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  • 1
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    Lung function trajectories using different reference equations in a birth cohort study up to the age of 20 years
    European Respiratory Society (ERS) ; 2018
    In:  European Respiratory Journal Vol. 52, No. 2 ( 2018-08), p. 1800364-
    Details
    In: European Respiratory Journal, European Respiratory Society (ERS), Vol. 52, No. 2 ( 2018-08), p. 1800364-
    Type of Medium: Online Resource
    ISSN: 0903-1936 , 1399-3003
    URL: Article
    DOI: 10.1183/13993003.00364-2018
    Language: English
    Publisher: European Respiratory Society (ERS)
    Publication Date: 2018
    detail.hit.zdb_id: 2834928-3
    detail.hit.zdb_id: 1499101-9
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  • 2
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    Socio-demographic and employment-related factors in the German National Cohort (GNC; NAKO Gesundheitsstudie)
    Springer Science and Business Media LLC ; 2020
    In:  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Vol. 63, No. 3 ( 2020-03), p. 267-278
    Details
    In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Springer Science and Business Media LLC, Vol. 63, No. 3 ( 2020-03), p. 267-278
    Abstract: In epidemiologic studies, standardised measurement of socio-demographic and employment-related factors is becoming increasingly important, as variables such as gender, age, education or employment status are factors influencing health and disease risks. Aims The article gives an overview of the scientific background and assessment of socio-demographic factors in the German National Cohort Study. In addition, the distribution of individual characteristics in the cohort as well as relationships with health-related measures are presented by way of example. Material and methods The analysis is based on the data of the first half of the baseline survey ( n  = 101,724). On this basis, we present the distribution of key socio-demographic characteristics and analyse relationships with exemplary selected health indicators (body mass index, self-reported health) to assess the validity of socio-demographic data measurements. Results On average, study participants were 52.0 years old (SD = 12.4). Of the participants, 53.6% were women, 54.3% had high education, 60.1% were married and 72% were employed while 3.4% were unemployed. Well-established correlations between socio-demographic factors and health could be reproduced with the German National Cohort data. For example, low education, old age and unemployment were associated with an increased prevalence of obesity and poor self-reported health. Discussion The German National Cohort provides a comprehensive measurement of socio-demographic characteristics. Combined with a wide range of health data and the longitudinal measurements available in the future, this opens up new opportunities for health science and social epidemiological research in Germany.
    Type of Medium: Online Resource
    ISSN: 1436-9990 , 1437-1588
    URL: Article
    DOI: 10.1007/s00103-020-03098-8
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1470303-8
    SSG: 20,1
    SSG: 8,1
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  • 3
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    School-to-work and school-to-university transition and health inequalities among young adults: a scoping review
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 7 ( 2022-07), p. e058273-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 7 ( 2022-07), p. e058273-
    Abstract: The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16–24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours. Design Scoping review. Study selection Relevant literature was systematically searched following the methodological framework proposed by Arksey and O’Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered. Data extraction To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment). Results A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible. Conclusions This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    URL: Article
    DOI: 10.1136/bmjopen-2021-058273
    DOI: 10.1136/bmjopen-2021-058273.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 4
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    Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers’ BMI in Germany
    Springer Science and Business Media LLC ; 2022
    In:  BMC Public Health Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: The number of obese children is rising worldwide. Many studies have investigated single determinants of children’s body mass index (BMI), yet studies measuring determinants at different potential levels of influence are sparse. The aim of this study is to investigate the independent role of parental socioeconomic position (SEP), additional family factors at the micro level, as well as early childhood education and care (ECEC) centre characteristics at the meso level regarding BMI. Methods Analyses used the baseline data of the PReschool INtervention Study (PRINS) including up to 1,151 children from 53 ECEC centres. Multi-level models first estimated the associations of parental SEP indicators (parental school education, vocational training, and household income) with the children’s standard deviation scores for BMI (SDS BMI, standardised for age and gender). Second, structural (number of siblings), psychosocial (strained family relationships), and nutrition behavioural (soft-drink consumption, frequency of fast-food restaurant visits) family factors at the micro level were included. Third, characteristics of the ECEC centre at the meso level in terms of average group size, the ratio of overweight children in the group, ECEC centre type (all-day care), and the location of the ECEC centre (rural vs urban) were included. All analyses were stratified by gender and adjusted for age, migration background, and parental employment status. Results Estimates for boys and girls appeared to differ. In the full model, for boys the parental SEP indicators were not related to SDS BMI. Factors related to SDS BMI in boys were: two or more siblings; B = -.55; p  = 0.045 [ref.: no sibling]), the characteristics of the ECEC centre in terms of average group size (20 – 25 children; B = -.54; p  = 0.022 [ref.:  〈  20 children]), and the ratio of overweight children (more overweight children B = -1.39; p   〈  0.001 [ref.: few overweight children]). For girls the number of siblings (two and more siblings; B = .67; p  = 0.027 [ref.: no sibling]) and average group size ( 〉  25 children; B = -.52; p  = 0.037 [ref.:  〈  20 children]) were related to SDS BMI. Conclusions The BMI of preschool children appears to be associated with determinants at the micro and meso level, however with some gender differences. The identified factors at the micro and meso level appear largely modifiable and can inform about possible interventions to reduce obesity in preschool children.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-022-13814-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041338-5
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  • 5
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    Occupational differences of COVID-19 morbidity and mortality in Germany. An analysis of health insurance data from 3.17 million insured persons
    Springer Science and Business Media LLC ; 2023
    In:  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Vol. 66, No. 8 ( 2023-08), p. 857-868
    Details
    In: Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, Springer Science and Business Media LLC, Vol. 66, No. 8 ( 2023-08), p. 857-868
    Abstract: During the COVID-19 pandemic, occupation was assumed to play a central role in the occurrence of infection and disease. For Germany, however, there are only a few studies that analyse occupational differences in risk of COVID-19, COVID-19-associated hospitalisation, and mortality. Methods The study uses longitudinal health insurance data from the research database of the Institute for Applied Health Research (InGef) with information on 3.17 million insured persons aged 18–67 years (1,488,452 women; 1,684,705 men). Outcomes (morbidity, hospitalisation, and mortality) were determined on the basis of submitted COVID-19 diagnoses between 1 January 2020 and 31 December 2021. Occupations were classified according to four groupings of the official German classification of occupations. In addition to cumulative incidences, relative risks (RR) were calculated – separately for men and women. Results There is an increased risk of disease in personal service occupations, especially in health care, compared to other occupations (RR for women 1.46; for men 1.30). The same applies to social and cultural service occupations (but only for women) and for manufacturing occupations (only for men). In addition, the risks for hospitalisation and mortality are increased for cleaning occupations and transport and logistics occupations (especially for men). For all three outcomes, the risks are higher in non-managerial occupations and differ by skill level (highest for unskilled jobs and lowest for expert positions). Conclusion The study provides important findings on work- and gender-related differences in COVID-19 morbidity and mortality in Germany, which indicate starting points for structural infection protection measures.
    Type of Medium: Online Resource
    ISSN: 1436-9990 , 1437-1588
    URL: Article
    DOI: 10.1007/s00103-023-03738-9
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1470303-8
    SSG: 20,1
    SSG: 8,1
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  • 6
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    Health inequalities among young workers: the mediating role of working conditions and company characteristics
    Springer Science and Business Media LLC ; 2023
    In:  International Archives of Occupational and Environmental Health
    Details
    In: International Archives of Occupational and Environmental Health, Springer Science and Business Media LLC
    Abstract: Few studies have investigated health inequalities among young workers. The objectives of this study are to assess the extent of health inequalities in a sample of job starters and to explore the contribution of job demands and organisational factors. Methods We analyze data from the BIBB/BAuA Youth Employment Survey 2012. The cross-sectional survey includes a representative sample of 3214 German employees, apprentices, and trainees aged 15–24 years. Individuals were grouped by their years of schooling into low ( 〈  12 years) and high levels of education (≥ 12 years). Regression analysis estimated the link between education and four health outcomes: self-rated health, number of health events, musculoskeletal symptoms, and mental health problems over the last 12 months. Counterfactual mediation analysis tested for indirect effects of education via working conditions (i.e., physical and psychosocial job demands) and company characteristics (i.e., company size, health prevention measures, financial situation, downsizing). All analyses were adjusted for age, sex, nationality, region, working hours, job tenure, employment relationship, and economic sector. Results Highly educated workers reported better self-rated health ( b  = 0.24, 95% CI 0.18–0.31) and lower numbers of health events (Rate Ratio (RR) = 0.74, 95% CI 0.67–0.82), musculoskeletal symptoms (RR = 0.73, 95% CI 0.66–0.80) and mental health problems (RR = 0.84, 95% CI 0.76–0.93). Total job demands explained between 21.6% and 87.2% of the educational differences (depending on health outcome). Unfavourable company characteristics were associated with worse health, but showed no or only small mediation effects. Conclusions Health inequalities are already present at the early working career due to socio-economically stratified working hazards. To enhance prevention measures that aim at reducing inequalities in workplace health, we propose shifting attention towards earlier stages of life.
    Type of Medium: Online Resource
    ISSN: 0340-0131 , 1432-1246
    URL: Article
    DOI: 10.1007/s00420-023-02010-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459213-7
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  • 7
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    Global economic burden of unmet surgical need for appendicitis
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Abstract: There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac195
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 8
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    Young Workers’ Access to and Awareness of Occupational Safety and Health Services: Age-Differences and Possible Drivers in a Large Survey of Employees in Italy
    MDPI AG ; 2018
    In:  International Journal of Environmental Research and Public Health Vol. 15, No. 7 ( 2018-07-17), p. 1511-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 15, No. 7 ( 2018-07-17), p. 1511-
    Abstract: Young workers are in particular need of occupational safety and health (OSH) services, but it is unclear whether they have the necessary access to such services. We compared young with older workers in terms of the access to and awareness of OSH services, and examined if differences in employment conditions accounted for age-differences. We used survey data from Italy (INSuLA 1, 2014), with a sample of 8000 employed men and women aged 19 to 65 years, including 732 young workers aged under 30 years. Six questions measured access to services, and five questions assessed awareness of different OSH issues. Several employment conditions were included. Analyses revealed that young workers had less access and a lower awareness of OSH issues compared with older workers. For instance, odds ratios (OR) suggest that young workers had a 1.44 times higher likelihood [95%—confidence interval 1.21–1.70] of having no access to an occupational physician, and were more likely (2.22 [1.39–3.38] ) to be unaware of legal OSH frameworks. Adjustment for selected employment conditions (company size, temporary contract) substantially reduced OR’s, indicating that these conditions contribute to differences between older and younger workers. We conclude that OSH management should pay particular attention to young workers in general and, to young workers in precarious employment, and working in small companies in particular.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph15071511
    Language: English
    Publisher: MDPI AG
    Publication Date: 2018
    detail.hit.zdb_id: 2175195-X
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  • 9
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    Increase in mental disorders during the COVID-19 pandemic—the role of occupational and financial strains. An analysis of the German National Cohort (NAKO) Study
    Deutscher Arzte-Verlag GmbH ; 2022
    In:  Deutsches Ärzteblatt international ( 2022-03-18)
    Details
    In: Deutsches Ärzteblatt international, Deutscher Arzte-Verlag GmbH, ( 2022-03-18)
    Type of Medium: Online Resource
    ISSN: 1866-0452
    URL: Article
    DOI: 10.3238/arztebl.m2022.0133
    Language: German
    Publisher: Deutscher Arzte-Verlag GmbH
    Publication Date: 2022
    detail.hit.zdb_id: 2406159-1
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  • 10
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    Working while sick in context of regional unemployment: a Europe-wide cross-sectional study
    BMJ ; 2021
    In:  Journal of Epidemiology and Community Health Vol. 75, No. 6 ( 2021-06), p. 574-580
    Details
    In: Journal of Epidemiology and Community Health, BMJ, Vol. 75, No. 6 ( 2021-06), p. 574-580
    Abstract: Research suggests that areas with high unemployment have lower rates of sickness absence, but the underlying mechanisms remain unclear. One assumption is that when unemployment is high people are more likely to work while being sick (discipline hypothesis). Against this background, we investigate the association between regional unemployment and sickness presenteeism. Second, we study interactions with factors of occupational disadvantage. Methods We combined survey data of 20 974 employees collected 2015 in 232 regions from 35 European countries with data on regional unemployment rates obtained from Eurostat. Presenteeism was assessed by the fraction of days worked while ill among all days with illness (presenteeism propensity). To investigate if unemployment was related to presenteeism, we estimated multi-level models (individuals nested in regions) that were adjusted for socio-demographic and occupational covariates to account for compositional differences of the regions. Results The mean presenteeism propensity was 34.8 (SD 40.4), indicating that workers chose presenteeism in 1 out of 3 days with sickness. We found that a change in unemployment by +10 percentage points was associated with a change in presenteeism by +5 percentage points (95% CI 1.2 to 8.6). This relationship was more pronounced among workers with low salary, low skill-level, and industrial and healthcare workers. Conclusion Our results support the assumption that high unemployment elevates presenteeism, and that people in disadvantaged occupations are particularly affected. Policies managing presenteeism should consider the labour market context, particularly during the aftermath of the COVID-19 pandemic.
    Type of Medium: Online Resource
    ISSN: 0143-005X , 1470-2738
    URL: Article
    DOI: 10.1136/jech-2020-214888
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2015405-7
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