@misc{LudwigDoyleLoeffleretal., author = {Ludwig, Angelique and Doyle, Ina-Merle and L{\"o}ffler, Antje and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver and Miani, Celine}, title = {The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany}, series = {Midwifery}, volume = {86}, journal = {Midwifery}, issn = {1532-3099}, doi = {10.1016/j.midw.2020.102688}, abstract = {Breastfeeding is beneficial for both mother and child. A breastfed child can benefit from improved mental developments, protection against infectious diseases and infectious disease mortality, and a decreased risk of overweight and obesity (Whalen and Cramton 2010)(Regional Office for Europe (World Health Organisation) 2019). Furthermore, there is evidence on protection against type 1 and 2 diabetes, allergic rhinitis, asthma or wheezing, atopic dermatitis, childhood leukemia, hypercholesterolemia later in life, sudden infant death syndrome (Whalen and Cramton 2010) and malocclusion (Victora et al. 2016). Breastfeeding women have a lower risk of breast and ovarian cancer, postpartum depression, and type 2 diabetes. They can, furthermore, benefit from prolonged lactational amenorrhea (Victora et al. 2016), improved postpartum sleep (Whalen and Cramton 2010) and postpartum weight loss (Kramer and Kakuma 2012).}, language = {en} } @misc{WandschneiderSauzetBreckenkampetal., author = {Wandschneider, Lisa and Sauzet, Odile and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver}, title = {Small-Area Factors and Their Impact on Low Birth Weight—Results of a Birth Cohort Study in Bielefeld, Germany}, series = {Frontiers in Public Health}, volume = {8}, journal = {Frontiers in Public Health}, issn = {2296-2565}, doi = {10.3389/fpubh.2020.00136}, pages = {10}, abstract = {Introduction: The location of residence is a factor possibly contributing to social inequalities and emerging evidence indicates that it already affects perinatal development. The underlying pathways remain unknown; theory-based and hypothesis-driven analyses are lacking. To address these challenges, we aim to establish to what extent small-area characteristics contribute to low birth weight (LBW), independently of individual characteristics. First, we select small-area characteristics based on a conceptual model and measure them. Then, we empirically analyse the impact of these characteristics on LBW. Material and methods: Individual data were provided by the birth cohort study "Health of infants and children in Bielefeld/Germany." The sample consists of 892 eligible women and their infants distributed over 80 statistical districts in Bielefeld. Small-area data were obtained from local noise maps, emission inventory, Google Street View and civil registries. A linear multilevel analysis with a two-level structure (individuals nested within statistical districts) was conducted. Results: The effects of the selected small-area characteristics on LBW are small to non-existent, no significant effects are detected. The differences in proportion of LBW based on marginal effects are small, ranging from zero to 1.1\%. Newborns from less aesthetic and subjectively perceived unsafe neighbourhoods tend to have higher proportions of LBW. Discussion: We could not find evidence for negative effects of small-area factors on LBW, but our study confirms that obtaining adequate sample size, reliable measure of exposure and using available data for operationalisation of the small-area context represent the core challenges in this field of research.}, language = {en} } @misc{KaucherKhilKajueteretal., author = {Kaucher, Simone and Khil, Laura and Kaj{\"u}ter, Hiltraud and Becher, Heiko and Reder, Maren and Kolip, Petra and Spallek, Jacob and Winkler, Volker and Berens, Eva-Maria}, title = {Breast cancer incidence and mammography screening among resettlers in Germany}, series = {BMC public health}, volume = {20}, journal = {BMC public health}, number = {1}, doi = {10.1186/s12889-020-08534-7}, pages = {10}, abstract = {Background - European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. Methods - Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. Results - Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95\% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. Conclusions - MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.}, language = {en} } @techreport{HoffmannWachtlerSanderetal., author = {Hoffmann, Stephanie and Wachtler, Benjamin and Sander, Lydia and Blume, Miriam and Hilger-Kolb, Jennifer and Herke, Max and Matos Fialho, Paula Mayara and Pischke, Claudia R. and Novelli, Anna and Lampert, Thomas and Spallek, Jacob}, title = {Health inequalities among infants and pre-school children: Protocol for a scoping review examining the moderating and mediating role of contextual and compositional family characteristics}, publisher = {Open Science Framework}, doi = {10.17605/OSF.IO/3U4ST}, abstract = {Background: Although early childhood is a life period of overall good health, research shows that families' socioeconomic position (SEP) is affecting children's health from pregnancy on, ultimately leading to health inequalities. Little is currently known about the pathways by which family SEP is influencing child health and health-related behaviour, and which role family characteristics play. The scoping review therefore aims to screen the international literature on the mediating and moderating effects of contextual and compositional family characteristics on socioeconomic health risks of pre-school children in developed countries. Methods: Following the PRISMA guidelines for scoping reviews, three online databases (Pubmed, PsycINFO, and Scopus) will be searched for literature in English or German published after year 2000. The two-step data screening approach and the subsequent data extraction will be conducted independently by two researchers in consideration of specific criteria and a previously tested standardized data extraction form. Due to the broad research question at hand, various study designs (e.g. cross-sectional, intervention, cohort studies, and qualitative studies), SEP measures (e.g. education, income) and compositional (e.g. family size, migration) or contextual (e.g. parenting, housing) family characteristics influencing children's health will be included. Since diverse definitions and reporting formats of subjective health, health behaviour, well-being, and diseases will be considered, a substantial heterogeneity in outcome measures focusing on the age group of 0-6 years is expected. Thus, a narrative synthesis of the findings will be performed according to the Centre for Reviews and Dissemination framework. Ethics and dissemination: Because no primary data will be collected, ethical clearance will not be required. Dissemination will include peer-reviewed publications and conferences.}, language = {en} } @misc{LudwigMianiBreckenkampetal., author = {Ludwig, Angelique and Miani, C{\´e}line and Breckenkamp, J{\"u}rgen and Sauzet, Odile and Borde, Theda and Doyle, Ina-Merle and Brenne, Silke and H{\"o}ller-Holtrichter, Chantal and David, Matthias and Spallek, Jacob and Razum, Oliver}, title = {Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies}, series = {Maternal and Child Health Journal}, volume = {24}, journal = {Maternal and Child Health Journal}, number = {7}, issn = {1573-6628}, doi = {10.1007/s10995-020-02937-z}, pages = {943 -- 952}, abstract = {Objective: Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of non-medical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. Methods: Baseline data of the Bielefeld BaBi birth cohort (2013-2016) and the Berlin perinatal study (2011-2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status.ResultsIn Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. Conclusions for Practice: Our study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups.}, language = {en} } @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} } @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{BreckenkampRazumSpalleketal., author = {Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob and Berger, Klaus and Chaix, Basile and Sauzet, Odile}, title = {A method to define the relevant ego-centred spatial scale for the assessment of neighbourhood effects: the example of cardiovascular risk factors}, series = {BMC Public Health}, volume = {21}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-021-11356-w}, pages = {7}, abstract = {Introduction: The neighbourhood in which one lives affects health through complex pathways not yet fully understood. A way to move forward in assessing these pathways direction is to explore the spatial structure of health phenomena to generate hypotheses and examine whether the neighbourhood characteristics are able to explain this spatial structure. We compare the spatial structure of two cardiovascular disease risk factors in three European urban areas, thus assessing if a non-measured neighbourhood effect or spatial processes is present by either modelling the correlation structure at individual level or by estimating the intra-class correlation within administrative units. Methods: Data from three independent studies (RECORD, DHS and BaBi), covering each a European urban area, are used. The characteristics of the spatial correlation structure of cardiovascular risk factors (BMI and systolic blood pressure) adjusted for age, sex, educational attainment and income are estimated by fitting an exponential model to the semi-variogram based on the geo-coordinates of places of residence. For comparison purposes, a random effect model is also fitted to estimate the intra-class correlation within administrative units. We then discuss the benefits of modelling the correlation structure to evaluate the presence of unmeasured spatial effects on health. Results: BMI and blood pressure are consistently found to be spatially structured across the studies, the spatial correlation structures being stronger for BMI. Eight to 22\% of the variability in BMI were spatially structured with radii ranging from 100 to 240 m (range). Only a small part of the correlation of residuals was explained by adjusting for the correlation within administrative units (from 0 to 4 percentage points). Discussion: The individual spatial correlation approach provides much stronger evidence of spatial effects than the multilevel approach even for small administrative units. Spatial correlation structure offers new possibilities to assess the relevant spatial scale for health. Stronger correlation structure seen for BMI may be due to neighbourhood socioeconomic conditions and processes like social norms at work in the immediate neighbourhood.}, language = {en} } @misc{HoffmannSchiebelHufertetal., author = {Hoffmann, Stephanie and Schiebel, Juliane and Hufert, Frank and Gremmels, Heinz-Detlef and Spallek, Jacob}, title = {COVID-19 among Healthcare Workers: A Prospective Serological-Epidemiological Cohort Study in a Standard Care Hospital in Rural Germany}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {20}, issn = {1660-4601}, doi = {10.3390/ijerph182010999}, pages = {8}, abstract = {Healthcare workers (HCW) play a vital role in the SARS-CoV-2 pandemic control. The aim of this study was to assess the prevalence of SARS-CoV-2 antibodies and the risk of COVID-19 infections in a cohort of HCW from four different risk groups (from intensive care unit to administration) of a hospital of a primary care level in rural Germany. The outcomes were monthly measures of antibody seroprevalence over a period of 6 months. Overall, a seroprevalence of 13.41\% was determined, with significantly higher prevalence rates among HCW working in areas with more frequent contact to confirmed or suspected cases (30.30\%, p = 0.003). The group specific differences in the risk of infection from COVID-19 were detected, as HCW groups with frequent exposure seemed to have an increased risk (RR = 3.18, p = 0.02; CI95 1.09-9.24). The findings contribute to the epidemiological understanding of the virus spread in an unvaccinated population group, which is highly relevant for the pandemic management.}, language = {en} } @misc{ScholzSchimboeckSpallek, author = {Scholz, Lisa and Schimb{\"o}ck, Florian and Spallek, Jacob}, title = {Community Child Health Nursing: Ein Konzept f{\"u}r Deutschland?}, series = {Public Health Forum}, volume = {29}, journal = {Public Health Forum}, number = {3}, doi = {10.1515/pubhef-2021-0063}, pages = {209 -- 212}, abstract = {Soziale Ungleichheit f{\"u}hrt bereits im Kindesalter zu gesundheitlicher Benachteiligung. Gesundheitsf{\"o}rdernde Angebote in Deutschland sind noch unzureichend miteinander verkn{\"u}pft und erreichen sozialbenachteiligte Familien nur bedingt. International ist Community Child Health Nursing (CCHN) verbreitet und bietet einen m{\"o}glichen Ansatz, um die gesundheitliche Chancengleichheit von Kindern zu st{\"a}rken. Dieser Beitrag diskutiert das Berufsbild der CCH-Nurses und konzeptionelle Aspekte f{\"u}r die Implementierung in Deutschland.}, language = {de} } @misc{MianiLudwigDoyleetal., author = {Miani, C{\´e}line and Ludwig, Angelique and Doyle, Ina-Merle and Breckenkamp, J{\"u}rgen and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: Results from a German birth cohort study}, series = {Public Health Nutrition}, journal = {Public Health Nutrition}, issn = {1475-2727}, doi = {10.1017/S1368980021003621}, pages = {1 -- 24}, abstract = {Objective: Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socioeconomic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors. Design: We used data (2013-2016) on nutrition and socioeconomic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses. Setting: Bielefeld, Germany. Participants: 947 women (pregnant or who had given birth in the past two months). Results: 16.7\% of the participants (158/947) didn't use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS. Conclusions: Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focussed on family planning.}, language = {en} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Othering in public health using the example of Covid-19 management in German asylum camps}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Issue Supplement_3}, doi = {10.1093/eurpub/ckab164.795}, pages = {2}, abstract = {Issue/problem In 2020, several German reception centers and asylum camps were imposed mass quarantine after single residents had been infected with SARS-CoV-2. Civil and research networks criticized this measure, as crowded housing conditions limited the implementation of infection protection measures, and mass quarantine further increased the risk of infection. This raised the question why public health (PH) measures in these settings differed from those implemented in the general population, and which implications for future PH approaches can be identified. Problem description Considering the epidemiological evidence and ethical perspectives on the PH strategies described above, we applied the concepts of "Exclusionary Othering" and "Inclusionary Othering" to PH. We further discussed the Covid-19 management in German reception centers and asylum camps. Results We identified three conceptual approaches: 1) exclusionary, 2) inclusionary, and 3) diversity-sensitive approaches to PH. Exclusionary PH is characterized by an exclusion of less powerful groups despite negative health consequences. Inclusive approaches seek to empower less powerful groups in order to understand each other's needs, build cooperations, protect everyone and to prevent the development of "hot spots". Diversity-sensitive PH approaches avoid othering and seek to implement measures for everyone, taking into account diverse needs, conditions, and resources. Lessons We propose a paradigm shift towards inclusionary and diversity-sensitive PH that benefits the entire population, including those forced to flee other countries. This requires a critical reflection of power dynamics and discrimination. The proposed concepts can be transferred to other social groups, regions, and areas of PH. Key messages Public health needs to shift its perspective from exclusion and subordination to inclusion and involvement. Inclusionary and diversity-sensitive PH approaches promote health equity.}, language = {en} } @misc{HoffmannSanderBlumeetal., author = {Hoffmann, Stephanie and Sander, Lydia and Blume, Miriam and Schneider, Sven and Herke, Max and Matos Fialho, Paula Mayara and Pischke, Claudia R. and Sch{\"u}ttig, Wiebke and Lampert, Thomas and Spallek, Jacob}, title = {Do families have moderating or mediating effects on early health inequalities? A scoping review}, series = {European Journal of Public Health}, volume = {31}, journal = {European Journal of Public Health}, number = {Supplement_3}, publisher = {Oxford University Press}, doi = {10.1093/eurpub/ckab165.506}, abstract = {Background During early childhood, families have a crucial impact on children's health behaviour, health, and development (bhd). However, a family's socioeconomic position (SEP) determines both the parental behaviour, living conditions, and child health. To understand how family characteristics may influence the development of health inequalities, this scoping review synthesised research on their mediating and moderating effects. Methods The review followed the guidelines of the PRISMA Extension for Scoping Reviews. The search included German and English peer-reviewed articles published between January 1st, 2000 and December 19th, 2019. The search in PubMed, PsycINFO, and Scopus used both free text terms in the title/abstract and index terms within linked keyword blocks: (1) family characteristics, (2) inequalities, (3) income, education, occupation, (4) bhd, (5) newborn, infant, toddler, preschooler. Two researchers independently examined eligibility for inclusion in two rounds (title/abstract; full-text). Results Of 7,089 articles identified, ten sources were included that studied family characteristics and health inequalities among 0-6 years olds. Parental rules, stress, and screentime, and TV in bedroom showed mediating effects on inequalities in behaviour problems or children's screentime. Families' negativity, single parenthood, and the number of children in the household moderated differences in impairment, health, behaviour problems, development or breastfeeding initiation. Conclusions The effect of family characteristics on early health inequalities has been sparsely investigated. The evidence supported models of family stress and investment. Further research is needed to comprehensively understand this association. Key messages Family characteristics contribute to health inequalities. Taking families' stress and investment into account could improve targeted prevention efforts aimed at reducing health inequalities.}, language = {en} } @incollection{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Gesundheitliche Situation von Migranten in Deutschland}, series = {Migration \& Gesundheit : Das Wichtigste f{\"u}r {\"A}rztinnen und {\"A}rzte aller Fachrichtungen}, booktitle = {Migration \& Gesundheit : Das Wichtigste f{\"u}r {\"A}rztinnen und {\"A}rzte aller Fachrichtungen}, editor = {Sieberer, Marcel and Jung, Petra and F{\"u}hrmann, Fabienne}, edition = {1}, publisher = {Urban \& Fischer Verlag/Elsevier GmbH}, address = {M{\"u}nchen, Jena}, isbn = {9783437235108}, abstract = {Kernaussagen - Menschen mit Migrationshintergrund sind nicht per se kr{\"a}nker oder ges{\"u}nder als die Bev{\"o}lkerung ohne Migrationshintergrund. Expositionen vor, w{\"a}hrend und nach der Migration k{\"o}nnen aber unterschiedliche Gesundheitsressourcen und Krankheitsrisiken mit sich bringen. - {\"U}ber das Merkmal „Migrationshintergrund" hinaus variiert eine Vielzahl an Krankheitsrisiken abh{\"a}ngig vom sozio{\"o}konomischen Status (SES), dem Alter, Geschlecht und der Aufenthaltsdauer im Zielland. - Bei 11 bis 17-j{\"a}hrigen Kindern und Jugendlichen mit und ohne Migrationshintergrund bestehen kaum Unterschiede in der Selbsteinsch{\"a}tzung der k{\"o}rperlichen Gesundheit. - Erwachsene mit Migrationshintergrund aus spezifischen Herkunftsl{\"a}ndern weisen statistisch ein geringeres Risiko f{\"u}r b{\"o}sartige Neubildungen wie Brust-, Haut- oder Lungenkrebs sowie f{\"u}r Herz-Kreislauf-Erkrankungen auf. Erh{\"o}hte Risiken bestehen f{\"u}r Arbeitsunf{\"a}lle, psychsiche Erkrankungen sowie in einzelnen Sub-Gruppen f{\"u}r Infektionskrankheiten wie Tuberkulose, Hepatitis und HIV. - Ausl{\"a}ndische S{\"a}uglinge, Kinder und Jugendliche in Deutschland weisen eine h{\"o}here Mortalit{\"a}tsrate auf als deutsche Gleichaltrige. Zugewanderte Menschen im Alter von 20 bis 60 Jahren haben eine geringere, im Alter von 65 bis 69 Jahren eine h{\"o}here Mortalit{\"a}tsrate als die nicht-migrierte Bev{\"o}lkerung. - Die Sterblichkeit ausl{\"a}ndischer Personen gleicht sich mit zunehmender Aufenthaltsdauer in Deutschland an das Mortalit{\"a}tsmuster der einheimischen Bev{\"o}lkerung an.}, language = {de} } @incollection{SpallekSchumannReeskeBehrens, author = {Spallek, Jacob and Schumann, Maria and Reeske-Behrens, Anna}, title = {Migration und Gesundheit - Gestaltungsm{\"o}glichkeiten von Gesundheitsversorgung und Public Health in diversen Gesellschaften}, series = {Gesundheitswissenschaften}, booktitle = {Gesundheitswissenschaften}, editor = {Haring, Robin}, edition = {2. Auflage}, publisher = {Springer}, address = {Berlin, Heidelberg}, isbn = {978-3-662-54179-1}, issn = {2662-6942}, doi = {10.1007/978-3-662-54179-1_49-2}, abstract = {Der Zusammenhang zwischen Migration und Gesundheit ist vielschichtig. In aktuellen Erkl{\"a}rungsmodellen werden verschiedene Determinanten und Dimensionen angef{\"u}hrt, die {\"u}ber den Lebenslauf von Migranten zu gesundheitlichen Vor- und Nachteilen f{\"u}hren k{\"o}nnen. Gesundheitsversorgung und Public Health in einem Einwanderungsland wie Deutschland m{\"u}ssen diese gesundheitlichen Unterschiede beachten und - neben den bei besonderen Risikokonstellationen notwendigen gezielten Maßnahmen f{\"u}r Migranten - sich insgesamt so ausrichten, dass sie der Diversit{\"a}t der Bev{\"o}lkerung gerecht werden. Besondere Chancen bieten dabei Ans{\"a}tze, die im Rahmen von integrierten kommunalen Strategien zur Gesundheitsf{\"o}rderung die Bedarfe der Menschen in ihren Lebenswelten aufgreifen.}, language = {de} } @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{HoffmannSanderWachtleretal., author = {Hoffmann, Stephanie and Sander, Lydia and Wachtler, Benjamin and Blume, Miriam and Schneider, Sven and Herke, Max and Pischke, Claudia R. and Matos Fialho, Paula Mayara and Schuettig, Wiebke and Tallarek, Marie and Lampert, Thomas and Spallek, Jacob}, title = {Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high‑income countries - a scoping review}, series = {BMC Public Health}, volume = {22}, journal = {BMC Public Health}, issn = {1471-2458}, doi = {10.1186/s12889-022-12603-4}, pages = {1 -- 14}, abstract = {Background: By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children's health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. Methods: This review followed the methodology of "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator "AND": (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. Results: The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent-child conflicts) are identified to have mediating or moderating effects. While families' living conditions (i.e., TVs in children's bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. Conclusion: Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children's health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.}, language = {en} } @misc{HoffmannTschornMichalskietal., author = {Hoffmann, Stephanie and Tschorn, Mira and Michalski, Niels and Hoebel, Jens and F{\"o}rstner, Bernd R. and Rapp, Michael A. and Spallek, Jacob}, title = {Association of regional socioeconomic deprivation and rurality with global developmental delay in early childhood: Data from mandatory school entry examinations in Germany}, series = {Health \& Place}, volume = {75}, journal = {Health \& Place}, issn = {1353-8292}, doi = {10.1016/j.healthplace.2022.102794}, pages = {8}, abstract = {Background From birth to young adulthood, health and development of young people are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living environment. The impact of regional characteristics on development in early childhood beyond family SEP has been rarely investigated. This study aimed to identify regional predictors of global developmental delay at school entry taking family SEP into consideration. Method We used representative, population-based data from mandatory school entry examinations of the German federal state of Brandenburg in 2018/2019 with n=22,801 preschool children. By applying binary multilevel models, we hierarchically analyzed the effect of regional deprivation defined by the German Index of Socioeconomic Deprivation (GISD) and rurality operationalized as inverted population density of the children's school district on global developmental delay (GDD) while adjusting for family SEP (low, medium and high). Results Family SEP was significantly and strongly linked to GDD. Children with the highest family SEP showed a lower odds for GDD compared to a medium SEP (female: OR=4.26, male: OR=3.46) and low SEP (female: OR=16.58, male: OR=12.79). Furthermore, we discovered a smaller, but additional and independent effect of regional socioeconomic deprivation on GDD, with a higher odds for children from a more deprived school district (female: OR=1.35, male: OR=1.20). However, rurality did not show a significant link to GDD in preschool children beyond family SEP and regional deprivation. Conclusion Family SEP and regional deprivation are risk factors for child development and of particular interest to promote health of children in early childhood and over the life course.}, language = {en} } @misc{RattayBlumeWachtleretal., author = {Rattay, Petra and Blume, Miriam and Wachtler, Benjamin and Wollgast, Lina and Spallek, Jacob and Hoffmann, Stephanie and Sander, Lydia and Herr, Raphael and Herke, Max and Reuter, Marvin and Novelli, Anna and H{\"o}vener, Claudia}, title = {Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study}, series = {PloS one}, volume = {17}, journal = {PloS one}, number = {4}, issn = {1932-6203}, doi = {10.1371/journal.pone.0266463}, abstract = {Objective Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family's socioeconomic position and adolescents' self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants. Methods Using data from wave 2 of the"German Health Interview and Examination Survey for Children and Adolescents" (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents' subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70\% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained. Conclusion The analysis revealed how a family's position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).}, language = {en} } @misc{TschornSchulzeFoerstneretal., author = {Tschorn, Mira and Schulze, Susanne and F{\"o}rstner, Bernd R. and Holmberg, Christine and Spallek, Jacob and Heinz, Andreas and Rapp, Michael A.}, title = {Predictors and prevalence of hazardous alcohol use in middle-late to late adulthood in Europe}, series = {Aging \& Mental Health}, volume = {27 (2023)}, journal = {Aging \& Mental Health}, number = {5}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2076208}, pages = {1001 -- 1010}, abstract = {Objectives: Even low to moderate levels of alcohol consumption can have detrimental health consequences, especially in older adults (OA). Although many studies report an increase in the proportion of drinkers among OA, there are regional variations. Therefore, we examined alcohol consumption and the prevalence of hazardous alcohol use (HAU) among men and women aged 50+ years in four European regions and investigated predictors of HAU. Methods: We analyzed data of N = 35,042 participants of the European SHARE study. We investigated differences in alcohol consumption (units last week) according to gender, age and EU-region using ANOVAs. Furthermore, logistic regression models were used to examine the effect of income, education, marital status, history of a low-quality parent-child relationship and smoking on HAU, also stratified for gender and EU-region. HAU was operationalized as binge drinking or risky drinking (<12.5 units of 10 ml alcohol/week). Results: Overall, past week alcohol consumption was 5.0 units (±7.8), prevalence of HAU was 25.4\% within our sample of European adults aged 50+ years. Male gender, younger age and living in Western Europe were linked to both higher alcohol consumption and higher risks of HAU. Income, education, smoking, a low-quality parent-child relationship, living in Northern and especially Eastern Europe were positively associated with HAU. Stratified analyses revealed differences by region and gender. Conclusions: HAU was highly prevalent within this European sample of OA. Alcohol consumption and determinants of HAU differed between EU-regions, hinting to a necessity of risk-stratified population-level strategies to prevent HAU and subsequent alcohol use disorders.}, language = {en} } @misc{JaehnSaskoHolmbergetal., author = {Jaehn, Philipp and Sasko, Benjamin and Holmberg, Christine and Hoffmann, Stephanie and Spallek, Jacob and Kelesidis, Theodoros and Rapp, Michael A. and Westhoff, Timm H. and Ritter, Oliver and Pagonas, Nikolaos}, title = {Levels of high-density lipoprotein lipid peroxidation according to spatial socioeconomic deprivation and rurality among patients with coronary artery disease}, series = {European Journal of Preventive Cardiology}, volume = {29}, journal = {European Journal of Preventive Cardiology}, number = {15}, issn = {2047-4873}, doi = {10.1093/eurjpc/zwac068}, pages = {e343 -- e346}, abstract = {Atherosclerotic coronary artery disease (CAD) is the leading cause of mortality worldwide.1 In this context, the burden of CAD shows considerable regional heterogeneity at the national level. For example, age-standardized mortality rates varied between 106 and 178 deaths per 100 000 at the level of German federal states in 2019.2 The regional heterogeneity of cardiovascular mortality suggests that the residential environment should be considered as an important determinant for successful secondary prevention. Environmental features that were frequently drawn upon to explain regional inequalities of cardiovascular outcomes are spatial socioeconomic deprivation (SSD) and rurality.3 Rurality may impact cardiovascular health due to impaired access to healthcare services. Socioeconomically deprived neighbourhoods, on the other hand, exhibit restricted opportunities to eat healthy, exercise regularly, utilize health care, and avoid environmental hazards such as air pollution.}, language = {en} } @misc{KielWeckmannChenotetal., author = {Kiel, Simone and Weckmann, Gesine and Chenot, Jean-Fran{\c{c}}ois and Stracke, Sylvia and Spallek, Jacob and Angelow, Aniela}, title = {Referral criteria for chronic kidney disease: implications for disease management and healthcare expenditure—analysis of a population-based sample}, series = {BMC Nephrology}, volume = {23}, journal = {BMC Nephrology}, issn = {1471-2369}, doi = {10.1186/s12882-022-02845-0}, pages = {1 -- 11}, abstract = {Background: Clinical practice guidelines recommend specialist referral according to different criteria. The aim was to assess recommended and observed referral rate and health care expenditure according to recommendations from: • Kidney Disease Improving Global Outcomes (KDIGO,2012) • National Institute for Health and Care Excellence (NICE,2014) • German Society of Nephrology/German Society of Internal Medicine (DGfN/DGIM,2015) • German College of General Practitioners and Family Physicians (DEGAM,2019) • Kidney failure risk equation (NICE,2021) Methods: Data of the population-based cohort Study of Health in Pomerania were matched with claims data. Proportion of subjects meeting referral criteria and corresponding health care expenditures were calculated and projected to the population of Mecklenburg-Vorpommern. Results: Data from 1927 subjects were analysed. Overall proportion of subjects meeting referral criteria ranged from 4.9\% (DEGAM) to 8.3\% (DGfN/DGIM). The majority of patients eligible for referral were ≥ 60 years. In subjects older than 60 years, differences were even more pronounced, and rates ranged from 9.7\% (DEGAM) to 16.5\% (DGfN/DGIM). Estimated population level costs varied between €1,432,440 (DEGAM) and €2,386,186 (DGfN/DGIM). From 190 patients with eGFR < 60 ml/min, 15 had a risk of end stage renal disease > 5\% within the next 5 years. Conclusions: Applying different referral criteria results in different referral rates and costs. Referral rates exceed actually observed consultation rates. Criteria need to be evaluated in terms of available workforce, resources and regarding over- and underutilization of nephrology services.}, language = {en} } @incollection{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Die gesundheitliche Situation von eingewanderten Menschen in Deutschland}, series = {Migration \& Gesundheit}, booktitle = {Migration \& Gesundheit}, editor = {Sieberer, Marcel and Jung, Petra and F{\"u}hrmann, Fabienne}, edition = {1}, publisher = {Urban \& Fischer}, address = {M{\"u}nchen}, doi = {10.1016/B978-3-437-23510-8.00007-0}, pages = {31 -- 36}, abstract = {Kernaussagen: - Menschen mit Migrationshintergrund sind nicht per se kr{\"a}nker oder ges{\"u}nder als die Bev{\"o}lkerung ohne Migrationshintergrund. Expositionen vor, w{\"a}hrend und nach der Migration k{\"o}nnen aber unterschiedliche Gesundheitsressourcen und Krankheitsrisiken mit sich bringen. - {\"U}ber das Merkmal „Migrationshintergrund" hinaus variiert eine Vielzahl an Krankheitsrisiken abh{\"a}ngig vom sozio{\"o}konomischen Status (SES), dem Alter, Geschlecht und der Aufenthaltsdauer im Zielland. - Bei 11 bis 17-j{\"a}hrigen Kindern und Jugendlichen mit und ohne Migrationshintergrund bestehen kaum Unterschiede in der Selbsteinsch{\"a}tzung der k{\"o}rperlichen Gesundheit. - Erwachsene mit Migrationshintergrund aus spezifischen Herkunftsl{\"a}ndern weisen statistisch ein geringeres Risiko f{\"u}r b{\"o}sartige Neubildungen wie Brust-, Haut- oder Lungenkrebs sowie f{\"u}r Herz-Kreislauf-Erkrankungen auf. Erh{\"o}hte Risiken bestehen f{\"u}r Arbeitsunf{\"a}lle, psychsiche Erkrankungen sowie in einzelnen Sub-Gruppen f{\"u}r Infektionskrankheiten wie Tuberkulose, Hepatitis und HIV. - Ausl{\"a}ndische S{\"a}uglinge, Kinder und Jugendliche in Deutschland weisen eine h{\"o}here Mortalit{\"a}tsrate auf als deutsche Gleichaltrige. Zugewanderte Menschen im Alter von 20 bis 60 Jahren haben eine geringere, im Alter von 65 bis 69 Jahren eine h{\"o}here Mortalit{\"a}tsrate als die nicht-migrierte Bev{\"o}lkerung. - Die Sterblichkeit ausl{\"a}ndischer Personen gleicht sich mit zunehmender Aufenthaltsdauer in Deutschland an das Mortalit{\"a}tsmuster der einheimischen Bev{\"o}lkerung an.}, language = {de} } @misc{SchulzeMerzThieretal., author = {Schulze, Susanne and Merz, Sibille and Thier, Anne and Tallarek, Marie and K{\"o}nig, Franziska and Uhlenbrock, Greta and N{\"u}bling, Matthias and Lincke, Hans-Joachim and Rapp, Michael A. and Spallek, Jacob and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data}, series = {BMC health services research}, volume = {22}, journal = {BMC health services research}, issn = {1472-6963}, doi = {10.1186/s12913-022-08333-3}, pages = {1 -- 13}, abstract = {Background: The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods: We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions: Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.}, language = {en} } @misc{WandschneiderBatramZantvoortAlazeetal., author = {Wandschneider, Lisa and Batram-Zantvoort, Stephanie and Alaze, Anita and Niehues, Vera and Spallek, Jacob and Razum, Oliver and Miani, C{\´e}line}, title = {Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study}, series = {Women's Health}, volume = {18}, journal = {Women's Health}, issn = {1617-8041}, doi = {10.1177/17455057221114274}, pages = {1 -- 17}, abstract = {Objectives: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave. Methods: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April-May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being. Results: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood. Discussion: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it.}, language = {en} } @misc{TallarekSpallek, author = {Tallarek, Marie and Spallek, Jacob}, title = {Die Selbstbestimmung Geb{\"a}render: F{\"o}rderliche und begrenzende Faktoren aus der Perspektive von Hebammen in Krankenh{\"a}usern, Geburtsh{\"a}usern und bei Hausgeburten}, series = {21. Deutscher Kongress f{\"u}r Versorgungsforschung : 05.10.-07.10.2022, Potsdam}, journal = {21. Deutscher Kongress f{\"u}r Versorgungsforschung : 05.10.-07.10.2022, Potsdam}, publisher = {Deutsches Netzwerk Versorgungsforschung e.V.}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkvf321}, abstract = {Hintergrund und Stand (inter)nationaler Forschung: Die Forderung nach einer selbstbestimmten Geburt ist in Deutschland und weltweit in den fachlichen und {\"o}ffentlichen Fokus ger{\"u}ckt. Allerdings liegen bisher wenige Forschungsergebnisse zur Selbstbestimmung Geb{\"a}render und ihrer f{\"o}rderlichen und begrenzenden Bedingungen vor. Diese Erkenntnisse sind jedoch essentiell, um Selbstbestimmung gezielt unterst{\"u}tzen und ihre Verletzung vermeiden zu k{\"o}nnen. Fragestellung und Zielsetzung: Die Studie untersucht und vergleicht die Erfahrungen und Perspektiven von Hebammen in Bezug auf f{\"o}rderliche und begrenzende Faktoren einer selbstbestimmten Geburt in Krankenh{\"a}usern, Geburtsh{\"a}usern und bei Hausgeburten in Deutschland. Methode: Es wurde eine qualitative Fallstudie auf der Basis von zehn problemzentrierten Einzelinterviews mit Hebammen durchgef{\"u}hrt. Eingeschlossen wurden Hebammen mit laufender oder abgeschlossener Ausbildung, deren letzte begleitete Geburt nicht l{\"a}nger als sechs Monate zur{\"u}cklag. Die Sampling-Strategie erlaubte die Ber{\"u}cksichtigung unterschiedlicher Geburtshilfe-Settings und Regionen in Deutschland. Alle Interviews wurden aufgezeichnet, transkribiert, anonymisiert und mittels der Thematischen Analyse ausgewertet. Ein positives Ethik-Votum liegt vor. Ergebnisse: Die Ergebnisse legen acht zusammenh{\"a}ngende Kategorien nahe, die jeweils f{\"o}rdernde und begrenzende Faktoren implizieren: 1. Strukturelle/rechtliche Bedingungen auf Meso-/Makroebene; 2. Wahrnehmung von Geburt (z.B. als medizinischer/nat{\"u}rlicher Vorgang, notwendige Kompetenz und Kontrolle); 3. Vertrauen/Atmosph{\"a}re; 4. Kennenlernen/ Beziehungsaufbau mit Geb{\"a}renden; 5. Sozio{\"o}konomische Position (SEP) der Geb{\"a}renden; 6. Information der Geb{\"a}renden; 7. Entscheidungs- und Artikulationsf{\"a}higkeit der Geb{\"a}renden und 8. Verhalten der Begleitpersonen. Zudem wurden Strategien der Hebammen zur Erweiterung des Handlungsspielraums identifiziert. Mehrere Faktoren unterscheiden sich abh{\"a}ngig vom Geburtssetting. Diskussion: Die M{\"o}glichkeiten f{\"u}r eine selbstbestimmte Geburt k{\"o}nnen sich je nach Setting (z.B. institutionelle Routinen), zwischenmenschlichen Beziehungen (z.B. Vertrauen) und individuellen Faktoren (z.B. SEP) unterscheiden. Folglich k{\"o}nnen politische, institutionelle und individuelle Strategien eine selbstbestimmte Geburt - und damit eine personenzentrierte, situativ angemessene Versorgung - unter Ber{\"u}cksichtigung der oben genannten Faktoren unterst{\"u}tzen. Praktische Implikationen: Die Ergebnisse liefern konkrete Anhaltspunkte f{\"u}r Maßnahmen zur Unterst{\"u}tzung einer selbstbestimmten Geburt in verschiedenen Geburtssettings. Empfohlen werden u. a. die Verbesserung von Informationsprozessen vor und w{\"a}hrend der Geburt, die Verbesserung des Zugangs zu Versorgungsangeboten, der Abbau finanzieller H{\"u}rden in der Inanspruchnahme, die F{\"o}rderung von Beziehungsaufbau und eine St{\"a}rkung der hebammengeleiteten Geburt. Appell f{\"u}r die Praxis (Wissenschaft und/oder Versorgung) in einem Satz: Akteur*innen und Entscheidungstr{\"a}ger*innen der Geburtshilfe k{\"o}nnen die Selbstbestimmung Geb{\"a}render durch gezielte individuelle, institutionelle und politische Maßnahmen f{\"o}rdern.}, language = {de} } @misc{EntringerScholaskeKurtetal., author = {Entringer, Sonja and Scholaske, Laura and Kurt, Medlin and Duman, Elif Aysimi and Adam, Emma K. and Razum, Oliver and Spallek, Jacob}, title = {Diurnal cortisol variation during pregnancy in Turkish origin and non-migrant women in a German birth cohort study}, series = {Journal of Psychosomatic Research}, volume = {162}, journal = {Journal of Psychosomatic Research}, issn = {0022-3999}, doi = {10.1016/j.jpsychores.2022.111020}, pages = {1 -- 10}, abstract = {Background Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy. Methods 109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy. Results Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants. Discussion A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group.}, language = {en} } @misc{SchulzeMerzLinckeetal., author = {Schulze, Susanne and Merz, Sibille and Lincke, Hans-Joachim and N{\"u}bling, Matthias and Rapp, Michael A. and Spallek, Jacob and Tallarek, Marie and Thier, Anne Kathrin and Holmberg, Christine}, title = {Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic}, series = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, journal = {21. Deutscher Kongress f{\"u}r Versorgungsforschung (DKVF) : 05.10.-07.10.2022, Potsdam}, publisher = {German Medical Science GMS Publishing House}, address = {D{\"u}sseldorf}, doi = {10.3205/22dkvf025}, abstract = {Background: Nurses' work-related strain and psychological burden increased during the Covid-19 pandemic, resulting in high prevalences of mental health problems among nurses worldwide. Nurses in long-term care facilities seem to be particularly prone to overall heightened burden and poor mental health. Research question: We investigated which work-related psychosocial burdens and potential positive aspects nurses working in nursing homes experience during the Covid-19 pandemic. Method: We conducted a mixed-methods study. Eligible for participation were nurses and nursing assistants working in nursing homes within the state of Brandenburg, Germany. Between August and October 2020, we distributed an anonymous survey containing the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses, drawn from the German COPSOQ databank and kindly shared by the Freiburg Research Centre for Occupational Science. In June 2021, we also conducted semi-structured interviews with geriatric nurses to reach a deeper understanding of their experiences on work-related changes and burdens during the first phases of the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results: Our survey sample (n=177) differed significantly from the reference group in 14 out of 31 COPSOQ scales. Amongst others, our sample scored significantly worse regarding the scales 'support at work', 'recognition', 'quantitative demands', 'hiding emotions', 'role conflicts', 'intention to leave profession', 'burnout' and 'inability to relax'. The interviews (n=17) revealed five main themes related to nurses' psychosocial stress: 'overall working conditions under the hygiene measures', 'concern for isolated residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' and 'meaning of work' were identified as positive effects of the pandemic. Discussion: Results indicate that nurses in nursing homes experience enhanced psychosocial and work-related strain. The comparisons with the pre-pandemic reference group suggest that the situation further aggravated during the pandemic. Nurses exhibited high psychosocial burden, e.g., due to strongly impeded possibilities to fulfill the emotional and social dimensions of care and the constant fear of infection or transmission. Deteriorated working conditions (e.g., higher workload through staff shortages and additional tasks) further exacerbated these burdens. Few positive aspects of the pandemic may be important sources of resilience. Practical implications: The reduction of nurses' strain through psychosocial support and the improvement of working conditions is crucial for the protection of nurses' health. Appeal for practice in one sentence: Political players as well as care facilities should take measures to improve nurses' situation in order to maintain a healthy workforce and high-quality care.}, language = {en} } @misc{HoffmannTschornMichalskietal., author = {Hoffmann, Stephanie and Tschorn, Mira and Michalski, Niels and Hoebel, Jens and F{\"o}rstner, Bernd R. and Rapp, Michael A. and Spallek, Jacob}, title = {Regionale sozio{\"o}konomische Deprivation, Ruralit{\"a}t und kindliche Entwicklung: Analyse von Daten der Schuleingangsuntersuchung des Bundeslandes Brandenburgs}, series = {17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK}, journal = {17. JAHRESTAGUNG DER DGEpi ABSTRACT BOOK}, abstract = {Einleitung Die gesundheitliche Entwicklung von Kindern wird neben der sozio{\"o}konomischen Position (SEP) der Familie auch von Merkmalen der Lebensumgebung gepr{\"a}gt. Ruralit{\"a}t oder regionale sozio{\"o}konomische Deprivation werden als m{\"o}gliche unabh{\"a}ngige Einflussgr{\"o}ßen postuliert, ohne dass bisher ausreichende empirische Ergebnisse vorliegen. In dieser Studie wurde untersucht, ob regionale sozio{\"o}konomische Deprivation und Ruralit{\"a}t unabh{\"a}ngig von famili{\"a}rer SEP mit der Entwicklung von Kindern assoziiert sind. Methoden Daten des Sozialp{\"a}diatrischen Entwicklungsscreenings im Rahmen der Einschulungsuntersuchungen aus dem Jahr 2018/2019 in Brandenburg (n=22.801 Kinder) wurden verkn{\"u}pft mit Daten zur regionalen Bev{\"o}lkerungsdichte (Ruralit{\"a}t) sowie mit dem German Index of Socioeconomic Deprivation (regionale Deprivation). Mittels gemischter Modelle wurde der Zusammenhang einer Allgemeinen Entwicklungsverz{\"o}gerung (AEV) mit Ruralit{\"a}t und mit regionaler Deprivation analysiert (OR=Odds Ratio (95\% Konfidenzintervall)), wobei f{\"u}r famili{\"a}re SEP (hoch, mittel, niedrig) adjustiert und nach Geschlecht (M=M{\"a}dchen, J=Jungen) stratifiziert wurde. Ergebnisse Kinder mit hoher famili{\"a}rer SEP zeigten geringere Chancen einer AEV als Kinder mit mittlerer famili{\"a}rer SEP (ORM=4,26(3,14-5,79); ORJ=3,46(2,83-4,22)) und niedriger famili{\"a}rer SEP (ORM=16,58(11,90-23,09); ORJ=12,79(10,13-16,16)). Gr{\"o}ßere regionale Deprivation war unabh{\"a}ngig von famili{\"a}rer SEP und Ruralit{\"a}t mit AEV assoziiert (ORM=1,35(1,13-1,62); ORJ=1,20(1,05-1,39)). Neben famili{\"a}rer SEP und regionaler Deprivation zeigte Ruralit{\"a}t keine Assoziation mit AEV. Schlussfolgerung Neben der famili{\"a}ren SEP wirkt sich die regionale sozio{\"o}konomische Deprivation auf Entwicklungsverz{\"o}gerungen von Kindern aus. Sozialepidemiologie und Public Health sollten daher neben den individuellen sozio{\"o}konomischen Voraussetzungen auch die regionalen sozio{\"o}konomischen Bedingungen als Determinante der gesundheitlichen Entwicklung {\"u}ber den Lebenslauf ber{\"u}cksichtigen.}, language = {de} } @incollection{TallarekZeebSpallek, author = {Tallarek, Marie and Zeeb, Hajo and Spallek, Jacob}, title = {Psychiatrisch-psychotherapeutische Versorgung von zugewanderten Menschen in Deutschland. Bedarf, Inanspruchnahme und Verbesserungspotenziale}, series = {Handbuch Transkulturelle Psychiatrie}, booktitle = {Handbuch Transkulturelle Psychiatrie}, editor = {Klosinski, Matthias and Castro N{\´u}{\~n}ez, Sandra and Oestereich, Cornelia and Hegemann, Thomas}, edition = {1}, publisher = {Psychiatrie Verlag}, address = {K{\"o}ln}, isbn = {978-3-8252-5945-7}, doi = {10.36198/9783838559452}, pages = {77 -- 92}, abstract = {Dieser Beitrag gibt einen {\"U}berblick {\"u}ber theoretische Konzepte sowie epidemiologisch-empirische Erkenntnisse zu H{\"a}ufigkeit und Determinanten psychischer Erkrankungen bei zugewanderten Menschen sowie zur Inanspruchnahme und Versorgungspraxis. Auf der Basis dieser Erkenntnisse werden vielversprechende Ans{\"a}tze der Versorgungspraxis sowie der weiteren Forschung vorgestellt.}, language = {de} }