Anke-Christine Saß

Inanspruchnahme von Krebsfrüherkennungsuntersuchungen

A growing number of people in Germany participate in the cancer screening services offered by statutory health insurance. Using data from the first wave of the German Health Interview and Examination Survey for Adults (DEGS1), current levels of participation in cancer screening services were determined. DEGS1 (2008-2011) permits representative cross-sectional analyses to be performed. In DEGS1, persons who were entitled to different cancer screening services were interviewed on their awareness, participation and regular utilisation of cancer screening for different types of cancer. Overall, 67.2% of women and 40.0% of men participate regularly. Participation rates fluctuate to a great extent for individual types of cancer screening. Women participate in cancer screening more frequently than men do. For women, a better socioeconomic status was associated with higher participation rates. Participation rates improve with increasing age, meaning that the difference in participation rates between women and men becomes smaller. The current analyses present information on specifically targeted population groups to promote informed decision-making about cancer screening, so that participation rates can be improved further. The analyses thus provide an important basis for health policy measures. An English full-text version of this article is available at SpringerLink as supplemental.ZusammenfassungEine wachsende Zahl von Menschen in Deutschland nimmt die von der Gesetzlichen Krankenversicherung angebotenen Krebsfrüherkennungsuntersuchungen (KFU) in Anspruch. Mit Daten der ersten Erhebungswelle der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) wurden aktuelle Inanspruchnahmeraten ermittelt. DEGS1 ist ein bundesweiter Befragungs- und Untersuchungssurvey (2008–2011), der repräsentative Querschnittsanalysen dazu ermöglicht. In DEGS1 wurden die jeweils anspruchsberechtigten Personen zur Kenntnis, Regelmäßigkeit sowie zur turnusmäßigen Inanspruchnahme von KFU für einzelne Krebsarten befragt. Regelmäßig gehen insgesamt etwa 67,2% der Frauen und 40,0% der Männer zur KFU. Bei den einzelnen Untersuchungen schwanken die Teilnahmeraten stark. Frauen nehmen an vielen KFU häufiger teil als Männer, und eine bessere sozioökonomische Lage war bei ihnen mit höheren Teilnahmeraten assoziiert. Im Alter verbessern sich die Teilnahmeraten und nähern sich zwischen den Geschlechtern an. Die Auswertungen geben Hinweise auf Bevölkerungsgruppen, die gezielt angesprochen und darin unterstützt werden sollten, eine informierte Entscheidung zur KFU zu treffen, um die Teilnahmeraten weiter zu erhöhen. Sie stellen damit eine wichtige Grundlage für gesundheitspolitische Maßnahmen dar.AbstractA growing number of people in Germany participate in the cancer screening services offered by statutory health insurance. Using data from the first wave of the German Health Interview and Examination Survey for Adults (DEGS1), current levels of participation in cancer screening services were determined. DEGS1 (2008–2011) permits representative cross-sectional analyses to be performed. In DEGS1, persons who were entitled to different cancer screening services were interviewed on their awareness, participation and regular utilisation of cancer screening for different types of cancer. Overall, 67.2% of women and 40.0% of men participate regularly. Participation rates fluctuate to a great extent for individual types of cancer screening. Women participate in cancer screening more frequently than men do. For women, a better socioeconomic status was associated with higher participation rates. Participation rates improve with increasing age, meaning that the difference in participation rates between women and men becomes smaller. The current analyses present information on specifically targeted population groups to promote informed decision-making about cancer screening, so that participation rates can be improved further. The analyses thus provide an important basis for health policy measures. An English full-text version of this article is available at SpringerLink as supplemental.

Alter und Gesundheit

ZusammenfassungMit fortschreitendem Alter ist ein deutlicher Anstieg von Gesundheitsproblemen zu beobachten, gleichzeitig wächst die Komplexität der vorliegenden Beeinträchtigungen. Neben den diagnostizierten somatischen und psychischen Erkrankungen spielen Funktions- und Fähigkeitsstörungen und auch die selbst eingeschätzte Gesundheit eine wichtige Rolle. Gesundheit im Alter ist heute und zukünftig ein Thema von hoher individueller und gesellschaftlicher Bedeutung. Für gesundheitspolitische Planungen sind die Abbildung des Morbiditätsgeschehens und Prognosen von großer Bedeutung. Sie erfordern repräsentative, valide, aktuelle und über die Zeit vergleichbare Daten. Die Datengrundlagen der Gesundheitsberichterstattung im Bereich Gesundheit älterer Menschen haben sich in den letzten Jahren deutlich verbessert. Nach wie vor bestehen allerdings Datenlücken, zum Beispiel im Bereich der Teilhabestörungen. Forschungsbedarf besteht wegen der Spezifik der Gesundheitsprobleme Älterer unter anderem bei der Erhebungsmethodik und der Auswahl geeigneter Indikatoren.AbstractWith advancing age, there is a significant increase in the number of health problems; at the same time, the complexity of the existing impairments increases. In addition to the diagnosed somatic and psychological illnesses, functional disorders and disabilities as well as the self-assessed health of the individual play an important role. Health in old age is an important individual and societal topic today and in the future. In order to plan health politics, mapping of morbidity and prognosis are important. They require representative, valid, current, and comparable data over time. Databases of the health reporting in the area of senior citizens have improved in recent years. However, data are still missing, for example, in the area of not being able to fully take part in daily life. Research is needed, because of the specificity of health problems in the elderly, including the survey methodology and the selection of suitable indicators.With advancing age, there is a significant increase in the number of health problems; at the same time, the complexity of the existing impairments increases. In addition to the diagnosed somatic and psychological illnesses, functional disorders and disabilities as well as the self-assessed health of the individual play an important role. Health in old age is an important individual and societal topic today and in the future. In order to plan health politics, mapping of morbidity and prognosis are important. They require representative, valid, current, and comparable data over time. Databases of the health reporting in the area of senior citizens have improved in recent years. However, data are still missing, for example, in the area of not being able to fully take part in daily life. Research is needed, because of the specificity of health problems in the elderly, including the survey methodology and the selection of suitable indicators.

Beteiligung von Menschen mit Migrationshintergrund an Gesundheitssurveys des Robert Koch-Instituts

People with migration background (PMB) make up a huge section of the population with specific health chances and risks. There are only limited data available on the health situation of PMB, since inclusion of PMB in surveys is hindered, e.g. due to language barriers. The present study has examined to what extent the population-based health surveys of the Robert Koch Institute have managed to include a representative extent of PMB, with the aim of deriving recommendations for analysis options and future recruitment strategies. The 2009 microcensus (MC) of the Federal Statistical Office was used as the basis to check whether the sample of KiGGS Wave 1 (2009-2012) and DEGS 1 (2008-2011) are representative regarding socio-demographic and migrant-specific characteristics. 1107 PMB participated in DEGS 1. In comparison to the MC, particular sub-groups are underrepresented in the sample: people who immigrated themselves (first-generation migrants), people with a low education and Turkish citizens. On the other hand, some age groups are overrepresented. In KiGGS Wave 1, 2021 children and adolescents with a migration background participated. Response was lower if parents had a low education. In total, the participation of children and adolescents with a migration background was lower in comparison to the KiGGS baseline survey. The data on PMB in DEGS 1 and KiGGS Wave 1 are appropriate for health analyses of this population group. However, analyses should be stratified according to characteristics like migrant generation, age or education level, or these characteristics should be adjusted for in statistical models. In order to achieve a representative inclusion of people with a migration background, in future surveys sub-group-specific activities to increase participation of PMB are recommended.

Nationales Gesundheitsziel „Gesund älter werden“

ZusammenfassungWelche Ziele sind in der Versorgung älterer Menschen anzustreben? Welche Maßnahmen sind notwendig, um vor dem Hintergrund zukünftiger Herausforderungen eine gute Versorgung älterer Menschen sicherzustellen? Der Kooperationsverbund gesundheitsziele.de hat sich im Rahmen des neuen nationalen Gesundheitsziels „Gesund älter werden“ mit diesen Fragen beschäftigt. Es werden konkrete Ziele und Empfehlungen von Maßnahmen zur Umsetzung anhand der Versorgungsbereiche „Ambulante und stationäre Versorgung“, „Pflegerische Versorgung“ und „Rehabilitation im Alter“ vorgestellt. gesundheitsziele.de will eine gemeinsame Zielorientierung unterstützen und auf Grundlage von Selbstverpflichtungen der Akteure konkrete Maßnahmen zur Zielerreichung in der gesundheitlichen Versorgung älterer Menschen anstoßen.AbstractWhat kind of health targets should be pursued concerning the health care of elderly people? What kind of activities should be implemented to ensure good health care with regard to future challenges? The Association for the Continuous Development of the National Health Target Process, health-targets.de, deals with these issues under the new national health target “Healthy Ageing”. We develop concrete objectives and proposals for practical implementation in the areas of “outpatient and inpatient care”, “nursing” and “rehabilitation in old age”. health-targets.de supports a common health target process and initiates interventions in the field of health care for elderly people.

Die gesundheitliche Lage von Menschen mit Migrationshintergrund und die Bedeutung des sozioökonomischen Status

People with a migrant background (PMB) have specific health-related risk factors and resources compared to the non-migrant population (NMP). The analysis focuses on the relationship between migrant background and health and health-related behavior. Moreover, the study analyses whether socio-economic status (SES) contributes to the explanation of differences between PMB and the NMP. The research is based on the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2012, n = 8151). The population for cross-sectional analyses contains 1107 PMB (weighted 19.8 %). The research question is addressed on the basis of nine exemplary health outcomes. All analyses are gender specific and make a distinction between first and second generation PMB. Logistic regression is calculated adjusting for age and SES. The results reveal clear gender-specific patterns: For women, differences are statistically significant mainly for first generation PMB. Compared to the NMP their self-assessed health status is lower, they are less physically active, consume less alcohol, feel less informed about cancer screening programs and make less use of preventive health services. However, daily smoking is more prevalent in second generation women. For men, differences are statistically significant for first and second generation PMB. Men with a migrant background show more symptoms of depression, consume less alcohol and feel less informed about cancer screening programs. After adjusting for SES the impact of migrant background on health status and health-related behavior largely remains stable. The study shows that the DEGS1 data offers valuable results and new insights into the health status of people with a migrant background. The use of this data for further research requires a differentiated approach to the concept of migrant background and a careful interpretation of results.

Alter und Gesundheit - Eine Bestandsaufnahme aus Sicht der Gesundheitsberichterstattung

ZusammenfassungMit fortschreitendem Alter ist ein deutlicher Anstieg von Gesundheitsproblemen zu beobachten, gleichzeitig wächst die Komplexität der vorliegenden Beeinträchtigungen. Neben den diagnostizierten somatischen und psychischen Erkrankungen spielen Funktions- und Fähigkeitsstörungen und auch die selbst eingeschätzte Gesundheit eine wichtige Rolle. Gesundheit im Alter ist heute und zukünftig ein Thema von hoher individueller und gesellschaftlicher Bedeutung. Für gesundheitspolitische Planungen sind die Abbildung des Morbiditätsgeschehens und Prognosen von großer Bedeutung. Sie erfordern repräsentative, valide, aktuelle und über die Zeit vergleichbare Daten. Die Datengrundlagen der Gesundheitsberichterstattung im Bereich Gesundheit älterer Menschen haben sich in den letzten Jahren deutlich verbessert. Nach wie vor bestehen allerdings Datenlücken, zum Beispiel im Bereich der Teilhabestörungen. Forschungsbedarf besteht wegen der Spezifik der Gesundheitsprobleme Älterer unter anderem bei der Erhebungsmethodik und der Auswahl geeigneter Indikatoren.AbstractWith advancing age, there is a significant increase in the number of health problems; at the same time, the complexity of the existing impairments increases. In addition to the diagnosed somatic and psychological illnesses, functional disorders and disabilities as well as the self-assessed health of the individual play an important role. Health in old age is an important individual and societal topic today and in the future. In order to plan health politics, mapping of morbidity and prognosis are important. They require representative, valid, current, and comparable data over time. Databases of the health reporting in the area of senior citizens have improved in recent years. However, data are still missing, for example, in the area of not being able to fully take part in daily life. Research is needed, because of the specificity of health problems in the elderly, including the survey methodology and the selection of suitable indicators.With advancing age, there is a significant increase in the number of health problems; at the same time, the complexity of the existing impairments increases. In addition to the diagnosed somatic and psychological illnesses, functional disorders and disabilities as well as the self-assessed health of the individual play an important role. Health in old age is an important individual and societal topic today and in the future. In order to plan health politics, mapping of morbidity and prognosis are important. They require representative, valid, current, and comparable data over time. Databases of the health reporting in the area of senior citizens have improved in recent years. However, data are still missing, for example, in the area of not being able to fully take part in daily life. Research is needed, because of the specificity of health problems in the elderly, including the survey methodology and the selection of suitable indicators.

Unintentional injuries in childhood and adolescence: current prevalence, determinants, and trends : Results of the KiGGS study: first follow-up (KiGGS Wave 1)

BACKGROUND In Germany and worldwide, unintentional injuries (UI) are a major health threat for children and adolescents. The first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012) continued the national UI monitoring that started with the KiGGS baseline study (2003-2006). The present analysis provides updated information and for the first time gives indications on time trends. METHODS KiGGS Wave 1 is a combined nationwide cross-sectional and longitudinal survey by the Robert Koch Institute (RKI) providing information about 12,368 participating children and adolescents (0-17 years old; response rates: 38.8% first time invited, 72.9% reinvited). Parents were asked about their childrens UI and poisonings via telephone interviews. Information on UI is available for 11,665 children and adolescents (1-17 years old). The 12-month prevalence rate and 95% confidence interval were calculated, and KiGGS Wave 1 was compared with the KiGGS baseline study. The Rao-Scott chi-square test corrected over the F distribution was used to test for the statistical significance of subgroup differences and trend effects. RESULTS Within the previous 12 months, 15.5% of all children and adolescents aged 1-17 years were medically treated for UI. UI were significantly more prevalent among boys (17.0%) than among girls (14.0%), and 3.4% of the subjects had more than one accident leading to UI. One in eight children and adolescents who suffered UI stayed in hospital (12.3%) for inpatient treatment for at least one night. The home, childcare and educational institutions, and sports facilities/playgrounds were the predominant accident locations. Compared to the baseline study, neither the overall prevalence of UI nor the gender- and age-specific patterns changed significantly. CONCLUSION Since a large proportion of UI is avoidable, knowledge of high-risk subgroups and accident locations is of particular use for prevention. KiGGS Wave 1 makes an important contribution to the comprehension of these issues. The transfer of research into practice is of particular importance for the avoidance of UI.

Gesundheitliche Versorgung von Geflüchteten: Herausforderungen und Lösungsansätze

Über eine Millionen Menschen haben im Jahr 2015 in Deutschland Schutz gesucht – vor Krieg und Verfolgung oder vor einer als hoffnungslos empfundenen wirtschaftlichen Situation in ihrem Herkunftsland. UmnachDeutschland zu gelangen, haben sie oft lange und ihre GesundheitbeeinträchtigendeWegeaufsich genommen. Eine große Zahl von Menschen hat auf der Flucht ihr Leben verloren: Laut dem „MissingMigrant Project“ der International Organisation forMigration (IOM) gab es 2015 allein im Mittelmeerraum 3770 Todesfälle. Es steht zu vermuten,dassdieFluchtmigrationunter gesundheitsgefährdenden Bedingungen weiter anhalten und Deutschland auch in den kommenden Jahren Ziel vieler Geflüchteter sein wird. Die angemessene Versorgung dieser Menschen stellt die Gesundheitsdienste vor große und in dieser Form noch nicht dagewesene Herausforderungen. Mit dem vorliegenden Schwerpunktheft möchten wir versuchen, die vorhandene Evidenz oder zumindest die besten verfügbaren Erfahrungen („Best Practice“) aus den Bereichen medizinische Versorgung, Prävention und der Stärkung lokaler Gesundheitssystemstrukturen aufzuzeigen. Angemessene Strategien entwickeln, bewährte übernehmen

Das Unfallgeschehen bei Kindern und Jugendlichen in Deutschland

Compared to adults, children and adolescents run a considerably higher risk of suffering unintentional injuries (UI). To prevent UI, detailed knowledge of the overall accident occurrence and the determinants of UI is needed. This article gives an overview of the data sources covering the occurrence of UI among children and adolescents in Germany. According to the Robert Koch Institutes German Health Interview and Examination Survey for Children and Adolescents (KiGGS), approximately 15.3 % of children and adolescents (1-17 years) in Germany suffer at least one UI within 12 months. Most accidents (60.7 %) occur at home or during leisure-time activities. In 2011, the German Statutory Accident Insurance (DGUV) registered more than 1.4 million accidents among children in day-care facilities and students in educational institutions. According to official statistics, in the same year, more than 50,000 children and adolescents were injured in traffic accidents. Moreover, the Federal Statistical Office registered 260,534 hospital admissions due to injuries and poisonings among children and adolescents. All data sources revealed age- and sex-specific differences. Boys suffer UI more frequently than girls do and they show higher injury rates in adolescence than during childhood. While UI among children mostly happen at home, road traffic and leisure-time accidents increase in occurrence during adolescence. In Germany, there are numerous initiatives dedicated to the prevention of UI in children and adolescents. The creation of target group-specific prevention measures is complicated by the fact that the methodological approaches of existing data sources differ considerably.

Das Unfallgeschehen im Kindes- und Jugendalter – Aktuelle Prävalenzen, Determinanten und Zeitvergleich

BACKGROUND In Germany and worldwide, unintentional injuries (UI) are a major health threat for children and adolescents. The first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012) continued the national UI monitoring that started with the KiGGS baseline study (2003-2006). The present analysis provides updated information and for the first time gives indications on time trends. METHODS KiGGS Wave 1 is a combined nationwide cross-sectional and longitudinal survey by the Robert Koch Institute (RKI) providing information about 12,368 participating children and adolescents (0-17 years old; response rates: 38.8% first time invited, 72.9% reinvited). Parents were asked about their childrens UI and poisonings via telephone interviews. Information on UI is available for 11,665 children and adolescents (1-17 years old). The 12-month prevalence rate and 95% confidence interval were calculated, and KiGGS Wave 1 was compared with the KiGGS baseline study. The Rao-Scott chi-square test corrected over the F distribution was used to test for the statistical significance of subgroup differences and trend effects. RESULTS Within the previous 12 months, 15.5% of all children and adolescents aged 1-17 years were medically treated for UI. UI were significantly more prevalent among boys (17.0%) than among girls (14.0%), and 3.4% of the subjects had more than one accident leading to UI. One in eight children and adolescents who suffered UI stayed in hospital (12.3%) for inpatient treatment for at least one night. The home, childcare and educational institutions, and sports facilities/playgrounds were the predominant accident locations. Compared to the baseline study, neither the overall prevalence of UI nor the gender- and age-specific patterns changed significantly. CONCLUSION Since a large proportion of UI is avoidable, knowledge of high-risk subgroups and accident locations is of particular use for prevention. KiGGS Wave 1 makes an important contribution to the comprehension of these issues. The transfer of research into practice is of particular importance for the avoidance of UI.