[Subnational population health monitoring and reporting: public health at the grassroots level]. / Gesundheitsberichterstattung in Ländern und Kommunen: Public Health an der Basis.

Population health monitoring and reporting provides regular and up-to-date information on health outcomes and its determinants. The outputs of population health monitoring aim to inform policymakers and other stakeholders to develop fact-based decisions. Population health monitoring is located at the national, but also federal state and county level. This paper describes the legal basis for population health monitoring in the federal states' public health acts as well as current challenges and possibilities for further development from a federal state and county perspective on population health monitoring.A legal basis for population health monitoring on the federal state and county level exists for almost all federal states in Germany. The level of detail of these laws varies in terms of responsibility, periodicity of population health monitoring and reporting, content, and designated use. Population health monitoring needs to respond to challenges in the areas of population health monitoring resources, data sources, (intersectoral) reporting, and impact. Practical examples illustrate how the challenges can be handled and further development can take place.Based on its solid legal basis, being a routine task, and its close link to the living conditions of the population, population health monitoring on the federal state and county level has the possibility for cocreating public health at the grassroots level and to be a pioneer for health equity.

[Good practice in health reporting-from the beginning to version 2.0]. / Gute Praxis Gesundheitsberichterstattung ­ von der Idee bis zur Version 2.0.

In the context of public health, health reporting functions as a mediator between science and policy. The development of guidelines for good practice in health reporting took place in response to needs that were frequently expressed by experts in this public health area. The pilot version of the guidelines was drawn up in 2011 and discussed at a number of relevant conferences. After the publication of version 1.0 in 2017, another peer review process followed, which led to the extensively revised guidelines for good practice in health reporting as version 2.0. As health reporting is currently in a process of innovation and increasing in importance, it is foreseeable that the guidelines will have to be revised again in the not too distant future.

[Meeting the challenge of Easy-to-Read language - Translating the North Rhine-Westphalian Public Health Report 2015 into Easy-to-Read language]. / Herausforderung Leichte Sprache.

BACKGROUND AND METHODS: The United Nations Convention on the Rights of Persons with Disabilities determines amongst others the right of access to information. Information for the general public must be made accessible for persons with disabilities in formats and technologies appropriate to different kinds of disabilities. The language poses the largest barrier for people with learning difficulties. Therefore, we translated parts of the Public Health Report 2015 of North Rhine-Westphalia into an Easy-to-Read language.The translation was performed by a professional translation agency in cooperation with an assessment group, composed by people with learning problems, and the NRW Centre for Health (LZG.NRW).During the translation the population health monitoring group of the LZG.NRW experienced several challenges. The scope of these challenges and the chosen solutions are described in detail in this paper. RESULTS: 3 challenges were experienced clearly during the translation of the Public Health Report: (1) (Large) numbers and rates are a key element in population health monitoring but they should be avoided in texts in Easy-to-Read language. (2) The translation of the age-standardization approach and the related effects appeared to be difficult. (3) Finding the right balance between the description of lifestyle influences and the influence of the wider health determinants as well as finding a non-discriminatory wording regarding the influence of social health determinants were challenging.The following approaches were chosen to counteract these challenges: (1) We avoided to report numbers and rates. In some cases simple fractions are presented. In addition, all of these fractions were explained and visualized in the introductory section of the translated report. (2) We resigned to describe time trends. In some cases time trends were mentioned as crude rates and an explanation of potential effects (e.g., demographic change) was added. If gender specific differences occurred in the crude and age-standardised rates, we described the age-standardised differences. (3) The relativization of direct and striking formulations regarding the influence of the social health determinants and the inclusion of recommendations related to the scope of upstream determinants needed to be recognized and incorporated. CONCLUSION: Translating a public health report into Easy-to-Read language is a challenging process. Continuous and smooth cooperation between translators, the assessment group and the authors of the original report is mandatory to be successful.

Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis.

OBJECTIVE: To identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence. DESIGN: A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle-Ottawa Scales. SETTING: High- and upper-middle-income countries. SUBJECTS: Pregnant or postpartum women reporting their dietary intake during pregnancy. RESULTS: Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail. CONCLUSIONS: The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake.

[Regionalization of federal health reporting using the example of diabetes surveillance : Aims and results of the discussion between the Robert Koch Institute and the federal states]. / Regionalisierung der Gesundheitsberichterstattung am Beispiel Diabetes-Surveillance : Ziele und Ergebnisse des Bund-Länder-Gesprächs am Robert Koch-Institut.

Insufficiently treated diabetes mellitus can lead to severe comorbidities. National and international analyses show a continuous increase in diabetes prevalence over the last decades. Currently, an indicator-based national diabetes surveillance system is implemented at the Robert Koch Institute (RKI) to monitor and report on diabetes development on the basis of available primary and secondary data. The aim of the meeting was to go into deeper discussions and to integrate expectations and expertise of the federal states into the design of the national surveillance system. A close collaboration between the RKI and the federal states is intended.

Good Practice in Health Reporting - Guidelines and Recommendations 2.0: The boards of the German Society for Social Medicine and Prevention and the German Society for Epidemiology have approved this second edition of Good Practice in Health Reporting.December 2018.

Health reporting provides a description of the health of the population, analyses problems and demonstrates areas in which action needs to be taken in health care provision, health promotion and disease prevention. Accordingly, it offers a rational basis for participatory processes and health policy decision-making. This edition of Good Practice in Health Reporting resulted from a revision of the first edition, which was first published in March 2017. It incorporates contributions from experts, and various institutions and associations from the German federal-state and national levels. This revised edition rose out of the need for continual development in health reporting. In some cases, a number of changes were made so that certain aspects could be defined more clearly; in other cases, changes were made to methodology, for example, in order to accommodate participatory and qualitative approaches. This publication is aimed at providing people working in health reporting with professional direction and guidance. We welcome your feedback.

Selecting and defining indicators for diabetes surveillance in Germany.

Mainly because of the large number of people affected and associated significant health policy implications, the Robert Koch Institute (RKI) is developing a public health surveillance system using diabetes as an example. In a first step to ensure long-term and comparable data collection and establish efficient surveillance structures, the RKI has defined a set of relevant indicators for diabetes surveillance. An extensive review of the available literature followed by a structured process of consensus provided the basis for a harmonised set of 30 core and 10 supplementary indicators. They correspond to the following four fields of activity: (1) reducing diabetes risk, (2) improving diabetes early detection and treatment, (3) reducing diabetes complications, (4) reducing the disease burden and overall costs of the disease. In future, in addition to the primary data provided by RKI health monitoring diabetes surveillance needs to also consider the results from secondary data sources. Currently, barriers to accessing this data remain, which will have to be overcome, and gaps in the data closed. The RKI intentends to continuously update this set of indicators and at some point apply it also to further chronic diseases with high public health relevance.

Good Practice in Health Reporting - guidelines and recommendations.

Health reporting provides descriptions of the health of a population, analyses problems and demonstrates areas in which action needs to be taken in health care, health promotion and disease prevention. As such, it provides a rational basis for participatory processes and a foundation for health policy decision-making. Good Practice in Health Reporting was developed by a working group that includes representatives from all levels of health reporting with the aim of strengthening the field at the local, federal-state and national level. The document sets out guidelines and recommendations that are intended to provide professional guidance for the creation of health reports. It makes 11 recommendations that address the ethical principles behind health reporting, the necessary framework, the selection of topics (the report's focus), the foundation of the work undertaken (data quality), data preparation, analysis, interpretation and protection, as well as communications and quality assurance. The pilot version of the document was presented at the conferences of the German Society for Epidemiology (DGEpi), the German Society for Social Medicine and Prevention (DGSMP) and the Federal Association of Physicians of German Public Health Departments (BVÖGD) where it was discussed and subsequently revised. After further review, the guidelines were adopted by all of these institutions. Finally, Good Practice in Health Reporting is to be strengthened and developed further as part of a comprehensive review.