H. Rüger

Over-indebtedness as a marker of socioeconomic status and its association with obesity: a cross-sectional study

BackgroundThe recent credit crunch will have implications for private households. Low socioeconomic status is associated to various diseases. While income, education and occupational status is frequently used in definitions of socioeconomic status, over-indebtedness of private households is usually not considered. Over-indebtedness is currently increasing in high-income countries. However, its association with health – particularly with obesity – remains unknown. Therefore, the aim of this study was to assess an association between over-indebtedness and overweight or obesity.MethodsA cross-sectional study on over-indebtedness and health including 949 over-indebted subjects from 2006 and 2007 in Rhineland-Palatinate and Mecklenburg-Western Pomerania (Germany) and the telephonic health survey 2003 of the Robert Koch-Institute including 8318 subjects, who are representative for the German population, were analysed with adjusted logistic regression considering overweight (BMI ≥25.0 kg/m2) and obesity (BMI ≥30 kg/m2) as response variable.ResultsAfter adjusting for socio-economic (age, sex, education, income) and health factors (depression, smoking habits) an independent effect of the over-indebt situation on the probability of overweight (aOR 1.97 95%-CI 1.65–2.35) and obesity (aOR 2.56 95%-CI 2.07–3.16) could be identified.ConclusionOver-indebtedness was associated with an increased prevalence of overweight and obesity that was not explained by traditional definitions of socioeconomic status. Over-indebtedness should be additionally considered when assessing health effects of socioeconomic status.

[Mental illness and over-indebtedness. Mental illness, social networks and financial strain in over-indebted persons].

In Germany, over-indebtedness of private households has been steadily increasing and is currently estimated to affect about 3 million private households. It is almost unknown in the German-speaking part, to what extent financial strain due to excessive debts is accompanied by mental health problems in affected persons. A cross-sectional study including over-indebted persons was conducted between July 2006 and March 2007 in Rhineland-Palatinate by an anonymously filled-in questionnaire of clients of debt counselling services. Altogether 666 persons (51% women) aged between 18-79 years took part (participation rate: 35.5%). 40% of the collective reported a current mental disorder. Especially persons experiencing over-indebtedness as a threat and cannot rely on a functioning social network are in danger of experiencing mental illnesses. When treating mental illnesses, the financial situation of the diseased person should be taken into account and the support of debt counselling services should be used at an early stage.

[Gender-specific risk factors for acute low back pain: starting points for target-group-specific prevention].

ZusammenfassungHintergrundFrauen geben häufiger akute Rückenschmerzen an als Männer. Es stellte sich die Frage, ob sich geschlechtsspezifische Risikoprofile aufzeigen lassen.MethodeEine Sekundärdatenanalyse des telefonischen Gesundheitssurveys 2003 des Robert-Koch-Instituts wurde durchgeführt (n=7829). Es wurden bivariate (χ2) und geschlechtsstratifizierte multivariate Tests durchgeführt („odd‘s ratios“, 95%-Konfidenzintervalle).ErgebnisseFrauen (28,5%) gaben signifikant häufiger als Männer (18%) akute Rückenschmerzen an (p<0,001). In der multivariaten Analyse ergaben sich geschlechtsspezifische Risikoschätzer für folgende Faktoren: Alter, degenerative Gelenkerkrankungen, Osteoporose, Depression, Raucherstatus, Anstellungsverhältnis, Gemeindegröße und Beeinträchtigung der täglichen Arbeit durch körperliche Beschwerden.SchlussfolgerungDie vorliegende Untersuchung stellt einen Versuch dar, Erkenntnisse abzuleiten, nach denen Geschlechtsunterschiede in der Versorgung von Rückenschmerzpatienten berücksichtigt werden sollten. Präventionsmaßnahmen und Therapieansätze könnten dadurch beeinflusst werden. Zukünftige Analysen, sollten besonders psychosoziale Faktoren einschließen, um sich dem Problem adäquat zu nähern.AbstractBackgroundWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.MethodsSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (χ2) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).ResultsWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.ConclusionThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.BACKGROUNDnWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.nnnMETHODSnSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (chi(2)) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).nnnRESULTSnWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.nnnCONCLUSIONnThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.

Geschlechtsspezifische Risikofaktoren akuter Rückenschmerzen

ZusammenfassungHintergrundFrauen geben häufiger akute Rückenschmerzen an als Männer. Es stellte sich die Frage, ob sich geschlechtsspezifische Risikoprofile aufzeigen lassen.MethodeEine Sekundärdatenanalyse des telefonischen Gesundheitssurveys 2003 des Robert-Koch-Instituts wurde durchgeführt (n=7829). Es wurden bivariate (χ2) und geschlechtsstratifizierte multivariate Tests durchgeführt („odd‘s ratios“, 95%-Konfidenzintervalle).ErgebnisseFrauen (28,5%) gaben signifikant häufiger als Männer (18%) akute Rückenschmerzen an (p<0,001). In der multivariaten Analyse ergaben sich geschlechtsspezifische Risikoschätzer für folgende Faktoren: Alter, degenerative Gelenkerkrankungen, Osteoporose, Depression, Raucherstatus, Anstellungsverhältnis, Gemeindegröße und Beeinträchtigung der täglichen Arbeit durch körperliche Beschwerden.SchlussfolgerungDie vorliegende Untersuchung stellt einen Versuch dar, Erkenntnisse abzuleiten, nach denen Geschlechtsunterschiede in der Versorgung von Rückenschmerzpatienten berücksichtigt werden sollten. Präventionsmaßnahmen und Therapieansätze könnten dadurch beeinflusst werden. Zukünftige Analysen, sollten besonders psychosoziale Faktoren einschließen, um sich dem Problem adäquat zu nähern.AbstractBackgroundWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.MethodsSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (χ2) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).ResultsWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.ConclusionThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.BACKGROUNDnWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.nnnMETHODSnSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (chi(2)) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).nnnRESULTSnWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.nnnCONCLUSIONnThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.

Präventionsansätze für akute Rückenschmerzen

ZusammenfassungIm vorliegenden Beitrag wurde eine Sekundärdatenanalyse des telefonischen Gesundheitssurveys 2003 (GSTel03) durchgeführt. Dabei wurden diejenigen Personen der deutschen Allgemeinbevölkerung eingeschlossen, die akut unter Rückenschmerzen litten (n=1849) bzw. eine hohe Schmerzintensität angaben (n=1813). Es wurden bivariate Testungen (χ2) und eine multivariate Auswertung durchgeführt und die adjustierten relativen Risiken mit dazugehörigen 95%-Konfidenzintervallen berechnet. Hinsichtlich der Prävalenz akuter Rückenschmerzen ergaben sich signifikante Risikoerhöhungen für weibliches Geschlecht, Vorerkrankungen, Rauchen, niedrige soziale Schicht und körperliche Beeinträchtigung bei der täglichen Arbeit. Hinsichtlich der Intensität wurden Alter, Geschlecht, Depression, Body-Mass-Index, Rauchen und körperliche Beeinträchtigung bei der täglichen Arbeit als Risikofaktoren identifiziert. Männer und v. a. Frauen aus niedrigen sozialen Schichten mit psychischen und muskulo-skelettalen Vorerkrankungen sollten für Maßnahmen der Primärprävention; ältere, übergewichtige Frauen mit depressiven Verstimmungen eher für die Sekundär- und Tertiärprävention angesprochen werden. AbstractThe present article performs a secondary data analysis of the 2003 telephone health survey (GSTel03), which included members of the general German population suffering from acute back pain (n, 1849) or who had high pain intensity data (n, 1813). Bivariate tests (χ2) and multivariate analysis were performed and the adjusted relative risks were calculated with the corresponding 95% confidence intervals. With regard to the prevalence of acute back pain, significantly increased risk was associated with female gender, previous diseases, smoking, low social level and physical impairment in the daily workplace. As far as intensity was concerned, age, sex, depression, body mass index, smoking and physical impairment at work were identified as risk factors. Men and in particular women from low social backgrounds with previous psychological and musculoskeletal diseases, as well as older overweight women with depressive tendencies, should be addressed with regard to secondary and tertiary prevention.

Heimtierhaltung in Armut. Ausgewählte Ergebnisse einer Gesundheitsstudie in überschuldeten Haushalten

Unter dem Begriff der Uberschuldung oder der dauerhaften Zahlungsunfahigkeit ist zu verstehen, dass das Einkommen einer Privatperson nach Abzug der notwendigen Lebenshaltungskosten nicht ausreicht, um alle ausstehenden Zahlungsverpflichtungen in absehbarer Zeit zu erfullen (Wimmer 2006, S. 1682). Selbst bei einer Reduzierung des eigenen Lebensstandards besteht in diesem Fall keine Perspektive, die Rechnungen oder Schulden langfristig abzubezahlen. Betroffene und die zum Haushalt gehorenden Personen und ggf. Haustiere sind damit in ihrem Alltag von akuter Ausgabenarmut betroffen, so dass selbst die Grundversorgung nicht gewahrleistet und soziale Teilhabe eingeschrankt sein konnen.

Geschlechtsspezifische Risikofaktoren akuter Rückenschmerzen@@@Gender-specific risk factors for acute low back pain: Ansatzpunkte für eine zielgruppenspezifische Prävention@@@Starting points for target-group-specific prevention

ZusammenfassungHintergrundFrauen geben häufiger akute Rückenschmerzen an als Männer. Es stellte sich die Frage, ob sich geschlechtsspezifische Risikoprofile aufzeigen lassen.MethodeEine Sekundärdatenanalyse des telefonischen Gesundheitssurveys 2003 des Robert-Koch-Instituts wurde durchgeführt (n=7829). Es wurden bivariate (χ2) und geschlechtsstratifizierte multivariate Tests durchgeführt („odd‘s ratios“, 95%-Konfidenzintervalle).ErgebnisseFrauen (28,5%) gaben signifikant häufiger als Männer (18%) akute Rückenschmerzen an (p<0,001). In der multivariaten Analyse ergaben sich geschlechtsspezifische Risikoschätzer für folgende Faktoren: Alter, degenerative Gelenkerkrankungen, Osteoporose, Depression, Raucherstatus, Anstellungsverhältnis, Gemeindegröße und Beeinträchtigung der täglichen Arbeit durch körperliche Beschwerden.SchlussfolgerungDie vorliegende Untersuchung stellt einen Versuch dar, Erkenntnisse abzuleiten, nach denen Geschlechtsunterschiede in der Versorgung von Rückenschmerzpatienten berücksichtigt werden sollten. Präventionsmaßnahmen und Therapieansätze könnten dadurch beeinflusst werden. Zukünftige Analysen, sollten besonders psychosoziale Faktoren einschließen, um sich dem Problem adäquat zu nähern.AbstractBackgroundWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.MethodsSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (χ2) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).ResultsWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.ConclusionThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.BACKGROUNDnWomen complain about back pain more often than men, giving rise to the question of whether gender-specific risk profiles could be identified.nnnMETHODSnSecondary data analysis was done of the telephone health survey conducted by the Robert Koch Institute in 2003 (n=7,829). Bivariate (chi(2)) and gender-stratified multivariate tests were conducted (odds ratio, 95% confidence intervals).nnnRESULTSnWomen (28.5%) complained about acute low back pain significantly more often than men did (18%; p<0.001). The multivariate analysis found gender-specific risk estimates for the following factors: age, degenerative diseases of the joints, osteoporosis, depression, smoking, employment, municipality size, and impairment of daily work because of physical impairment.nnnCONCLUSIONnThe present examination is an attempt to deduce factors to be taken into account for gender-specific care of patients with acute low back pain. Preventive measures and therapy approaches could be influenced by these findings. To adequately address the problem, future analyses should specifically include psychosocial factors.