Journal of health monitoring最新文献

Background: The Robert Koch Institute (RKI) continuously monitors key health indicators in the general population by collecting data repeatedly. As changes in survey design can affect prevalence estimates and thus make interpreting trends difficult, the launch of the RKI Panel 'Health in Germany' was accompanied by a methodological study.

Methods: The RKI Panel is based on a random sample drawn from population registers. The survey is self-administered in written format (online or paper). The composition of the sample, prevalence estimates and response behaviour were then compared with data collected in parallel in the GEDA 2024 telephone survey. Data from previous surveys were included in the modelling to quantify method-related differences in prevalence estimates.

Results: The RKI Panel 2024 was more successful in representing young adults, the elderly and individuals with low levels of education. The prevalence estimates differ significantly from GEDA 2024 in some cases, particularly for mental health indicators and their associated factors. The RKI Panel includes more older adults with limited physical health, while in young adults more participants with poorer mental health are present. Despite method-related differences in prevalence, modelling can usually be used to assess trends.

Conclusions: The RKI Panel provides a more realistic representation of the German population than previous telephone surveys. The differences in prevalence are due to effects of the survey mode, questionnaire design, and changes in sample composition.

Background: As the RKI's new data collection infrastructure, the RKI Panel 'Health in Germany' offers the opportunity to regularly collect primary data on topics relevant to public health among the population in Germany (survey mode: online - CAWI and written - PAPI). This article presents the participation rates for the sub-waves and the composition of the sample. It also describes the special features of the 2024 annual survey.

Methods: The 2024 annual survey followed on from the initial recruitment study of the RKI panel. For this survey wave, the registered panel participants were surveyed in three sub-waves with four different questionnaires on different topics.

Results: Participation rates between 81.3 % and 75.3 % were achieved in the three sub-waves of the 2024 annual survey. In the first sub-wave, 38,212 people participated, and in the second, 36,134 interviews were conducted. The third and final sub-wave comprised 35,786 interviews.

Conclusions: The 2024 annual survey provides a comprehensive data basis for various public health-related issues. The following topics are covered: physical and mental health, use of healthcare services, health-related behaviour, health literacy, social conditions, and the relationship between climate change and health. The data refer to the German resident population aged 18 and over.

Background: Telephone surveys show a decline in the mental health of adults in Germany between 2020 and 2023. For 2024, results from the Robert Koch Institute's new panel 'Health in Germany' on depressive and anxiety symptoms are presented and contextualised within existing time series.

Methods: Using data from n = 27,102 participants surveyed online or on paper, prevalences were estimated and subgroup differences were examined. Trends for 2014 - 2024 were modelled taking into account methodological discontinuities.

Results: In 2024, an estimated 22 % of adults showed depressive symptoms (PHQ-9 ≥ 10) and 14 % showed anxiety symptoms (GAD-7 ≥ 10). 8 % of adults had moderately severe to severe depressive or anxiety symptoms (PHQ-9/GAD-7 ≥ 15). Women, younger adults and people with low or medium levels of education were more frequently affected. The burden was particularly high among young women: 47 % showed depressive or anxiety symptoms. The figures for 2024 are significantly higher than those for the previous year; however, these differences appear to be largely due to a change in methodology. Whether the symptom rise observed from 2020 to 2023 continued in 2024 cannot be conclusively assessed owing to this methodological transition.

Conclusions: There continues to be a high demand for measures to promote mental health in the population. The establishment of the RKI Panel in the coming years will enable methodologically consistent monitoring of depressive and anxiety symptoms in the future, which is a key prerequisite for the reliable assessment of trends.

Background: Regular physical activity is essential for health, yet a large proportion of the German population remains inactive, with significant health and economic consequences. As physical activity promotion spans multiple settings and political sectors, systematic overviews of available data on behaviour and promotion practices are often lacking.

Methods: This article draws on four policy briefs on physical activity promotion in Germany published by the Federal Ministry of Health (2022 - 2024). Data on physical activity behaviour (secondary analysis) and promotion practices across sectors (mixed methods approach) were analysed. A distinction was made between good practice (projects with proven effectiveness) and routine practice (large-scale programmes).

Results: Between 1993 and 2024, eleven institutions from different political sectors collected data on physical activity behaviour in 23 larger studies. Current data show lower activity levels among older adults, women, socioeconomically disadvantaged groups, and individuals living with a non-communicable disease. In total, 43 good practice projects and 88 routine practice measures were identified. While all good practice projects demonstrated effectiveness, this was true for only 11 % of routine practices. Good practice projects were less likely to reach at least 100,000 people (12 %) compared to routine practice (25 %), and were more often limited to less than five years (33 % vs. 9 %).

Conclusions: Physical activity promotion is an intersectoral challenge requiring stronger structures and shared responsibility. To increase population-level impact, the reach of good practice should be expanded and the effectiveness of routine practice evaluated more systematically. The planned establishment of a National Competence Centre for Physical Activity Promotion offers a key opportunity to advance these goals.

Background: Remaining physically active in later life has been shown to contribute to a longer and healthier life without the need for care or support. Accordingly, a societal expectation to stay active in old age (prescriptive age norm) has emerged - particularly among older adults themselves. Yet, are they in fact as physically active as expected?

Methods: Using representative data from the Age_ISM Germany survey (ages 16 - 96 years), we examine the extent to which older individuals agree with the prescriptive age norm that 'old people should normally remain physically active' compared to younger individuals. This is contrasted with the actual activity behavior of 18- to 90-year-olds based on the 2019/2020 GEDA survey data from the Robert Koch Institute. This allows us to compare endorsement of the prescriptive norm with actual behavior.

Results: Although the prescriptive age norm of remaining physically active is more strongly endorsed in the older age groups than in the younger age groups, the proportion of individuals who are sufficiently active according to the World Health Organization's definition is significantly lower in the older age groups.

Conclusions: The findings point to a 'norm-behavior gap': from around the age of 75 onwards, expectations regarding physical activity and actual behavior diverge increasingly. At the individual level, the negative age stereotype of older people as inactive and passive may, for instance, contribute to older adults' perception of being less addressed by exercise programs. At the socio-structural level, this may indicate a lack of age-sensitive exercise programs.

Background: Physical activity promotion should start early, as a physical active lifestyle is easier to establish at a young age and can have a positive impact into adulthood. Day care centres are particularly suitable for promoting physical activity, as over 90 % of children aged three and above attend a day care centre. Despite numerous programmes, there is a lack of scientific data on the prevalence of specific measures and insufficient evidence on factors influencing their implementation.

Methods: The survey on the status of physical activity promotion in day care centres (BeweKi survey 2022/2023) asked day care centre directors about structural conditions and pedagogical staff about physical activity-related personal characteristics. Data is available for 1,647 day care centres.

Results: Most day care centres engaged in walks, excursions, and used (external) sport halls at least once per week to promote physical activity, while digital resources or swimming pools were used very rarely. Almost all provided at least one hour of free physical activity time per day. Only a quarter offered an equally long period of structured units for physical activity, for which regular team discussions on physical activity, sufficient area in the day care centre and staff moving together with children were enabling factors.

Conclusions: Physical activity promotion is widespread in day care centres, but structured physical activity time is not sufficiently established. To increase this, spatial and organisational conditions could be addressed, as well as staff physical activity behaviour.

Background: Mental health problems are widespread among young adults in Germany, yet the use of professional help remains low. This study aimed to identify the most common perceived barriers to help-seeking and to examine which individual and regional factors are associated with unmet need for mental health care.

Methods: A total of 3,051 former participants of the KiGGS cohort study (aged 16 to 25 years) took part in an online survey. Group comparisons and regression analyses were conducted to examine associations of individual and regional characteristics with unmet need for care.

Results: Overall, 42.6 % of respondents reported not having used professional help despite being advised to do so or perceiving a need themselves. The most frequently reported barriers were difficulties in acknowledging one's own need for help (problem denial) and negative attitudes towards seeking professional help (help-seeking stigma). Within this group, unmet need was more likely reported by women, individuals with lower subjective social status, depression or anxiety symptoms, low mental health-related quality of life, or inadequate health literacy. Regional characteristics such as the density of care provision or socioeconomic deprivation were not significantly associated with unmet need.

Conclusions: The findings highlight the importance of subjective barriers to help-seeking behaviour. Low-threshold interventions may help improve self-awareness, appraisal competence, and openness in dealing with psychological distress, thereby reducing the risk of mental health disorders.

Background: With the passage of the Consumer Cannabis Act, cannabis was partially legalised on 1 April 2024 in Germany. Cannabis remains prohibited for adolescents under the age of 18. This article analyses how the prevalence of cannabis use among young people in Germany has developed up to this point and presents prevention measures and funding projects offered by the Federal Institute of Public Health (BIÖG, formerly the Federal Centre for Health Education, BZgA).

Methods: Based on representative studies by the BIÖG, sociodemographic differences in 2023 and trends in the 12-month prevalence of cannabis use between 2008 and 2023 are analysed for 12- to 17-year-old adolescents and 18- to 25-year-old young adults. Current prevention measures are systematically presented.

Results: The 12-month prevalence of cannabis use remained relatively stable among female and male adolescents before partial legalisation, but increased significantly among young women (2008: 8.3 %; 2023: 19.4 %) and men (2008: 14.8 %; 2023: 26.9 %). Cannabis prevention measures focus on the school setting and digital services.

Conclusions: The effects of partial legalisation on cannabis use among adolescents and young adults must be evaluated in future studies. The BIÖG offers well-founded information on cannabis, its effects and health risks, as well as digital counselling services and self-tests for different target groups, and is continuously expanding its services.

Background: As part of the German Burden of Disease Study, population-based prevalences of important diseases are estimated. This allows regional patterns and temporal trends to be identified.

Methods: The 10-year prevalence of stroke in the population was estimated cross-sectionally for the years 2017 to 2022 at the level of the Spatial Planning Regions using routine data of persons insured in the statutory health insurance AOK, adjusted for age, sex and morbidity (administrative 10-year prevalence).

Results: In 2022, 1.4 % of the population in Germany was living with the consequences of a stroke that had occurred up to 10 years ago (women: 1.3 %, men: 1.6 %). Prevalence increases continuously with age - from 1.2 % (women) and 2.3 % (men) in the 60 - 64 age group to 8.3 % and 9.8 % in the 90 - 94 age group. Over time, age-standardised prevalence has remained largely stable since 2017. The age-standardised regional distribution shows a variation of up to 60 % between regions. Low values (below 1.1 %) are found mainly in southern German regions, while the highest values (above 1.5 %) without a clear pattern are found, for example, in the Emscher-Lippe, Saar, and southern Thuringia regions.

Conclusions: Measured in terms of administrative 10-year prevalence, the significance of stroke for public health remains high, not least because of the high mortality rate, with high prevalence rates continuing to be achieved, especially in older age groups. In order to achieve a decline, more low-threshold, evidence-based prevention services are needed in addition to targeted interventions.

Background: According to the new position statement of the German Nutrition Society, there is no level of alcohol consumption that is risk-free to health. One to two alcoholic drinks per week are associated with a low risk of negative health consequences, three to six with a moderate risk, and more than six with a high risk. Alcohol consumption in Germany was assessed according to these categories.

Methods: The analyses are based on the survey German Health Update (GEDA 2019/2020-EHIS) conducted by the Robert Koch Institute with data from 22,708 adults. The frequency and amount of alcohol consumption were asked in a telephone interview.

Results: 21.1 % of adults stated that they did not drink alcohol. 46.3 % had an alcohol consumption with a low risk of negative health consequences. 32.5 % of adults reported moderate or high-risk consumption, with significantly more men (44.3 %) than women (21.4 %) doing so. This consumption pattern was most prevalent among men aged 45 to 64 and 65 and over (almost one in two in both groups), as well as among women aged 45 to 64 (about one in four), and increased in both sexes in higher education groups.

Conclusions: Almost one in three adults consume three or more alcoholic drinks per week, which is associated with a moderate to high risk of disease. Therefore, measures proven to reduce alcohol consumption, such as advertising bans, higher taxation and restrictions on availability, should be implemented.