TY - GEN A1 - Tallarek, Marie A1 - Bozorgmehr, Kayvan A1 - Spallek, Jacob T1 - 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 T2 - BMJ Global Health N2 - 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. KW - inclusionary public health KW - exclusionary public health KW - diversity-sensitive public health KW - othering KW - COVID-19 KW - refugees KW - asylum seekers KW - mass quarantine Y1 - 2020 UR - https://gh.bmj.com/content/bmjgh/5/12/e003789.full.pdf U6 - https://doi.org/10.1136/bmjgh-2020-003789 SN - 2059-7908 VL - 5 IS - 12 ER - TY - GEN A1 - Herke, Max A1 - Moor, Irene A1 - Winter, Kristina A1 - Hoffmann, Stephanie A1 - Spallek, Jacob A1 - Hilger-Kolb, Jennifer A1 - Pischke, Claudia R. A1 - Dragano, Nico A1 - Novelli, Anna A1 - Richter, Matthias T1 - Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review T2 - BMJ Open N2 - 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. KW - contextual characteristics KW - compositional characteristics KW - schools KW - health inequalities KW - childhood KW - adolescence KW - scoping review Y1 - 2020 UR - https://bmjopen.bmj.com/content/10/12/e038999 U6 - https://doi.org/10.1136/bmjopen-2020-038999 SN - 2044-6055 VL - 10 IS - 12 ER - TY - GEN A1 - Hintermeier, Maren A1 - Gencer, Hande A1 - Kajikhina, Katja A1 - Rohleder, Sven A1 - Santos-Hövener, Claudia A1 - Tallarek, Marie A1 - Spallek, Jacob A1 - Bozorgmehr, Kayvan T1 - SARS-CoV-2 among migrants and forcibly displaced populations: a rapid systematic review T2 - medRxiv N2 - 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. KW - SARS-CoV-2 KW - migrants KW - displaced populations KW - rapid systematic review Y1 - 2020 UR - https://www.medrxiv.org/content/10.1101/2020.12.14.20248152v1.full.pdf+html U6 - https://doi.org/10.1101/2020.12.14.20248152 ER - TY - GEN A1 - Miani, Céline A1 - Batram-Zantvoort, Stephanie A1 - Wandschneider, Lisa A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Potential of Standard Perinatal Data for Measuring Violation of Birth Integrity T2 - Frontiers in global women's health N2 - 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. KW - childbirth KW - respectful maternity care KW - mistreatment KW - perinatal data KW - Germany KW - birth integrity KW - obstetric violence Y1 - 2021 U6 - https://doi.org/10.3389/fgwh.2020.581244 SN - 2673-5059 IS - 1 ER - TY - GEN A1 - Schilling, Laura A1 - Spallek, Jacob A1 - Maul, Holger A1 - Schneider, Sven T1 - Study on E-Cigarettes and Pregnancy (STEP) – Results of a Mixed Methods Study on Risk Perceptionof E-Cigarette Use During Pregnancy T2 - Geburtshilfe und Frauenheilkunde N2 - 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. KW - electronic cigarette KW - pregnancy KW - risk perception KW - Health Belief Model KW - online forums KW - mixed methods Y1 - 2021 UR - https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-1308-2376.pdf U6 - https://doi.org/10.1055/a-1308-2376 SN - 0016‑5751 VL - 81 IS - 02 SP - 214 EP - 223 ER - TY - GEN A1 - Novelli, Anna A1 - Schüttig, Wiebke A1 - Spallek, Jacob A1 - Wachtler, Benjamin A1 - Diehl, Katharina A1 - Moor, Irene A1 - Richter, Matthias A1 - Dragano, Nico A1 - Sundmacher, Leonie T1 - Correlation of mesolevel characteristics of the healthcare system and socioeconomic inequality in healthcare use: a scoping review protocol T2 - BMJ Open N2 - 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. KW - mesolevel characteristics KW - healthcare KW - inequality KW - scoping review Y1 - 2021 UR - https://bmjopen.bmj.com/content/11/2/e044301.info U6 - https://doi.org/10.1136/bmjopen-2020-044301 SN - 2044-6055 VL - 11 IS - 2 ER - TY - GEN A1 - Lueckmann, Sara Lena A1 - Hoebel, Jens A1 - Roick, Julia A1 - Markert, Jenny A1 - Spallek, Jacob A1 - Knesebeck, Olaf von dem A1 - Richter, Matthias T1 - Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review T2 - International journal for equity in health N2 - 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. KW - Socioeconomic inequalities KW - primary-care KW - specialist physician KW - systematic review Y1 - 2021 U6 - https://doi.org/10.1186/s12939-020-01375-1 SN - 1475-9276 VL - 20 ER - TY - GEN A1 - Tallarek, Marie A1 - Spallek, Jacob T1 - Inclusionary und diversitätssensibles Public Health in der Pandemie T2 - Public Health Forum N2 - Othering beschreibt die Markierung von Menschen als „anders“ oder „nicht zugehörig“. Ausgehend von den Konzepten des exclusionary und inclusionary Othering diskutiert dieser Beitrag drei Ansätze zu i) exclusionary Public Health, ii) inclusionary Public Health und iii) diversitätssensiblem Public Health. Die Implikationen der Ansätze werden am Beispiel des Umgangs mit der COVID-19 Pandemie bei schutzsuchenden Menschen in Aufnahmeeinrichtungen und Sammelunterkünften in Deutschland aufgezeigt. KW - Othering KW - exclusionary public health KW - inclusionary public health KW - diversitätssensibles Public Health KW - Pandemie KW - Covid-19 Y1 - 2021 UR - https://www.degruyter.com/document/doi/10.1515/pubhef-2020-0112/html U6 - https://doi.org/10.1515/pubhef-2020-0112 SN - 1876-4851 SN - 0944-5587 VL - 29 IS - 1 SP - 22 EP - 26 ER - TY - CHAP A1 - Spallek, Jacob A1 - Razum, Oliver ED - Spallek, Jacob ED - Zeeb, Hajo T1 - Epidemiologische Erklärungsmodelle für den Zusammenhang zwischen Migration und Gesundheit T2 - Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien N2 - Migration beeinflusst die Gesundheit. Ob sich Migration gesundheitlich positiv oder negativ auswirkt, hängt von einer Vielzahl von Faktoren ab, die in verschiedenen Erklärungsmodellen in einen Zusammenhang gebracht werden. Wichtig bei der Beschreibung des Zusammenhangs sind eine zeitliche Komponente und die Einbeziehung der individuellen Lebensläufe der Migrant*innen mit ihren Lebensabschnitten vor, während und nach der Migration. KW - Epidemiologische Erklärungsmodelle KW - Migration KW - Gesundheit Y1 - 2021 SN - 978-3-456-85995-8 U6 - https://doi.org/10.1024/85995-000 SP - 81 EP - 90 PB - Hogrefe AG CY - Bern ET - 1 ER - TY - CHAP A1 - Scholaske, Laura A1 - Spallek, Jacob A1 - Entringer, Sonja ED - Spallek, Jacob ED - Zeeb, Hajo T1 - Intergenerationale Übertragung von Migrationserfahrungen und fetale Programmierung von Krankheit und Gesundheit T2 - Handbuch Migration und Gesundheit : Grundlagen, Perspektiven und Strategien N2 - Gesundheitsdisparitäten manifestieren sich in der Nachkommengeneration von Migrant*innen teilweise schon in frühen Lebensjahren. Viele dieser Gesundheits-disparitäten werden durch sozioökonomische Benachteiligung und Akkulturation vermittelt. Anhand des Konzeptes der fetalen Pro-grammierung kann erklärt werden, dass das mütterliche Stresserleben – vermittelt über endokrine und immunologische Prozesse – die spätere Gesundheit und Krank-heitsvulnerabilität der Nachkommen bereits in der Schwangerschaft beeinflusst. Es gibt aus der internationalen Forschung zahlreiche Belege dafür, dass endokrine und immunologische Prozesse den Zusam-menhang zwischen mütterlichen migrationsbezogenen Stressoren und Schwangerschafts-, Geburts- und späteren Gesundheitsoutcomes des Kindes vermitteln. Bei Migrant*innen in Deutschland sind diese Zusammenhänge weitestgehend unterforscht. KW - Intergenerationale Übertragung KW - Migrationserfahrungen Y1 - 2021 SN - 978-3-456-85995-8 SP - 351 EP - 368 PB - Hogrefe AG CY - Bern ET - 1 ER -