Association between Physical Activity and Sleep Difficulties among Adolescents in Germany: The Role of Socioeconomic Status

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.Peer Reviewe

Overweight and obesity among adults in Germany - Results from GEDA 2019/2020-EHIS

Background: Overweight and obesity and their associated secondary diseases are of high public health relevance. Methods: Self-reported body weight and body height data are available in the study German Health Update (GEDA 2019/2020-EHIS). The body mass index (BMI, kg/m2) was calculated and overweight (including obesity, BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) were derived. Results: According to this self-report, 53.5% of adults in Germany are overweight, men more often than women. The obesity prevalence for both sexes is 19.0%. The prevalence of overweight and obesity increases with age in both women and men. Obesity is significantly more prevalent in low education groups compared to high education groups. Compared to GEDA 2012, the prevalence of overweight is unchanged, but the obesity prevalence has continued to increase, particularly among 45- to 64-year-olds. Conclusion: The prevention potential of avoiding overweight and obesity remains high

Übergewicht und Adipositas bei Erwachsenen in Deutschland - Ergebnisse der Studie GEDA 2019/2020-EHIS

Hintergrund: Übergewicht und Adipositas und die damit verbundenen Folgekrankheiten sind von hoher Public-Health- Relevanz. Methode: In der Studie Gesundheit in Deutschland aktuell (GEDA 2019/2020-EHIS) liegen Selbstangaben zu Körpergewicht und Körpergröße vor. Daraus wurde der Body-Mass-Index (BMI, kg/m2) berechnet und die Indikatoren Übergewicht (einschließlich Adipositas, BMI ≥ 25 kg/m2) und Adipositas (BMI ≥ 30 kg/m2) abgeleitet. Ergebnisse: Laut dieser Selbstauskunft sind in Deutschland 53,5 % der Erwachsenen von Übergewicht betroffen, Männer häufiger als Frauen. Die Adipositasprävalenz liegt für beide Geschlechter bei 19,0 %. Mit zunehmendem Alter steigt bei Frauen und Männern die Prävalenz von Übergewicht sowie Adipositas an. Adipositas ist in unteren Bildungsgruppen im Vergleich zu oberen Bildungsgruppen deutlich häufiger zu finden. Im Vergleich zu GEDA 2012 ist die Prävalenz von Übergewicht unverändert, die Adipositasprävalenz hat jedoch weiter zugenommen, insbesondere bei den 45- bis 64-Jährig Schlussfolgerung: Das Präventionspotenzial, Übergewicht und Adipositas zu vermeiden, ist nach wie vor groß

COVID-19 vaccination status among people with selected citizenships: results of the study GEDA Fokus

Background: the COVID-19 vaccination offers protection against severe disease progression. Data show that people with a history of migration are less likely to be vaccinated against COVID-19 than people without a history of migration, but are at increased risk of infection. Methods: Data were used from the GEDA Fokus interview survey (November 2021 – May 2022), which included people living in Germany with Croatian, Italian, Polish, Syrian or Turkish citizenship (n=5,495). In addition to bivariate analyses, Poisson regressions were used to examine the association between uptake of at least one COVID-19 vaccination and sociodemographic, health- and migration-related factors. Results: 90.0% of participants reported having received at least one COVID-19 vaccination. Having visited a general practitioner or specialist in the past 12 months, living in Germany for 31 years or more, and having a greater sense of belonging to society in Germany were associated with vaccination uptake in bivariate analyses. Regression analysis showed that older people and those with higher education were more likely to be vaccinated. Conclusions: Sociodemographic factors are associated with uptake of the COVID-19 vaccine among individuals with selected citizenships. Low-threshold information and vaccination offers are important to ensure equal access to vaccination

Health of people with selected citizenships: results of the study GEDA Fokus

Background: The health situation of people with a history of migration is influenced by a variety of factors. This article provides an overview of the health of people with selected citizenships using various indicators. Methods: The analyses are based on the survey ‘German Health Update: Fokus (GEDA Fokus)’, which was conducted from November 2021 to May 2022 among people with Croatian, Italian, Polish, Syrian and Turkish citizenship. The prevalence for each health outcome is presented and differentiated by sociodemographic and migration-related characteristics. Poisson regressions were performed to identify relevant factors influencing health situation. Results: Self-assessed general health, the presence of depressive symptoms, prevalence of current smoking and the utilisation of general and specialist healthcare differed according to various factors considered here. In addition to sociodemographic determinants, the sense of belonging to society in Germany and self-reported experiences of discrimination were particularly associated with health outcomes. Conclusions: This article highlights the heterogeneity of the health situation of people with a history of migration and points to the need for further analyses to identify the reasons for health inequalities

Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study

Objective: Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family’s socioeconomic position and adolescents’ self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants. Methods: Using data from wave 2 of the”German Health Interview and Examination Survey for Children and Adolescents” (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents’ subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity). Results: A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained. Conclusion: The analysis revealed how a family’s position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).Peer Reviewe

What is the health status of girls and boys in the COVID-19 pandemic? Selected results of the KIDA study

Background: It is well known that there are gender differences in the health behaviour and physical and mental health of children. The COVID-19 pandemic influenced the health and lifestyles of children and adolescents by changing their living conditions. The present work investigates whether gender differences in selected health indicators are evident more than two years after the onset of the pandemic. Methods: In the study Kindergesundheit in Deutschland aktuell (KIDA) (German Children’s Health Update), cross-sectional telephone surveys were conducted with parents of 3- to 15-year-olds (n=3,478). Parental information on the general and mental health of the child, on increased need for health care and mental health services, as well as on physical activity and utilisation of sports activities were queried in standardised manner. Gender differences were assessed using Chi2 tests. Results: A total of 91% of the girls and 92% of the boys had their general health assessed as being (very) good by their parents (difference not significant, n.s.). An increased need for care and support was indicated for 10.6% of the 3- to 15-year-olds (girls: 9%, boys: 12%, n.s.). Boys met the physical activity recommendations of the WHO significantly more often (60%) than girls (54%). Good to excellent mental health was reported for 93% of both boys and girls. When changes during the pandemic were reported, no differences were found in the responses for girls compared to boys. Conclusions: Gender differences were found for individual parameters and age groups. These differences must be assessed in the context of other social determinants of health, and need to be considered when planning preventive measures

Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics

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.Peer Reviewe

Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high-income countries – a scoping review

Background: By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children’s health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. Methods: This review followed the methodology of “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews”. To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator “AND”: (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. Results: The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent–child conflicts) are identified to have mediating or moderating effects. While families’ living conditions (i.e., TVs in children’s bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. Conclusion: Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children’s health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.Peer Reviewe

Gesundheit von Menschen mit ausgewählten Staatsangehörigkeiten in Deutschland – Ergebnisse der Studie GEDA Fokus

Hintergrund: Die gesundheitliche Lage von Menschen mit Migrationsgeschichte wird durch eine Vielzahl von Faktoren beeinflusst. Dieser Beitrag gibt anhand verschiedener Indikatoren einen Überblick zur Gesundheit von Menschen mit ausgewählten Staatsangehörigkeiten. Methode: Die Auswertungen basieren auf der Befragungsstudie „Gesundheit in Deutschland aktuell: Fokus“ (GEDA Fokus), die von November 2021 bis Mai 2022 unter Menschen mit italienischer, kroatischer, polnischer, syrischer und türkischer Staatsangehörigkeit durchgeführt wurde. Dargestellt werden die Prävalenzen der jeweiligen Gesundheitsoutcomes, differenziert nach soziodemografischen sowie migrationsbezogenen Merkmalen. Zur Identifikation relevanter Einflussfaktoren auf die gesundheitliche Lage wurden Poisson-Regressionen durchgeführt. Ergebnisse: Der selbsteingeschätzte allgemeine Gesundheitszustand, das Vorliegen einer depressiven Symptomatik, die Prävalenz des aktuellen Rauchens und die Inanspruchnahme allgemein- sowie fachärztlicher Leistungen variieren nach den hier betrachteten Merkmalen. Neben den soziodemografischen Determinanten sind insbesondere das Zugehörigkeitsgefühl zur Gesellschaft in Deutschland sowie die subjektiv wahrgenommenen Diskriminierungserfahrungen mit den Gesundheitsoutcomes assoziiert. Schlussfolgerungen: Der Beitrag zeigt die Heterogenität der gesundheitlichen Lage von Menschen mit Migrationsgeschichte auf und verweist auf den Bedarf weiterer Analysen, um Gründe für gesundheitliche Ungleichheiten sichtbar zu machen