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Background Daily vegetable intake is considered an important behavioural health resource associated with improved immune function and lower incidence of non-communicable disease. Analyses of population-based data show that being female and having a high educational status is most strongly associated with increased vegetable intake. In contrast, men and individuals with a low educational status seem to be most affected by non-daily vegetable intake (non-DVI). From an intersectionality perspective, health inequalities are seen as a consequence of an unequal balance of power such as persisting gender inequality. Unravelling intersections of socially driven aspects underlying inequalities might be achieved by not relying exclusively on the male/female binary, but by considering different facets of gender roles as well. This study aims to analyse possible interactions of sex/gender or sex/gender related aspects with a variety of different socio-cultural, socio-demographic and socio-economic variables with regard to non-DVI as the health-related outcome. Method Comparative classification tree analyses with classification and regression tree (CART) and conditional inference tree (CIT) as quantitative, non-parametric, exploratory methods for the detection of subgroups with high prevalence of non-DVI were performed. Complete-case analyses (n = 19,512) were based on cross-sectional data from a National Health Telephone Interview Survey conducted in Germany. Results The CART-algorithm constructed overall smaller trees when compared to CIT, but the subgroups detected by CART were also detected by CIT. The most strongly differentiating factor for non-DVI, when not considering any further sex/gender related aspects, was the male/female binary with a non-DVI prevalence of 61.7% in men and 42.7% in women. However, the inclusion of further sex/gender related aspects revealed a more heterogenous distribution of non-DVI across the sample, bringing gendered differences in main earner status and being a blue-collar worker to the foreground. In blue-collar workers who do not live with a partner on whom they can rely on financially, the non-DVI prevalence was 69.6% in men and 57.4% in women respectively. Conclusions Public health monitoring and reporting with an intersectionality-informed and gender-equitable perspective might benefit from an integration of further sex/gender related aspects into quantitative analyses in order to detect population subgroups most affected by non-DVI. more...

In public health research and reporting, there is an increasing interest in eco-social theory and intersectional approaches to understand health inequity. Both approaches focus on the macrosocial c... more...

IntroductionHealth reporting is one of the foundations on which public health interventions and policies as well as prevention measures are developed. However, it faces the challenge of adequately reflecting social and sex/gender-related heterogeneity. The German Federal Ministry of Education and Research-funded joint project, AdvanceGender, aims to develop guidelines for sex/gender-sensitive and intersectional approach to population-based studies and health reporting. In its subproject, AdvanceHealthReport, four focus groups will be conducted to provide essential information on possible ways of participation of civil society stakeholders and on communication of health information for the further development of the guidelines (research period: from January 2019 to March 2020).Methods and analysisThe civil society stakeholders provide valuable information which health topics are relevant in regard to specific populations and how health information should be communicated in a non-stigmatising way. The groups will also discuss how civil society stakeholders should participate in health reporting. The starting point for intersections will be sex/gender. The intersection of sex/gender and migration and sex/gender and sexual orientation is particularly taken into account. The focus groups will be recorded, transcribed, anonymised and then analysed according to the qualitative content analysis.ResultsThe results will show the pathways as well as benefits and possible limitations of civil society stakeholder involvement in national health reporting and will contribute in developing guidelines for sex/gender-sensitive and intersectional health reporting.Ethics and DisseminationThe results of the focus groups will be published in scientific journals and presented at various national and international conferences. Furthermore, the findings will be incorporated into guidelines for research and health reporting. The study was approved by the Ethics Commission of Brandenburg Medical School Theodor Fontane (AZ: E-01–20180529). more...

Palliative care is more and more in the focus of politics and the public. Although provision and utilization of palliative care have increased considerably in recent years, there is still a great need for palliative services and a comprehensive supply has not yet been achieved. Reliable and continually available data are indispensable to describe developments in Germany, to identify existing gaps in palliative care provision, and to assess the impact of relevant policies. In this article, we present a systematic outline of publicly available data sources on palliative care in Germany and point out their potentials and limitations. We show that mainly data on palliative care provision are available. Data on utilization are basically limited to inpatient and specialized outpatient palliative care ("spezialisierte ambulante Palliativversorgung", SAPV). Periodical analyses of routine data, e. g. from statutory health insurances or from the Association of Statutory Health Insurance Physicians, would be helpful to fill these data gaps. Monitoring the sociodemographic characteristics of users of palliative care could also be of major interest. Another important indicator is the place of death. The difference between the places where people die and where they wish to die indicates that there is a continuous need to strengthen outpatient structures of palliative care. more...

Kinder und Jugendliche haben im Vergleich zu Erwachsenen ein besonders hohes Risiko, Unfallverletzungen zu erleiden. Um Unfallverletzungen vorzubeugen, sind detaillierte Kenntnisse uber das gesamte Unfallgeschehen und uber die Determinanten von Unfallverletzungen notwendig. Dieser Artikel gibt einen Uberblick uber Daten zu Unfallen bei Kindern und Jugendlichen in Deutschland. Laut dem Kinder- und Jugendgesundheitssurvey (KiGGS-Basiserhebung) des Robert Koch-Instituts (RKI) erleiden in Deutschland etwa 15,3 % der Kinder und Jugendlichen (1 bis 17 Jahre) pro Jahr mindestens eine Unfallverletzung. Die meisten Unfalle (60,7 %) ereignen sich zu Hause oder bei Freizeitbeschaftigungen. In Bildungs- und Betreuungseinrichtungen registrierte die Deutsche Gesetzliche Unfallversicherung (DGUV) im Jahr 2011 uber 1,4 Mio. Unfalle. Die amtliche Verkehrsunfallstatistik zahlte im gleichen Jahr mehr als 50.000 minderjahrige Verkehrsunfallopfer. Die Krankenhausdiagnosestatistik erfasste im Jahr 2011 insgesamt 260.534 stationare Behandlungsfalle aufgrund von Verletzungen und Vergiftungen bei Kindern und Jugendlichen. Alters- und geschlechtsspezifische Unterschiede zeigen sich in allen Datenquellen. Jungen sind haufiger von Unfallverletzungen betroffen als Madchen. Im Jugendalter erleiden sie mehr Unfalle als im Kleinkind- und Grundschulalter. Bei jungen Kindern ereignen sich Unfalle hauptsachlich zu Hause, bei Jugendlichen zunehmend im Verkehr oder bei Freizeitbeschaftigungen. Es gibt zahlreiche Initiativen in Deutschland, die sich der Pravention von Unfallen bei Kindern und Jugendlichen widmen. Die Ableitung zielgruppenspezifischer Praventionsmasnahmen wird durch die unterschiedlichen methodischen Zugange der verfugbaren Datenquellen erschwert. more...

Eine wachsende Zahl von Menschen in Deutschland nimmt die von der Gesetzlichen Krankenversicherung angebotenen Krebsfruherkennungsuntersuchungen (KFU) in Anspruch. Mit Daten der ersten Erhebungswelle der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) wurden aktuelle Inanspruchnahmeraten ermittelt. DEGS1 ist ein bundesweiter Befragungs- und Untersuchungssurvey (2008–2011), der reprasentative Querschnittsanalysen dazu ermoglicht. In DEGS1 wurden die jeweils anspruchsberechtigten Personen zur Kenntnis, Regelmasigkeit sowie zur turnusmasigen Inanspruchnahme von KFU fur einzelne Krebsarten befragt. Regelmasig gehen insgesamt etwa 67,2% der Frauen und 40,0% der Manner zur KFU. Bei den einzelnen Untersuchungen schwanken die Teilnahmeraten stark. Frauen nehmen an vielen KFU haufiger teil als Manner, und eine bessere soziookonomische Lage war bei ihnen mit hoheren Teilnahmeraten assoziiert. Im Alter verbessern sich die Teilnahmeraten und nahern sich zwischen den Geschlechtern an. Die Auswertungen geben Hinweise auf Bevolkerungsgruppen, die gezielt angesprochen und darin unterstutzt werden sollten, eine informierte Entscheidung zur KFU zu treffen, um die Teilnahmeraten weiter zu erhohen. Sie stellen damit eine wichtige Grundlage fur gesundheitspolitische Masnahmen dar. more...

The aim of this special issue is therefore to combine the different perspectives and to bring together the available data sources and research results on the accident and its consequences. Experts from the fields of public health, medicine, nursing, sports, psychology, prevention, come from the insurance sector and from research to speak. Equally varied are the target groups for which should provide a good introduction to the subject, or new insights for their own area of ​​interest . Language: de more...

To review migration and health as a potential new national health target for Germany. The theme was evaluated along 13 standardized criteria preset by the Health Targets Network. For each of the criteria an expert opinion based on an extensive (but nonsystematic) review of literature is presented. Migrants differ in many health-related aspects from the majority population in Germany. Despite having some health advantages, their health status, on average, is lower than that of non-migrants. They also experience barriers in health care and cannot participate in the society on equal terms with the majority population. Different measures to improve the health situation of migrants are available, but their current implementation in the health system is limited in several ways. Present data on the health of migrants is inadequate and limits migrant-sensitive health reporting. The evaluation of potential health targets based on standardized criteria is a valuable tool for health policy formulation. The present documentation can assist other countries in evaluating migration and health as a national health target. It may also contribute to similar activities at the European level. more...

Background Unintentional injuries (UIs) caused by falls are an important public health issue in ageing populations. This paper describes the incidence and consequences of falls in the adult population in Germany; the focus is on age and gender differences. Methods The representative phone survey “German Health Update 2010” (n = 22,050) provides information on up to three medically treated UIs within twelve months. Analyses focus on the characteristics of falls compared to other types of UIs. Frequencies and 95% confidence intervals (CI: 95) were calculated and logistic regression was applied to control for confounders. Results Like UIs in general, falls are more frequent in younger than in older age, particularly in men. The prevalence decreases from 5.3% (CI95: 4.2–6.7) in men aged 18–29 to 1.8% (CI95: 1.0–3.3) in men aged 70 and over. However, at the same time, the proportion of falls among all UIs rises with age: from 22.7% (CI95: 18.4–27.7) to 52.6% (CI95: 32.7–71.7) in men and from 20.1% (CI95:15.2–26.0) to 63.9% (CI95: 47.7–77.5) in women. The proportion of falls that occur at home also increases significantly with age: from 14% to over 50%. Still, among the elderly, about one third of falls occurs in public places (among pedestrians). The consequences of UIs caused by falls are often serious: 34.4% (CI95:29.8–39.4) of all falls cause bone fractures (all UIs: 20.4%; CI95: 18.3–22.6). One-quarter (26.8%; CI95: 22.4–31.7) result in hospitalisation (all UIs: 18.3%; CI95: 16.2–20.5). Moreover, the need for physical therapy and rehabilitation is higher after falling compared to all other UIs. Conclusions The data demonstrate the severity of UIs caused by falls and reveal important age and gender specific patterns. Older people are no more at risk than younger people, but the consequences for them are more serious than for the younger. Consequently, fall-related UIs are of importance in all ages and require age and gender specific approaches to prevention. more...

Background The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. Methods/design The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. Discussion DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health. more...

Background To plan preventive measures against accident-related injuries, it is important to have detailed epidemiological data on this topic. The aim of this report was to present population-based incidence estimates of injuries due to non-fatal accidents in relation to age, gender and educational level. Methods We performed a cross-sectional telephone survey from 2003 to 2004 of the resident adult population of Germany, which included 7,341 subjects (response rate: 32.6 to 39.4%). The interview included 13 questions about injuries caused by accidents that happened in the 12 months preceding the interview. We estimated one-year cumulative incidences of injuries by gender, age and educational level. Results Overall, 10.3% of the subjects reported an unintentional injury requiring medical treatment in the previous 12 months. The age-standardised incidence of injuries was higher among men than women (men: 11.3%, women: 8.9%). Generally, accidents at home were the most frequently reported (27.4%). Men and women aged 18 to 29 years suffered accident-related injuries (and also repeated injuries) the most often during the preceding 12 months. Although the overall incidence of injuries caused by accidents did not differ by educational level, the incidences of accidents at different places differed by educational level. The incidence of work-related injuries was higher among people with a low educational level. Conclusions Our age- and gender-specific results provide detailed insight into specific patterns of accident-related injuries in Germany. Young men are especially at high risk of injuries. This information is valuable because a nationwide comprehensive recording of injuries caused by accidents does not exist. The data highlight the target groups for injury prevention measures. more...