Health of single mothers and fathers in Germany. Results of the GEDA studies 2019 - 2023.

Background: The living situation of single parents is often characterised by sole responsibility for family and household, problems in reconciling work and family life, and a high risk of poverty. In a comparative perspective with parents in partner households, the health of single mothers and fathers was analysed, considering differences in their social status. Methods: The analyses are based on data from the GEDA studies 2019 - 2023 (7,999 women, 6,402 men). Prevalences for single mothers and fathers and mothers and fathers living in partner households were calculated for self-rated health, chronic diseases, depressive symptoms, smoking and utilisation of professional help for mental health problems. In multivariate models, adjustments were made for income, education, employment status and social support, and interactions with family type were included. Results: Single mothers and fathers show higher prevalences for all health indicators in comparison to parents living in partner households. Also after adjustment, the differences between family types remain significant. The health of single mothers also varies partially with income, employment status and social support. Conclusions: Health promotion measures have to consider that single parents are a heterogeneous group. In addition to strengthening personal skills, policy and setting-based interventions aim to reduce health inequalities.

Potential COVID-19 test fraud detection: Findings from a pilot study comparing conventional and statistical approaches.

Background: Some COVID-19 testing centres have reported manipulated test numbers for antigen tests/rapid tests. This study compares statistical approaches with traditional fraud detection methods. The extent of agreement between traditional and statistical methods was analysed, as well as the extent to which statistical approaches can identify additional cases of potential fraud. Methods: Outlier detection marking a high number of tests, modeling of the positivity rate (Poisson Regression), deviation from distributional assumptions regarding the first digit (Benford's Law) and the last digit of the number of reported tests. The basis of the analyses were billing data (April 2021 to August 2022) from 907 testing centres in a German city. Results: The positive agreement between the conventional and statistical approaches ('sensitivity') was between 8.6% and 24.7%, the negative agreement ('specificity') was between 91.3% and 94.6%. The proportion of potentially fraudulent testing centres additionally identified by statistical approaches was between 7.0% and 8.7%. The combination of at least two statistical methods resulted in an optimal detection rate of test centres with previously undetected initial suspicion. Conclusions: The statistical approaches were more effective and systematic in identifying potentially fraudulent testing centres than the conventional methods. Testing centres should be urged to map paradata (e.g. timestamps of testing) in future pandemics.

Toxoplasma gondii Infections and Associated Factors in Female Children and Adolescents, Germany.

In a representative sample of female children and adolescents in Germany, Toxoplasma gondii seroprevalence was 6.3% (95% CI 4.7%-8.0%). With each year of life, the chance of being seropositive increased by 1.2, indicating a strong force of infection. Social status and municipality size were found to be associated with seropositivity.

New Reference Values for Thyroid Volume by Ultrasound in German Children and Adolescents from a Population-Based Study.

CONTEXT: Reliable reference values for thyroid ultrasound measurements are essential to effectively guide individual diagnostics and direct health care measures at the population level, such as iodine fortification programs. However, the latest reference values for total thyroid volume (Tvol) provided by the WHO in 2004 only apply to the 6 to 12-year-old age group and are limited to countries with a long history of iodine sufficiency, which does not reflect the situation in most European countries, including Germany. OBJECTIVE: The present aims to derive up to date thyroid volume ultrasound reference values in German children and adolescents. DESIGN: Data from the baseline assessment of a nationwide study in German children and adolescents (KiGGS) conducted between 2003 and 2006 were used to determine sex-specific reference values for Tvol in thyroid-healthy participants aged 6 to 17 years by age and body surface area (BSA) according to the Lambda-Mu-Sigma (LMS) method. RESULTS: Data from 5559 participants were available for reference chart construction (girls: 2509 (45.1%)). On average, the 97th percentile is 33.4% and 28.5% higher than the corresponding WHO's reference values for boys and girls, respectively. These findings are consistent with most other studies in German and European children and adolescents at a similar time of investigation. Notably, the sample used for this study was iodine-sufficient according to WHO criteria. CONCLUSIONS: The reference values provided by the WHO are overly conservative for this population and could potentially apply to other European countries with a similar history of iodine supply.

Gender equality and smoking among 15 to 25 year olds-a time-based ecological analysis of developments in Germany from 1960 to 2005.

Introduction: Smoking is a major risk factor for premature death and health problems in which there are significant gender differences in the prevalence of smoking. This ecological study examines the correlation between changes in gender equality and prevalence of smoking among young adults (15-25 years old) in Germany over a period of 45 years (1960-2005). Methods: Gender inequality was measured using the United Nations Gender Inequality Index (GII), which is composed of three dimensions; health, empowerment and labour market. It was calculated for the entire registered German population in five-year intervals with values between 0 and 1 (1 = highest inequality). The smoking prevalence of young women and men in Germany was established using a reconstruction method. A gender smoking ratio (GSR) with values between 0 and 1 was determined (1 = identical smoking prevalence among men and women). The smoking behaviour was illustrated and stratified by education. The correlation between the GII and the GSR was analysed. Results: The GII decreased from 0.98 to 0.56 between 1960 and 2005. The GSR increased from 0.34 to 0.93. There was a strong negative correlation between the GII and the GSR (r = -0.71). The strength of the correlation fell slightly as the level of education decreased. An increase in gender equality as measured by the GII came along with similarities of smoking prevalence between young women and young men. Conclusion: Successful tobacco prevention among young women and men may benefit from involving experts in gender-specific public health research to develop counter-advertising and gender-specific information as needed.

Physical activity and psychopathology: are long-term developmental trajectories of physical activity in children and adolescents associated with trajectories of general mental health problems and of attention-deficit hyperactivity (ADHD) symptoms?

A medium-to-high level of physical activity (PA) may have at least a short-term positive effect on psychopathology in children and adolescents. Hence, the objective of this study was to investigate the long-term effects of PA in non-adult age groups on their general mental health problems and/or ADHD symptoms, using trajectories of concurrent development over a period of 10 years. This study employed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected at three time points (baseline, Wave 1, Wave 2, over 10 years) from 17,640 children and adolescents. Using parent-reported data from the Strengths and Difficulties Questionnaire (SDQ), different developmental trajectories of general mental health problems (SDQ-total) and ADHD symptoms (SDQ-H/I) were identified with latent class mixed models (LCMM) statistics. This was also applied to parent- and self-reported data of three levels of PA. The latter was assessed according to WHO recommendations. The joint probability of class membership for SDQ-total as well as ADHD symptoms with PA was calculated to generate the concurrent developmental trajectories between variables. Results showed a 4-class trajectory model for both SDQ-total and ADHD symptoms among boys and girls. The majority of children and adolescents showed "low general difficulties" and "low ADHD symptoms" over the period of 10 years. Three distinct trajectories in boys and four distinct trajectories in girls were found for PA. Most of the participants showed an "increasing-decreasing activity" trajectory. No statistically significant correlations were found between the different SDQ-total or ADHD symptom trajectories and the trajectories of PA in the two genders. Taken together, our findings did not indicate any significant relationship between waxing and waning PA course over 10 years and various classes of mental health problems for children and adolescents. In contrast to our cross-sectional findings, no steady long-term medium/high-level of PA was present, which could (at least partly) explain the non-significant findings.