@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{MoorSpallekRichter, author = {Moor, Irene and Spallek, Jacob and Richter, Matthias}, title = {Explaining socioeconomic inequalities in self-rated health - A systematic review of the relative contribution of material, psychological and behavioural factors}, series = {Journal of Epidemiology \& Community Health}, volume = {71}, journal = {Journal of Epidemiology \& Community Health}, number = {6}, issn = {1470-2738}, doi = {10.1136/jech-2016-207589}, language = {en} } @misc{MoorLampertRathmannetal., author = {Moor, Irene and Lampert, Thomas and Rathmann, Katharina and Kuntz, Benjamin and Kolip, Petra and Spallek, Jacob and Richter, Matthias}, title = {Explaining educational inequalities in adolescent life satisfaction: Do health behaviour and gender matter}, series = {International Journal of Public Health}, volume = {59}, journal = {International Journal of Public Health}, number = {2}, issn = {1661-8564}, pages = {309 -- 317}, language = {en} } @misc{MoorRathmannStronksetal., author = {Moor, Irene and Rathmann, Katharina and Stronks, Karien and Levin, Kate and Spallek, Jacob and Richter, Matthias}, title = {Psychosocial and behavioural factors in the explanation of socioeconomic inequalities in adolescent health. A multilevel analysis in 28 European and North American countries}, series = {Journal of epidemiology and community health}, volume = {68}, journal = {Journal of epidemiology and community health}, number = {10}, issn = {1470-2738}, doi = {10.1136/jech-2014-203933}, pages = {912 -- 921}, language = {en} } @misc{LampertRichterSchreiberetal., author = {Lampert, Thomas and Richter, Matthias and Schreiber, Sven and Spallek, Jacob and Dragano, Nico}, title = {Soziale Ungleichheit und Gesundheit. Stand und Perspektiven der sozialepidemiologischen Forschung in Deutschland}, series = {Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz}, volume = {59}, journal = {Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz}, number = {2}, issn = {1436-9990}, doi = {10.1007/s00103-015-2275-6}, pages = {153 -- 165}, language = {de} } @misc{SchroederHoebelRoicketal., author = {Schr{\"o}der, Sara Lena and Hoebel, Jens and Roick, Julia and Markert, Jenny and Spallek, Jacob and Knesebeck, Olaf von dem and Richter, Matthias}, title = {Inequalities in the utilisation of primary and specialist physicians in Europe - a systematic review}, series = {European Journal of Public Health}, volume = {29}, journal = {European Journal of Public Health}, number = {4}, issn = {1101-1262}, doi = {10.1093/eurpub/ckz186.377}, abstract = {Background: The evidence on inequalities in health clearly shows that people with lower socioeconomic status (SES) have poorer health and higher mortality. Nevertheless, generalized evidence for inequalities in healthcare is lacking. So far, the international literature was only summarised with regard to inequalities in the utilisation of disease-specific treatment. Therefore, our aim was to synthetize the literature on socioeconomic inequalities in the utilisation of primary and specialist physicians in the general population. Methods: This systematic review searched Medline und Web of Science from 2004 to 2018. Articles that reported quantitative data on the association of SES with utilisation of primary or specialist physicians in Europe were included. Title and abstract screening were performed by two independent researchers and 50 full texts are currently sifted whether they fulfil the inclusion criteria. Results: The studies analysed utilisation of physicians in terms of probability or frequency. The initial check of the studies indicates that socioeconomic inequalities in the utilisation of physicians differ between primary and specialist care. Specialist physicians were found to be visited with a higher probability and more often by the least disadvantaged in most studies. Inequalities in the utilisation of primary physicians revealed to be more diverse with a weak pattern of equally distributed probability of GP visits and more frequent utilisation by the disadvantaged. Conclusions: The preliminary results indicate that pro-rich utilisation seems to be more pronounced in visiting specialists compared to primary health care. Aiming to reduce inequalities in healthcare, public health actions might primarily focus on reaching a needs-based consultation of specialist physicians.}, language = {en} } @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{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{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{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} } @misc{BlumeRattayHoffmannetal., author = {Blume, Miriam and Rattay, Petra and Hoffmann, Stephanie and Spallek, Jacob and Sander, Lydia and Herr, Raphael and Richter, Matthias and Moor, Irene and Dragano, Nico and Pischke, Claudia R. and Iashchenko, Iryna and H{\"o}vener, Claudia and Wachtler, Benjamin}, title = {Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {15}, issn = {1660-4601}, doi = {10.3390/ijerph18157739}, pages = {33}, abstract = {This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6-18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.}, language = {en} } @misc{HerkeMoorWinteretal., author = {Herke, Max and Moor, Irene and Winter, Kristina and Hack, Miriam and Hoffmann, Stephanie and Spallek, Jacob and Hilger-Kolb, Jennifer and Herr, Raphael 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: a scoping review}, series = {BMJ Open}, volume = {12}, journal = {BMJ Open}, number = {2}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-052925}, pages = {16}, abstract = {Objectives: To synthesise the evidence on the role of compositional or contextual characteristics of schools in the association between students' socioeconomic position and their health in primary and secondary education in developed economies. Design: Scoping review. We included studies examining the role of at least one school or class characteristic on students' health inequalities and was published since 1 January 2000, in English or German. We searched PubMed/Medline, Web of Science and Education Resources Information Center. We provided a narrative synthesis and an overview of findings. School characteristics were grouped into five broad categories: school composition, school climate, school policies and organisation, food environment and facilities. Results: Of 8520 records identified, 26 studies were included. Twelve studies found a moderating and 3 a mediating effect. The strongest evidence came from studies examining the moderating effect of school composition, that is, the negative impact of a low individual socioeconomic position on mental health and well-being was aggravated by a low average socioeconomic position of schools. Evidence concerning the role of school climate, school stratification (eg, performance base tracking) and sponsorship, food environment and sport facilities and equipment was generally weak or very weak and mostly based on singular findings. Overall, favourable meso-level characteristics mitigated the negative impact of low individual socioeconomic position on health outcomes. Conclusions: School characteristics affect health inequalities in children and adolescents to some degree, but future research is necessary to strengthen the existing evidence and address under-represented aspects in school characteristics and health outcomes.}, language = {en} } @misc{MatosFialhoDraganoReuteretal., author = {Matos Fialho, Paula Mayara and Dragano, Nico and Reuter, Marvin and Deindl, Christian and Schleberger, Sarah and Metzendorf, Maria-Inti and Hoffmann, Stephanie and Diehl, Katharina and Wachtler, Benjamin and Sch{\"u}ttig, Wiebke and Herke, Max and Richter, Matthias and Pischke, Claudia R.}, title = {School-to-work and school-to-university transition and health inequalities among young adults: a scoping review}, series = {BMJ Open}, volume = {12}, journal = {BMJ Open}, number = {7}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-058273}, pages = {e058273}, abstract = {Objectives The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16-24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours. Design Scoping review. Study selection Relevant literature was systematically searched following the methodological framework proposed by Arksey and O'Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered. Data extraction To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment). Results A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible. Conclusions This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited.}, language = {en} } @misc{ReuterHerkeRichteretal., author = {Reuter, Marvin and Herke, Max and Richter, Matthias and Diehl, Katharina and Hoffmann, Stephanie and Pischke, Claudia R. and Dragano, Nico}, title = {Young people's health and well-being during the school-to-work transition: a prospective cohort study comparing post-secondary pathways}, series = {BMC Public Health}, volume = {22}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-022-14227-0}, pages = {1 -- 13}, abstract = {Background: At the end of secondary education, young people can either start vocational training, enter university, directly transition to employment or become unemployed. Research assumes that post-secondary pathways have immediate and/or long-term impacts on health and well-being, but empirical investigations on this are scarce and restricted to few countries. Therefore, this study traced the development of health and well-being throughout the highly institutionalised school-to-work transition (STWT) in Germany. Methods: We used longitudinal data of the National Educational Panel Study (NEPS), a representative sample of 11,098 school-leavers (50.5\% girls) repeatedly interviewed between 2011 and 2020. We estimated the effect of post-secondary transitions on self-rated health and subjective well-being by applying fixed-effects (FE) regression, elimi-nating bias resulting from time-constant confounding and self-selection into different pathways. A multiple-sample strategy was used to account for the increasing diversity of STWTs patterns. Models were controlled for age, as well as household and residential changes to minimise temporal heterogeneity. Results: Findings indicate that leaving school was good for health and well-being. Compared with participants who did not find a training position after school, direct transitions to vocational training or university were linked to higher absolute levels of health and well-being, but also to a lower relative decline over time. Furthermore, upward transi-tions (e.g. to programs leading to better education or from unemployment to employment) were associated with improvements in health and well-being, while downward transitions were followed by deteriorations. Conclusion: Findings suggest that school-leave is a sensitive period and that post-secondary pathways provide young people with different abilities to maintain health and well-being. Youth health interventions might benefit when setting a stronger focus on unsuccessful school-leavers.}, language = {en} } @misc{DeindlDiehlSpalleketal., author = {Deindl, Christian and Diehl, Katharina and Spallek, Jacob and Richter, Matthias and Sch{\"u}ttig, Wiebke and Rattay, Petra and Dragano, Nico and Pischke, Claudia R.}, title = {Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status}, series = {Frontiers in Public Health}, volume = {11}, journal = {Frontiers in Public Health}, issn = {2296-2565}, doi = {10.3389/fpubh.2023.1075142}, abstract = {Health inequalities start early in life. The time of young adulthood, between late teens and early twenties, is especially interesting in this regard. This time of emerging adulthood, the transition from being a child to becoming an adult, is characterised by the detachment from parents and establishing of an own independent life. From a health inequality perspective, the question about the importance of the socio-economic background of parents is important. University students are an especially interesting group. Many students come from a privileged background and the question of health inequality among university students has not yet been properly studied. Based on the National Educational Panel Study (NEPS), we analysed health inequalities among 9,000 students in Germany ({\O} 20 years in the first year of their studies) over a period of eight years. We found that university students in Germany report a good and very good health. Yet, we still found substantial health inequalities. Students whose parents had a higher occupational status also reported less health problems. We were also able to tie health inequality on health behaviour, psychosocial resources, and material conditions.}, language = {en} } @misc{ReuterDiehlRichteretal., author = {Reuter, Marvin and Diehl, Katharina and Richter, Matthias and Sundmacher, Leonie and H{\"o}vener, Claudia and Spallek, Jacob and Dragano, Nico}, title = {A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes}, series = {Advances in Lifecourse Research}, volume = {Vol. 59}, journal = {Advances in Lifecourse Research}, issn = {1879-6974}, doi = {10.1016/j.alcr.2024.100593}, abstract = {Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.}, language = {en} } @misc{BammertSchuettigIashchenkoetal., author = {Bammert, Philip and Sch{\"u}ttig, Wiebke and Iashchenko, Iryna and Spallek, Jacob and Rattay, Petra and Schneider, Sven and Richter, Matthias and Pischke, Claudia R. and Dragano, Nico and Sundmacher, Leonie}, title = {The role of sociodemographic, psychosocial, and behavioral factors in the use of preventive healthcare services in children and adolescents: results of the KiGGS Wave 2 study}, series = {BMC Pediatrics}, volume = {24}, journal = {BMC Pediatrics}, issn = {1471-2431}, doi = {10.1186/s12887-024-04650-0}, abstract = {Background: In Germany, various preventive services are offered to children and adolescents. These include regular standardized examinations (so called U/J examinations) and several vaccinations. Although strongly recommended, most of them are not mandatory. Our aim is to identify factors associated with the use of U/J examinations and vaccination against diphtheria, hepatitis B, Hib, pertussis, polio, and tetanus. While previous research has focused on sociodemographic factors, we also include socioeconomic, behavioral, and psychosocial factors. Methods: We analyzed cross-sectional data from 15,023 participants (aged 0-17 years) of the nationwide representative KiGGS Wave 2 Survey. Participation in U/J examinations was assessed using a questionnaire, filled out by participants and/or their parents. Information on vaccination status was drawn from the participants' vaccination booklets. To identify relevant determinants for the use of preventive examinations and vaccinations, unadjusted and adjusted logistic regression models were employed with up to 16 different independent variables. Results: Various independent variables showed an association with the use of preventive services. Higher socioeconomic status, absence of migration background, and lower household size were associated with significantly higher utilization of U examinations. Parents' marital status, area of residence, behavioral and psychosocial factors yielded insignificant results for most U/J examinations. Higher vaccination rates were found for children with no migration background, with residence in eastern Germany, lower household size, and with married parents. Conclusion: This study attempted to depict the influence of sociodemographic, psychosocial, and behavioral factors on the use of several preventive services. Our results indicate that predominantly sociodemographic variables influence the use of preventive services. Further efforts should be made to investigate the interplay of different determinants of healthcare use in children and adolescents.}, language = {en} } @misc{HerkeReuterMayeretal., author = {Herke, Max and Reuter, Marvin and Mayer, A. and Spallek, Jacob and Rattay, Petra and Moor, Irene and Richter, Matthias}, title = {Wie wirkt sich die sozio{\"o}konomische Komposition der Schule auf Ungleichheiten im subjektiven Wohlbefinden von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland aus?}, series = {Gesundheitswesen}, volume = {84}, journal = {Gesundheitswesen}, number = {08/09}, publisher = {Georg Thieme Verlag}, doi = {10.1055/s-0042-1753867}, pages = {826}, abstract = {Einleitung Zielsetzung des Beitrags ist es, zu untersuchen, inwiefern die sozio{\"o}konomische Komposition von Schulen mit dem Wohlbefinden von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland assoziiert ist. Konkret wurden die Assoziationen der Bildung, des Einkommens und des beruflichen Status der Eltern auf Individualebene und aggregiert auf Schulebene sowie die Interaktionen zwischen diesen Ebenen auf das subjektive Wohlbefinden von Sch{\"u}lern der Sekundarstufe I untersucht. Methoden Es wurden Daten der Startkohorte „Klasse 5" des Nationalen Bildungspanels (NEPS) herangezogen. Die Kohorte startete 2010 mit einer repr{\"a}sentativen Stichprobe von F{\"u}nftkl{\"a}sslern in Deutschland, welche j{\"a}hrlich nachverfolgt wurden. Es wurden Erhebungswellen von der f{\"u}nften bis zur neunten Klasse zusammengefasst. Damit konnten 14.265 Beobachtungen mit vollst{\"a}ndigen Angaben von 3.977 Sch{\"u}lerinnen und Sch{\"u}lern in 218 Schulen in den Analysen ber{\"u}cksichtigt werden. Mit Mixed-Models wurde getestet, ob die sozio{\"o}konomische Position auf individueller und/oder schulischer Ebene und die ebenen{\"u}bergreifende Interaktion dieser Indikatoren mit dem Wohlbefinden (adaptierter Personal Well-Being - School Children-Index) der Jugendlichen assoziiert ist. Es wurde f{\"u}r Alter, Geschlecht, Migrationshintergrund, Familienform, Schultyp und Notendurchschnitt kontrolliert. Ergebnisse Auf individueller Ebene war das elterliche Einkommen mit h{\"o}herem Wohlbefinden verbunden. Der berufliche Status der Eltern zeigte keine signifikanten Assoziationen. Auf Schulebene fanden wir einen geringen, positiven Zusammenhang zwischen dem durchschnittlichen elterlichen Einkommen und dem individuellen Wohlbefinden, aber auch einen m{\"a}ßig negativen Einfluss eines hohen Anteils hoch gebildeter Eltern auf das Wohlbefinden. In Sensitivit{\"a}tsanalysen blieben diese Zusammenh{\"a}nge auch bei separater Betrachtung dieser Indikatoren bestehen. Die Zusammenh{\"a}nge auf Individualebene wurden nicht durch die sozio{\"o}konomische Komposition von Schulen moderiert, es konnten keine signifikanten ebenen{\"u}bergreifende Interaktionen festgestellt werden. Schlussfolgerung Es wurde ein Zusammenhang der sozio{\"o}konomischen Zusammensetzung der Schule mit dem subjektiven Wohlbefinden der Jugendlichen gefunden. Internationale Befunde einer Moderation der Zusammenh{\"a}nge auf individueller Ebene durch sozio{\"o}konomische Charakteristika auf Schulebene konnten jedoch nicht repliziert werden. Die Zusammenh{\"a}nge zwischen individueller SEP und Wohlbefinden variieren somit nicht in Abh{\"a}ngigkeit von der SEP auf Schulebene. Es zeigen sich vielmehr in Teilen additive Effekte f{\"u}r die individuelle und schulische SEP.}, language = {de} } @misc{ReuterPischkeRigoetal., author = {Reuter, Marvin and Pischke, Claudia R. and Rigo, Mariann and Diehl, Katharina and Spallek, Jacob and Richter, Matthias and H{\"o}vener, Claudia and Dragano, Nico}, title = {Health inequalities among young workers: the mediating role of working conditions and company characteristics}, series = {International Archives of Occupational and Environmental Health}, volume = {96}, journal = {International Archives of Occupational and Environmental Health}, number = {10}, issn = {1432-1246}, doi = {10.1007/s00420-023-02010-6}, pages = {1313 -- 1324}, abstract = {Objective Few studies have investigated health inequalities among young workers. The objectives of this study are to assess the extent of health inequalities in a sample of job starters and to explore the contribution of job demands and organisational factors. Methods We analyze data from the BIBB/BAuA Youth Employment Survey 2012. The cross-sectional survey includes a representative sample of 3214 German employees, apprentices, and trainees aged 15-24 years. Individuals were grouped by their years of schooling into low (< 12 years) and high levels of education (≥ 12 years). Regression analysis estimated the link between education and four health outcomes: self-rated health, number of health events, musculoskeletal symptoms, and mental health problems over the last 12 months. Counterfactual mediation analysis tested for indirect effects of education via working conditions (i.e., physical and psychosocial job demands) and company characteristics (i.e., company size, health prevention measures, financial situation, downsizing). All analyses were adjusted for age, sex, nationality, region, working hours, job tenure, employment relationship, and economic sector. Results Highly educated workers reported better self-rated health (b = 0.24, 95\% CI 0.18-0.31) and lower numbers of health events (Rate Ratio (RR) = 0.74, 95\% CI 0.67-0.82), musculoskeletal symptoms (RR = 0.73, 95\% CI 0.66-0.80) and mental health problems (RR = 0.84, 95\% CI 0.76-0.93). Total job demands explained between 21.6\% and 87.2\% of the educational differences (depending on health outcome). Unfavourable company characteristics were associated with worse health, but showed no or only small mediation effects. Conclusions Health inequalities are already present at the early working career due to socio-economically stratified working hazards. To enhance prevention measures that aim at reducing inequalities in workplace health, we propose shifting attention towards earlier stages of life.}, language = {en} } @misc{HoffmannSanderRattayetal., author = {Hoffmann, Stephanie and Sander, Lydia and Rattay, Petra and Blume, Miriam and H{\"o}vener, Claudia and Schneider, Sven and Richter, Matthias and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and De Bock, Freia and Spallek, Jacob}, title = {Do family characteristics contribute to a socioeconomic gradient in overweight in early childhood? - Single mediation analyses of data from German preschool children}, series = {Preventive Medicine Reports}, volume = {33}, journal = {Preventive Medicine Reports}, issn = {2211-3355}, doi = {10.1016/j.pmedr.2023.102178}, abstract = {Children's overweight is strongly associated with family socioeconomic position (SEP) and family characteristics (FC). There is limited research on the extent to which FC account for a socioeconomic gradient in childhood overweight. This study examined whether FC explain SEP differences in the prevalence of overweight. The study used baseline data of preschool-aged children from the German 'PReschool INtervention Study'. The sample (n = 872, 48\% girls) was recruited at kindergartens in Baden-W{\"u}rttemberg, Germany. Data included children's measured weight status and parents' reports on socioeconomic indicators (e.g., school education, vocational education, income) and FC. Variables represent main determinants of overweight (nutrition: sweets consumption in front of TV, soft drink consumption, regular breakfast, child sets table; physical activity: outdoor sports; parental role model). In single mediation analyses indirect effects of SEP on overweight were analysed (OR[95\%CI]). Preschool girls and boys with low parental education had higher odds for overweight than children with high parental education. Among boys, low levels of parental education contributed to the odds of overweight via indirect effects by both factors 'sweets consumption in front of TV' (OR = 1.31[1.05-1.59]) and 'no sports' (OR = 1.14[1.01-1.38]). Among girls, FC measured did not explain SEP differences in overweight. Family nutrition and parental/family physical activity contribute to inequalities in overweight among preschool boys, but not girls. Research is needed to identify FC that explain inequalities in overweight for both.}, language = {en} }