Lars Eric Kroll

Central Research Institute of Ambulatory Health Care in Germany (Zi) · Data Science and Health Care Analysis

Unemployment is a major determinant of health. We investigate whether health inequalities with regards to employment status have changed in Germany. We used longitudinal data for the years 1994-2008 from a representative panel study (GSOEP). The sample consisted of respondents aged 30-59 years (15 waves, 21,329 persons, 129,526 observations). We an...

Social inequalities in health are a characteristic of almost all European Welfare States. It has been estimated, that this is associated with annual costs that amount to approximately 9% of total member state GDP. We investigated the influence of inequalities in German health care utilization on direct medical costs. We used longitudinal data from...

This paper describes the construction and validation of comprehensive scales for overall, physical and psycho-social job demands (ABges, ABphy, ABpsy) that were constructed using a large-scale representative survey from 2006 conducted by the German Federal Institute for Vocational Education and Training (BIBB). The overall goal is to provide compre...

Most chronic diseases follow a socioeconomic gradient with higher rates in lower socioeconomic groups. A growing body of research, however, reveals cancer to be a disease group with very diverse socioeconomic patterning, even demonstrating reverse socioeconomic gradients for certain cancers. To investigate this matter at the German national level f...

The aim of this study was to measure the extent to which the association between socioeconomic status and laryngeal cancer among males is mediated by smoking, alcohol consumption, and occupational exposure. We used Karlson et al's decomposition method for logit models, which returns the percentage of change in odds ratios (OR) due to confounding. T...

Hintergrund: Regionale Deprivationsindizes erlauben, Zusammenhänge zwischen sozialer Benachteiligung und Gesundheit mit Daten zu analysieren, die selbst keine Information über die sozioökonomische Position der Individuen enthalten. Der vorliegende Beitrag stellt die Revision des German Index of Socioeconomic Deprivation (GISD) vor und präsentiert b...

Background: Regional deprivation indices enable researchers to analyse associations between socioeconomic disadvantages and health outcomes even if the health data of interest does not include information on the individuals' socioeconomic position. This article introduces the recent revision of the German Index of Socioeconomic Deprivation (GISD)...

BACKGROUND ICD-10-based diagnoses in claims data are a crucial part of patients' electronic health records (EHR). Any analysis that uses diagnosis codes of patients to predict subsequent outcomes requires a numerical representation of these string-encoded profiles. So far, most often binary encoded numerizations, usually on a subset of diagnoses, h...

Several determinants are suspected to be causal drivers for new cases of COVID-19 infection. Correcting for possible confounders, we estimated the effects of the most prominent determining factors on reported case numbers. To this end, we used a directed acyclic graph (DAG) as a graphical representation of the hypothesized causal effects of the det...

Der Verlust des Arbeitsplatzes geht mit erheblichen gesundheitlichen Folgen einher, Arbeitslose sind von Depressionen häufiger betroffen als Erwerbstätige. Der Beitrag geht der Frage nach, inwiefern der Zusammenhang zwischen Arbeitslosigkeitserfahrung und Depression durch soziale Unterstützung vermittelt wird. Dazu werden bevölkerungsweite Querschn...

Mobility, awareness, and weather are suspected to be causal drivers for new cases of COVID-19 infection. Correcting for possible confounders, we estimated their causal effects on reported case numbers. To this end, we used a directed acyclic graph (DAG) as a graphical representation of the hypothesized causal effects of the aforementioned determina...

Trotz vieler Einzelbefunde zu gesundheitlichen Ungleichheiten in jungen Lebensjahren bleibt unklar, wie verschiedene Aspekte sozialer Ungleichheit (familienbasierte und nicht-familiäre, objektive und subjektiv empfundene) miteinander verbunden sind und psychische Auffälligkeiten im Zeitverlauf prägen. Mit Hilfe gerichteter Annahmen (directed acycli...

Objectives This study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population. Design Population-based c...

This study aimed at estimating the prevalence in adults of complying with the aerobic physical activity (PA) recommendation through transportation-related walking and cycling. Furthermore, potential determinants of transportation-related PA recommendation compliance were investigated. 10,872 men and 13,144 women aged 18 years or older participated...

Background Studies show that occupational physical activity (OPA) has less health-enhancing effects than leisure-time physical activity (LTPA). The spare data available suggests that OPA rarely includes aerobic PAs with little or no enhancing effects on cardiorespiratory fitness (CRF) as a possible explanation. This study aims to investigate the as...

The increasing labor market participation of women in Europe leads to many women and men having to reconcile paid work with family work and thus reporting work-family conflict (WFC). WFC is related to different dimensions of health. In the present article, we analyzed the role different reconciliation policies among European countries may play rega...

Objective: Despite extensive study of the obesity epidemic, research on whether obesity has risen faster in lower or in higher socioeconomic groups is inconsistent. This study examined secular trends in obesity prevalence by socioeconomic position and the resulting obesity inequalities in the German adult population. Methods: Data were drawn fro...

Soziale Unterschiede in der Mortalität und Lebenserwartung sind ein deutlicher Ausdruck bestehender sozialer und gesundheitlicher Ungleichheit in der Bevölkerung. Nach Daten des Sozio-oekonomischen Panels (SOEP) der Jahre 1992 bis 2016 sterben 13% der Frauen und 27% der Männer aus der niedrigsten Einkommensgruppe bereits vor Vollendung des 65. Lebe...

Social differences in mortality and life expectancy are a clear demonstration of the social and health-related inequalities that exist within a particular population. According to data from the Socio-Economic Panel (SOEP) for the period ranging from 1992 to 2016, 13% of women and 27% of men in the lowest income group died before the age of 65; the...

Background High-sensitivity C-reactive protein (hsCRP) is a sensitive biomarker of systemic inflammation and is related to the development and progression of cardiometabolic diseases. Beyond individual-level determinants, characteristics of the residential physical and social environment are increasingly recognized as contextual determinants of sys...

Residential population-weighted ambient PM10 concentration levels in 2009 across exposure categories in the DEGS1 study sample of adults aged 18–79 years and in the total population in Germany in 2009 (pdf file 285 kb). (PDF)

Bivariate associations of differently operationalized population-weighted PM10 concentration with hsCRP among adults aged 18–79 years (n = 6,768) (pdf file 229 kb). (PDF)

[This corrects the article on p. 3-22 in vol. 2.].

Zusammenfassung Soziale Unterschiede in der Mortalität können als extreme Ausprägungsform sozialer und gesundheitlicher Ungleichheiten verstanden werden. Die für Deutschland vorliegenden Studien sprechen dafür, dass die mittlere Lebenserwartung bei Geburt in den sozial benachteiligten Bevölkerungsgruppen etwa 5–10 Jahre niedriger liegt als in den s...

Background: Studies show that people with a low occupational status are more likely to smoke than those with a high occupational status. Against the background of a general decline in tobacco consumption, time trends of occupational differences in smoking behaviour of employed men and women in Germany were examined. Methods: The analyses were ba...

Background: Carbapenem resistance in Klebsiella pneumoniae is of significant public health concern and recently spread across several countries. We investigated the extent of carbapenem non-susceptibility in K. pneumoniae isolates in Germany. Methods: We analysed 2011-2016 data from the German Antimicrobial Resistance Surveillance (ARS) System,...

Objectives To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. Design Cross-sectional multilevel analysis of survey data. Setting German...

Objective: Time trends in health inequalities have scarcely been studied in Germany as only few national data have been available. In this paper, we explore trends in socioeconomic inequalities in the prevalence of chronic illness using Germany-wide data from four cross-sectional health surveys conducted between 2003 and 2012 (n = 54,197; ages 25-...

Der Beitrag beschreibt die Messung des sozioökonomischen Status (SES) und des subjektiven sozialen Status (SSS) in der aktuellen Datenerhebung der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS Welle 2), die in den Jahren 2014 bis 2017 durchgeführt wurde. Der mehrdimensionale SES-Index wird als Punktsummenscore auf Basis v...

Social epidemiological research has consistently demonstrated that people with a low socioeconomic status are particularly at risk of diseases, health complaints and functional limitations, and die at younger ages than those with a higher socioeconomic status. Greater stresses and strains in the workplace, family and living environment are under di...

This article describes the method applied to measure socioeconomic status (SES) and subjective social status (SSS) in the current wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2), which was conducted over three years between 2014 and 2017. The composite multidimensional SES index was calculated...

Introduction: Since the early 2000s, several tobacco control policies have been implemented in Germany. Current research is inconsistent about how strengthening tobacco control can affect social inequalities in smoking. This study examines whether educational inequalities in adult smoking have widened in Germany since 2003. Methods: Data were used...

Free Download at https://lekroll.github.io/GISD/Update_2018

Aims This population-based study sought to extend knowledge on factors explaining regional differences in type 2 diabetes mellitus medication patterns in Germany. Methods Individual baseline and follow-up data from four regional population-based German cohort studies (SHIP [northeast], CARLA [east], HNR [west], KORA [south]) conducted between 1997...

Die Versorgung von Menschen mit psychischen Störungen wird in Deutschland kontrovers diskutiert. Einerseits bestehen regionale Unterschiede in der Verteilung von Psychotherapeutinnen und -therapeuten. Andererseits können Patientinnen und Patienten lange Anfahrtswege und Kosten in Kauf nehmen, um auch bei einem geringen Versorgungsangebot eine Behan...

In Germany, the provision of health services to people with mental disorders is an issue that is subject to controversial debate. On the one hand, regional differences exist in the distribution of psychotherapists in Germany. On the other hand, patients are often willing to accept the extra effort of having to travel further in order to access trea...

Data on the prevalence of perceived exposure to hazardous working conditions were gathered for the GEDA 2014/2015-EHIS study using a simple graduated question. Approximately one-fifth of people in employment state that they face serious or very serious occupational health hazards. However, women (18.6%) are significantly less likely to have this pe...

In Germany, the provision of health services to people with mental disorders is an issue that is subject to controversial debate. On the one hand, regional differences exist in the distribution of psychotherapists in Germany. On the other hand, patients are often willing to accept the extra effort of having to travel further in order to access trea...

Geoinformationssysteme (GIS) sind computergestützte Systeme, mit welchen geografische Daten erfasst, gespeichert, verwaltet, analysiert, visualisiert und bereitgestellt werden können. In den letzten Jahren sind sie fester Bestandteil der Public-Health-Forschung geworden. Durch vielfältige Analysewerkzeuge bieten sie die Möglichkeit, gesundheitsrele...

Bundesweite Gesundheitssurveys können herangezogen werden, um Aussagen zu regionalen Unterschieden in der gesundheitlichen Lage zu machen. Mit traditionellen Verfahren ist die räumliche Tiefe, für die Aussagen möglich sind, aber eng begrenzt. So konnten bisher – ohne spezielle Aufstockungsstichproben – nur für bevölkerungsreiche Bundesländer Ergebn...

For Germany, regional differences for various health indicators, which are also associated with socioeconomic factors, have been documented. This article aims to develop a regional socioeconomic deprivation index for Germany that (1) can be used to analyse regional socioeconomic inequalities in health and (2) provides a basis for explaining regiona...

Background: Social inequalities in health can be explained in part by the social patterning of leisure-time physical activity, such as non-participation in sports. This study is the first to explore whether absolute and relative educational inequalities in sporting inactivity among adults have changed in Germany since the early 2000s. Methods: D...

Zusammenfassung In dieser Studie gehen wir der Frage nach, welche Faktoren die einkommensbedingten Unterschiede in der Mortalität erklären können. Auf der Basis des Sozio-oekonomischen Panels (SOEP) werden ereignisanalytische Modelle der Mortalität ab dem Alter 65 geschätzt, die Auskunft über den Mediatoreffekt von acht Faktorenbündeln geben. Als M...

Soziale Unterschiede in der Gesundheit und Lebenserwartung sind ein zentrales Thema von Public Health und Gesundheitspolitik. Mittlerweile belegen zahlreiche Studien, dass die Angehörigen sozial benachteiligter Bevölkerungsgruppen häufiger von chronischen Krankheiten und Beschwerden betroffen sind, ihre eigene Gesundheit und gesundheitsbezogene Leb...

Background: Physical therapy (PT) is included in many clinical guidelines and a commonly used health service. However, access to its benefits should not strongly depend on social or demographic factors. Objective: The present study used the Andersen model to explain to what extent PT utilization in Germany depends on factors beyond medical need....

Eine nach wie vor stark ausgeprägte soziale Ungleichheit spiegelt sich in einer Ungleichverteilung von Gesundheit und Krankheit wider. Die Arbeitswelt trägt über die ungleiche Verteilung physischer, psychischer und sozialer Anforderungen zur Entstehung gesundheitlicher Ungleichheit bei, wodurch persönliche Krisen entstehen können, die wiederum Einf...

Background: More than half of all cardiovascular diseases are caused by eight, mostly preventable risk factors. Objectives: In view of the considerable differences in the prevalence and mortality of cardiovascular diseases between the 16 German federal states, the regional distribution of cardiovascular risk factors was analyzed stratified for m...

Background: Cardiovascular disease continues to be the single most common cause of death and to account for the largest single portion of treatment costs in Germany. Reliable data on regional differences in the frequency of cardiovascular disease are important for the planning of targeted care structures and preventive measures. Methods: Pooled dat...

▶ Im Jahr 2012 erlitten 2,6 % der erwerbstätigen Personen zwischen 18 und 70 Jahren in Deutschland einen Arbeitsunfall, der ärztlich versorgt werden musste. ▶ Erwerbstätige Frauen erleiden deutlich seltener Arbeitsunfälle (1,3 %) als Männer (3,7 %). Mehr als drei Viertel aller Arbeitsunfälle entfallen auf männliche Beschäftigte. ▶ In Berufen mit st...

Background: Today's men want to participate in their children's upbringing more than in the past, but they are heavily involved in their occupation at the same time. This article describes the significance of parenthood, partnership and occupation in relation to health and health behaviours among men of working age in Germany. Data: We summarise...

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand th...

Comparison of sampling characteristics (GEDA 2010, n = 14,041) with census data, gainfully employed men and women (age 18–70). (DOCX)

Associations between occupational injuries and individual factors (blockwise logistic regression; 95% confidence intervals of odds ratios), GEDA 2010, n = 12,946. (DOCX)

This study analyzes the association of unemployment and health using national and international research data. It is based on data from the 2010 and 2012 German Health Update (GEDA), conducted by the Robert Koch Institute. For our analysis, participants aged from 18 to 64 years were selected if they gave information on their unemployment experience...

This article describes the measurement of socioeconomic status in the first follow-up of the KiGGS study (KiGGS Wave 1) conducted from 2009 to 2012. A multidimensional index score was used. The score is the sum of three metric components: Education and Occupational Qualification, Occupational Status, and Net Income. Compared with the approach in th...

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 Ado...