Background:School entry examinations (SEE) conducted by the federal states provide measurement data on the height and weight of preschool-aged children. Prevalence rates for overweight and obesity are available for Health Reporting and can be linked to other factors at the aggregate level. This article describes the prevalence of overweight and obesity among preschool children based on aggregated data from SEE, differentiated by two socio-spatial indicators. Method:In the AdiRaum 2.0 project, aggregated SEE data on overweight and obesity from the 2006 - 2024 school entry years were compiled from 13 federal states (where available). As an example, the prevalence of overweight and obesity among children starting school in 2019 was linked to the degree of urbanisation and socioeconomic deprivation. Results:Data from 4,269,299 children aged 4 to 7 years were collected. Between 2006 - 2024, the prevalence of overweight (including obesity) ranged from 8.6 % to 13.4 %, and the prevalence of obesity ranged from 3.7 % to 5.9 %. In 2019, children from districts with high socioeconomic deprivation were more frequently affected by obesity than children from other districts. Conclusions:The analyses confirm that high socioeconomic deprivation is a key risk factor for overweight and obesity already in childhood. Aggregated SEE data on preschool-aged children are suitable for this analysis. Prevention efforts should address and reduce health inequalities in childhood at the environmental level.
Background:For the last 40 years, the Myocardial Infarction Registry Augsburg recorded all cases of hospitalized acute myocardial infarction (AMI) and prehospital coronary artery disease (CAD) deaths. Obesity, hypertension, hyperlipidemia, diabetes mellitus and smoking are important risk factors for CAD and AMI. Methods:We analysed the presence and trends over time of these comorbidities in hospitalized patients with first-time AMI. Results:The prevalence of obesity (BMI > 30 kg/m²) in male and female AMI patients increased steadily from 1985 onwards until today. For hypertension and hyperlipidemia, there was an increase from 1985 until the early 2000s followed by a subsequent decline until 2023. Similarly, after an increase in the first two decades, the prevalence of diabetes in male AMI patients decreased slightly in recent years. For women, the proportion of patients with known diabetes remained unchanged in the first two decades but decreased since the turn of the millennium. While the number of male AMI patients that were current or former smokers did not vary much over time, there was a substantial increase in female patients. Conclusion:The prevalence of important comorbidities in hospitalized AMI patients changed within the past four decades. Especially the steady increase in obesity and smoking in female patients clearly shows that prevention efforts must be intensified to reduce the negative effects not only on coronary but also on cardiovascular and overall health.
Background:To date, little is known about the mental health of Ukrainian refugees living in Germany. Therefore, this study aims to describe the prevalence of depressive (DS) and anxiety symptoms (AS) among refugees from Ukraine, identify relevant associated factors, and compare the prevalence of psychological distress across different groups of origin. Methods:The analyses are based on data from the IAB-BAMF-SOEP Survey of Refugees (2023), supplemented by data from the SOEP main survey. Age-adjusted, weighted prevalences of psychological distress were calculated for non-migrants (n =13,210), non-refugee migrants (n = 4,889), as well as refugees from Ukraine (n = 3,039) and those from Afghanistan, Iran, Iraq, and Syria (n = 3,011). To investigate associations between psychological distress and selected social determinants, prevalence ratios were estimated using Poisson regressions. Results:The age-adjusted prevalences of DS (21 %) and AS (13 %) were higher among refugees from Ukraine than among non-migrants and non-refugee migrants. Overall, women reported psychological distress more frequently than men, regardless of experiences of migration or forced displacement. Social integration, experiences of discrimination, and employment were important factors associated with mental health among refugees from all countries of origin included in the study. Among Ukrainians, associations with age, gender, income, and housing satisfaction were also evident, whereas German language proficiency was associated with mental health among refugees from other countries of origin. Conclusions:The results indicate a substantial need for psychosocial support services. Furthermore, post-migration factors were closely associated with psychological distress, with experiences of exclusion and discrimination in particular being linked to poorer mental health.
Background:One year after the partial legalisation of cannabis, the effects on cannabis use among young people in Germany were investigated. Methods:Based on twelve representative studies from 2008 to 2025, changes in the 12-month prevalence of cannabis use among 12- to 17-year-old adolescents and 18- to 25-year-old young adults were presented, and trends over time were estimated. Results:Among female and male adolescents as well as young women, there was no statistically significant change in the 12-month prevalence of cannabis use between 2023 and 2025. In contrast, a statistically significant increase in consumption was observed among young men. However, this does not represent a new development but rather continues a trend that has been observed in this group since 2008. Conclusions:One year after partial legalisation, there was no evidence of an immediate effect on the prevalence of cannabis use among young people in Germany. Further studies should monitor future developments.
Background:Stress and coping are key determinants of mental health. However, representative data for Germany remain scarce. This study provides population-based findings on the prevalence of perceived stress and coping as well as on their association. Methods:Data were derived from the representative study series 'Health in Germany' conducted by the Robert Koch Institute (wave 2024; n = 27,102; 51.1 % women; age range: 18 - 99 years). Descriptive analyses of stress (Perceived Stress Scale; PSS-10) and coping (Short Adult Coping Scale; SACS-16) were conducted by gender, age, and education, as well as regression analyses examining their associations. Results:Approximately 20 % of respondents showed elevated stress levels, particularly women, individuals of working age, and those with low or medium formal education. Problem solving, proactive coping, and coping flexibility were associated with lower perceived stress, whereas repression and wishful thinking were associated with higher perceived stress. Differences in coping strategies were observed primarily across age groups. Conclusions:The findings underscore the public health relevance of stress and indicate potential approaches for preventive measures by promoting suitable and target-group-specific coping strategies.
Background: Sleep problems can have negative consequences for quality of life, functioning and health. This fact sheet investigates the prevalence of sleep onset problems and problems maintaining sleep among adults in Germany in 2024. Methods: In the Robert Koch Institute’s panel ‘Health in Germany’, n = 27,038 participants (51.1 % female) were surveyed on the frequency of sleep onset problems and problems maintaining sleep over the past four weeks. The analyses were stratified by gender, age and education group. Results: Overall, 16.3 % of participants reported sleep onset problems and 31.7 % reported problems maintaining sleep. Differences were found across gender, age and education group, with higher prevalence among women and individuals in the low education group. Conclusions: Around one in three adults in Germany reports sleep onset problems or problems maintaining sleep. The results highlight the high public health relevance of problems with falling asleep and staying asleep.
Background: Accidents cause human suffering, high costs and are a significant cause of death. In 2024, 34,060 people died in accidents in Germany. Data on non-fatal accidents is provided by the Panel ‘Health in Germany’ 2024 conducted by the Robert Koch Institute. Methods: In the accident module of the study, 26,923 people aged 18 and over provided information about accident-related injuries in the last twelve months that required medical treatment. Detailed information was recorded about the last accident. Accident prevalence (95 % CI) and other results on accidents (proportions with 95 % CI) were calculated. Results: Overall, 9.5 % of women and 10.5 % of men report at least one accidental injury. The difference is significant. The majority of accidents occurred at home (36.0 %), followed by traffic, leisure and work. Accidents occur significantly more often at home and less often at work for women than for men. There are differences in workplace accidents among men depending on their level of education. The most common cause of accidents is falls (30.4 %). Significantly more accidents involving falls occur among women than among men. Almost one in five accident victims was treated as an inpatient in hospital (18.7 %). Conclusions: The results highlight the social relevance of accidental injuries. Initial analyses of the accident module identify key accident locations and affected groups. Further evaluations will reveal prevention potential in greater detail.
Background: Discrimination is prohibited by law in specific contexts. Nevertheless, it does occur and may seriously impact health. This contribution analyses social differences regarding the prevalence of experiences of discrimination and its associations with health among adults living in Germany. Methods: The analyses are based on the population-based panel ‘Health in Germany’ conducted by the Robert Koch Institute. Participants were asked about experiences of everyday discrimination and possible reasons for these experiences. The frequency of experiencing everyday discrimination as well as the occurrence of multiple discrimination were examined for different social groups. Associations between experiences of discrimination and self-rated general as well as mental health were investigated using Poisson regression. Results: Everyday and multiple discrimination is reported more often by younger, trans or gender diverse persons as well as from people in socioeconomically disadvantaged situations and migrants. The frequency of experiencing everyday and multiple discrimination is associated with progressively worse self-rated general and mental health. Conclusions: Discrimination is a relevant social determinant of health. The results corroborate the approach of the World Health Organization to reduce and overcome discrimination as a central field of action to foster health equity.
Background: Long-term health effects associated with SARS-CoV-2 pose major challenges for public health and health research worldwide. Methods: Based on an ongoing literature review, a narrative review (as of June 2025) on the epidemiology and public health implications of long COVID in adults was compiled. Results: According to population-based, controlled studies, long COVID symptoms occur with a frequency of approximately 10 to 15 % in adults infected with SARS-CoV-2. In addition to COVID-19 vaccination status and virus variant, the risk of experiencing long COVID symptoms is primarily influenced by pre-existing health conditions and sociodemographic factors. In most affected individuals, long COVID symptoms resolve within a year. Particularly multiple and prolonged symptoms can be associated with significant impairments in quality of life, everyday functioning and social participation, as well as an increased need for healthcare. In addition, there is growing evidence of an infection-associated increase in newly diagnosed symptom complexes, organ damage and chronic diseases, contributing to the ongoing public health relevance of long COVID. Conclusions: Long COVID is not only a major burden for those affected and their families, but also has unpredictable long-term consequences for public health and the healthcare system.
Background:Paid work can have a significant impact on employees' health. This article describes the perceived health risks associated with paid work in Germany. Methods:Data from full-time and part-time employed persons aged 18 to 64 from the GEDA 2014/2015-EHIS study (6,782 women; 6,170 men) and the 2024 'Health in Germany' panel (10,634 women; 8,907 men) were analysed. The perceived health risk posed by paid work was measured using a four-point Likert scale and evaluated on an age-standardised basis by gender and level of qualification. Results:Approximately one quarter of the working population reported a high or very high health risk from their paid work in both survey periods. Among women, the prevalence in 2024 was higher than around ten years earlier. The highest prevalence was found among men with a low level of qualification. Conclusions:Working conditions remain key entry points for prevention and health promotion - also with regard to health equity.
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: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: 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: 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: The World Health Organization’s Framework Convention on Tobacco Control recommends tobacco control measures. The implementation of these measures in Europe is assessed using the Tobacco Control Scale. The aim of this analysis is to examine smoking behaviour in European countries in the context of national measures to curb tobacco consumption. Methods: In addition to analysing current tobacco consumption, the relationship between the 2019 Tobacco Control Scale results, including policy areas, and smoking prevalence in 29 European countries was examined based on data from the third wave of the European Health Interview Survey (EHIS 3). This was visualised using scatter plots and analysed using Pearson’s correlation coefficients. Results: On average, 24.4 % of adults in Europe smoke, with substantial differences between countries. There are also some clear differences between the sexes, with a higher proportion of men than women smoking in all countries studied. A higher overall score on the Tobacco Control Scale is associated with a lower smoking prevalence among both women and men. Negative correlations are also evident between smoking prevalence and the policy areas of smoking cessation support and advertising bans. Conclusions: Consistent implementation of tobacco control measures is associated with lower smoking prevalence in Europe. This highlights the importance of comprehensive tobacco control strategies to reduce tobacco consumption.
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.
