[Participation of people with migration background in health surveys of the Robert Koch Institute]. / 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.

[Health status of people with a migrant background and impact of socio-economic factors: First results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Die gesundheitliche Lage von Menschen mit Migrationshintergrund und die Bedeutung des sozioökonomischen Status : Erste Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

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.

[Mental health in adolescents in Germany: A comparison with regard to migration background and country of origin]. / Psychische Gesundheit von Jugendlichen in Deutschland : Ein Vergleich nach Migrationshintergrund und Herkunftsland.

Many children and adolescents in Germany grow up in families with a migration background. Different cultural, religious, and linguistic backgrounds have an influence on their behavior in various ways. Health status can be affected both negatively and positively by a migration background. The aim of this study was to analyze associations between migration background and self-reported psychological problems. In addition, it was tested whether country of origin had a differential effect on the associations found. Because of its migration-specific approach, the baseline survey (2003-2006) of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) offers a solid basis for migrant-specific analyses. Self-reported mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), which was completed by 6,719 adolescents aged 11-17 years. Adolescents with a two-sided migration background (i.e., both parents) reported higher SDQ total difficulties scores compared with adolescents without a migration background (16.9 vs 11.5%) or those with a one-sided migration background (16.9 vs 11.3%). Adolescents with a Turkish background had higher odds (boys: OR 2.0; 95%CI 1.3-3.2; girls: OR 2.0; 95%CI 1.2-3.4) of reporting mental health problems than adolescents without a migration background. Also, girls with a migration background from Western Europe, the USA or Canada had higher odds (OR 2.2; 95%CI 1.3-3.6). In some cases, adjusting for socioeconomic status led to insignificant associations with regard to the country of origin. The findings underline the importance of migrant-specific and culture-sensitive prevention, which also takes the environment and culture-specific characteristics into account.

Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008-11.

Germany was reported to have higher blood pressure (BP) and lower awareness, treatment and control of BP than other western countries based on 1998 data. BP distribution and hypertension management were examined for 1998 and 2008-11 in 7108 adult participants of the German National Health Interview and Examination Survey 1998 (GNHIES98) and in 7095 adult participants the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) aged 18-79 years. Age- and sex-standardized mean systolic BP (SBP) dropped from 129.0 to 124.1 mm Hg (women 127.3-120.8, men 130.7-127.4), mean diastolic BP (DBP) from 78.3 to 73.2 mm Hg (women 78.0-71.2, men 78.5-75.3). Mean SBP and DBP decreased most in treated hypertensives but were also lower in participants without hypertension. The overall prevalence of hypertension, including controlled hypertension, remained almost unchanged (30% vs 32%). Uncontrolled hypertension (BP⩾140/90 mm Hg) decreased from 23% to 15% (women 22-13%, men 24-18%). Among hypertensives, awareness increased from 69% to 82% (women 74-87%, men 65-78%), treatment increased from 55% to 72% (women 62-79%, men 48-65%) and control increased from 23% to 51% (women 25-58%, men 20-45%). However, men aged 18-29 years had an opposite trend with 1.5 mm Hg higher SBP and increased prevalence of hypertension, which was mostly uncontrolled. These findings suggest that BP has decreased substantially in Germany, while leaving a persistent gender gap in management and room for further improvement of prevention and treatment, particularly in men.

Health-related quality of life in women and men with type 2 diabetes: a comparison across treatment groups.

AIM: This study compares health-related quality of life (HRQL) in patients with type 2 diabetes (T2DM) across treatment groups and explores gender differences. METHODS: Four regional surveys (KORA, CARLA, SHIP, DHS) and a national survey (GNHIES98) were pooled at individual level. HRQL was assessed with the SF-12/-36v1. Linear regression models were used to assess the effect of T2DM by treatment type (no medication; oral; oral/insulin combination; insulin) on the physical (PCS-12) and mental summary score (MCS-12) and the SF-6D, controlling for age, sex, study and covariates. We also performed an explanatory analysis of single items. RESULTS: PCS-12 scores and treatment type were associated (P-value 0.006), with lowest values for insulin treatment (-4.44 vs. oral; -4.41 vs. combination). MCS-12 scores were associated with treatment type and gender (P-value <0.012), with lower scores for women undergoing oral (-4.25 vs. men) and combination treatment (-6.99 vs. men). Similar results were observed for SF-6D utilities and single items, related to mental health, social functioning, vitality and role limitation (emotional). Comorbidities were predictors of lower PCS-12 and SF-6D scores. CONCLUSIONS: T2DM treatment impacts differently on physical and mental HRQL and on women and men. Further studies of gender-specific perceptions of T2DM treatment regimens are needed.

[Prevalence of common allergies in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1)]. / Verbreitung häufiger Allergien bei Kindern und Jugendlichen in Deutschland : Ergebnisse der KiGGS-Studie - Erste Folgebefragung (KiGGS Welle 1).

The first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1) was conducted from 2009 to 2012 as a combined cross-sectional and longitudinal study and provides, among other things, data on allergic diseases. Data collection was carried out by telephone interviews. In total, 6,093 girls and 6,275 boys were included, among them 4,455 newly recruited 0- to 6-year-olds (response 38.8%) and 7,913 KiGGS follow-up participants aged 7-17 years (response 72.9%). Based on parent reports, 15.6% (95% confidence interval 14.7-16.5) of children and adolescents aged 0-17 years were currently affected by at least one atopic disease. The 12-month prevalence rates of hay fever, atopic dermatitis, and asthma were 9.1% (8.4-9.8), 6.0% (5.4-6.6), and 4.1% (3.6-4.6), respectively. In all, 2.2% (1.9-2.6) of the children and adolescents were currently suffering from contact dermatitis. Compared with the baseline KiGGS survey from 2003 to 2006, a higher percentage of participants reported the occurrence of asthma within the past 12 months in the recent KiGGS Wave 1 (4.1 vs. 3.2%; p = 0.0034). The total increase is mainly due to higher prevalence rates among 0- to 6-year-olds, especially in girls. Higher 12-month prevalence rates can be also observed for hay fever among 0- to 6-year-olds, especially in girls, although the total increase is not statistically significant (9.1 vs. 8.3%; p = 0.08). There was a declining trend for atopic dermatitis: 6.8% (2003-2006) vs. 5.4% (2009-2012); p = 0.0015.

[Health-related quality of life in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1)]. / Gesundheitsbezogene Lebensqualität bei Kindern und Jugendlichen in Deutschland : Ergebnisse der KiGGS-Studie - Erste Folgebefragung (KiGGS Welle 1).

In recent years, there has been a change in the health and disease spectrum among children and adolescents, with an increase in mental health problems and a shift from acute to chronic illness. In this phase, the health-related quality of life (HRQoL) has increased in importance as a dimension of subjective health. The aim of this study is to describe the HRQoL of children and adolescents measured with the internationally standardized screening instrument KIDSCREEN-10. In the follow-up of the KiGGS study in 2009-2012 (KiGGS Wave 1), 2,567 parents of children aged 7-10 years and 4,878 adolescents aged 11 years or older completed the KIDSCREEN-10 questionnaire. In all, 94% of parents of 7- to 10-year-old girls and boys estimate the HRQoL of their children to be "very good" or "good." Of the 11- to 17-year-old adolescents, 96% report their HRQoL as "very good" or "good." Somatic diseases and pain as well as mental health problems and a low social status are included in the HRQoL in only a limited way. Potential differences in HRQoL by social status were not confirmed in multivariate models. The HRQoL of the examined children and adolescents is predominantly very good or good. Interventions to improve the HRQoL of children and adolescents with diseases and psychopathological problems are necessary, regardless of their social status.

[Health-related quality of life of overweight and obese adolescents: what differences can be seen by socio-economic status and education?]. / Gesundheitsbezogene Lebensqualität von übergewichtigen und adipösen Jugendlichen : Welche Unterschiede zeigen sich nach Sozialstatus und Schulbildung?

In the present study the relation between overweight/obesity and health-related quality of life (HRQoL) in adolescence is analysed. Of special interest is the question, to what extent this relation varies by socio-economic status (SES) and education. Data base is a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, n = 6,813, 11-17 years). For the assessment of overweight and obesity, body mass index (BMI) was calculated based on standardised body height and weight measurements. The HRQoL was collected using the KINDL-R-questionnaire, which allows statements concerning a total rating as well as 6 dimensions: physical well-being, emotional well-being, self-worth, family well-being, well-being in relation to friends/peers and school well-being. SES and education are analysed as moderating factors. The results show that obese boys as well as overweight and obese girls have a diminished HRQoL compared to normal weight peers. The analyses according to SES and education suggest that in girls this finding applies for all considered subgroups. Thus, in girls neither SES nor education has a moderating impact on the relation between overweight/obesity and HRQoL. In boys, only SES has a moderating impact on the relation between overweight and HRQoL in favour of the low status group. In terms of the relation between obesity and HRQoL, in boys also only SES has a moderating impact on the analysed relation, but here in favour of the high status group. Altogether, the results show that overweight and especially obese adolescents are affected in their HRQoL, this being almost independent of SES and education. Interventions to improve the HRQoL of overweight and obese adolescents should be independent of SES and education.

[Health related quality of life in adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Gesundheitsbezogene Lebensqualität bei Erwachsenen in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

The aim of this study is to describe health related quality of life (HRQL) of the German adult population and provide current representative normative data for the version 2 of the SF-36 (SF-36V2) in the German population. In the German Health Interview and Examination Survey for Adults (DEGS1) the SF-36V2 was used to measure health-related quality of life. Men report in all areas better HRQOL compared to women, a lower social status is associated with lower HRQOL-values. Having one or more chronic diseases is associated with lower values in all dimensions of health-related quality of life. Compared to 10 years ago, the General health seems to be much better in women aged 40 to 49 years and older and in men aged 50 to 59 years and older. Version 2 of the SF-36 has proved to be a robust instrument of health-related quality of life that is able to plausible map differences regarding socio-demographic and health characteristics. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of sensitisation to aeraoallergens and food allergens: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Prävalenz von Sensibilisierungen gegen Inhalations- und Nahrungsmittelallergene : Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

In view of the increasing prevalence of allergies, up-to-date data on the prevalence of allergic sensitisation are of major interest. In the German Health Interview and Examination Survey for Adults (DEGS1) (2008-2011) blood samples from a population-based sample of 7,025 participants aged 18 to 79 years were analysed for specific IgE antibodies against 50 common single allergens and screened for common aeroallergens (SX1) and grass pollen (GX1). In all, 48.6 % of the participants were sensitised to at least one allergen. Overall, men were more frequently sensitised to at least one allergen than women were. Sensitisations to at least one allergen were more common among younger than older participants and among participants with a higher socio-economic status. In all, 33.6 % of the participants were sensitised to common aeroallergens, 25.5 % to food allergens and 22.6 % to wasp or bee venoms. Compared with the German National Health Interview and Examination Survey 1998 (GNHIES98), the prevalence of sensitisation to common aeroallergens increased from 29.8 to 33.6 %.This increase was statistically significant only in women. The results of DEGS1 still showed a high prevalence of allergic sensitisation. An English full-text version of this article is available at SpringerLink as supplemental.

[Blood pressure in Germany 2008-2011: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Blutdruck in Deutschland 2008-2011 : Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

High blood pressure is one of the most important risk factors for cardiovascular diseases and chronic kidney disease. It is a main determinant of morbidity and mortality in Germany. In the German Health Interview and Examination Survey for Adults (DEGS1) the blood pressure of 7,096 adults aged 18-79 years was measured in a standardised way using oscillometric blood pressure devices (Datascope Accutorr Plus). The average of the second and third measurements was used for analysis. The mean systolic blood pressure was 120.8 mmHg in women and 127.4 mmHg in men, while the mean diastolic blood pressure was 71.2 mmHg in women and 75.3 mmHg in men. Blood pressure values were hypertensive (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg) in 12.7 % of women and in 18.1 % of men. Hypertension (defined as having hypertensive blood pressure or taking antihypertensive medication in known cases of hypertension) was present in 29.9 % of women and 33.3 % of men. Almost 75 % of the survey's highest age group, 70-79, had hypertension. DEGS1 demonstrates that high blood pressure remains a highly prevalent risk factor in the population at large. The methodology employed in measuring blood pressure has been improved as compared to that of the German National Health Interview and Examination Survey 1998 (GNHIES98) and it will be possible to draw comparisons soon, once a procedure for calibrating the 1998 data has been finalised. An English full-text version of this article is available at SpringerLink as supplemental.

Analgesic use in a national community sample of German children and adolescents.

BACKGROUND: Previous studies suggest that pain management by analgesic medications may be low among children. This study aims to investigate analgesic use and its correlates among children in Germany. METHODS: Analgesic use during a 1-week period was investigated in a community sample of 14,836 children and adolescents aged between 3 and 17 years in Germany. SPSS complex sample method was used to estimate the prevalence and associated factors of analgesic use among the general child population and among those children with pain in the same child population. RESULTS: The prevalence of analgesic use was 8.9% among the general child population and 17.5% among children with pain that occurred at least once a week. Paracetamol (acetaminophen), aspirin and ibuprofen were the most frequently used paediatric analgesics, accounting for two-thirds of all analgesics. The vast majority of painkillers were self-medicated (67%, bought over the counter or obtained from other sources), used for a short term within 1 week (92%) and taken for the treatment of pain (85%). Use of analgesics was closely associated with girls, older age groups, children with a poor overall health status and children with recurrent pain, irrespective of family immigrant background and socioeconomic status. CONCLUSION: Analgesic use appears to be low among children in Germany, reflecting largely the fact that pain perceived among children under ambulant care may be mild to moderate and does not need analgesic medications. As the majority of paediatric analgesics were self-medicated, use of analgesics still should be closely monitored particularly among specific subpopulations such as adolescents to avoid potential abuse.

Regional differences in the prevalence of known Type 2 diabetes mellitus in 45-74 years old individuals: results from six population-based studies in Germany (DIAB-CORE Consortium).

AIM: In Germany, regional data on the prevalence of Type 2 diabetes mellitus are lacking for health-care planning and detection of risk factors associated with this disease. We analysed regional variations in the prevalence of Type 2 diabetes and treatment with antidiabetic agents. METHODS: Data of subjects aged 45-74 years from five regional population-based studies and one nationwide study conducted between 1997 and 2006 were analysed. Information on self-reported diabetes, treatment, and diagnosis of diabetes were compared. Type 2 diabetes prevalence estimates (95% confidence interval) from regional studies were directly standardized to the German population (31 December 2007). RESULTS: Of the 11,688 participants of the regional studies, 1008 had known Type 2 diabetes, corresponding to a prevalence of 8.6% (8.1-9.1%). For the nationwide study, a prevalence of 8.2% (7.3-9.2%) was estimated. Prevalence was higher in men (9.7%; 8.9-10.4%) than in women (7.6%; 6.9-8.3%). The regional standardized prevalence was highest in the east with 12.0% (10.3-13.7%) and lowest in the south with 5.8% (4.9-6.7%). Among persons with Type 2 diabetes, treatment with oral antidiabetic agents was more frequently reported in the south (56.9%) and less in the northeast (46.0%), whereas treatment with insulin alone was more frequently reported in the northeast (21.6%) than in the south (16.4%). CONCLUSION: The prevalence of known Type 2 diabetes showed a southwest-to-northeast gradient within Germany, which is in accord with regional differences in the distribution of risk factors for Type 2 diabetes. Furthermore, the treatment with antidiabetic agents showed regional differences.

Health-related quality of life in subjects with and without Type 2 diabetes: pooled analysis of five population-based surveys in Germany.

AIMS: To estimate population values of health-related quality of life (HRQL) in subjects with and without Type 2 diabetes mellitus across several large population-based survey studies in Germany. Systematic differences in relation to age and sex were of particular interest. METHODS: Individual data from four population-based studies from different regions throughout Germany and the nationwide German National Health Interview and Examination Survey (GNHIES98) were included in a pooled analysis of primary data (N = 9579). HRQL was assessed using the generic index instrument SF-36 (36-item Short Form Health Survey) or its shorter version, the SF-12 (12 items). Regression analysis was carried out to examine the association between Type 2 diabetes and the two component scores derived from the SF-36/SF-12, the physical component summary score (PCS-12) and the mental component summary score (MCS-12), as well as interaction effects with age and sex. RESULTS: The PCS-12 differed significantly by -4.1 points in subjects with Type 2 diabetes in comparison with subjects without Type 2 diabetes. Type 2 diabetes was associated with significantly lower MCS-12 in women only. Higher age was associated with lower PCS-12, but with an increase in MCS-12, for subjects with and without Type 2 diabetes. CONCLUSIONS: Pooled analysis of population-based primary data offers HRQL values for subjects with Type 2 diabetes in Germany, stratified by age and sex. Type 2 diabetes has negative consequences for HRQL, particularly for women. This underlines the burden of disease and the importance of diabetes prevention. Factors that disadvantage women with Type 2 diabetes need to be researched more thoroughly.

Body mass index percentiles for children and adolescents in Germany based on a nationally representative sample (KiGGS 2003-2006).

OBJECTIVE: To present body mass index (BMI) percentiles representative for children in Germany and to compare them with the currently used percentiles by Kromeyer-Hauschild (KH) and international percentiles of the World Health Organisation (WHO) and the International Obesity Task Force (IOTF). METHODS: Representative examination survey of 17 641 children and adolescents aged 0-17 years living in Germany (KiGGS 2003-2006 study, response rate 67%) with standardized measurement of height and weight. RESULTS: Generally, BMI in KiGGS was higher than in the reference populations from previous decades. KiGGS shows an asymmetric upward shift of the BMI distribution from about age 6 years and an earlier adiposity rebound compared with KH. The BMI peak in the first year of life is shown by KiGGS and WHO, but much less by KH. The cut-offs for overweight and obesity determined with the IOTF methodology in KiGGS (percentiles corresponding to BMI 25 and 30 kg/m(2) at 18 years of age) were similar to IOTF cut-offs from age 18 to 10 years but systematically lower for younger children. CONCLUSIONS: The KiGGS BMI percentiles appear more valid for Germany than present alternatives and should be used for population monitoring. Despite their methodological limitations, the general shape of the older German KH references is confirmed by KiGGS for the ages 2-17 years. In order not to obscure the increase in obesity rates in the last decades, we therefore propose to continue using KH for individual diagnosis and estimation of the prevalence of overweight and obesity in this age range.

The role of the inflammatory markers ferritin, transferrin and fibrinogen in the relationship between major depression and cardiovascular disorders - The German Health Interview and Examination Survey.

OBJECTIVE: To determine levels of inflammation (ferritin, transferrin and fibrinogen) in major depression (MDD) and comorbid cardiovascular disease (CVD) in an adult population. METHOD: In 4181 participants of the German Health Interview and Examination Survey MDD was assessed through the Composite International Diagnostic Interview (CIDI). Coronary heart disease, stroke, and hypertension were diagnosed by a computer-assisted physician interview. Analyses were performed using anova models stratified for gender. RESULTS: Ferritin, transferrin and fibrinogen levels showed opposing patterns in individuals with either CVD or MDD alone. In comorbidity analyses, male participants with MDD plus comorbid CHD or hypertension had lower levels of ferritin and lower fibrinogen levels in hypertension compared to men without MDD, while in women, results were inconsistent. CONCLUSION: Opposing patterns of inflammatory markers in CVD or MDD alone were reversed when both conditions were present. MDD reduced levels of ferritin, transferrin and fibrinogen in CVD in a gender-specific way.

Changes of menopausal hormone therapy use pattern since 2000: results of the Berlin Spandau Longitudinal Health Study.

BACKGROUND: There are virtually no prospective cohort studies in Germany regarding the changes of menopausal hormone therapy (HT) use pattern and factors associated with HT discontinuation after the release of the Women's Health Initiative (WHI) trial results. METHODS: We assessed HT prevalence and use pattern as well as factors associated with HT discontinuation in a cohort of 903 women 40 years of age and older, who participated in two consecutive follow-up visits in a 20-year prospective health study from July 2000 to February and from August 2002 to December 2004. RESULTS: Overall, the prevalence of HT users in the cohort declined significantly from 35.4% in 2000-2002 to 22.5% in 2002-2004. Adjusting for aging of the population, a statistically significant decrease in HT user prevalence was consistently observed across subgroups of HT users defined by type and duration of HT use. The decline was most pronounced with respect to women using combined estrogen-progestin regimens (-10.5%), higher-dose estrogens (-11.6%), oral preparations (-11.1%), as well as long-term HT users (-8.4%). The prevalence of women indicating HT use for climacteric symptoms decreased significantly (-12.4%), whereas the prevalence of women reporting use of HT for the prevention of osteoporosis increased (+1.8%) significantly. Irrespective of hysterectomy status, half of the women who continued HT changed their HT preparations and switched to lower estrogen doses (11.5%), topical estrogens (8.2%), or phytohormones (3.8%). We did not observe any significant differences between women who continued and discontinued HT regarding health-related characteristics of the study population as of 2000-2002. However, women seeing a gynecologist in the 12 months preceding the 2002-2004 visit were significantly less likely to discontinue HT use in bivariate and multivariate analyses. CONCLUSIONS: Substantial declines in HT user prevalence as well as changes in HT use patterns to lower-dose estrogen preparations and non-oral routes of administration are likely to reflect effects of the publication of the WHI results. Consulting a gynecologist appeared to be relevant for a woman's decision to continue HT.

[Health care needs of children and adolescents with chronic conditions]. / Versorgungsbedarf chronisch kranker Kinder und Jugendlicher.

Using data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), we studied the association between chronic health conditions and specific health care needs among children and adolescents in Germany. A chronic health condition was defined based on standardized parent questionnaires and computer-assisted parent interviews regarding any lasting illness or health problem, congenital malformation or officially recognized disability. As part of the parent questionnaire, the validated German version of the Children with Special Health Care Needs (CSHCN) screener was used to assess special health care needs. Overall, 38.7% of the study population had at least one chronic health condition, as compared to 73.0% of children and adolescents who were identified as having specific health care needs. Only 25.8% of children and adolescents with chronic health conditions were found to have any special health care needs. However, this proportion varied considerably according to the type of health condition. Overall 3.7% of study participants screened positive for special health care needs, while no specific chronic health condition was reported by their parents. In multiple logistic regression analyses, factors independently associated with the absence of perceived health care needs among children and adolescents with chronic health conditions included female gender, migration background, a lower socioeconomic status, residence in former West Germany, a lower number of concomitant health problems, and the absence of behavioural problems. The identification of special health care needs among children and adolescents without any reported chronic health condition was determined by male gender, having no migration background, and evidence of behavioural problems. Further analyses are necessary to elucidate the relationship between chronic health conditions and health care needs among children and adolescents. These need to focus on specific health conditions and should include additional information on health-related quality of life, health care services use, and psychosocial resources.

[Children and adolescents in Germany with a migration background. Methodical aspects in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. / Kinder und Jugendliche mit Migrationshintergrund in Deutschland. Methodische Aspekte im Kinder- und Jugendgesundheitssurvey (KiGGS).

A migration-specific approach was used in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and thus it was possible for the first time to include children with a migration background in a nationwide health survey in Germany in a number corresponding to their percentage of the population. This article presents the migration-specific approach used in KiGGS as well as a definition of the term "migrant" and its operationalisation. In addition, we analyse the representativity of the migrant subsample and present data on its composition. Altogether 2,590 children and adolescents with a migration background (both parents) took part in the study; in the weighted sample they account for 17.1% of all children and adolescents. Another 8.3% of the children and adolescents have one parent with a migration background. The two largest groups among the migrant children are Germans from Russia (29.9%) and children and adolescents of Turkish origin (28.2%). There are differences between migrants and non-migrants related to socio-economic status and place of living (rural/urban and East/West). Analyses of the representativity of the migrant sample show that children and adolescents with a lower level of education are under-represented, whereas there were no differences with regard to sex, the fathers' occupation or the mothers' smoking status. Non-respondents rate their children's health better than respondents. Since the successful integration of children and adolescents with a migration background into the KiGGS study brings with it a sufficiently large number of cases and since KiGGS covers a wide range of health-related topics, comprehensive migration-specific analyses can be performed. Thus, KiGGS will contribute to filling some of the current gaps in our knowledge of migrant children's health.

[Prevalence of somatic diseases in German children and adolescents. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. / Prävalenz von somatischen Erkrankungen bei Kindern und Jugendlichen in Deutschland. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS).

In the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which was conducted from 2003 to 2006, data on acute/infectious and chronic diseases were collected from a population-based sample of 17,641 subjects aged 0 to 17 years. The annual prevalence rates among acute diseases vary widely. Children and adolescents are most frequently affected by acute (infectious) respiratory conditions. 88.5 % of the surveyed children and adolescents experienced at least one episode of common cold within the last 12 months. Among the other acute respiratory infections, bronchitis and tonsillitis were the most frequently encountered conditions with 19.9 % and 18.5 %, respectively. The 12-month prevalence of otitis media and pseudocroup was 11 % and 6.6 %, respectively. 1.5 % of the children and adolescents experienced an episode of pneumonia. Apart from respiratory infections, gastrointestinal infections were very frequently stated as reasons for acute illness. Furthermore, 12.8 % of the children and adolescents experienced a herpetic infection, 7.8 % a conjunctivitis and 4.8 % a urinary tract infection. Lifetime prevalence rates of infectious diseases were as follows: pertussis 8.7 %, measles 7.4 %, mumps 4.0 %, rubella 8.5 %, varicella 70.6 %, scarlet fever 23.5 %. The various chronic somatic diseases in children and adolescents had different lifetime prevalence rates. Most frequently, children and adolescents were affected by obstructive bronchitis (13.3 %), neurodermatitis/atopic eczema (13.2 %) and hay fever (10.7 %). Scoliosis and asthma had been diagnosed by a doctor in 5.2 % and 4.7 % of subjects aged 0-17 years, respectively. The lifetime prevalence rates of the remaining diseases varied between 0.14 % for diabetes mellitus and 3.6 % for convulsions/epileptic fits. For the first time ever, these survey results provide nationwide representative information on the prevalence rates of acute/infectious and chronic diseases in children and adolescents which is based on a population-representative sample.