Angebote der Prävention – Wer nimmt teil?

Schwerpunkt dieser Ausgabe ist das Thema Verhaltensprävention. Darunter sind Angebote zu verstehen, die Gesundheitsverhaltensweisen fördern und verbessern sollen. Die Studie "Gesundheit in Deutschland aktuell" (GEDA) 2009 bietet dazu aktuelle Daten. Die Auswertungen gehen dabei folgenden Fragen nach: Wer nimmt an diesen Angeboten teil und beeinflussen zum Beispiel Faktoren wie Sozialstatus oder Partnerschaften die Inanspruchnahme der präventiven Maßnahmen

Hysterektomie

Die Gebärmutterentfernung (Hysterektomie) zählt zu den häufigsten gynäkologischen Eingriffen weltweit. Auch in Deutschland sind viele Frauen betroffen. In der aktuellen Ausgabe von GBE kompakt werden die wichtigsten zugrundeliegenden Erkrankungen dargestellt und die verschiedenen Operationsmethoden einer Hysterektomie skizziert. Einen weiteren Fokus legen die Autorinnen Franziska Prütz und Elena von der Lippe auf die Beschreibung der Häufigkeit des Eingriffs in Deutschland und auf mögliche Einflussfaktoren einer Hysterektomie. Als Datengrundlage dienen dabei vor allem die Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) des Robert Koch-Instituts

A systematic literature review of disability weights measurement studies: evolution of methodological choices

Background: The disability weight is an essential factor to estimate the healthy time that is lost due to living with a certain state of illness. A 2014 review showed a considerable variation in methods used to derive disability weights. Since then, several sets of disability weights have been developed. This systematic review aimed to provide an updated and comparative overview of the methodological design choices and surveying techniques that have been used in disability weights measurement studies and how they evolved over time. Methods: A literature search was conducted in multiple international databases (early-1990 to mid-2021). Records were screened according to pre-defined eligibility criteria. The quality of the included disability weights measurement studies was assessed using the Checklist for Reporting Valuation Studies (CREATE) instrument. Studies were collated by characteristics and methodological design approaches. Data extraction was performed by one reviewer and discussed with a second. Results: Forty-six unique disability weights measurement studies met our eligibility criteria. More than half (n = 27; 59%) of the identified studies assessed disability weights for multiple ill-health outcomes. Thirty studies (65%) described the health states using disease-specific descriptions or a combination of a disease-specific descriptions and generic-preference instruments. The percentage of studies obtaining health preferences from a population-based panel increased from 14% (2004–2011) to 32% (2012–2021). None of the disability weight studies published in the past 10 years used the annual profile approach. Most studies performed panel-meetings to obtain disability weights data. Conclusions: Our review reveals that a methodological uniformity between national and GBD disability weights studies increased, especially from 2010 onwards. Over years, more studies used disease-specific health state descriptions in line with those of the GBD study, panel from general populations, and data from web-based surveys and/or household surveys. There is, however, a wide variation in valuation techniques that were used to derive disability weights at national-level and that persisted over time.Peer Reviewe

Diabetes free life expectancy and years of life lost associated with type 2 diabetes: projected trends in Germany between 2015 and 2040

Background: Type 2 diabetes (T2D) causes substantial disease burden and is projected to affect an increasing number of people in coming decades. This study provides projected estimates of life years free of type 2 diabetes (T2D) and years of life lost (YLL) associated with T2D for Germany in the years 2015 and 2040. Methods: Based on an illness-death model and the associated mathematical relation between prevalence, incidence and mortality, we projected the prevalence of diagnosed T2D using currently available data on the incidence rate of diagnosed T2D and mortality rates of people with and without diagnosed T2D. Projection of prevalence was achieved by integration of a partial differential equation, which governs the illness-death model. These projected parameters were used as input values to calculate life years free of T2D and YLL associated with T2D for the German population aged 40 to 100 years in the years 2015 and 2040, while accounting for different assumptions on future trends in T2D incidence and mortality. Results: Assuming a constant incidence rate, women and men at age 40 years in 2015 will live approximately 38 years and 33 years free of T2D, respectively. Up to the year 2040, these numbers are projected to increase by 1.0 years and 1.3 years. Assuming a decrease in T2D-associated excess mortality of 2% per year, women and men aged 40 years with T2D in 2015 will be expected to lose 1.6 and 2.7 years of life, respectively, compared to a same aged person without T2D. In 2040, these numbers would reduce by approximately 0.9 years and 1.6 years. This translates to 10.8 million and 6.4 million YLL in the German population aged 40–100 years with prevalent T2D in 2015 and 2040, respectively. Conclusions: Given expected trends in mortality and no increase in T2D incidence, the burden due to premature mortality associated with T2D will decrease on the individual as well as on the population level. In addition, the expected lifetime without T2D is likely to increase. However, these trends strongly depend on future improvements of excess mortality associated with T2D and future incidence of T2D, which should motivate increased efforts of primary and tertiary prevention.Peer Reviewe

Psychische und körperliche Gewalterfahrungen in den vergangenen 12 Monaten in der Allgemeinbevölkerung

Gewalterfahrungen können erhebliche psychosoziale und gesundheitliche Auswirkungen haben. In der bevölkerungsrepräsentativen Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) wurde ein Instrument zur Erfassung körperlicher und psychischer Gewalterfahrung (sowohl aus der Opfer- und als auch aus der Täterperspektive) implementiert. Dieses Instrument wurde in der Altersgruppe 18–64 Jahre (n = 5939) eingesetzt. Ziel der vorliegenden Publikation ist es, den Anteil von Personen, denen innerhalb der letzten 12 Monate mehrfach Gewalt widerfuhr oder die infolge der Gewalterfahrung stark beeinträchtigt waren, zu berichten, sowie den Anteil der Personen, die mehrfach Gewalt ausgeübt haben. Des Weiteren werden die Konfliktpartner von Gewaltopfern bzw. Tätern beschrieben und besondere Konstellationen von Gewalterfahrungen in Bezug auf die gesundheitsbezogene Lebensqualität dargestellt. Abschließend wird der Zusammenhang zwischen ausgewählten Einflussfaktoren und dem Risiko, Gewaltopfer zu werden oder Gewalt auszuüben, untersucht. 2,7 % der Frauen und 4,3 % der Männer berichten von mehrfachen Erfahrungen körperlicher Gewalt in den letzten 12 Monaten oder erlebten sich durch diese Erfahrung stark beeinträchtigt; von psychischer Gewalt berichteten 18,9 % der Frauen und 15,4 % der Männer. Frauen sind häufiger als Männer sowohl Opfer als auch Täterin von Gewalt in der Familie. Männer berichten dagegen häufiger von Opfer- und Tätererfahrungen außerhalb des engeren familiären Umfelds. Unabhängig davon, ob sie Opfer oder Täter körperlicher oder psychischer Gewalt waren, ist das psychische Wohlbefinden von Personen mit Gewalterfahrungen signifikant schlechter als das von Personen ohne Gewalterfahrung. Erfahrungen von Gewalt in der Kindheit und Jugend erhöhen das Risiko, später Gewaltopfer oder Gewalttäter zu werden. Die vorliegenden Ergebnisse beschreiben psychische und körperliche Gewalterfahrungen als einen Teil von Gewalthandlungen in der Allgemeinbevölkerung näher und geben so Hinweise auf mögliche Präventionspotenziale.Experiences of violence may have considerable psychosocial and health implications. A violence screening tool was implemented in the German Health Interview and Examination Survey for Adults (DEGS1) to depict the perpetrators’ and victims’ point of view. The study participants were between 18 and 64 years old (n = 5939). The aim of this article is to assess the percentage of people who experienced physical and psychological violence in the last 12 months or who suffered negative effects on their quality of life as a consequence or who were perpetrators of multiple acts of violence. The characteristics of victims, offenders, and their conflict partners are described. Furthermore, specific constellations of violence experience with regard to health-related quality of life are described. Finally, the association between being a victim of violence and different factors is estimated. In total, 2.7 % of women and 4.3 % of men reported multiple experiences of physical violence in the last 12 months or having their lives negatively impacted as a consequence of violence. Experience of psychological violence was reported by 18.9 % of women and 15.4 % of men. Women are more likely than men to be both perpetrator and victim within the family. Men are more likely than women to be both the perpetrator and victim outside of the family environment. Regardless of whether they are the victim or perpetrator of violence, the psychological well-being is significantly worse than those of people who did not experience violence. Experience of violence in childhood and adolescence increases the risk of becoming victim or perpetrator of violence later on in life. The findings presented here describe the psychological and physical experience of violence as one part of violence committed in the whole population. Some prevention advice is also presented

Redistributing ill-defined causes of death – a case study from the BURDEN 2020-project in Germany

Background The cause of death statistics in Germany include a relatively high share (26% in 2017) of ill-defined deaths (IDD). To make use of the cause of death statistics for Burden of Disease calculations we redistribute those IDD to valid causes of death. Methods The process of proportional redistribution is described in detail. It makes use of the distribution of the valid ICD-codes in the cause of death data. We use examples of stroke, diabetes, and heart failure to illustrate how IDD are reallocated. Results The largest increases in the number of deaths for both women and men were found for lower respiratory infections, diabetes mellitus, and stroke. The numbers of deaths for these causes more than doubled after redistribution. Conclusion This is the first comprehensive redistribution of IDD using the German cause of death statistics. Performing a redistribution is necessary for burden of disease analyses, otherwise there would be an underreporting of certain causes of death or large numbers of deaths coded to residual or unspecific codes.Peer Reviewe

Methodological considerations in injury burden of disease studies across Europe: a systematic literature review

Background: Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods: We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results: We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions: Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond. © 2022, The Author(s)