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In allen hochentwickelten Ländern hat sich in den letzten 30 Jahren der Gesundheitsstatus der Bevölkerung deutlich verbessert. Ein wesentlicher Grund dafür ist die gestiegene wirtschaftliche Prosperität. Diese ist heute aber ungleicher verteilt als vor 3 Jahrzehnten. Die Unterschiede in der Verfügbarkeit materieller Ressourcen und die Diskrepanzen im sozioökonomischen Status hängen eng mit der Gesundheitslage der Bevölkerung zusammen. Ländervergleiche zeigen, dass eine auf ökonomische Gleichheit ausgerichtete Wohlfahrtspolitik, wie sie für die skandinavischen Länder typisch ist, mit relativ günstigen gesundheitlichen Indikatoren korreliert. Bisher ist allerdings nicht geklärt, wie ökonomische Ungleichheit und gesundheitliche Lage zusammenhängen. Als besonders unklar erweist sich in neueren Studien der Zusammenhang von ökonomischer und gesundheitlicher Ungleichheit. In diesem Beitrag geben wir einen Überblick zu den vorliegenden länderübergreifenden Analysen. Diese zeigen, dass die skandinavischen Länder dank ihrer intensiv umverteilenden Wohlfahrtspolitik zwar das höchste Ausmaß von ökonomischer, aber nicht von gesundheitlicher Gleichheit erreichen. Wir entwickeln auf der Basis dieser überraschenden Erkenntnis Vorschläge für künftige empirische Untersuchungen. Die Vorschläge gehen von der Annahme aus, dass in wohlhabenden Gesellschaften mit hohem Reichtum nicht mehr nur materielle, sondern verstärkt immaterielle Lebensbedingungen über die Verteilung gesundheitlicher Ungleichheit entscheiden. Als entscheidender Parameter wird die Verfügbarkeit von gesundheitsfördernden, „salutogenen” Potenzialen und Kompetenzen des Selbstmanagement in benachteiligten Gruppen der Bevölkerung postuliert.
In diesem Beitrag suchen wir nach möglichen Gründen für die seit einigen Jahrzehnten abfallende schulische Leistungsfähigkeit der jungen Männer. Hierzu analysieren wir die vorliegenden Studien und schlagen ein sozialisationstheoretisch fundiertes Erklärungsmodell vor, das die bisherigen Ansätze aufnimmt und weiterführt. Im Zentrum steht dabei das Konzept der „Entwicklungsaufgaben“. Die zentrale These lautet: Die schlechte schulische Leistungsbilanz der jungen Männer ist nicht alleine durch Faktoren zu erklären, die sich auf ihr Zurückbleiben im Bildungssystem selbst und damit auf ihre mangelnde Auseinandersetzung mit der Entwicklungsaufgabe „Qualifikation“ beziehen. Vielmehr kann sie nur dann erklärt werden, wenn auch die Probleme bei der Bewältigung der anderen für die junge Generation typischen Entwicklungsaufgaben „Bindung“, „Regeneration“ und „Partizipation“ mit herangezogen werden. Diese Bewältigung gelingt, wie die ausgewerteten Untersuchungen zeigen, unter den heutigen Sozialisationsbedingungen den Schülerinnen besser als den Schülern. Damit tritt ein soziologisch sehr seltenes Ereignis ein, nämlich die Umkehrung der Richtung einer seit Generationen etablierten sozialen Stratifikation. Nicht mehr junge Männer, sondern junge Frauen erwerben die privilegierten Titel des Bildungssystems und damit die formal aussichtsreicheren Anwartschaften auf späteren beruflichen Status. Als Schlussfolgerung ergibt sich aus dieser Analyse, dass eine isolierte Verstärkung der gezielten Leistungsförderung von männlichen Schülern nur begrenzt zielführend sein kann. Vielmehr lässt sich das relative Leistungsdefizit von jungen Männern nur dann langfristig abbauen, wenn auch ihre Kompetenzdefizite in allen anderen Entwicklungsbereichen ausgeglichen werden, die wichtigen gesellschaftlichen Erwartungen einer individualisierten Leistungsgesellschaft entsprechen.
Young women, and not young men, acquire the privileged diplomas offered by the educational system, and it is they who obtain the more promising career prospects. In this paper, we seek to identify factors that account for the declining school performance of boys and young men. After reviewing and analysing the international literature on gender and education, we integrate various explanatory approaches into a comprehensive socialisation model. The model focuses on the developmental tasks young men face during adolescence. Our central thesis is that the declining school performance of young men cannot be fully explained by their failure to cope with the developmental task ‘qualification’. Rather, the three other central clusters of developmental tasks – ‘social attachment’, ‘regeneration’, and ‘participation’ – have to be incorporated. The crucial implication is that supporting young men at school will show only limited results. Rather, to improve the school performance of young men, it is also necessary to address their deficits in coping with the other developmental tasks.
PURPOSE:
Adherence to dental preventive programmes in young adults is low. The aim of the present longitudinal study was to evaluate whether tutoring peers can be a compliance-enhancing tool or not.
METHODS:
In Part 1, two randomly selected classes (49 female students, mean age 19.8 + or - 2.3 years) were taught adult toothbrushing technique (the modified Bass technique) in a project-like manner. After the course, knowledge was tested using a class test, and compliance was evaluated using anonymous quantitative questionnaires. Compliance was defined as a reported degree of change from the easy-to-learn childhood toothbrushing techniques to the more efficient and challenging Bass technique. In Part 2 of the present longitudinal study, the compliance of these students was re-evaluated after having developed and applied themselves a programme of how to tutor peers in oral health. Re-evaluation of compliance was performed after 3 and 9 months.
RESULTS:
In Part 1, 28.5% of the students were compliant after 1 week. Compared with Part 1, the compliance in Part 2 was significantly higher (P u 0.001), both after 3 months (90%) and after 9 months (82%).
CONCLUSIONS:
Tutoring peers can significantly enhance the compliance over a period of 9 months. Tutoring can function as a form of empowerment and can establish a strong sustained health engagement. Tutoring peers in health-related subjects can readily be implemented in schools and might be an additional means of oral health promotion with fewer additional costs.
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.
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.
BACKGROUND:
Health literacy is of increasing importance in public health research. It is a necessary pre-condition for the involvement in decisions about health and health care and related to health outcomes. Knowledge about limited health literacy in different age groups is crucial to better target public health interventions for subgroups of the population. However, little is known about health literacy in Germany. The study therefore assesses the prevalence of limited health literacy and associated factors among different age groups.
METHODS:
The Health Literacy Survey Germany is a cross-sectional study with 2,000 participants aged 15 years or older in private households. Perceived health literacy was assessed via computer-assisted personal interviews using the HLS-EU-Q-47 questionnaire. Descriptive analyses, chi-square tests and odds ratios were performed stratified for different age groups.
RESULTS:
The population affected by limited perceived health literacy increases by age. Of the respondents aged 15-29 years, 47.3 % had limited perceived health literacy and 47.2 % of those aged 30-45 years, whereas 55.2 % of the respondents aged 46-64 years and 66.4 % aged 65 years and older showed limited perceived health literacy. In all age groups, limited perceived health literacy was associated with limited functional health literacy, low social status, and a high frequency of doctor visits.
CONCLUSIONS:
The results suggest a need to further investigate perceived health literacy in all phases of the life-course. Particular attention should be devoted to persons with lower social status, limited functional health literacy and/or a high number of doctor visits in all age groups.