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Background and Objectives Given the increasing academic interest in older migrants, this study aims at examining the likelihood of establishing contact and cooperation in a survey among first-generation migrants in Germany, comparing migrants of age 50 and older with younger migrants (aged 16–49). Research Design and Methods We analyze data from the Migrants' Welfare State Attitudes (MIFARE) study collected in Germany, which contains information about first-generation migrants from 9 different origin groups living in private households. Potential survey participants were contacted via mail and invited to participate in a paper- or online-based survey. In addition, an incentive experiment was implemented and age-dependent response rates were analyzed. Using logistic regression analyses, we compare older and younger migrants with regard to their likelihood of contact, cooperation, reaction to incentives, and mode choice. Results Within the MIFARE study, older migrants are more likely to be contacted than younger ones. Older migrants are also more likely to cooperate in survey research than younger migrants. Both groups respond equally positively to the use of unconditional incentives. Lastly, older migrants show a strong preference to fill out the questionnaire on paper, rather than online. Discussion and Implications Older first-generation migrants living in private households are easier to contact and are more likely to cooperate in survey research than younger first-generation migrants. Offering unconditional incentives and surveys on paper are likely to increase response rates among older migrants. [ABSTRACT FROM AUTHOR]

Background Prevalence of overweight and obesity in Germany is increasing. High body weight can affect children's growth and development. This paper aimed to determine the association between body mass index (BMI) and visual impairment among preschool children and explore the potential role of obesity in predicting visual developmental disorder. Methods Six consecutive years of data from the School Entry Examination were collected for all preschool children aged from 4 to 6 years residing in Rhine-Neckar County and the City of Heidelberg, Germany from 2013 to 2018. Univariate and multivariate regression were used to analyze the complete data, multiple imputation was used to deal with missing data. Results Among the group with an immigrant background, children with obesity [OR = 1.20, 99% (1.02–1.42)] were more likely to have visual impairment compared to those with normal body weight (P  <   0.01) after adjusting for survey year, age, and gender of children, education and occupation of parents, screen time-frequency, whether a television was in their bedroom, and quality of preschool outdoor environment. Conclusion There were significant associations between obesity and visual impairment among German preschool children with immigrant backgrounds. Strategies to support vulnerable groups were needed across all regional schools. [ABSTRACT FROM AUTHOR]

Aims Germany is experiencing a decline in alcohol consumption but not for every alcoholic beverage type. Given the differential health impacts of alcoholic beverage type, it is important to understand the drivers of these trends. We investigated: (a) temporal trends in beverage preference and (b) the effects of age, period and cohort on these trends. Methods Data came from nine waves (1995–2018; n total = 75,550) of the German Epidemiological Survey of Substance Abuse, a nationally representative household survey of individuals aged 18–59 years. The quantity of beer, wine, spirits and mixed drinks drank in the last 30 days was transformed into grammes of ethanol, and the beverage type preference was estimated as the proportion of total ethanol consumption. Fractional multinomial logit regression was applied to analyse the age, period and cohort effects on temporal trends of beverage preference by sex. Results The preference for spirits and mixed drinks decreased with increasing age, while the preference for wine increased with no age effect on beer. There was a general decrease in the preference for beer and an increase in the preference for wine among both sexes, with an additional increase in the preference for spirits in males. Conclusion Trends in beverage preference were more related to individual ageing and changes in the whole population than to cohorts. With the continued reduction in alcohol consumption, the decreasing preference for beer and the growing preference for wine suggest a positive development. Trends of an increasing preference for spirits in males are of concern. [ABSTRACT FROM AUTHOR]

The article provides information on study which investigated barriers to workplace health promotion (WHP) in Germany as perceived by employees themselves using a representative sample. Topics discussed include six factor solution found for a mainly highly educated, white collar sample in Austria working in companies already engaged in WHP, methodology of the study, and demographic differences regarding barriers.

This paper is a based on the Baltes Award Lecture given at the Annual Meeting of The Gerontological Society of America held in Boston, Massachusetts, in November, 2011.This article reviews the empirical studies that test socioemotional aging across cultures. The review focuses on comparisons between Western (mostly North Americans and Germans) and Eastern cultures (mostly Chinese) in areas including age-related personality, social relationships, and cognition. Based on the review, I argue that aging is a meaning-making process. Individuals from each cultural context internalize cultural values with age. These internalized cultural values become goals that guide adult development. When individuals from different cultures each pursue their own goals with age, cultural differences in socioemotional aging occur. [ABSTRACT FROM PUBLISHER]

Background Policy and social change have increased women's participation in the labour market and their opportunity to combine paid work with family care. We analyse whether a specific combination of employment and domestic duties over the life course are associated with variations in English and French women's health, focusing on two birth cohorts. Methods We used sequence analysis to group women in English Longitudinal Study of Ageing and Survey of Health, Ageing and Retirement in Europe, according to their work and family histories. Using ordered logistic regression, we tested for group differences in later self-reported health and depressive symptoms, while controlling for a range of adult socio-economic circumstances. Results The findings confirm important differences between birth cohorts and countries. French women report a higher risk of poor self-reported health and mental issues than English women. Full-time domestic duties were particularly deleterious for the health of the two younger cohorts, whereas a combination of employment and domestic duties across the life course had a positive association with later-life health. Discussion Further research is needed to explore the mechanisms linking work and care trajectories to poor health. [ABSTRACT FROM AUTHOR]

Background Since the first cases of the novel coronavirus disease SARS-CoV-2 were reported in December 2019 in China, the virus has spread in most countries. The aim of the present study was to assess initial data on the mental health burden of the German public during the COVID-19 pandemic. Methods A cross-sectional study was conducted in Germany and collected complete datasets from 15 704 German residents aged 18 years and over. Besides demographics, generalized anxiety (GAD-7), depression (PHQ-2) and psychological distress (DT) were assessed. Furthermore, COVID-19-related fear, trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 were covered. Results Significantly increased symptoms were highly prevalent in all dimensions: generalized anxiety (44.9%), depression (14.3%), psychological distress (65.2%) and COVID-19-related fear (59%). Females and younger people reported higher mental burden. Trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 are negatively associated with mental health burden. However, the subjective level of information regarding COVID-19 is positively associated with increased COVID-19-related fear. Conclusions The provision of appropriate psychological interventions for those in need and the provision of transparency and comprehensible information are crucial during the current pandemic. [ABSTRACT FROM AUTHOR]

Objectives Preparation for age-related changes has been shown to be beneficial to adjustment in later life. However, an understanding of the factors that influence such preparations is rather limited. This study examines whether perceived control and future-self views (FSV) influence preparations for old age, and if this influence varies across ages, domains of functioning, and cultures. Methods Assessments of perceived control, FSV, and preparations for old age in each of four different life domains (social relationships, finances, work, and health) were obtained from 1,813 adults (ages 35–85) from Germany, Hong Kong, and the United States. Results Future-self views partially mediated the relationship between perceived control and preparation for old age across both domains of functioning and cultures. With one exception, the association between perceived control and preparations increased with advancing age across contexts. Evidence for similar age-related moderation of the indirect effect of control through FSV was more limited. Discussion These results suggest that perceived control that is not necessarily related to aging affect FSV, which in turn influence preparing for old age. Further, our results indicate that such relationships are context- and age-specific, highlighting the importance of considering the salience and diversity of life domains and cultures. [ABSTRACT FROM AUTHOR]

To investigate the risk of lung cancer after exposure to welding fumes, hexavalent chromium (Cr(VI)), and nickel, we analyzed 3,418 lung cancer cases and 3,488 controls among men from 2 German case-control studies (1988–1996). We developed a welding-process exposure matrix from measurements of these agents, and this was linked with welding histories from a job-specific questionnaire to calculate cumulative exposure variables. Logistic regression models were fitted to estimate odds ratios with confidence intervals conditional on study, and they adjusted for age, smoking, and working in other at-risk occupations. Additionally, we mutually adjusted for the other exposure variables under study. Overall, 800 cases and 645 controls ever worked as regular or occasional welders. Odds ratios for lung cancer with high exposure were 1.55 (95% confidence interval (CI): 1.17, 2.05; median, 1.8 mg/m3 × years) for welding fumes, 1.85 (95% CI: 1.35, 2.54; median, 1.4 μg/m3 × years) for Cr(VI), and 1.60 (95% CI: 1.21, 2.12; median, 9 μg/m3 × years) for nickel. Risk estimates increased with increasing cumulative exposure to welding fumes and with increasing exposure duration for Cr(VI) and nickel. Our results showed that welding fumes, Cr(VI), and nickel might contribute independently to the excess lung cancer risk associated with welding. However, quantitative exposure assessment remains challenging. [ABSTRACT FROM AUTHOR]

Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99–4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29–3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed. [ABSTRACT FROM AUTHOR]

Background: The European population is aging. The main drivers of public spending on health care for people of 65 years and older are hospital admission and admission to long-term care facilities. High quality community care can be a cost-effective and quality solution to respond to the impact of ageing populations on health-care systems. It is unclear how well countries are equipped to provide affordable and quality community care. The aim of this article is to describe and compare community care delivery with care-dependent older people in Europe. Methods: This study is conducted within the European Union-financed IBenC project [Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (FP7)] in which six European countries are involved. To compare the community care delivery with care-dependent older people in these countries, we performed a systematic comparison of macro indicators using metadata complemented with data from multinational surveys. Results: Data on the following dimensions are described and compared: population of the country, governmental expenditures on health, sources of community health services funding, governmental vision and regulation on community care, community care organisations and care professionals, eligibility criteria for and equity in receiving care and the involvement of informal care. Conclusion: Because of the variations in the European community care contexts, the growing demand for community care as a cost-effective and quality solution to the care burden of aging populations will have country-specific impacts. When learning from other countries' best practices, in addition to researchers, policy makers should take full account of local and national care contexts. [ABSTRACT FROM AUTHOR]

We compared alcohol use among adolescents with and without hearing loss. Adolescents with hearing loss reported consuming less alcohol, less binge drinking, fewer episodes of drunkenness, and a higher age at first drunkenness than their hearing peers. Alcohol use did not vary between students who were deaf or hard of hearing or between students with congenital versus acquired hearing loss. Although higher age, male gender, and larger friend networks predicted higher alcohol consumption among adolescents with and without hearing loss, worse grades at school were associated only with alcohol use among hearing students. Lower alcohol use among students with hearing loss when compared with hearing peers was, in part, explained by their lower level of peer-group integration. Although alcohol use is a less serious problem among students with hearing loss, a minority with risky consumption would benefit from interventions aimed at reducing alcohol use. [ABSTRACT FROM PUBLISHER]

Background: Incidence rates of cervical and uterine cancer are usually determined without elimination of hysterectomized women from the population at risk. The aim of this report is to provide age-specific incidence rates of these cancers uncorrected and corrected for hysterectomized women in Germany and to compare these findings with the international literature. Methods: Most recent incidence estimates of cervical and uterine cancer (11,318 and 26,379 cervical and uterine cancer cases, respectively) of the years 2003–7 in Germany were included. The population at risk was corrected by age-specific prevalence estimates of hysterectomy in Germany. Thereafter, corrected incidence rates were estimated. Results: The incidence of cervical and uterine cancer among women aged 65 years or more increased by 67% (cervical cancer from 16.5 to 27.5 and uterine cancer from 79.6 to 133.2 per 100,000 person-years) after correction for hysterectomized women. The distortion of the age pattern of uncorrected incidence rates of cervical cancer for women aged 45–64 years (apparent decline) in Germany virtually disappeared after correction for hysterectomized women. Correction for hysterectomized women resulted in larger relative increases of the cancer rates in the U.S. than European countries. Conclusions: Inclusion of hysterectomized women in the population at risk results in a marked underestimate of the incidences of cervical and uterine cancer among elderly women and potentially biases age-specific incidence patterns and lifetime risk estimates of these cancers. Continuous monitoring of the incidences of cervical cancer corrected for hysterectomized women is needed. [ABSTRACT FROM AUTHOR]

Background: To date, there is hardly any study focussing on the question how the concept of HRQL could deepen our understanding of health inequalities. The study aims at describing this potential by analysing data for adults from Germany. Methods: The analyses are based on three national, representative surveys conducted from 2006 to 2008. HRQL was assessed by the EuroQol-5D (EQ-5D), the descriptive part (problems in five dimensions) and the valuation of health by visual analogue scale (VAS) rendering a value between ‘0’ (worst) and ‘100’ (best imaginable). The major independent variable is educational level (high vs. low). Four other variables were included (i.e. age, sex, per capita income and chronic disease). Multivariate analyses were performed by logistic and linear regression. Results: Data were available for 5676 persons aged &geq;20 years (response rate 73%). The prevalence of ‘moderate or severe problems’ is especially high in the dimension ‘pain/discomfort’ (low resp. high educational level: 46.3% resp. 25.0%). The mean VAS-value is 79.8 (low resp. high educational level: 75.3 resp. 83.6). Bivariate and multivariate analyses show that similar differences in VAS-values can be seen even after restricting the analyses to participants with a chronic disease. Conclusion: Empirical analyses concerning HRQL could further our understanding of health inequalities. They indicate that low status groups are faced with a double burden, first by increased levels of health impairments, and second by lower levels of HRQL once health is impaired. Thus, the extent of health inequalities could be underestimated if measures of HRQL are not taken into account. [ABSTRACT FROM PUBLISHER]

Objectives. We tested whether formal volunteering, in terms of its associations with mental health, compensates for the absence of major work and family roles among older adults or rather complements such roles among both younger and older adults. Method. Two cross-sectional samples of younger (aged 18–42 years, N = 2,346) and older (aged 56–75 years, N = 1,422) German adults were used. We regressed mental health indicators on control variables, 2 indicators of formal volunteering (participation in voluntary organizations and volunteer work), and their interactions with employment/partnership status. Results. Participation in voluntary organizations was associated with higher positive affect, higher life satisfaction, and fewer depressive symptoms in younger adults. In older adults, it was related to higher life satisfaction only among working individuals, although the difference from nonworking individuals was not significant. Volunteer work was associated with higher positive affect in both age groups. In younger adults, it had no relation to life satisfaction and depressive symptoms. In older adults, it was related to higher life satisfaction among nonworking individuals and to fewer depressive symptoms among those without a steady partner. Discussion. Volunteer work but not participation in voluntary organizations yielded compensatory effects on mental health among older adults. [ABSTRACT FROM PUBLISHER]

Background: As exposure to tobacco smoke pollution (TSP) has been identified as a cause of premature death and disease in non-smokers, and studies have demonstrated that smoking in cars produces high levels of TSP, this study will investigate smokers’ rules for smoking in their cars, and predictors of car smoking rules, including potentially modifiable correlates. Methods: Data were drawn from nationally representative samples of current smokers from the International Tobacco Control Policy Evaluation Project surveys in France (2007), Germany (2007), and the Netherlands (2008). Smokers in France and Germany were asked about smoking rules in their cars, and smokers in the Netherlands were asked about smoking rules in cars carrying children. Results: In France and Germany, 59% and 52% of smokers respectively, allowed smoking in their cars. In the Netherlands, 36% of smokers allowed smoking in cars carrying children. Predictors of allowing smoking in cars included: being a daily vs. non-daily smoker, being younger vs. older age, having no (young) children in the home, being a heavier smoker, and allowing smoking in the home. In the Netherlands, smokers who agreed that TSP is dangerous to non-smokers were less likely to allow smoking in cars carrying children. Conclusion: Overall, a sizeable proportion of smokers allowed smoking in their cars across the three countries. Media campaigns with information about the dangers of TSP may increase the adoption of smoke-free cars. These media campaigns could target smokers who are most likely to allow smoking in cars. [ABSTRACT FROM AUTHOR]

Background: Despite the ban on misleading descriptors such as light or mild cigarettes in Europe, there are still widespread misperceptions of the relative harmfulness of different brands of cigarettes among smokers. This study examined the extent to which smokers in three European countries believed that some cigarette brands are less harmful and why, using data from the International Tobacco Control (ITC) Europe surveys. Methods: Cross-sectional analyses were completed among nationally representative samples of 4,956 current smokers (aged ≥ 18) from Germany (n = 1,515), France (n = 1,735) and the United Kingdom (n = 1,706) conducted between September 2006 and November 2007. Logistic regression models examined whether outcomes, including beliefs that some cigarettes could be less harmful than others, varied by socio-demographic and country of residence. Findings: Around a quarter of smokers in the UK and France, and a third in Germany believed some cigarettes are less harmful than others. Overall, of smokers who falsely believed that some cigarettes are less harmful, 86.3% thought that tar/nicotine yields, 48.7% taste, and 40.4% terms on packs such as ‘smooth’ or ‘ultra’ indicated less harmful brands. About a fifth of smokers across all countries chose their brand based on health reasons, and a similar proportion gave tar yields as a reason for choosing brands. Conclusions: Our research suggests that the current European Tobacco Products Directive is inadequate in eliminating misperceptions about the relative risk of brand descriptors on cigarettes. There is therefore an urgent need to protect smokers in Europe from these misperceptions via stronger measures such as plain packaging regulations. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the age-specific pattern of administration of chemotherapy and its association with long-term survival and quality of life (QoL) in stage II and III colorectal cancer patients. Methods. Chemotherapy allocation according to disease and patient characteristics was investigated in a population-based cohort of 562 stage II and III colorectal cancer patients. Five years after diagnosis, survival was determined and QoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 Items and a tumor specific module. The association among chemotherapy, survival, and QoL was examined while controlling for potential confounders. Results. Chemotherapy was administered in 71% of patients aged <60 years and in only 20% of patients aged ≥80 years. A significant association between chemotherapy and longer survival time was found for stage III cancer only. Chemotherapy was associated with higher symptom levels for trouble with taste, anxiety, and hair loss. In age-specific analyses, younger survivors (<70 years at time of follow-up) with a history of chemotherapy reported significantly lower physical, role, and cognitive functioning and higher pain, appetite loss, hair loss, and trouble with taste symptom levels. In contrast, for older survivors (≥70 years), only two (hair loss and dry mouth) out of 38 QoL scores were significantly associated with chemotherapy. Discussion. Chemotherapy is associated with lower long-term QoL, especially in younger survivors. In cases of uncertain survival benefits of chemotherapy, consideration of its long-term effects on QoL should be incorporated into final decisions on treatment. [ABSTRACT FROM AUTHOR]

The UK has long experienced a shortage of social workers and has recruited internationally to meet demand. There have been few specific data quantifying the scale of social work mobility to the UK through which such experiences can be set in context. The analysis reported in this article uses data from October 2008, relating to registered social workers working in England. As part of a wider study of migrant social care workers in England, the article reports analysis of data records of over 7,000 non-UK social workers registered to work in England and compares their characteristics to UK-qualified social workers. These analyses are supplemented by analysis of more recent application and registration data from the General Social Care Council pertaining to social workers qualified within and outside the European Union during 2008 and 2009. The findings highlight several important observations in terms of non-UK-qualified social workers' profile as well as some possible trends in migration and variations in rates of qualification verification. Over half of all international social workers in England were trained in four countries: Australia, South Africa, India and the USA. Findings are contextualised with qualitative data obtained from the wider study and policy debates. [ABSTRACT FROM PUBLISHER]