@book{HurrelmannRichter, author = {Hurrelmann, Klaus and Richter, Matthias}, title = {Gesundheits- und Medizinsoziologie : eine Einf{\"u}hrung in sozialwissenschaftliche Gesundheitsforschung}, publisher = {Beltz Juventa}, address = {Weinheim [u.a.]}, isbn = {978-3-7799-2605-4}, pages = {255}, abstract = {In diesem Band werden sozialwissenschaftliche Theorien vorgestellt, die sich mit Gesundheit und Krankheit besch{\"a}ftigen. Die Theorien konzentrieren sich auf die Wechselbeziehungen zwischen Belastung, Bew{\"a}ltigung und Gesundheit. Aus ihnen lassen sich Strategien ableiten, um das f{\"u}r die Gesundheit relevante Verhalten, die entscheidenden Umweltbedingungen und die Strukturen des Gesundheitssystems zu beeinflussen.}, language = {de} } @article{HurrelmannRathmannRichter, author = {Hurrelmann, Klaus and Rathmann, Katharina and Richter, Matthias}, title = {Health inequalities and welfare state regimes: a research note}, series = {Journal of Public Health}, volume = {19}, journal = {Journal of Public Health}, number = {1}, publisher = {Springer}, address = {Berlin [u.a.]}, issn = {1613-2238}, doi = {http://nbn-resolving.de/urn:nbn:de:0168-ssoar-216295}, pages = {3 -- 13}, abstract = {Aim Comparative research on health and health inequalities has recently begun implementing a welfare regime perspective. The aim of the study was to review the existing evidence for identifying the determinants of health and health inequalities in highly developed welfare states and to develop a theoretical model for future research approaches. Subject A welfare state regime typology is applied to comparatively analyse (1) the relationship between the level of economic prosperity in a society and its respective level of overall population health and (2) the nature of the corresponding relationship between economic inequalities and health inequalities in different groups of countries. Results Although the Social Democratic welfare states have a relatively equal distribution of material wealth as well as the highest levels of population health, they are not characterised by the smallest levels of health inequality. Rather, with respect to health equality, conservative countries seem to perform better than social democracies. We propose a comprehensive theoretical model that takes into account different factors on the structural (macro), organisational (meso) and individual (micro) level in order to contribute to a better understanding of this important challenge for public health policy and practice. Conclusion Future research will require an appropriate theoretical model with the potential to explain health and health inequalities in different types of welfare states. On the basis of this model, future research should test the hypothesis that in highly developed countries not only economic, but also social, cultural and lifestyle factors are important in determining health outcomes in different segments of the population.}, language = {en} } @article{RathmannOttovaJordanHurrelmannetal., author = {Rathmann, Katharina and Ottov{\´a}-Jordan, Veronika and Hurrelmann, Klaus and Richter, Matthias}, title = {Makro-strukturelle Determinanten der Gesundheit und gesundheitlichen Ungleichheit von Jugendlichen in 27 Wohlfahrtsstaaten: Eine Mehrebenenanalyse}, series = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, volume = {36}, journal = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, number = {4}, publisher = {Beltz Juventa}, issn = {1436-1957}, pages = {356 -- 381}, abstract = {Dieser Beitrag untersucht die Relevanz makro-struktureller Merkmale f{\"u}r die Gesundheit und sozio{\"o}konomische Ungleichheit in der Gesundheit von Jugendlichen in hochentwickelten Wohlfahrtsstaaten. Datenbasis ist die internationale "Health Behaviour in School-aged Child-ren (HBSC)"-Studie 2005/06. Sie umfasst 11- bis 15-j{\"a}hrige Jugendliche in 27 europ{\"a}ischen und nordamerikanischen L{\"a}nder (n=134.632), die in f{\"u}nf Wohlfahrtsstaatsregimes (sozialde-mokratisch, konservativ, liberal, s{\"u}d- und osteurop{\"a}isch) zusammengefasst wurden. In hierar-chischen Regressionsmodellen wurden f{\"u}r die psychosomatische Beschwerdelast als gesund-heitliche Zielgr{\"o}ßee individuelle (famili{\"a}rer Wohlstand) und makro-strukturelle Determinanten (Einkommensungleichheit, Ausgaben f{\"u}r das Gesundheitssystem, Regime-Dummies) unter Kontrolle des nationalen Wohlstands analysiert. Im liberalen Regime und damit in L{\"a}ndern mit hoher Einkommensungleichheit fallen die Beschwerderate und sozio{\"o}konomische Un-gleichheiten in der Beschwerdelast am h{\"o}chsten aus. Der gesellschaftliche Wohlstand und die Ausgaben f{\"u}r das Gesundheitssystem sind dagegen nicht mit den Beschwerden assoziiert}, language = {de} } @article{RichterHurrelmann, author = {Richter, Matthias and Hurrelmann, Klaus}, title = {Life course influences on health and health inequalities: A socialisation perspective}, series = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, volume = {3}, journal = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, publisher = {Beltz Juventa}, issn = {1436-1957}, pages = {264 -- 280}, abstract = {This paper reviews life course approaches applied in epidemiology, sociology and psychology and proposes a theoretical framework that integrates the concept of socialisation. We argue that the paradigmatic principles of interdisciplinary life course research (human agency, timing in lives, linked lives and historical context) provide a strong basis for a more holistic and theory-driven view of the life course and its interdependent pathways. The ´agency within structure´ paradigm on which these principles are based is an essential part of socialisation theory. We emphasize that socialisation theory has the potential to act as a theoretical link between social science and epidemiology, because it offers a multi-causal framework to illuminate the association between social structure and health across the life course. In order to better understand the development of health and health inequalities in a life course perspective, an interdisciplinary approach is required. The increased attention to socialisation principles might open new dialogue and empirical research perspectives for health sociology and epidemiology. Keywords: ageing, health, life course, social inequalities, socialisation theory}, language = {en} } @article{RathmannPfoertnerHurrelmannetal., author = {Rathmann, Katharina and Pf{\"o}rtner, Timo-Kolja and Hurrelmann, Klaus and Osorio, Ana M. and Bosakova, Lucia and Elgar, Frank J. and Richter, Matthias}, title = {The great recession, youth unemployment and inequalities in psychological health complaints in adolescents: a multilevel study in 31 countries}, series = {International Journal of Public Health}, volume = {61}, journal = {International Journal of Public Health}, number = {7}, issn = {1661-8556}, doi = {10.1007/s00038-016-0866-0}, pages = {809 -- 819}, abstract = {Objectives Little is known about the impact of recessions on young people's socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America. Methods Data from the WHO collaborative 'Health Behaviour in School-aged Children' (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005-2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10. Results Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005-2010) were not associated with adolescents' psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment. Conclusions This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.}, language = {en} } @article{HurrelmannRathmannMooretal., author = {Hurrelmann, Klaus and Rathmann, Katharina and Moor, Irene and Kunst, Anton E. and Dragano, Nico and Pf{\"o}rtner, Timo-Kolja and Elgar, Frank J. and Kannas, Lasse and Baška, Tibor and Richter, Matthias}, title = {Is educational differentiation associated with smoking and smoking inequalities in adolescence? A multilevel analysis across 27 European and North American countries}, series = {Sociology of Health \& Illness}, volume = {38}, journal = {Sociology of Health \& Illness}, number = {7}, pages = {1005 -- 1025}, abstract = {This study aims to determine whether educational differentiation (i.e. early and long tracking to different school types) relate to socioeconomic inequalities in adolescent smoking. Data were collected from the WHO-Collaborative 'Health Behaviour in School-aged Children (HBSC)' study 2005/2006, which included 48,025 15-year-old students (Nboys = 23,008, Ngirls = 25,017) from 27 European and North American countries. Socioeconomic position was measured using the HBSC family affluence scale. Educational differentiation was determined by the number of different school types, age of selection, and length of differentiated curriculum at the country-level. We used multilevel logistic regression to assess the association of daily smoking and early smoking initiation predicted by family affluence, educational differentiation, and their interactions. Socioeconomic inequalities in both smoking outcomes were larger in countries that are characterised by a lower degree of educational differentiation (e.g. Canada, Scandinavia and the United Kingdom) than in countries with higher levels of educational differentiation (e.g. Austria, Belgium, Hungary and The Netherlands). This study found that high educational differentiation does not relate to greater relative inequalities in smoking. Features of educational systems are important to consider as they are related to overall prevalence in smoking and smoking inequalities in adolescence.}, language = {en} } @article{RathmannHerkeHurrelmannetal., author = {Rathmann, Katharina and Herke, Max G. and Hurrelmann, Klaus and Richter, Matthias}, title = {Perceived class climate and school-aged children's life satisfaction: The role of the learning environment in classrooms}, series = {PLoS ONE}, journal = {PLoS ONE}, doi = {10.1371/journal.pone.0189335}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:b1570-opus4-24735}, abstract = {The aim of this study is to examine the impact of class-level class climate on school-aged children's life satisfaction. Data was derived from the German National Educational Panel Study (NEPS) using sixth grade school-aged children (n = 4,764, 483 classes). Class climate includes indicators of teachers' care and monitoring, demands, interaction, autonomy, as well as school-aged children's attitudes towards schoolwork at the class- and individual-level. Results showed that individual perceived class climate in terms of teachers' care and monitoring and autonomy was positively related to life satisfaction, whereas school-related demands were related to lower life satisfaction. Besides teachers' care and monitoring at class-level, indicators of class climate were not associated with school-aged children's life satisfaction, while the individual perceived class climate is more important for life satisfaction.}, language = {en} } @article{RathmannHerkeKuntzetal., author = {Rathmann, Katharina and Herke, Max G. and Kuntz, Benjamin and Lampert, Thomas and Loter, Katharina and Moor, Irene and Hurrelmann, Klaus and Richter, Matthias}, title = {Die Bedeutung intergenerationaler Bildungsmobilit{\"a}t f{\"u}r die Gesundheit und die Lebenszufriedenheit von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland}, series = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, volume = {38}, journal = {Zeitschrift f{\"u}r Soziologie der Erziehung und Sozialisation}, number = {1}, pages = {80 -- 99}, language = {de} } @article{RathmannBilzHurrelmannetal., author = {Rathmann, Katharina and Bilz, Ludwig and Hurrelmann, Klaus and Kiess, Wieland and Richter, Matthias}, title = {Is being a "small fish in a big pond" bad for students' psychosomatic health? A multilevel study on the role of class-level school performance?}, series = {BMC Public Health}, volume = {18}, journal = {BMC Public Health}, number = {1}, doi = {10.1186/s12889-018-5977-5}, pages = {1098 -- 1113}, abstract = {Background Features of schools and classes are closely related to students´ health and wellbeing. However, class composition (e.g. in terms of school performance) has rarely been examined in relation to students´ health and wellbeing. This study focuses on the so called Big-Fish-Little-Pond-Effect (BFLPE), by investigating whether the level of high-performing students in classroom is negatively associated with psychosomatic complaints of students who perceive themselves as poor performers. Methods Data were derived from the German sample of the WHO-Collaborative "Health Behaviour in School-aged Children (HBSC)" study 2013/2014. The sample included 5226 11-, 13- and 15-year-old students. Individual perceived school performance (PSP) was included (very good/good vs. average/below average PSP) at the individual student-level. At the class-level, school performance in class was generated by aggregating the share (in percentage) of students who report a very good/good PSP to the class-level, indicating the percentage of students with good/very good PSP in classroom. Using multilevel regression models, the association between class-level school performance (in percentage of students with very good/good PSP) and individual psychosomatic complaints were analyzed, stratified by students´ individual PSP. Results Students who report average/below average PSP showed higher likelihoods of psychosomatic complaints (Odds Ratio: 1.75; 95\% Confidence Interval: 1.52-2.03) compared to counterparts with very good/good PSP. The aggregated class-level PSP was not significantly associated with psychosomatic complaints. However, in line with the BFLPE, results further revealed that students with average/below average PSP, who attend classes with a higher percentage of students who report very good/good PSP, had higher likelihoods of psychosomatic complaints (Odds Ratio: 1.91; 95\% Confidence Interval: 1.01-4.01) compared to classmates with very good/good PSP. Conclusions This study revealed that class composition in terms of PSP was differentially associated with students´ psychosomatic complaints, depending on their individual PSP. Findings highlight the vulnerability of students with poor PSP placed in classes with a higher percentage of students with good PSP. Results of this study therefore indicate a need for initiatives for low performing students from teachers and school staff in class.}, language = {en} } @article{HurrelmannRathmannRichter, author = {Hurrelmann, Klaus and Rathmann, Katharina and Richter, Matthias}, title = {Welche Wohlfahrtspolitik f{\"o}rdert die Gesundheit?: Der ungekl{\"a}rte Zusammenhang von {\"o}konomischer und gesundheitlicher Ungleichheit}, series = {Das Gesundheitswesen}, volume = {73}, journal = {Das Gesundheitswesen}, number = {6}, publisher = {Thieme}, address = {Stuttgart}, issn = {1439-4421}, doi = {10.1055/s-0030-1265195}, pages = {335 -- 343}, abstract = {In allen hochentwickelten L{\"a}ndern hat sich in den letzten 30 Jahren der Gesundheitsstatus der Bev{\"o}lkerung deutlich verbessert. Ein wesentlicher Grund daf{\"u}r ist die gestiegene wirtschaftliche Prosperit{\"a}t. Diese ist heute aber ungleicher verteilt als vor 3 Jahrzehnten. Die Unterschiede in der Verf{\"u}gbarkeit materieller Ressourcen und die Diskrepanzen im sozio{\"o}konomischen Status h{\"a}ngen eng mit der Gesundheitslage der Bev{\"o}lkerung zusammen. L{\"a}ndervergleiche zeigen, dass eine auf {\"o}konomische Gleichheit ausgerichtete Wohlfahrtspolitik, wie sie f{\"u}r die skandinavischen L{\"a}nder typisch ist, mit relativ g{\"u}nstigen gesundheitlichen Indikatoren korreliert. Bisher ist allerdings nicht gekl{\"a}rt, wie {\"o}konomische Ungleichheit und gesundheitliche Lage zusammenh{\"a}ngen. Als besonders unklar erweist sich in neueren Studien der Zusammenhang von {\"o}konomischer und gesundheitlicher Ungleichheit. In diesem Beitrag geben wir einen {\"U}berblick zu den vorliegenden l{\"a}nder{\"u}bergreifenden Analysen. Diese zeigen, dass die skandinavischen L{\"a}nder dank ihrer intensiv umverteilenden Wohlfahrtspolitik zwar das h{\"o}chste Ausmaß von {\"o}konomischer, aber nicht von gesundheitlicher Gleichheit erreichen. Wir entwickeln auf der Basis dieser {\"u}berraschenden Erkenntnis Vorschl{\"a}ge f{\"u}r k{\"u}nftige empirische Untersuchungen. Die Vorschl{\"a}ge gehen von der Annahme aus, dass in wohlhabenden Gesellschaften mit hohem Reichtum nicht mehr nur materielle, sondern verst{\"a}rkt immaterielle Lebensbedingungen {\"u}ber die Verteilung gesundheitlicher Ungleichheit entscheiden. Als entscheidender Parameter wird die Verf{\"u}gbarkeit von gesundheitsf{\"o}rdernden, „salutogenen" Potenzialen und Kompetenzen des Selbstmanagement in benachteiligten Gruppen der Bev{\"o}lkerung postuliert.}, language = {de} } @article{RichterRathmannNicGabhainnetal., author = {Richter, Matthias and Rathmann, Katharina and Nic Gabhainn, S. and Zambon, A. and Boyce, W. and Hurrelmann, Klaus}, title = {Welfare state regimes, health and health inequalities in adolescence: A multilevel analysis in 32 countries}, series = {Sociology of Health and Illness}, volume = {34}, journal = {Sociology of Health and Illness}, number = {6}, publisher = {Wiley-Blackwell}, address = {Hoboken (NJ) [u.a.]}, issn = {1467-9566}, doi = {10.1111/j.1467-9566.2011.01433.x}, pages = {858 -- 879}, abstract = {Comparative research on health and health inequalities has recently started to establish a welfare regime perspective. The objective of this study was to determine whether different welfare regimes are associated with health and health inequalities among adolescents. Data were collected from the 'Health Behaviour in School-aged Children' study in 2006, including 11- to 15-year-old students from 32 countries (N = 141,091). Prevalence rates and multilevel logistic regression models were calculated for self-rated health (SRH) and health complaints. The results show that between 4 per cent and 7 per cent of the variation in both health outcomes is attributable to differences between countries. Compared to the Scandinavian regime, the Southern regime had lower odds ratios for SRH, while for health complaints the Southern and Eastern regime showed high odds ratios. The association between subjective health and welfare regime was largely unaffected by adjusting for individual socioeconomic position. After adjustment for the welfare regime typology, the country-level variations were reduced to 4.6 per cent for SRH and to 2.9 per cent for health complaints. Regarding cross-level interaction effects between welfare regimes and socioeconomic position, no clear regime-specific pattern was found. Consistent with research on adults this study shows that welfare regimes are important in explaining variations in adolescent health across countries.}, language = {en} } @article{HurrelmannRathmannOttovaetal., author = {Hurrelmann, Klaus and Rathmann, Katharina and Ottova, Veronika and de Looze, Margarethe and Levin, Kate and Molcho, Michael and Elgar, Frank and Nic Gabhainn, Saoirse and van Dijk, Jitse P. and Richter, Matthias}, title = {Macro-level determinants of young people's subjective health and health inequalities: A multilevel analysis in 27 welfare states}, series = {Maturitas}, volume = {80}, journal = {Maturitas}, number = {4}, publisher = {Elsevier}, address = {Amsterdam [u.a.]}, issn = {0378-5122}, doi = {10.1016/j.maturitas.2015.01.008}, pages = {414 -- 420}, abstract = {Objectives Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. Study design Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n = 134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. Main outcome measure Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. Results Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. Conclusion Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence.}, language = {en} } @article{RathmannHerkeBilzetal., author = {Rathmann, Katharina and Herke, Max and Bilz, Ludwig and Rimpel{\"a}, Arja and Hurrelmann, Klaus and Richter, Matthias}, title = {Class-Level School Performance and Life Satisfaction: Differential Sensitivity for Low- and High-Performing School-Aged Children}, series = {International Journal of Environmental Research and Public Health}, volume = {15}, journal = {International Journal of Environmental Research and Public Health}, number = {2}, doi = {10.3390/ijerph15122750}, abstract = {This study investigates whether class-level school performance affects students' life satisfaction and if there are differential effects for high- and low-performing students. Data were derived from the National Educational Panel Study, including n = 5196 students (49.6\% girls), nested in 478 classes and 250 secondary schools. School performance in class was measured by aggregating individual grade point average in Mathematics and German. The study could not reveal the "big-fish-little-pond"-effect regarding students' life satisfaction but found differential effects for high- vs. low performing students. There was no significant association for low-performing students attending classes with higher class-level performance However, low-performing students revealed the lowest life satisfaction. High-performing students placed in classes with higher average performance reported lower life satisfaction compared to high-performing students in classes with lower average performance. This study provides evidence for the impact of the learning environment in class on school-aged children's life satisfaction, by highlighting the differential sensitivity of high-performing students when placed in classes with higher or lower average performance.}, language = {en} } @article{RathmannHerkeHurrelmannetal., author = {Rathmann, Katharina and Herke, Max and Hurrelmann, Klaus and Richter, Matthias}, title = {Klassenklima, schulisches Wohlbefinden und Gesundheit von Sch{\"u}lerinnen und Sch{\"u}lern in Deutschland: Ergebnisse des Nationalen Bildungspanels}, series = {Das Gesundheitswesen}, volume = {80}, journal = {Das Gesundheitswesen}, number = {4}, issn = {0941-3790, 1439-4421}, doi = {10.1055/s-0043-121886}, pages = {332 -- 341}, abstract = {Ziel Ziel des Beitrags ist es, erstmalig mit den Daten des Nationalen Bildungspanels den Zusammenhang zwischen Merkmalen des Klassenklimas und des schulischen Wohlbefindens mit der selbstberichteten Gesundheit und krankheitsbedingten Schulfehltagen von Sch{\"u}lern in deutschen Regelschulen zu untersuchen. Methodik Datenbasis bildet das Nationale Bildungspanel (NEPS). Die Stichprobe umfasst (n=7348) Sch{\"u}ler der siebten Klassen in Regelschulen (Startkohorte 3, Welle 3, 2012). Merkmale des Klassenklimas umfassen Anforderungen, Kontrolle und Lernorientierung im Unterricht, Autonomie und Interaktion der Sch{\"u}ler sowie die Unterrichtsqualit{\"a}t, jeweils auf die Lehrkr{\"a}fte in Deutsch bezogen. Das schulische Wohlbefinden wird {\"u}ber die Schulzufriedenheit sowie Hilflosigkeit in zentralen Schulf{\"a}chern erfasst. Es werden sowohl bivariate Analysen als auch logistische Mehrebenenmodelle, unter Kontrolle von Alter, Geschlecht und besuchter Schulform, durchgef{\"u}hrt. Ergebnisse Die Ergebnisse der Mehrebenenmodelle zeigen, dass insbesondere Sch{\"u}ler mit einer h{\"o}heren Schulzufriedenheit eine bessere Gesundheit und weniger krankheitsbedingte Fehltage berichten. Eine h{\"o}here Hilflosigkeit und Lernorientierung sind dagegen negativ mit beiden Zielgr{\"o}ßen assoziiert. Hauptsch{\"u}ler besitzen zudem ein erh{\"o}htes Risiko krankheitsbedingter Fehltage im Vergleich zu Gymnasiasten. Schlussfolgerung Die Ergebnisse unterstreichen, dass insbesondere das schulische Wohlbefinden in Form der Schulzufriedenheit sowie der Hilflosigkeit in zentralen Schulf{\"a}chern eng mit der subjektiven Gesundheit und krankheitsbedingten Fehltagen assoziiert ist. Maßnahmen zur Gesundheitsf{\"o}rderung sollten daher v. a. auf das schulische Wohlbefinden gerichtet werden sowie Sch{\"u}ler adressieren, die eine andere Schulform als das Gymnasium besuchen.}, language = {de} } @book{HurrelmannRichter, author = {Hurrelmann, Klaus and Richter, Matthias}, title = {Understanding Public Health}, publisher = {Routledge}, address = {Oxon}, isbn = {978-0367360764}, publisher = {Hertie School}, pages = {116}, abstract = {This book develops a new model of the genesis of health, on the basis of the interplay between genetic and environmental factors. Hurrelmann and Richter build upon the basic theories of health and the popular model of salutogenesis to offer a comprehensive interdisciplinary theory of health genesis and success: Productive Processing of Reality (PPR). The authors show that health is the lifelong dynamic process of dealing with the internal reality of physical and psychological impulses and the external reality of social and material impulses. To demonstrate this, the book is split into three interconnected parts. Part A analyses the determinants of health, providing an overview of the insights of current research and the impact of socioeconomic influences and gender on health. Part B covers public health, social, learning and coping theories, all of which understand health as an interaction between people and their environment. Part C draws on these four theories to outline PPR, stressing the interrelation between physical and mental constitution and the demands of the social and mental environment, and suggesting strategies for coping with these demands during the life course. Understanding Public Health: Productive Processing of Internal and External Reality will be valuable reading for students and researchers in psychology, sociology, educational science, public health and medical science, and for policymakers in public health.}, language = {en} }