Gesundheitliche Ungleichheiten im Kindes- und Jugendalter: Trends und Mechanismen

Moor I. Gesundheitliche Ungleichheiten im Kindes- und Jugendalter: Trends und Mechanismen. Bielefeld: Universität Bielefeld; 2016

The Accidental Prospector

While excavating an ant nest in the river gravels of the NW Cape Diamond fields, Amanda de Bruyn, an entomologist studying the aggressive Camponotus fulvopilosus,finds a diamond. She is torn between the necessity of handing it in to the authorities and the dream of making a quick buck. When a stroke of bad luck renders her current research project null and void she is faced with the prospect of losing her career and her research funding. She is forced to consider selling her diamond and embarks on an adventure that will carry herback into South Africa’s dark past and derail her marriage and career

Methods for assessing the susceptibility of freshwater ecosystems in Southern Africa to invasion by alien aquatic animals

Two methods for predicting regions susceptible to invasion by alien aquatic animals were developed for southern Africa (excluding Zimbabwe and Mozambique). In the "traditional" (data-poor) approach, distributions of three categories of alien "indicator" species (warm mesothermal, cold stenothermal and eurytopic) were compared to seven existing biogeographical models of distribution patterns of various animals in southern Africa. On the basis of these comparisons a synthesis model was developed which divided southern Africa into seven regions characterised by their susceptibility to invasion by alien aquatic animals with particular habitat requirements. In the "data-rich," geographic information systems (GIS) approach, the distribution of trout (Oncorhynchus mykiss and Salmo trutta) in selected "sampled regions" was related to elevation (as a surrogate of water temperature) and median annual rainfall (MAR) (as a surrogate of water availability). Using concentration analysis, optimum conditions for trout were identified. Regions within a larger "predictive area" which satisfied these conditions, were plotted as a digital map using the IDRISI package. Using this method seven models of potential trout distribution were generated for the following regions: northern Natal (two); southern Natal/Lesotho/Transkei (three), eastern Cape (two) and western Cape (two). Since two of the models were used to refine the methods, only five models were considered for the final assessment. In a modification of the GIS method, another model of potential trout distribution, based on mean monthly July minimum air temperature and MAR parameters, was developed for the region bounded by 29º - 34º S and 26 º - 32°E. This model showed marked similarities to another model, developed for the region bounded by 29 º - 32°S and 26º - 32°E, which was based on elevation and MAR parameters. The validity of the models developed was assessed by independent experts. Of the six models considered, four received favourable judgements, one was equivocal and one was judged to be poor. Based on these assessments it was concluded that the GIS method has credibility and could be used to develop a "data-rich" model of the susceptibility of southern Africa to invasion by alien aquatic animals. This method represents an alternative to the bioclimatic matching approach developed by scientists in Australia. The GIS method has a number of advantages over the "traditional" method: it is more amenable to testing, has greater flexibility, stores more information, produces images of a finer resolution, and can be easily updated. The traditional method has the advantage of being less expensive and requiring a less extensive database

Correlation of mesolevel characteristics of the healthcare system and socioeconomic inequality in healthcare use: a scoping review protocol

Introduction Although the impact of macrolevel characteristics of health systems on socioeconomic inequity in health has been studied extensively, the impact of access characteristics on a smaller scale of health systems has received less attention. These mesolevel characteristics can influence access to healthcare and might have the potential to moderate or aggravate socioeconomic inequity in healthcare use. This scoping review aims to map the existing evidence of the association of socioeconomic inequity in healthcare use and mesolevel access characteristics of the health system. Methods and analysis In conducting the scoping review, we follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews. The search will be carried out in four scientific databases: MEDLINE (via PubMed), Web of Science, Scopus and PsycINFO. Main eligibility criteria are inclusion in the analysis of a measure of socioeconomic position, a measure of individual healthcare use and a mesolevel determinant of access to healthcare services. The selection process consists of two consecutive screening stages (first: title/abstract; second: full text). At both stages, two reviewers independently assess the eligibility of studies. In case of disagreement, a third reviewer will be involved. Cohen’s kappa will be calculated to report inter-rater agreement between reviewers. Results are synthesised narratively, as a high heterogeneity of studies is expected. Ethics and dissemination No primary data are collected for the presented scoping review. Therefore, ethical approval is not necessary. The scoping review will be published in an international peer-reviewed journal, and findings will be presented on national and international conferences.Peer Reviewe

Alkohol-, Tabak- und Cannabiskonsum im Jugendalter – Querschnittergebnisse der HBSC-Studie 2017/18

Tabak, Alkohol und Cannabis sind psychoaktive Substanzen, die oftmals im Jugendalter zum ersten Mal ausprobiert und im späteren Leben weiter konsumiert werden. Die gesundheitlichen Folgen eines regelmäßigen Tabak- und Cannabiskonsums oder des Alkoholmissbrauchs sind gravierend. Im Sinne der Gesundheitsberichterstattung ist es das Ziel, aktuelle Prävalenzen für den Substanzkonsum bei Heranwachsenden nach sozialen Determinanten auszuweisen. Datenbasis bilden die für Deutschland repräsentativen Daten der „Health Behaviour in School-Aged Children (HBSC)“-Studie 2017/18 von Schülerinnen und Schülern im Alter von 11, 13 und 15 Jahren. Analysiert wird sowohl die Lebenszeit- und 30-Tages-Prävalenz des Tabak-, Alkohol- und Cannabiskonsums (letztere nur 15-Jährige) als auch alkoholbedingte Rauscherfahrungen (Binge Drinking). Tabak und Alkohol wird unter 11- und 13-Jährigen noch vergleichsweise selten konsumiert, die Prävalenz steigt bei den 15-Jährigen jedoch deutlich an. Auch Cannabiskonsum ist bei 15-Jährigen recht weit verbreitet. Schülerinnen und Schüler, die nicht das Gymnasium besuchen, haben ein höheres Risiko zu rauchen. Schülerinnen und Schüler mit einem hohen familiären Wohlstand haben ein höheres Risiko Alkohol zu konsumieren, vor allem Mädchen. Heranwachsende mit Migrationshintergrund haben einerseits ein geringeres Risiko für einen regelmäßigen Alkoholkonsum oder Binge Drinking, andererseits jedoch ein erhöhtes Risiko für Cannabiskonsum (Mädchen mit einseitigem Migrationshintergrund). Die Ergebnisse verweisen darauf, dass Präventionsmaßnahmen vor allem früh ansetzen sollten, da die Prävalenzen bei älteren Schülerinnen und Schülern für den Substanzkonsum deutlich höher ausfallen. Es lassen sich je nach betrachteter Substanz unterschiedliche Risikogruppen identifizieren, die besonderer Berücksichtigung bei Präventionsmaßnahmen bedürfen

Role of contextual and compositional characteristics of schools for health inequalities in childhood and adolescence: protocol for a scoping review

Introduction: Childhood and adolescence are crucial life stages for health trajectories and the development of health inequalities in later life. The relevance of schools for health and well-being of children and adolescents has long been recognised, and there is some research regarding the association of contextual and compositional characteristics of schools and classes with health, health behaviour and well-being in this population. Little is known about the role of meso-level characteristics in relation to health inequalities. The aim of this scoping review is to retrieve and synthesise evidence about the mediating or moderating role of compositional or contextual characteristics of schools for the association between students' socioeconomic position and health in primary and secondary education. Methods and analysis We will conduct a systematic search of electronic databases in PubMed/Medline, Web of Science and Education Resources Information Center. Studies must meet the following inclusion criteria: (1) The population must be students attending primary or secondary schools in developed economies. (2) The outcomes must include at least one indicator for individual health, health behaviour or well-being. (3) The study must include at least one contextual or compositional characteristic of the school context and one individual determinant of socioeconomic position. (4) The study must also examine the mediating or moderating role of the contextual or compositional characteristic of the school context for the associations between socioeconomic position and health, health behaviour or well-being. (5) The study must be published since 1 January 2000 in English or German language. We will provide a narrative synthesis of findings. Ethics and dissemination We will not collect primary data and only include secondary data derived from previously published studies. Therefore, ethical approval is not required. We intend to publish our findings in an international peer-reviewed journal and to present them at national and international conferences

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

The 2017/18 Health Behaviour in School-aged Children (HBSC) study – Methodology of the World Health Organization’s child and adolescent health study

The Health Behaviour in School-aged Children (HBSC) study is an international research project in collaboration with the World Health Organization (WHO) for over 35 years. HBSC is the largest study on child and adolescent health and one of the most important sources of data for the WHO’s international comparative health monitoring. Every four years, data on the health and health behaviour of students aged 11, 13 and 15, as well as the social contexts and conditions for growing up healthy, are collected. A total of 50 countries belong to the HBSC network, with 45 countries taking part in the 2017/18 survey. Germany has contributed to the HBSC surveys since 1993/94. For the most recent 2017/18 cycle, students at 146 schools in Germany were interviewed (response rate of schools: 15.6%). A net sample of n = 4,347 girls and boys was achieved for Germany (response rate: 52.7%). Participation was voluntary and the survey was conducted in German school years five, seven and nine (corresponding to ages 11, 13 and 15). A weighting procedure was applied to allow for representative findings on the health of children and adolescents in Germany. HBSC offers a valuable contribution to health monitoring and provides numerous starting points to identify needs, risk groups and fields of action to initiate targeted and actual needs-based measures of prevention and health promotion in the school setting

National-level wealth inequality and socioeconomic inequality in adolescent mental well-being: a time series analysis of 17 countries

Purpose: Although previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level. Methods: Data were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n = 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups. Results: Higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms. No associations between either national wealth inequality or income inequality and life satisfaction were found. Smaller differences in somatic symptoms between higher and lower SES groups were found in countries with higher levels of national wealth inequality. In contrast, larger differences in psychological symptoms and life satisfaction (but not somatic symptoms) between higher and lower SES groups were found in countries with higher levels of national income inequality. Conclusions: Although both national wealth and income inequality are associated with socioeconomic inequalities in adolescent mental well-being at the aggregated level, associations are in opposite directions. Social policies aimed at a redistribution of income resources at the national level could decrease socioeconomic inequalities in adolescent mental well-being while further research is warranted to gain a better understanding of the role of national wealth inequality in socioeconomic inequalities in adolescent health. (C) 2020 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine