Stephan Müters

Messung des sozioökonomischen Status in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1)

ZusammenfassungDer sozioökonomische Status (SES) stellt eine zentrale Analysekategorie der epidemiologischen Forschung und Gesundheitsberichterstattung dar. Im Rahmen der Deutschen Herz-Kreislauf-Präventionsstudie 1984–1991 wurde zur Messung des SES ein mehrdimensionaler aggregierter Index entwickelt, der bis heute in vielen Studien verwendet wird. Für das Gesundheitsmonitoring am Robert Koch-Institut (RKI) wurde der Index nach einer kritischen Überprüfung grundlegend überarbeitet. Der Beitrag beschreibt, welche Überlegungen der Überarbeitung zugrunde lagen und wie diese in Bezug auf die „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) umgesetzt wurden. Zudem werden Ergebnisse zur alters- und geschlechtsspezifischen Verteilung der Werte des überarbeiteten SES-Index und zum Zusammenhang mit anderen Maßen des sozioökonomischen Status berichtet. Die Ergebnisse basieren auf den Daten von DEGS1 2012 und des Bundes-Gesundheitssurveys 1998 (BGS98).AbstractSocioeconomic status (SES) constitutes a central analysis category of epidemiological research and health reporting. As part of the German cardiovascular disease prevention study 1984-1991, a multi-dimensional aggregated index was developed for the purpose of measuring SES. This index continues to be used in numerous studies to this day. For the purpose of health monitoring at the Robert Koch Institute (RKI), the index was fundamentally revised following critical assessment. This article describes the basic concepts underlying the revision and how they were implemented in relation to the “German health interview and examination survey for adults” (DEGS1). In addition, the results of the age and sex-specific distribution of the values of the revised SES index and those relating to the connection with other measurements of socioeconomic status are reported. The results are based on the data of DEGS1 2012 and the German national health interview and examination survey 1998 (GNHIES98). An English full-text version of this article is available at SpringerLink as supplemental.

Messung des sozioökonomischen Status in der Studie „Gesundheit in Deutschland aktuell“ (GEDA)

The socioeconomic status (SES) is a central analytical concept for epidemiologic research and health reporting in Germany. Within the German Cardiovascular Prevention Study (GCP), a multidimensional aggregated index of SES has been developed, which is used to this date. We have revised this index critically and reworked it according to the necessities of German health monitoring at the Robert Koch Institute (RKI). The main changes involve the operationalization and categorization of the status-constituting dimensions education, occupation, and income as well as the categorization of the resulting socioeconomic status groups. This paper explains the steps of the revision process and the ideas behind it. In addition, it provides empirical evidence on the association of the revised index with three important health outcomes (self-rated health, obesity, and smoking) using data of the German Health Update 2009 (GEDA) study. It is planned to apply the revised SES concept in all studies on German health monitoring at the RKI, i.e., not only to GEDA but also to the German Health Interview and Examination Survey for Adults (DEGS) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in the same way.

Verbreitung des Rauchens in der Erwachsenenbevölkerung in Deutschland

Although various tobacco control measures have been implemented in Germany in the recent years, smoking is still widespread and constitutes a considerable health risk for the population. According to the data of the German Health Interview and Examination Survey for Adults (DEGS1), which was conducted by Robert Koch Institute from 2008 to 2011, 29.7% of the 18 to 79-year old population smokes (women = 26.9%, men = 32.6%). The proportion of women and men who smoke 20 or more cigarettes a day amounts to 6.0% and 10.6% respectively. Smoking is mostly widespread among young adults, as well as among persons with low social status who are also overrepresented among the heavy smokers. Comparison with data from previous health surveys indicates that the proportion of smokers has reduced slightly over the last 10 years. An English full-text version of this article is available at SpringerLink as supplemental.

Barriers to pandemic influenza vaccination and uptake of seasonal influenza vaccine in the post-pandemic season in Germany

BackgroundIn Germany, annual vaccination against seasonal influenza is recommended for certain target groups (e.g. persons aged ≥60 years, chronically ill persons, healthcare workers (HCW)). In season 2009/10, vaccination against pandemic influenza A(H1N1)pdm09, which was controversially discussed in the public, was recommended for the whole population. The objectives of this study were to assess vaccination coverage for seasonal (seasons 2008/09-2010/11) and pandemic influenza (season 2009/10), to identify predictors of and barriers to pandemic vaccine uptake and whether the controversial discussions on pandemic vaccination has had a negative impact on seasonal influenza vaccine uptake in Germany.MethodsWe analysed data from the ‘German Health Update’ (GEDA10) telephone survey (n=22,050) and a smaller GEDA10-follow-up survey (n=2,493), which were both representative of the general population aged ≥18 years living in Germany.ResultsOverall only 8.8% of the adult population in Germany received a vaccination against pandemic influenza. High socioeconomic status, having received a seasonal influenza shot in the previous season, and belonging to a target group for seasonal influenza vaccination were independently associated with the uptake of pandemic vaccines. The main reasons for not receiving a pandemic vaccination were ‘fear of side effects’ and the opinion that ‘vaccination was not necessary’. Seasonal influenza vaccine uptake in the pre-pandemic season 2008/09 was 52.8% among persons aged ≥60 years; 30.5% among HCW, and 43.3% among chronically ill persons. A decrease in vaccination coverage was observed across all target groups in the first post-pandemic season 2010/11 (50.6%, 25.8%, and 41.0% vaccination coverage, respectively).ConclusionsSeasonal influenza vaccination coverage in Germany remains in all target groups below 75%, which is a declared goal of the European Union. Our results suggest that controversial public discussions about safety and the benefits of pandemic influenza vaccination may have contributed to both a very low uptake of pandemic vaccines and a decreased uptake of seasonal influenza vaccines in the first post-pandemic season. In the upcoming years, the uptake of seasonal influenza vaccines should be carefully monitored in all target groups to identify if this trend continues and to guide public health authorities in developing more effective vaccination and communication strategies for seasonal influenza vaccination.

Seasonal influenza vaccine uptake in Germany 2007/2008 and 2008/2009: Results from a national health update survey

In 2008/2009 a nationwide cross-sectional telephone survey was conducted to assess, among other health-relevant parameters, seasonal influenza vaccination coverage. Data from 21,262 household-interviews representative of the adult population in Germany were collected and analyzed. In seasons 2007/2008 and 2008/2009, vaccine uptake in individuals aged ≥60 years was 57% and 55% and in individuals with underlying chronic diseases 44% and 42%. Living in the eastern part of Germany, higher age, and medium household income level were independently associated with higher vaccine uptake in both target groups. Healthcare workers were significantly less frequently (21.9% in 2007/2008; 20.4% in 2008/2009) vaccinated than the general population (30.8% and 28.1%). Special effort must be undertaken to develop immunization strategies for improved vaccine uptake in target groups, especially in healthcare workers.

Measurement of socioeconomic status in the German Health Interview and Examination Survey for Adults (DEGS1)

ZusammenfassungDer sozioökonomische Status (SES) stellt eine zentrale Analysekategorie der epidemiologischen Forschung und Gesundheitsberichterstattung dar. Im Rahmen der Deutschen Herz-Kreislauf-Präventionsstudie 1984–1991 wurde zur Messung des SES ein mehrdimensionaler aggregierter Index entwickelt, der bis heute in vielen Studien verwendet wird. Für das Gesundheitsmonitoring am Robert Koch-Institut (RKI) wurde der Index nach einer kritischen Überprüfung grundlegend überarbeitet. Der Beitrag beschreibt, welche Überlegungen der Überarbeitung zugrunde lagen und wie diese in Bezug auf die „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1) umgesetzt wurden. Zudem werden Ergebnisse zur alters- und geschlechtsspezifischen Verteilung der Werte des überarbeiteten SES-Index und zum Zusammenhang mit anderen Maßen des sozioökonomischen Status berichtet. Die Ergebnisse basieren auf den Daten von DEGS1 2012 und des Bundes-Gesundheitssurveys 1998 (BGS98).AbstractSocioeconomic status (SES) constitutes a central analysis category of epidemiological research and health reporting. As part of the German cardiovascular disease prevention study 1984-1991, a multi-dimensional aggregated index was developed for the purpose of measuring SES. This index continues to be used in numerous studies to this day. For the purpose of health monitoring at the Robert Koch Institute (RKI), the index was fundamentally revised following critical assessment. This article describes the basic concepts underlying the revision and how they were implemented in relation to the “German health interview and examination survey for adults” (DEGS1). In addition, the results of the age and sex-specific distribution of the values of the revised SES index and those relating to the connection with other measurements of socioeconomic status are reported. The results are based on the data of DEGS1 2012 and the German national health interview and examination survey 1998 (GNHIES98). An English full-text version of this article is available at SpringerLink as supplemental.

Data Resource Profile: German Health Update (GEDA)—the health interview survey for adults in Germany

The German Health Update (GEDA) study is one component of the recently established nationwide health monitoring system administered by the Robert Koch Institute. The repeated cross-sectional GEDA surveys aim to provide current data on health and disease, health determinants and time trends in health and morbidity in the adult population in Germany. This forms the basis for planning requirements and recommendations for public health policy.Between 2008 and 2013, three GEDA waves were carried out, involving a total of 62,606 computer-assisted telephone interviews with adults in Germany, living in private household, and reachable via landline.A core set of indicators was used in all GEDA waves to gather information on subjective health and health-related quality of life, chronic diseases, injuries, impairment to health and disabilities, mental health, health behaviours, social determinants, use of health services and socio-demographic characteristics.The data from the GEDA surveys are provided for public use and epidemiological research. After submitting an application form, the data are accessible from: [http://www.rki.de/EN/Content/Health_Monitoring/Public_Use_Files/public_use_file_node.htm].

Determinants of tetanus and seasonal influenza vaccine uptake in adults living in Germany.

The primary objective of this study was to assess determinants of vaccine uptake in adults living in Germany exemplified by one standard vaccination (tetanus) and one vaccination targeting specific risk-groups (seasonal influenza). Data from 21,262 telephone household-interviews representative of the adult population in Germany were collected in 2009 and analysed. A total 73.1% of the adult population had a sufficient tetanus vaccination status according to national recommendations (i.e. last tetanus shot ≤10 years ago). Influenza vaccination coverage in the target population (i.e. persons ≥60 years, chronically ill, healthcare workers) was 44.1%. Persons who received professional vaccination advice within the past five years were more frequently vaccinated against tetanus and influenza than persons without (p

Messung des sozioökonomischen Status in der KiGGS-Studie

This article describes the measurement of socioeconomic status in the first follow-up of the KiGGS study (KiGGS Wave 1) conducted from 2009 to 2012. A multidimensional index score was used. The score is the sum of three metric components: Education and Occupational Qualification, Occupational Status, and Net Income. Compared with the approach in the KiGGS baseline study, some modifications were made in accordance with changes in the other components of the health-monitoring program at the Robert Koch Institute, i.e., the German Health Update (GEDA) and the German Health Interview and Examination Survey for Adults (DEGS1). These changes facilitate the analysis of temporal developments and trends, ensure international comparability of the data, and support the transfer of the results into politics and practice. In order to demonstrate the application of the revised instrument, we report on exemplary results of KiGGS Wave 1 regarding the relationship between socioeconomic status and the general health status of children and adolescents aged 3-17 years.

[Prevalence of smoking in the adult population of Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

Although various tobacco control measures have been implemented in Germany in the recent years, smoking is still widespread and constitutes a considerable health risk for the population. According to the data of the German Health Interview and Examination Survey for Adults (DEGS1), which was conducted by Robert Koch Institute from 2008 to 2011, 29.7% of the 18 to 79-year old population smokes (women = 26.9%, men = 32.6%). The proportion of women and men who smoke 20 or more cigarettes a day amounts to 6.0% and 10.6% respectively. Smoking is mostly widespread among young adults, as well as among persons with low social status who are also overrepresented among the heavy smokers. Comparison with data from previous health surveys indicates that the proportion of smokers has reduced slightly over the last 10 years. An English full-text version of this article is available at SpringerLink as supplemental.