {10.1016/j.bbi.2021.06.010}, pages = {271 -- 278}, abstract = {Background Health disparities in children of immigrants are prevalent from birth and are hypothesized to - in part - emerge as a biological consequence of migration's unfavorable social and psychological sequelae. The aim of this study was to examine whether maternal migrant background is associated with inflammation during pregnancy - a key pathway by which maternal states and conditions during pregnancy may influence fetal development and subsequent pregnancy, birth, and child developmental and health outcomes. Material and Methods Data was available from 126 pregnant women who participated in a population based multi-site prospective birth cohort study in Bielefeld and Berlin, Germany. The study included two study visits in mid- and late pregnancy. At each visit, a composite maternal pro-inflammatory score was derived from circulating levels of plasma inflammatory markers (IL-6, CRP). Migrant background was defined by country of origin of participants and their parents' (Turkey or other) and generation status (1st or 2nd generation). We applied hierarchical linear models (HLM) in order to quantify the relationship between different migrant background variables and inflammation during pregnancy after adjustment for potential confounders (including socioeconomic status). Results Migrant background was significantly associated with inflammation during pregnancy. When compared to women without migrant background, levels of inflammation were increased in 1) pregnant women with migrant background in general (B = 0.35, SE = 0.12, p < .01); 2) 1st (B = 0.28, SE = 0.15, p < .10) and 2nd generation (B = 0.40, SE = 0.15, p < .01); 3) women with a Turkish migrant background (B = 0.28, SE = 0.14, p < .10) and women with another migrant background (B = 0.42, SE = 0.15, p <.01); and 4) 2nd generation Turkish origin women (B = 0.38, SE = 0.20, p <.10), 1st generation women with other migrant background (B = 0.44, SE = 0.26, p <.10), and 2nd generation women with other migrant background (B=0.43, SE = 0.17, p <.05). Discussion Our findings support a role for maternal inflammation as a pathway of intergenerational transmission of migration-related health inequalities, suggest that the effect seems to persist in 2nd generation immigrants, and highlight the need for future research and targeted interventions in this context.}, language = {en} } @misc{HintermeierGencerKajikhinaetal., author = {Hintermeier, Maren and Gencer, Hande and Kajikhina, Katja and Rohleder, Sven and Santos-H{\"o}vener, Claudia and Tallarek, Marie and Spallek, Jacob and Bozorgmehr, Kayvan}, title = {SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review}, series = {Journal of Migration and Health}, volume = {4}, journal = {Journal of Migration and Health}, issn = {2666-6235}, doi = {10.1016/j.jmh.2021.100056}, pages = {13}, abstract = {The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesise the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12\% to 2•08\% in non-outbreak settings and from 5•64\% to 21•15\% in outbreak settings. Migrants showed a lower hospitalisation rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.}, language = {en} } @incollection{HoffmannTallarekSpallek, author = {Hoffmann, Stephanie and Tallarek, Marie and Spallek, Jacob}, title = {Gesundheitswissenschaftliche Grundlagen f{\"u}r den Gesundheitsunterricht. Gesundheit und Vielfalt in Schule, Ausbildung und Studium}, series = {Gesundheitsdidaktik}, booktitle = {Gesundheitsdidaktik}, editor = {Goldfriedrich, Martin and Hurrelmann, Klaus}, edition = {1}, publisher = {Beltz Juventa}, address = {Weinheim, Basel}, isbn = {978-3-7799-6371-4}, pages = {134 -- 155}, abstract = {Dieses Kapitel stellt theoretische und empirische Grundlagen der Gesundheit, ihrer Determinanten und der gesundheitlichen Ungleichheit als Gegenstand eines systematischen Gesundheitsunterrichts vor (Goldfriedrich/Hurrelmann in diesem Band, Kern-Wert 2 des Gesundheitsunterrichtes). Das Wissen um die Komplexit{\"a}t menschlicher Vielfalt und deren Einfluss auf die gesundheitliche Situation bildet die Grundlage f{\"u}r das Verst{\"a}ndnis zentraler Gesundheitsdimensionen (u. a. M{\"u}ller/Porges in diesem Band) sowie die didaktische Schwerpunktsetzung in verschiedenen Institutionen im Entwicklungsverlauf, wie dem Gymnasium (Schwegmann in diesem Band), der Berufsschule (Trumpa/Dorn in diesem Band) oder in Hochschulen (Sprenger in diesem Band). In diesem Kontext erl{\"a}utert das Kapitel die Problematik ungleich verteilter Gesundheitschancen und stellt die Bandbreite relevanter Einflussfaktoren am Beispiel der sozialen Lage, des Migrationshintergrunds und des Geschlechts bei Kindern und Jugendlichen vor. Es zeigt auf, wie dieses Wissen im Bildungskontext curricular implementiert werden kann, um bereits im Kindes- und Jugendalter einen Beitrag zur gesundheitlichen Chancengleichheit leisten zu k{\"o}nnen.}, language = {de} }