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Zusammenfassung Hintergrund Die Lebenslage von Alleinerziehenden und ihren Kindern geht oft mit besonderen Herausforderungen einher, die in Folge gesundheitliche Beeinträchtigungen mit sich bringen können. Es ist daher von Relevanz, für diese Zielgruppe wirksame Maßnahmen der Gesundheitsförderung zu identifizieren. Ziel der Arbeit Die vorliegende Arbeit gibt einen aktuellen Überblick zu Ansätzen der Gesundheitsförderung/Prävention bei Alleinerziehenden und ihren Kindern sowie deren Wirksamkeit. Methode Es erfolgte eine systematische Recherche in relevanten Datenbanken mit anschließendem mehrschrittigen Screeningprozess und einer narrativen Ergebnissynthese. Ergebnisse Es wurden 27 Studien eingeschlossen, in denen 22 Interventionsprogramme evaluiert wurden. Die Studienlage ist verhaltenspräventiv geprägt, die Evidenzlage ist heterogen. Es zeigen sich eingeschränkte Wirksamkeitsnachweise von Workshop-Formaten, Bildungsangeboten und Kompetenztrainings mit dem Ziel der psychosozialen Ressourcenstärkung bei Alleinerziehenden und ihren Kindern. Schlussfolgerung Die Belastbarkeit der Ergebnisse wird durch die mäßige methodische Qualität der Studien relativiert. Durch die Suchstrategie, die auf Studien mit Outcomes für Alleinerziehende fokussiert war, sowie die Methodik des systematischen Reviews wurden fast ausschließlich Angebote der Verhaltensprävention identifiziert. Für verhältnispräventive Interventionen liegen nur selten Studien vor, die explizit Auskunft zur Wirksamkeit bei Alleinerziehenden geben. Das gewählte Vorgehen war somit nur begrenzt in der Lage, das Handlungsfeld umfassend abzubilden. Das Review liefert dennoch einen Baustein eines evidenzbasierten Vorgehens in der Gesundheitsförderung für Alleinerziehende und ihre Kinder.

Zusammenfassung. Zeigt sich in Deutschland ein Zusammenhang zwischen elterlichen Belastungen und emotionalen und Verhaltensauffälligkeiten bei Kindern und Jugendlichen? Mit den Daten der ersten Folgebefragung des Kinder- und Jugendgesundheitssurveys (KiGGS Welle 1) wurde der Zusammenhang von 13 subjektiv berichteten elterlichen Belastungsformen mit einem auffälligen SDQ-Gesamtproblem- und Impactwert bei 3- bis 17-Jährigen analysiert (n=10891). Eltern mit psychischen Erkrankungen, niedrigem sozioökonomischen Status sowie Alleinerziehende berichten überdurchschnittlich häufig von Belastungen. Belastete Eltern haben eine deutlich höhere Chance ein als auffällig eingestuftes Kind zu haben als nicht belastete Eltern; dies trifft auch nach Kontrolle für familiäre Faktoren zu. Die Reduzierung elterlicher Belastungen kann einen wichtigen Ansatzpunkt darstellen, um die psychische Gesundheit von Kindern und Jugendlichen gerade aus sozial benachteiligten Familien zu verbessern.

In the last decades, young adulthood has established as an independent phase of life with important biographical transitions impacting further life course and health. In turn, health in adolescence can also affect the transitions into young adulthood. So far, for Germany there are no analyses on the association between family-related and employment-related biographies and obesity in young adults. The analysis is based on data from the KiGGS cohort study on 3,100 participants aged 23-31 at second follow-up (t2). Using BMI measurements at t0 (2003-2006) and at t2 (2014-2017), obesity groups were formed (no obesity, incidence, remission, persistence). Sequence analysis was used to retrospectively determine family-related and education/employment-related individual trajectories. Differences in life courses between obesity groups were calculated using discrepancy tests. Young adults with incident obesity were more likely to have children or to be a single parent than young adults without obesity at t2. Young adults with obesity at t0 lived longer in the parental home than those without obesity. Young adults with incident or persistent obesity were less likely to attend university and had experienced longer periods of unemployment than those without obesity at t0 and t2. The employment sequences of those without obesity at t2 were not statistically different. Both family and employment biographies were associated with obesity trajectories in young people. However, based on the analysis, it cannot be clarified whether early parenthood led to obesity or early transitions into parenthood led to interruptions in education or employment and subsequently to obesity. The finding that young adults with obesity were less likely to attend university and more likely to be unemployed could be related to disadvantages or discrimination in school, education or work. Obesity in adolescence that did not persist into young adulthood had less adverse effects on education and employment. Key messages Young people’s obesity trajectories were linked to different family/employment biographies. The life courses of young adults with obesity were more often marked by early parenthood and unemployment.

We examined sleep difficulties among adolescents in Germany and the association with physical activity (PA). Furthermore, we analyzed whether the association varied with the socioeconomic status (SES) among adolescent girls and boys in Germany. Using data from the German Health Interview Examination Survey for Children and Adolescents (KiGGS) study (Wave 2), 6599 adolescents aged 11 to 17 years were included in the analyses. We conducted sex-stratified logistic regression analyses. Dependent variables were unrecommended sleep duration (defined as a duration of sleep that does not meet the recommended duration), sleep-onset difficulties, trouble sleeping, and daytime sleepiness. Most adolescent girls and boys reported sleep difficulties. While no associations between PA and sleep difficulties were observed, a significant interaction between PA and SES was found for sleep duration in boys and daytime sleepiness in girls. Thus, adolescents with low SES had fewer sleep difficulties if they met the recommendation for PA, compared with those in other SES groups. In Germany, a large proportion of adolescents have sleep difficulties. We found that the experience of sleep difficulties varied according to PA, sex, and the family SES. Future sleep promotion programs should consider these differences.

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.

IntroductionWomen are more likely than men to provide unpaid care work. Previous research has shown that lack of support for various forms of unpaid care work and work-family conflicts have negative impacts on caregivers’ mental health, especially among female caregivers. COVID-19 containment measures may exacerbate existing gender inequalities both in terms of unpaid care work and adverse mental health outcomes. This scoping review protocol describes the systematic approach to review published literature from March 2020 onwards to identify empirical studies and grey literature on the mental health impact of COVID-19 containment measures on subgroups of unpaid caregivers at the intersection of gender and other categories of social difference (eg, ethnicity, age, class) in Europe.Methods and analysisThis scoping review is informed and guided by Arksey and O’Malley’s methodological framework. We will search the databases Medline, PsycINFO, Scopus, CINAHL, Social Sciences Abstracts, Sociological Abstracts as well as Applied Social Sciences Index & Abstracts (ASSIA) and hand-search reference lists of selected articles to identify relevant peer-reviewed studies. We will conduct a grey literature search using Google Scholar and targeted hand-search on known international and European websites and include reports, working papers, policy briefs and book chapters that meet the inclusion criteria. Studies that report gender-segregated findings for mental health outcomes associated with unpaid care work in the context of COVID-19 containment measures in Europe will be included. Two reviewers will independently screen all abstracts and full texts for inclusion, and extract general information, study characteristics and relevant findings. Results will be synthesized narratively.Ethics and disseminationThis study is a review of published literature; ethics approval is not warranted. The findings of this study will inform public health research and policy. The results will be disseminated through a peer-reviewed publication and conference presentations.

The main strategy for combatting SARS-CoV-2 infections in 2020 consisted of behavioural regulations including contact reduction, maintaining distance, hand hygiene, and mask wearing. COVID-19-related risk perception and knowledge may influence protective behaviour, and education could be an important determinant. The current study investigated differences by education level in risk perception, knowledge and protective behaviour regarding COVID-19 in Germany, exploring the development of the pandemic over time. The COVID-19 Snapshot Monitoring study is a repeated cross-sectional online survey conducted during the pandemic in Germany from 3 March 2020 (waves 1–28: 27,957 participants aged 18–74). Differences in risk perception, knowledge and protective behaviour according to education level (high versus low) were analysed using linear and logistic regression. Time trends were accounted for by interaction terms for education level and calendar week. Regarding protective behaviour, interaction terms were tested for all risk perception and knowledge variables with education level. The strongest associations with education level were evident for perceived and factual knowledge regarding COVID-19. Moreover, associations were found between low education level and higher perceived severity, and between low education level and lower perceived probability. Highly educated men were more worried about COVID-19 than those with low levels of education. No educational differences were observed for perceived susceptibility or fear. Higher compliance with hand washing was found in highly educated women, and higher compliance with maintaining distance was found in highly educated men. Regarding maintaining distance, the impact of perceived severity differed between education groups. In men, significant moderation effects of education level on the association between factual knowledge and all three protective behaviours were found. During the pandemic, risk perception and protective behaviour varied greatly over time. Overall, differences by education level were relatively small. For risk communication, reaching all population groups irrespective of education level is critical.

The combination of work and family roles can lead to work-to-family conflict (WTFC), which may have consequences for the parents’ health. We examined the association between WTFC and self-reported general health among working parents in Germany over time. Data were drawn from wave 6 (2013) and wave 8 (2015) of the German family and relationship panel. It included working persons living together with at least one child in the household (791 mothers and 723 fathers). Using logistic regressions, we estimated the longitudinal effects of WTFC in wave 6 and 8 on self-reported general health in wave 8. Moderating effects of education were also considered. The odds ratio for poor self-reported general health for mothers who developed WTFC in wave 8 compared to mothers who never reported conflicts was 2.4 (95% CI: 1.54–3.68). For fathers with newly emerged WTFC in wave 8, the odds ratio was 1.8 (95% CI: 1.03–3.04). Interactions of WTFC with low education showed no significant effects on self-reported general health, although tendencies show that fathers with lower education are more affected. It remains to be discussed how health-related consequences of WTFC can be reduced e.g., through workplace interventions and reconciliation policies.

ZusammenfassungDie Lebenssituation alleinerziehender Mütter und Väter geht mit spezifischen Anforderungen einher, aus denen im Vergleich zu Eltern in Partnerschaft höhere psychosoziale und körperliche Belastungen entstehen können. Dabei wird sozialer Unterstützung als Ressource eine protektive Rolle zugeschrieben. Der vorliegende Beitrag untersucht, inwiefern soziale Unterstützung das Ausmaß der psychosozialen Belastungen von Alleinerziehenden moderiert. Datenbasis bilden die Erhebungen 2009, 2010 und 2012 der Studie „Gesundheit in Deutschland aktuell“ (GEDA) des Robert Koch-Instituts. Die Stichprobe alleinerziehender Eltern umfasst 2062 Mütter und 242 Väter. Mit logistischen und negativ-binomialen Regressionen wird für Alleinerziehende die Bedeutung sozialer Unterstützung für seelische Belastungen (selbstberichtete Anzahl seelisch belasteter Tage in den letzten 4 Wochen) sowie Depressionen (12-Monats-Prävalenz) geschätzt (adjustiert für familiäre und sozioökonomische Faktoren). Alleinerziehende Mütter mit geringer sozialer Unterstützung haben eine doppelt so hohe statistische „Chance“ (OR=2,0; 95%-KI: 1,35–2,87) für mindestens einen seelisch belasteten Tag im Vergleich zu alleinerziehenden Müttern mit starker sozialer Unterstützung. Bei alleinerziehenden Vätern ist diese „Chance“ bei geringer sozialer Unterstützung um das 3,3-Fache (95%-KI: 1,09–10,23) erhöht. Die Anzahl seelisch belasteter Tage unter alleinerziehenden Müttern steigt bei geringer sozialer Unterstützung um das 1,4-Fache (95%-KI: 1,20–1,66) (IRR). Für alleinerziehende Väter zeigt sich ein IRR von 1,7 (95%-KI: 0,97–3,01). Die „Chance“ für eine Depression in den letzten 12 Monaten ist bei alleinerziehenden Müttern mit geringer sozialer Unterstützung um das 1,8-Fache (95%-KI: 1,18–2,67) und für alleinerziehende Väter um das 2,1-Fache (95%-KI: 0,51–8,83) erhöht. Die Ergebnisse zeigen, dass soziale Unterstützung für alleinerziehende Eltern eine wichtige Ressource für die psychosoziale Gesundheit ist und unabhängig von den Lebensumständen wirkt. Forschungsbedarf besteht in Hinblick auf weitere Einflussfaktoren sowie Interaktionen zwischen sozioökonomischem Status (SES) und sozialer Unterstützung.

The increasing labor market participation of women in Europe leads to many women and men having to reconcile paid work with family work and thus reporting work-family conflict (WFC). WFC is related to different dimensions of health. In the present article, we analyzed the role different reconciliation policies among European countries may play regarding WFC and its association with self-reported health. The analyses are based on data from Eurofound's European Working Conditions Survey 2015. The working populations from 23 European countries aged between 18 and 59 with at least one child up to 18 years of age are included (n = 10,273). Weighted logistic regression was applied to estimate the association between WFC and self-reported general health (SRH). Using multilevel models, country-level variations in the association of individual-level WFC and health were calculated. In a second step, the effect of country-level reconciliation policies on WFC was examined (adjusted for age, sociodemographic and occupational characteristics). The odds ratio for moderate to very poor SRH is 2.5 (95% CI: 1.92–3.34) for mothers with high WFC compared to mothers with low WFC. For fathers with high WFC, the adjusted odds ratio is also 2.5 (95% CI: 1.80–3.37). Between countries, the association between WFC and health is similar. Country-level parental leave policies, the use of formal childcare and mothers’ labor market participation are associated with reduced WFC in Europe. In conclusion, the results reveal a strong association between WFC and SRH in Europe. The multilevel analyses show that certain reconciliation policies have an impact on the prevalence of WFC, with different results for mothers and fathers. Mothers in particular can be supported by sufficient maternal leave and formal care for children. These are tangible policy approaches for reducing WFC and may thus improve health in Europe., Highlights • Work-family conflict is associated with the self-reported general health of parents. • This association is similar for all European countries. • The proportion of parents with high work-family conflict differs between countries. • Policies explain differences in work-family conflict between European countries. • National reconciliation policies have different effects on mothers and fathers.

Ein ausgewogenes Fruhstuck ist ein wichtiger Baustein einer gesunden Ernahrung und im Kindes- und Jugendalter mit gesundheitlichen und schulleistungsbezogenen Vorteilen assoziiert. Untersucht wird, inwieweit sich das Fruhstucksverhalten von Schulkindern in Deutschland in Abhangigkeit von Alter, Geschlecht, Familienform, Sozialstatus (SES) und Migrationshintergrund (MH) unterscheidet. Die Auswertungen basieren auf Daten der ersten Folgebefragung der KiGGS-Studie (2009–2012). Analysiert wird der Anteil 6‑ bis 17-jahriger Schulkinder (n = 7547), die angeben, an jedem Wochentag zuhause zu fruhstucken. Bei der Familienform wird zwischen Kern‑, Eineltern- und Stieffamilien differenziert. Der SES wird anhand von Bildung, Beruf und Einkommen der Eltern erfasst. Der MH wird uber Informationen zum Geburtsland und zur Staatsangehorigkeit des Kindes und der Eltern bestimmt. Insgesamt fruhstucken rund zwei Drittel der Schulerinnen (65,7 %) und Schuler (70,3 %) an jedem Wochentag zuhause. Mit zunehmendem Alter nimmt der entsprechende Anteil sukzessive ab. Kinder, die in Kernfamilien aufwachsen, fruhstucken haufiger an jedem Wochentag zuhause als Gleichaltrige in Stief- und Einelternfamilien. Je hoher der SES, desto groser ist auch der Anteil der Kinder, die jeden Wochentag zuhause fruhstucken. Kinder mit beidseitigem MH fruhstucken seltener an jedem Wochentag zuhause als Gleichaltrige ohne MH. Die Ergebnisse liefern Ansatzpunkte zur Forderung einer gesunden Ernahrung in Familien und Schulen. Bei der Interpretation der Befunde gilt es jedoch zu beachten, dass die Wahrnehmung auserhauslicher Fruhstucksangebote unberucksichtigt bleibt und die Daten keine Ruckschlusse auf die Qualitat des Fruhstucks zulassen.

In the wake of a rising labor market participation of women and changing and family arrangements, parents are increasingly faced with the challenge of reconciling work and family life, which can lead to work-family conflicts (WFC). The present study examined the longitudinal effect of WFC on self-rated health among working parents in Germany. The data was drawn from wave 6 (2013) and wave 8 (2015) of the pairfam family and relationship panel. It included working persons living together with at least one child (662 mothers and 529 fathers). Pairfam is a random sample of about 12,000 persons drawn from German habitants in private households. Data was collected via computer-assisted personal interviews with yearly follow-ups. The drop-out rate of the panel from wave 1 to wave 8 is 62%. Self-rated health was measured as a single item with five response options. Using logistic regressions, we estimated the longitudinal effects of the effect of WFC in wave 8 on self-rated health. Moderating effects of education and household income were considered. The analyses were adjusted for self-rated health in wave 6. The odds ratio for poor self-rated health for mothers who developed WFC in wave 8 compared to mothers who did not report a conflict in both waves was 2.6 (95% CI: 1.47-2.41). For fathers with newly emerged WFC in wave 8, the odds ratio was 2.1 (95% CI: 1.08-3.80). Interaction of WFC with education and household income showed a weak non-significant effect on the self-rated health of mothers and fathers. The health of parents who reported a conflict in wave 6 but not in wave 8 was on a similar level as the health of parents with no conflict in both waves. The results point out that WFC can lead to a decline of self-rated health. Further investigations should be carried out to determine groups who are particularly affected by health-related outcomes of WFC. It also remains to be discussed how self-rated health can be improved e.g. through reconciliation policies. Key messages Work-family conflict leads to a poorer self-rated health of working parents in Germany. The health of working parents with lower education and income is affected more severely by work-family conflict compared to parents with higher education and income.

The lives of single mothers and fathers are associated with specific demands, which may result in higher psychosocial and physical strain compared to parents sharing their household with a partner. In this context, social support is known to function as a protective resource. The present article examines how different levels of social support interrelate with levels of mental health in single mothers and fathers in Germany. The data is drawn from the surveys 2009, 2010 and 2012 of the study "German Health Update" (GEDA) by the Robert Koch Institute. The sample includes 2062 single mothers and 242 single fathers. Logistic and negative binomial regressions estimate the interrelation between social support and psychosocial strain (self-reported number of unhealthy days due to psychological strain in the last 4 weeks) and depression (12-month prevalence) for single parents (adjusted for family and socio-economic factors). Single mothers with low social support have a 2-fold statistical odds (OR=2.0, 95% CI: 1.35-2.87) for at least one unhealthy day due to psychosocial strain compared to single mothers with strong social support. The odds for single fathers with low social support are 3.3-fold (95%-CI: 1.09-10.23). Furthermore, the number of unhealthy days increased by a factor of 1.4 (95%-CI: 1.20-1.66) for single mothers with low social support (IRR). The IRR for single fathers of the same group was 1.7-fold (95%-KI: 0.97-3.01). The odds of reported depression in the past twelve months is 1.8-fold (95%-CI: 1.18-2.67) for single mothers and 2.1 (95%-CI: 0.51-8.83) for single fathers with low social support compared to single parents with high social support. The results show that social support is an important resource for the mental health of single parents, regardless of other social circumstances. The results identify key populations to target for future health interventions. However, the correlations between social support and socio-economic status have to be explored further.Die Lebenssituation alleinerziehender Mütter und Väter geht mit spezifischen Anforderungen einher, aus denen im Vergleich zu Eltern in Partnerschaft höhere psychosoziale und körperliche Belastungen entstehen können. Dabei wird sozialer Unterstützung als Ressource eine protektive Rolle zugeschrieben. Der vorliegende Beitrag untersucht, inwiefern soziale Unterstützung das Ausmaß der psychosozialen Belastungen von Alleinerziehenden moderiert. Datenbasis bilden die Erhebungen 2009, 2010 und 2012 der Studie „Gesundheit in Deutschland aktuell“ (GEDA) des Robert Koch-Instituts. Die Stichprobe alleinerziehender Eltern umfasst 2062 Mütter und 242 Väter. Mit logistischen und negativ-binomialen Regressionen wird für Alleinerziehende die Bedeutung sozialer Unterstützung für seelische Belastungen (selbstberichtete Anzahl seelisch belasteter Tage in den letzten 4 Wochen) sowie Depressionen (12-Monats-Prävalenz) geschätzt (adjustiert für familiäre und sozioökonomische Faktoren). Alleinerziehende Mütter mit geringer sozialer Unterstützung haben eine doppelt so hohe statistische „Chance“ (OR=2,0; 95%-KI: 1,35–2,87) für mindestens einen seelisch belasteten Tag im Vergleich zu alleinerziehenden Müttern mit starker sozialer Unterstützung. Bei alleinerziehenden Vätern ist diese „Chance“ bei geringer sozialer Unterstützung um das 3,3-Fache (95%-KI: 1,09–10,23) erhöht. Die Anzahl seelisch belasteter Tage unter alleinerziehenden Müttern steigt bei geringer sozialer Unterstützung um das 1,4-Fache (95%-KI: 1,20–1,66) (IRR). Für alleinerziehende Väter zeigt sich ein IRR von 1,7 (95%-KI: 0,97–3,01). Die „Chance“ für eine Depression in den letzten 12 Monaten ist bei alleinerziehenden Müttern mit geringer sozialer Unterstützung um das 1,8-Fache (95%-KI: 1,18–2,67) und für alleinerziehende Väter um das 2,1-Fache (95%-KI: 0,51–8,83) erhöht. Die Ergebnisse zeigen, dass soziale Unterstützung für alleinerziehende Eltern eine wichtige Ressource für die psychosoziale Gesundheit ist und unabhängig von den Lebensumständen wirkt. Forschungsbedarf besteht in Hinblick auf weitere Einflussfaktoren sowie Interaktionen zwischen sozioökonomischem Status (SES) und sozialer Unterstützung.

Objective This study's aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities. Methods We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003-2006, follow-up: 2009-2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models. Results We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents' health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower. Conclusions Because the direct effects of family structure on adolescents' health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents' health, prevention programmes and interventions should be directed towards the parent-adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.

Beginning living with a partner and becoming a parent are major life events for both men and women, bringing important changes. These life changes may translate to a more responsible concern with lifestyle and health, and alterations in the evaluation of health behaviours. From the perspective of health behaviour, the transition to marriage exerts a positive influence—in marriage, an enhanced sense of obligation inhibits harmful behaviours and encourages healthy ones. Parenting similarly increases responsibility and greater self-regulation. Based on the theoretical background and the previous empirical research, the chapter investigates whether there is an association between health behaviour and either partner or parental status insofar, that partnered persons and persons living with children display healthier behaviours than individuals without a partner or without children, respectively. Because of higher levels of social control, parents of preschool-aged children and/or a higher number of children may show healthier behaviours than parents of older children or lower number of children, respectively; and single parents may display higher risk behaviour than do partnered parents because of higher levels of stress and lower levels of social support. These relationships should strongly depend on gender and may depend on SES and/or employment status. The chapter tests these hypotheses by using pooled data from the German Health Update (GEDA) survey for the years 2009 and 2010 for ages 18–45. Health behaviour is defined by tobacco consumption, at-risk alcohol consumption, fruit and vegetable consumption, and physical activity.

Der Beitrag untersucht anhand der Daten von KiGGS Welle 1, ob sich die gesundheitliche Lage von 3- bis 17-jahrigen Kindern und Jugendlichen aus Kern-, Eineltern- und Stieffamilien (n = 10.298) unterscheidet und ob die Unterschiede auch nach Kontrolle fur Alter, Geschlecht, Wohnregion sowie den elterlichen Sozialstatus und das familiare Miteinander Bestand haben (Pravalenzen, Odds Ratios). Analysiert wird dies fur die allgemeine Gesundheit, chronische Erkrankungen, emotionale und Verhaltensprobleme, die gesundheitsbezogene Lebensqualitat sowie den taglichen Obst- und Gemuseverzehr. Wahrend die allgemeine Gesundheit unabhangig von der Familienform ist, zeigen sich in den Pravalenzen der anderen Outcomes signifikante Unterschiede zwischen Kern-, Stief- und Einelternfamilien. In der multivariaten Analyse lassen sich auch nach Kontrolle fur Alter, Geschlecht, Wohnregion, den elterlichen Sozialstatus sowie das familiare Miteinander emotionale und Verhaltensprobleme haufiger bei Heranwachsenden aus Einelternfamilien (OR 1,62; 95 %-KI 1,17–2,26) und Stieffamilien (OR 2,36; 95 %-KI 1,63–3,41) als bei Heranwachsenden aus Kernfamilien feststellen. Kinder und Jugendliche aus Einelternfamilien sind zudem haufiger chronisch krank (OR 1,53; 95 %-KI 1,20–1,96) als Gleichaltrige, die mit beiden leiblichen Elternteilen zusammenleben. Kinder und Jugendliche aus Stieffamilien unterscheiden sich von Gleichaltrigen aus Kernfamilien durch das hohere Risiko fur eine geringe gesundheitsbezogene Lebensqualitat (OR 2,91; 95 %-KI 1,76–4,80) sowie fur einen geringen Obst- und Gemuseverzehr (OR 1,30; 95 %-KI 1,01–1,67). Die Ergebnisse weisen auf die Bedeutung des familiaren Kontextes fur die Gesundheit von Kindern und Jugendlichen hin.

This article provides information on trends in the utilization of outpatient medical care in childhood and adolescence in Germany on the basis of data from two waves of the KiGGS study (prevalences and odds ratios). In the period 2009-2012, 91.9% (95% CI 91.1-92.7%) of children and adolescents used outpatient medical services at least once a year. In the 12 months prior to the interview, 67.9% (95% CI 65.9-69.8%) of the 0- to 17-year-olds consulted a pediatrician and 34.1% (95% CI 31.6-36.3%) a general practitioner. Whereas there was no change in the use of either overall outpatient or general practice medical care compared to 2003-2006, a significant increase of 8.7% points in the utilization of pediatricians was found. This could be explained by, among other factors, an expansion of pediatric services (additional vaccinations and health screening examinations) in recent years. It may also be related to a significantly greater participation in the health screening program in early childhood (U3-U9 examinations), which was seen especially when comparing the youngest birth cohorts and in children from families with low social status (from U7 onwards). The increased use of health screening examinations can probably be attributed to the invitation, reminding and reporting procedures that have been introduced in recent years. Whereas at KiGGS baseline urban-rural differences in participation in health screening examinations could be seen, these were no longer apparent in KiGGS Wave 1. Similarly, differences between rural and urban regions in the use of general and pediatric medical services have also diminished. Nevertheless, currently children and young people in rural areas use outpatient general medical care to a greater extent than those in urban areas.

Hintergrund: Eine Familiengrundung beeinflusst die Erwerbsbeteiligung von Mannern deutlich weniger als die von Frauen. Die Vollzeitquote liegt bei Mannern bei etwa 90%, etwa ein Funftel davon arbeitet mehr als 48 Stunden pro Woche. Angesichts dieser hohen Arbeitsmarktintegration wird untersucht, welche Bedeutung der Erwerbsstatus und die Lange der Arbeitszeit unter Berucksichtigung von Eltern- und Partnerschaft fur die Gesundheit und das Gesundheitsverhalten von Mannern im erwerbsfahigen Alter haben. Methode: Die Analysen basieren auf gepoolten Daten der Studie Gesundheit in Deutschland aktuell (GEDA) aus den Jahren 2009, 2010 und 2012. Die Grundgesamtheit bilden deutschsprachige Erwachsene in Privathaushalten in Deutschland. Die Responseraten (Response Rate 3 nach AAPOR) lagen fur 2009 bei 29,1%, fur 2010 bei 29,8% und fur 2012 bei 22,1%. Fur die Analysen standen Daten von 18.465 Mannern im Alter von 18 bis 64 Jahren zur Verfugung, 11.429 davon lebten mit Kindern im Haushalt. Mittels regressionsanalytischer Verfahren wurde der Zusammenhang zwischen Erwerbstatigkeit und seelischen Belastungen, Gesundheitsbewusstsein, sportlicher Aktivitat und Rauchen in Abhangigkeit von Partner- und Elternschaft betrachtet. Ergebnisse: Vollzeiterwerbstatige, die mehr als 48 Stunden pro Woche arbeiten, sowie Arbeitslose sind signifikant haufiger seelisch belastet (OR = 1,44, 95%-KI = 1,29 – 1,61, p < 0,05 bzw. OR = 2,35, 95%-KI = 2,02 – 2,75, p < 0,05) als Vollzeiterwerbstatige mit Arbeitszeiten von 48 Stunden oder weniger pro Woche. Vergleichbare Zusammenhange zeigen sich auch fur das Achten auf die eigene Gesundheit, die sportliche Aktivitat und das Rauchverhalten. Das Zusammenleben in Partner- und Elternschaft ist positiv mir der Gesundheit assoziiert: Manner, die mit Kindern und Partnerin im Haushalt leben, zeigen sich insgesamt weniger belastet und verhalten sich gesundheitsforderlicher als alleinstehende Manner. Bei gleichzeitiger Betrachtung von Erwerbsstatus, Eltern- und Partnerschaft sind Arbeitslose und Vollzeiterwerbstatige mit langen Arbeitszeiten besonders belastet. Schlussfolgerungen: Die vorliegenden Ergebnisse zeigen, dass Arbeit, Partnerschaft und Familie wichtige Ressourcen fur die Gesundheit von Mannern sind. Gesundheitliche Belastungen aufgrund von Arbeitslosigkeit und uberlangen Arbeitszeiten kommen unabhangig von ihrer Partner- oder Vaterschaft zum Tragen. Die vorliegenden Befunde auf Basis der GEDA-Studien stehen im Einklang mit nationalen und internationalen Ergebnissen zum Zusammenhang von Arbeitszeit, Arbeitslosigkeit sowie Partner- und Elternschaft und Gesundheit von Mannern.

Today's men want to participate in their children's upbringing more than in the past, but they are heavily involved in their occupation at the same time. This article describes the significance of parenthood, partnership and occupation in relation to health and health behaviours among men of working age in Germany.We summarised data from the "German Health Update" (GEDA) studies conducted in 2009, 2010 and 2012. Data on 18,465 men aged 18-64 years were available, 11,429 of which were living with children. We included mental health problems, general health awareness, sports activity and smoking as outcomes.Full-time employees working more than 48 h per week and unemployed persons had mental health problems more frequently (OR 1.44 and 2.35, p 0.05) than full-time employees working 48 h or fewer. Similar associations can be shown for health awareness, physical activity and smoking. Concerning partnership and parenthood, the associations were considerably weaker: men living together with children and a partner in the household were overall less burdened and their behaviour was also healthier than single men without children. After simultaneous consideration of employment status, parenthood and partnership, our results show that the unemployed and employees with long working hours were the most burdened.The results provide supporting evidence regarding health problems of men in Germany due to unemployment and long working hours that are of importance for their health whether they are living with a partner and/or with children or not. The association between health and occupation was stronger than between health and fatherhood or partnership.

Die Familie ist im Kindes- und Jugendalter die zentrale Sozialisationsinstanz. Aber welche Faktoren der familialen Lebenswelt sind fur die Gesundheit von Kindern und Jugendlichen in welcher Lebensphase von Bedeutung? Der Frage wird am Beispiel der durch die Eltern eingeschatzten allgemeinen Gesundheit nachgegangen. Datenbasis bildet die fur Deutschland reprasentative KiGGS-Studie 2003–2006 (n = 17.641, Alter: 0 bis 17 Jahre). Zur Quantifizierung der Effekte der familialen Faktoren auf die Gesundheit werden – stratifiziert nach funf Altersgruppen und Geschlecht – binar logistische Regressionsanalysen gerechnet. Einbezogen werden strukturelle, soziallagen- und herkunftsbezogene Faktoren von Familie sowie die Wohnsituation und das Familienklima. Die bivariate Analyse belegt, dass nahezu alle Faktoren (zumindest in einzelnen Altersgruppen) Einfluss auf die allgemeine Gesundheit haben. In der multivariaten Analyse zeigt sich, dass insbesondere dem Familienklima eine wichtige Bedeutung fur eine gute Gesundheit zukommt. Bei den Jungen besitzt bis zum Beginn des Jugendalters zudem ein beidseitiger Migrationshintergrund einen ungunstigen Einfluss auf eine gute allgemeine Gesundheit.