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Methorst J. Positive relationship between bird diversity and human mental health: an analysis of repeated cross-sectional data. Lancet Planet Health 2024; 8:e285-e296. [PMID: 38729669 DOI: 10.1016/s2542-5196(24)00023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND An increasing body of research has examined the link between biodiversity of birds and human mental health, but most studies only use cross-sectional data. Few studies have used longitudinal or repeated cross-sectional data to investigate the mental health benefits of bird diversity. The aim of this study is to analyse the relationship between bird diversity and mental health at the national level using a unique repeated cross-sectional dataset. METHODS I used repeated cross-sectional health data from the German National Cohort health study, collected between March, 2014, and September, 2019, and annual bird citizen science data to investigate the effects of bird-diversity exposure on mental health. Mental health was measured using the summary score of the Patient Health Questionnaire depression module 9 (SumPHQ) and the Short Form Health Survey-12 Mental Health Component Scale. As a proxy for bird diversity, I created a unique indicator called reporting-rate richness and combined it with the health data. Reporting-rate richness measures the number of bird species within postcode areas across Germany in probabilities while accounting for variation in survey efforts. Alternative indicators of bird diversity, such as bird-species richness or abundance, were also calculated. Associations between bird diversity and mental health were estimated using linear regression with region and time fixed effects, adjusted for a range of sociodemographic and environmental confounders and spatial autocorrelation. Interaction terms between income levels and reporting-rate richness were also analysed to examine the moderating effect of socioeconomic status. FINDINGS I did the analyses for an unbalanced (n=176 362) and balanced (n=125 423) dataset, with the balanced dataset comprising only regions (postcode areas) in which health data were available for each year. The linear fixed-effects regression analysis indicated a significant negative association between reporting-rate richness and SumPHQ, as observed in both the unbalanced dataset (β -0·02, p=0·017) and the balanced dataset (β -0·03, p=0·0037). Similarly, regression results with both datasets showed a positive relationship between reporting-rate richness and Mental Health Component Scale (MCS; unbalanced β 0·02, p=0·0086; balanced β 0·03, p=0·0018). The moderator analyses revealed a significant influence of socioeconomic status on the relationship between reporting-rate richness and mental health. The robustness of these findings was confirmed through sensitivity analyses. INTERPRETATION The results suggest that a greater likelihood of having many different bird species in a person's area of residence might positively contribute to mental health, especially for people with lower socioeconomic status. These findings could have implications for biodiversity conservation and health policy decisions, as governments are facing challenges such as global biodiversity loss and growing public mental health problems. FUNDING None.
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Affiliation(s)
- Joel Methorst
- Helmut-Schmidt University, Holstenhofweg, Hamburg, Germany; Hamburg Institute of International Economics, Hamburg, Germany.
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Stein MJ, Fischer B, Bohmann P, Ahrens W, Berger K, Brenner H, Günther K, Harth V, Heise JK, Karch A, Klett-Tammen CJ, Koch-Gallenkamp L, Krist L, Lieb W, Meinke-Franze C, Michels KB, Mikolajczyk R, Nimptsch K, Obi N, Peters A, Pischon T, Schipf S, Schmidt B, Stang A, Thierry S, Willich SN, Wirkner K, Leitzmann MF, Sedlmeier AM. Differences in Anthropometric Measures Based on Sex, Age, and Health Status. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:207-213. [PMID: 38377337 DOI: 10.3238/arztebl.m2024.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Obesity is a worldwide health problem. We conducted detailed analyses of anthropometric measures in a comprehensive, population-based, current cohort in Germany. METHODS In the German National Cohort (NAKO), we analyzed cross-sectional data on body mass index (BMI), waist and hip circumference, subcutaneous (SAT) and visceral adipose tissue (VAT) as measured by ultrasound, and body fat percentage. The data were stratified by sex, age, and self-reported physicians' diagnoses of cardiovascular diseases (CVD), metabolic diseases (MetD), cardiometabolic diseases (CMD), and cancer. RESULTS Data were available from 204 751 participants (age, 49.9 ± 12.8 years; 50.5% women). Body size measures generally increased with age. Men had a higher BMI, larger waist circumference, and more VAT than women, while women had a larger hip circumference, more SAT, and a higher body fat percentage than men. For example, the mean BMI of participants over age 60 was 28.3 kg/m2 in men and 27.6 kg/m2 in women. CVD, MetD, and CMD were associated with higher anthropometric values, while cancer was not. For example, the mean BMI was 25.3 kg/m2 in healthy women, 29.4 kg/m2 in women with CMD, and 25.4 kg/m2 in women with cancer. CONCLUSION Obesity is widespread in Germany, with notable differences between the sexes in anthro - pometric values. Obesity was more common in older participants and those with chronic diseases other than cancer. Elevated values were especially common in multimorbid individuals.
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Affiliation(s)
- Michael J Stein
- Department of Epidemiology and Preventive Medicine, University of Regensburg; Department of Epidemiology and Preventive Medicine, Center for Translational Oncology, University Hospital Regensburg and Bavarian Cancer Research Center (BZKF), Regensburg; Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Epidemiology, Kiel University, Kiel, Germany; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; Institute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany; Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; Institute of Epidemiology, Helmholtz Munich, German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany; Biobank Technology Platform, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, University of Duisburg-Essen, Germany; NAKO Study Center, Department of Diagnostic and Interventional Radiology and Neuroradiology, Augsburg University Hospital, Augsburg, Germany; LIFE-Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Lange B, Jaeger VK, Harries M, Rücker V, Streeck H, Blaschke S, Petersmann A, Toepfner N, Nauck M, Hassenstein MJ, Dreier M, von Holt I, Budde A, Bartz A, Ortmann J, Kurosinski MA, Berner R, Borsche M, Brandhorst G, Brinkmann M, Budde K, Deckena M, Engels G, Fenzlaff M, Härtel C, Hovardovska O, Katalinic A, Kehl K, Kohls M, Krüger S, Lieb W, Meyer-Schlinkmann KM, Pischon T, Rosenkranz D, Rübsamen N, Rupp J, Schäfer C, Schattschneider M, Schlegtendal A, Schlinkert S, Schmidbauer L, Schulze-Wundling K, Störk S, Tiemann C, Völzke H, Winter T, Klein C, Liese J, Brinkmann F, Ottensmeyer PF, Reese JP, Heuschmann P, Karch A. Estimates of protection levels against SARS-CoV-2 infection and severe COVID-19 in Germany before the 2022/2023 winter season: the IMMUNEBRIDGE project. Infection 2024; 52:139-153. [PMID: 37530919 PMCID: PMC10811028 DOI: 10.1007/s15010-023-02071-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. METHODS In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n = 33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses ("confirmed exposures"). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest. RESULTS Most participants were seropositive against the spike antigen; 37% of the participants ≥ 79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46-56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4-28% of participants having less than three confirmed exposures. CONCLUSION Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups.
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Affiliation(s)
- Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany.
- German Center for Infection Research (DZIF), TI BBD, Brunswick, Germany.
| | - Veronika K Jaeger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany
| | - Viktoria Rücker
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Brunswick, Germany
| | - Sabine Blaschke
- Emergency Department, University Medical Center Göttingen, Göttingen, Germany
| | - Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Max J Hassenstein
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany
| | - Maren Dreier
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Isabell von Holt
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Axel Budde
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Brunswick, Germany
| | - Antonia Bartz
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Julia Ortmann
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany
| | - Marc-André Kurosinski
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Reinhard Berner
- Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Max Borsche
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Gunnar Brandhorst
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Melanie Brinkmann
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Kathrin Budde
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Geraldine Engels
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Marc Fenzlaff
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christoph Härtel
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Olga Hovardovska
- Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Brunswick, Germany
| | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Katja Kehl
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Brunswick, Germany
| | - Mirjam Kohls
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Stefan Krüger
- Dimap, das Institut Für Markt- Und Politikforschung GmbH, Bonn, Germany
| | - Wolfgang Lieb
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Biobank Technology Platform, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Berlin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Daniel Rosenkranz
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Oldenburg, Oldenburg, Germany
| | - Nicole Rübsamen
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Jan Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Lübeck, Germany
| | - Christian Schäfer
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Mario Schattschneider
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anne Schlegtendal
- University Children's Hospital, Ruhr University Bochum, Bochum, Germany
| | - Simon Schlinkert
- Dimap, das Institut Für Markt- Und Politikforschung GmbH, Bonn, Germany
| | - Lena Schmidbauer
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Kai Schulze-Wundling
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Brunswick, Germany
| | - Stefan Störk
- Department of Clinical Research and Epidemiology, Comprehensive Heart Failure Center (CHFC), and Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Theresa Winter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Johannes Liese
- Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany
| | - Folke Brinkmann
- University Children's Hospital, Ruhr University Bochum, Bochum, Germany
| | - Patrick F Ottensmeyer
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Brunswick, Germany
| | - Jens-Peter Reese
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
| | - Peter Heuschmann
- Institute of Clinical Epidemiology and Biometry, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Institute for Medical Data Science, University Hospital Würzburg, Würzburg, Germany
- Clinical Trial Center, University Hospital Würzburg, Würzburg, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
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Bühler N. Precision public health in the making: examining the becoming of the "social" in a Swiss environmental health population-based cohort. FRONTIERS IN SOCIOLOGY 2023; 8:1219275. [PMID: 38162929 PMCID: PMC10754959 DOI: 10.3389/fsoc.2023.1219275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
Expanding the concept of "precision" or "personalized" medicine, personalized health and precision public health designate the use of various kinds of data-genomic, other omics, clinical, or those produced by individuals themselves through self-tracking-to optimize health interventions benefiting the whole population. This paper draws on an ethnography of the implementation of a population-based environmental health cohort to shed light on the reconfigurations brought about by the "personalization" of public health in Switzerland. Combining human biomonitoring and molecular epidemiology, this cohort aims to advance the science of the exposome, a notion referring to the totality of exposures to which individuals are subjected over their lifecourse. Addressing the tension between holism and reductionism, this paper points to the important gap between the promissory horizon of the exposome and the realities of practices. Situations of reductionism are defined as moments of friction and negotiation between different rationales and values, exposing what makes the science of the exposome, including its material, economic, institutional, and methodological constraints, as well as its imaginaries and values. Rather than opposing holism and reductionism, I emphasize that they constitute two sides of the same coin, as they both pragmatically enable action and produce situated versions of the social. This empirical case shows how reductionism operates at the chemical, biological, and populational levels to produce public health scientific and social values. It thus contributes to contextualizing the pragmatic and strategic choices made by scientists, as well as the values they favor, in a research environment marked by the predominance of biomedicine over public health. It shows how the reductionism of the "social environment" was made for a better social integration of the cohort into the Swiss political and scientific landscape of public health. Bringing together actors involved in public health and questions of environmental exposures, this cohort can be interpreted as a biomedicalization of public health research, as well as an attempt to socialize it through the broad category of the exposome.
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Vonneilich N, Becher H, Bohn B, Brandes B, Castell S, Deckert A, Dragano N, Franzke CW, Führer A, Gastell S, Greiser H, Keil T, Klett-Tammen C, Koch-Gallenkamp L, Krist L, Leitzmann M, Meinke-Franze C, Mikolajczyk R, Moreno Velasquez I, Obi N, Peters A, Pischon T, Reuter M, Schikowski T, Schmidt B, Schulze M, Sergeev D, Stang A, Völzke H, Wiessner C, Zeeb H, Lüdecke D, von dem Knesebeck O. Associations of Migration, Socioeconomic Position and Social Relations With Depressive Symptoms - Analyses of the German National Cohort Baseline Data. Int J Public Health 2023; 68:1606097. [PMID: 37533684 PMCID: PMC10391163 DOI: 10.3389/ijph.2023.1606097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Objectives: We analyze whether the prevalence of depressive symptoms differs among various migrant and non-migrant populations in Germany and to what extent these differences can be attributed to socioeconomic position (SEP) and social relations. Methods: The German National Cohort health study (NAKO) is a prospective multicenter cohort study (N = 204,878). Migration background (assessed based on citizenship and country of birth of both participant and parents) was used as independent variable, age, sex, Social Network Index, the availability of emotional support, SEP (relative income position and educational status) and employment status were introduced as covariates and depressive symptoms (PHQ-9) as dependent variable in logistic regression models. Results: Increased odds ratios of depressive symptoms were found in all migrant subgroups compared to non-migrants and varied regarding regions of origins. Elevated odds ratios decreased when SEP and social relations were included. Attenuations varied across migrant subgroups. Conclusion: The gap in depressive symptoms can partly be attributed to SEP and social relations, with variations between migrant subgroups. The integration paradox is likely to contribute to the explanation of the results. Future studies need to consider heterogeneity among migrant subgroups whenever possible.
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Affiliation(s)
- Nico Vonneilich
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Heiko Becher
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Barbara Bohn
- NAKO e.V., Heidelberg University, Heidelberg, Baden-Württemberg, Germany
| | - Berit Brandes
- Leibniz Institute for Prevention Research and Epidemiology (LG), Bremen, Germany
| | - Stefanie Castell
- Department of Epidemiology, Helmholtz Center for Infection Research, Helmholtz Association of German Research Centers (HZ), Braunschweig, Niedersachsen, Germany
| | - Andreas Deckert
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Nico Dragano
- Institute for Medical Sociology, University Hospital of Düsseldorf, Düsseldorf, Germany
| | - Claus-Werner Franzke
- Institute for Prevention and Cancer Epidemiology, University of Freiburg Medical Center, Freiburg, Baden-Württemberg, Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), University Hospital in Halle, Halle, Saxony-Anhalt, Germany
| | - Sylvia Gastell
- NAKO Study Center, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Potsdam, Brandenburg, Germany
| | - Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
- Institute of Clinical Epidemiology and Biometry, Faculty of Medicine, University of Würzburg, Würzburg, Bavaria, Germany
- State Institute of Health I, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Carolina Klett-Tammen
- Department of Epidemiology, Helmholtz Center for Infection Research, Helmholtz Association of German Research Centers (HZ), Braunschweig, Niedersachsen, Germany
| | - Lena Koch-Gallenkamp
- Department of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Berlin, Germany
| | - Michael Leitzmann
- Deptartment of Epidemiology and Preventive Medicine, University Medical Center Regensburg, Regensburg, Bavaria, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), University Hospital in Halle, Halle, Saxony-Anhalt, Germany
| | - Ilais Moreno Velasquez
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers (HZ), Berlin, Baden-Wurttemberg, Germany
| | - Nadia Obi
- Institute for Occupational and Maritime Medicine Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Center München, Helmholtz Association of German Research Centres (HZ), Neuherberg, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine, Helmholtz Association of German Research Centers (HZ), Berlin, Baden-Wurttemberg, Germany
- Berlin Institute of Health (BIH), Charité University Medicine Berlin, Berlin, Germany
| | - Marvin Reuter
- Subject Sociology, University of Bamberg, Bamberg, Bavaria, Germany
| | - Tamara Schikowski
- Leibniz-Institut für Umweltmedizinische Forschung (IUF), Dusseldorf, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany
| | - Matthias Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Potsdam, Brandenburg, Germany
- Institute of Nutrition Science, Faculty of Mathematics and Natural Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Dmitry Sergeev
- Department of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Baden-Württemberg, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, Essen University Hospital, Essen, North Rhine-Westphalia, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medical Center Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Christian Wiessner
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology (LG), Bremen, Germany
| | - Daniel Lüdecke
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Merz S, Jaehn P, Pischon T, Fischer B, Wirkner K, Rach S, Guenther K, Obi N, Holmberg C. Investigating people's attitudes towards participating in longitudinal health research: an intersectionality-informed perspective. Int J Equity Health 2023; 22:23. [PMID: 36721141 PMCID: PMC9887766 DOI: 10.1186/s12939-022-01807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/14/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that participation proportions in longitudinal health research vary according to sex/gender, age, social class, or migration status. Intersectionality scholarship purports that such social categories cannot be understood in isolation and makes visible the co-dependent nature of the social determinants of health and illness. This paper uses an intersectionality-informed approach in order to expand the understanding of why people participate in health research, and the impact of intersecting social structures and experiences on these attitudes. METHODS A sample of 80 respondents who had previously either accepted or declined an invitation to participate in the German National Cohort (NAKO) participated in our interview study. Interviews were semi-structured and contained both narrative elements and more structured probes. Data analysis proceeded in two steps: first, the entire data set was analysed thematically (separately for participants and non-participants); second, key themes were compared across self-reported sex/gender, age group and migration status to identify differences and commonalities. RESULTS Respondents' attitudes towards study participation can be categorised into four themes: wanting to make a contribution, seeking personalised health information, excitement and feeling chosen, and seeking social recognition. Besides citing logistical challenges, non-participants narrated adverse experiences with or attitudes towards science and the healthcare system that deterred them from participating. A range of social experiences and cultural value systems shaped such attitudes; in particular, this includes the cultural authority of science as an arbiter of social questions, transgressing social categories and experiences of marginalisation. Care responsibilities, predominantly borne by female respondents, also impacted upon the decision to take part in NAKO. DISCUSSION Our findings suggest that for participants, health research constitutes a site of distinction in the sense of making a difference and being distinct or distinguishable, whereas non-participants inhabited an orientation towards science that reflected their subjective marginalisation through science. No clear relationship can thereby be presumed between social location and a particular attitude towards study participation; rather, such attitudes transgress and challenge categorical boundaries. This challenges the understanding of particular populations as more or less disadvantaged, or as more or less inclined to participate in health research.
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Affiliation(s)
- Sibille Merz
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany
| | - Philipp Jaehn
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany ,grid.11348.3f0000 0001 0942 1117Faculty of Health Sciences, joint Faculty of the Brandenburg University of Technology Cottbus – Senftenberg, Brandenburg Medical School, University of Potsdam, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
| | - Tobias Pischon
- grid.419491.00000 0001 1014 0849Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Robert-Rössle-Straße 10, 13125 Berlin, Germany ,grid.419491.00000 0001 1014 0849Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Robert-Rössle-Straße 10, 13125 Berlin, Germany ,grid.484013.a0000 0004 6879 971XBerlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Biobank, Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany ,grid.6363.00000 0001 2218 4662Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitépl. 1, 10117 Berlin, Germany
| | - Beate Fischer
- grid.7727.50000 0001 2190 5763University of Regensburg, Department of Epidemiology and Preventive Medicine, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Kerstin Wirkner
- LIFE – Leipzig Research Centre for Civilization Diseases, Philipp-Rosenthal-Straße 27, 04103 Leipzig, Germany
| | - Stefan Rach
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Kathrin Guenther
- grid.418465.a0000 0000 9750 3253Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany
| | - Nadia Obi
- grid.13648.380000 0001 2180 3484University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
| | - Christine Holmberg
- grid.473452.3Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Hochstr. 15, 14770 Brandenburg an der Havel, Germany ,grid.11348.3f0000 0001 0942 1117Faculty of Health Sciences, joint Faculty of the Brandenburg University of Technology Cottbus – Senftenberg, Brandenburg Medical School, University of Potsdam, Fehrbelliner Str. 38, 16816 Neuruppin, Germany
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Framework and baseline examination of the German National Cohort (NAKO). Eur J Epidemiol 2022; 37:1107-1124. [PMID: 36260190 PMCID: PMC9581448 DOI: 10.1007/s10654-022-00890-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022]
Abstract
The German National Cohort (NAKO) is a multidisciplinary, population-based prospective cohort study that aims to investigate the causes of widespread diseases, identify risk factors and improve early detection and prevention of disease. Specifically, NAKO is designed to identify novel and better characterize established risk and protection factors for the development of cardiovascular diseases, cancer, diabetes, neurodegenerative and psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases in a random sample of the general population. Between 2014 and 2019, a total of 205,415 men and women aged 19–74 years were recruited and examined in 18 study centres in Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires and a wide range of biomedical examinations. Biomaterials were collected from all participants including serum, EDTA plasma, buffy coats, RNA and erythrocytes, urine, saliva, nasal swabs and stool. In 56,971 participants, an intensified examination programme was implemented. Whole-body 3T magnetic resonance imaging was performed in 30,861 participants on dedicated scanners. NAKO collects follow-up information on incident diseases through a combination of active follow-up using self-report via written questionnaires at 2–3 year intervals and passive follow-up via record linkages. All study participants are invited for re-examinations at the study centres in 4–5 year intervals. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. NAKO is a major resource for population-based epidemiology to identify new and tailored strategies for early detection, prediction, prevention and treatment of major diseases for the next 30 years.
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Brayne C, Moffitt TE. The limitations of large-scale volunteer databases to address inequalities and global challenges in health and aging. NATURE AGING 2022; 2:775-783. [PMID: 37118500 PMCID: PMC10154032 DOI: 10.1038/s43587-022-00277-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/02/2022] [Indexed: 04/30/2023]
Abstract
Large-scale volunteer databanks (LSVD) have emerged from the recognized value of cohorts, attracting substantial funding and promising great scientific value. A major focus is their size, with the implicit and sometimes explicit assumption that large size (thus power) creates generalizability. We contend that this is open to challenge. In the context of aging and age-related disease research, LSVD typically have limitations such as healthy volunteer, white ethnicity and high-education biases, and they omit early and late life stages critical for understanding aging. Their outputs are heavily focused on biomedical pathways of single chronic diseases. LSVD outputs increasingly dominate the funding and the publication landscapes. This Perspective discusses LSVD limitations and calls for more transparent reporting in LSVD research, as well as a greater reflection on the value of LSVD in relation to resources consumed. We invite funders and researchers to examine whether LSVD do actually contribute knowledge needed for our acute global health challenges including inequalities.
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Affiliation(s)
- Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK.
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Promenta Centre, University of Oslo, Oslo, Norway
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