Good Practice in Health Reporting - guidelines and recommendations

Health reporting provides descriptions of the health of a population, analyses problems and demonstrates areas in which action needs to be taken in health care, health promotion and disease prevention. As such, it provides a rational basis for participatory processes and a foundation for health policy decision-making. Good Practice in Health Reporting was developed by a working group that includes representatives from all levels of health reporting with the aim of strengthening the field at the local, federal-state and national level. The document sets out guidelines and recommendations that are intended to provide professional guidance for the creation of health reports. It makes 11 recommendations that address the ethical principles behind health reporting, the necessary framework, the selection of topics (the report's focus), the foundation of the work undertaken (data quality), data preparation, analysis, interpretation and protection, as well as communications and quality assurance. The pilot version of the document was presented at the conferences of the German Society for Epidemiology (DGEpi), the German Society for Social Medicine and Prevention (DGSMP) and the Federal Association of Physicians of German Public Health Departments (BVÖGD) where it was discussed and subsequently revised. After further review, the guidelines were adopted by all of these institutions. Finally, Good Practice in Health Reporting is to be strengthened and developed further as part of a comprehensive review.

12-Month prevalence of stroke or chronic consequences of stroke in Germany

Stroke is the second most common cause of death globally and an important cause of disability in adults. According to the GEDA 2014/2015-EHIS study, 1.6% of adults (1.7% of women and 1.5% of men) in Germany had a stroke or chronic consequences of stroke during the past 12 months. For those aged under 55 years, the 12-month prevalence of these health problems remains well below 1% for both sexes, but then increases steeply and disproportionately to 6.3% for those aged 75 years and over. Prevalence among women with a low level of education (3.6%) is higher than among women with a high level of education (0.6%). Education has only a weak effect on prevalence among men. The indicator analysed here (12-month prevalence of stroke or chronic consequences of stroke) was developed for the European Health Interview Survey (EHIS) 2014/2015, which means that comparative data for Germany is not yet available.

12-Month prevalence of hypertension in Germany

Hypertension is among the most important risk factors for cardiovascular diseases and therefore a significant determinant of the most frequent causes of death in adults. According to the GEDA 2014/2015-EHIS survey nearly one in three adults in Germany have self-reported physician-diagnosed hypertension. Men are affected more in the age group of under 65 year olds. Nearly two thirds of all men and women aged 65 and over have hypertension. An educational gradient is particularly evident among women, with a higher prevalence of self-reported hypertension among women with low levels of education. Compared to the German average, prevalence of self-reported hypertension among men is higher in Mecklenburg-Western Pomerania and Saxony-Anhalt and among women in all East German federal states with the exception of Berlin. Only in Bremen is the prevalence among men lower than the national average.

12-Month prevalence of known diabetes mellitus in Germany

Diabetes mellitus is a metabolic disease involving chronic dysfunction of blood sugar regulation; if left untreated, it can result in serious secondary illnesses. In 2014 and 2015, a total of 7.0% of women and 8.6% of men in Germany with an age of 18 and over reported having diabetes mellitus in the past 12 months (these figures do not include gestational diabetes). There are significant differences in the 12-month prevalence among adults: the prevalence of known diabetes increases significantly with age, and is particularly high among people with a low educational status and those living in Saxony-Anhalt or Brandenburg. The Robert Koch Institute is currently developing a diabetes surveillance system in order to establish a data-based fundament for guiding health policy decisions in Germany.

12-Month prevalence of hypertension in Germany

Hypertension is among the most important risk factors for cardiovascular diseases and therefore a significant determinant of the most frequent causes of death in adults. According to the GEDA 2014/2015-EHIS survey nearly one in three adults in Germany have self-reported physician-diagnosed hypertension. Men are affected more in the age group of under 65 year olds. Nearly two thirds of all men and women aged 65 and over have hypertension. An educational gradient is particularly evident among women, with a higher prevalence of self-reported hypertension among women with low levels of education. Compared to the German average, prevalence of self-reported hypertension among men is higher in Mecklenburg-Western Pomerania and Saxony-Anhalt and among women in all East German federal states with the exception of Berlin. Only in Bremen is the prevalence among men lower than the national average.

12-Month prevalence of allergies in Germany

The prevalence of allergies has increased dramatically during recent decades, and thus, got into the focus of public health. As part of the 2014 German Health Update (GEDA 2014/2015-EHIS), 28.1% of respondents reported that they were affected by an allergic disease other than asthma. Reports of allergies are more common among women than men and among younger and middle-aged adults than people over the age of 65. Adults with higher levels of education stated more frequently that they are affected by allergies than adults with lower levels of education. Allergic reactions occur in various organ systems, but the skin, mucous membranes, respiratory tract and the intestines are most commonly affected. As allergic reactions often significantly restrict people's quality of life, early diagnosis and appropriate care for sufferers is essential.

Prevalence of persons following a vegetarian diet in Germany

People adopt a vegetarian diet for various reasons. A largely plant-based diet not only has advantages for health, it also has positive social and environmental aspects. The aim of this analysis is to provide a description of the people in Germany who follow a predominantly vegetarian diet and to compare their food consumption with those of non-vegetarians. As part of DEGS1 (2008-2011), a validated questionnaire was used within a representative sample of 6,933 persons aged 18 to 79 to study how often and how much of 53 different food groups was consumed during a four-week period. The questionnaire also included a question about a vegetarian diet. The data were analysed descriptively and with a binary-logistical regression model. In Germany, 4.3% of the population (6.1% of women and 2.5% of men) aged 18 to 79 usually follows a vegetarian diet. The highest proportion of vegetarians is found among 18- to 29-year-olds (women 9.2% and men 5.0%) and among women aged 60 to 69 (7.3%). People with a higher level of education are more likely to usually follow a vegetarian diet. The same applies to people who live in large cities and those who conduct more than four hours of sports per week. In addition, women and men who usually follow a vegetarian diet not only consume significantly less meat compared with non-vegetarians, they also drink less energy-reduced drinks, and less beer and wine; they also drink more tea and eat more fruit and vegetables. A vegetarian lifestyle is often associated with positive socio-political impacts. It can, among others, contribute to a reduction in factory farming, which means it can help preserve the environment. A reduction in meat consumption in Germany would also be beneficial from a public health perspective, since meat consumption is currently considerably higher than the amounts recommended by the German Nutrition Society. The benefits linked to a vegetarian diet would be further strengthened, if, in addition to the relatively small group of people who completely refrain from eating meat, a larger section of the population would reduce their meat consumption.

Vitamin D status of adults in Germany

Vitamin D plays an important role in the body as part of bone metabolism. Blood serum concentrations demonstrate that 30.2% of adults (29.7% of women and 30.8% of men) have a deficient vitamin D status. In total, 38.4% of adults (38.6% of women, 38.3% of men) have an adequate status. Although there is little variation among men between the various age groups, the proportion of women with deficient vitamin D status increases with age, while the proportion of women with an adequate status decreases. Furthermore, adults with a low socio-economic status are significantly more likely to have a deficient vitamin D status than adults with a higher socio-economic status. Vitamin D status is subject to strong seasonal fluctuations. In order to ensure adequate concentrations of serum vitamin D, it is recommended to expose the face, hands and arms to the sun two to three times a week between March and October without using sun protection; however, sunburn should be strictly avoided.

Folate status in Germany

Folate is important for cell division and thus for growth and physical development. Serum folate concentrations can be used to assess a population's folate status. In Germany, the median serum folate level of adults aged 18 to 79 is 7.5 ng/ml (women: 7.9 ng/ml, and men: 7.2 ng/ml). Approximately 86% of the adult population in Germany has adequate folate levels. Higher folate concentrations are observed among older age groups and individuals with a higher socio-economic status. However, the World Health Organization recommends that women of reproductive age should, at the population level, have significantly higher folate levels in order to reduce the risk for neural tube defects. However, the majority of women in this age group do not achieve these concentrations.

Sodium intake in Germany

For many years, a high sodium intake has been discussed as a potential risk factor in the development of hypertension and, consequently, cardiovascular diseases. As part of the German Health Interview and Examination Survey for Adults (DEGS1), which was conducted between 2008 and 2011, sodium excretion in casual urine samples was used as a biomarker to measure sodium intake. DEGS1 observed that the median daily sodium intake of women (3.4 g) as well as men (4.0 g) exceeds the levels recommended by German and international organisations. Among other factors, men's higher sodium intake could be explained by their higher energy intake. In addition, DEGS1 demonstrates an association between women's sodium intake and age; however, no equivalent correlation was identified for men. Furthermore, although high socio-economic status is associated with lower sodium intake in men, no comparable correlation was observed among women.

Cooking frequency in Germany

The growing range of ready-to-cook and ready-to-eat foods (convenience foods) and opportunities to eat outside of the home is tending to reduce the number of fresh meals that people prepare themselves. However, people continue to place great importance on preparing their own meals from fresh foods, as this provides them with greater influence over the quality and composition of the food they eat. The German Health Interview and Examination Survey for Adults (DEGS1, 2008-2011) observed that 50.8% of adults aged between 18 and 79 (61.4% of all women and 40.2% of all men) prepare their meals daily or almost daily from fresh food. Moreover, women report less often that they never cook (2.9%) than men (16.1%) and older participants report far more often to cook daily or almost daily than younger participants. Finally, among both genders is a low level of employment associated with an increased cooking frequency.

Cases of alcohol poisoning involving in-patient treatment

Alcohol poisonings represent the direct consequences of excess alcohol consumption. In 2014, in Germany 115,967 persons aged 10 to 79 years were treated as in-patients with the diagnosis "acute alcohol intoxication". In almost all age groups, male persons are affected significantly more frequently than female persons. In the past 14 years, the number of alcohol poisonings involving in-patient treatment amongst children, adolescents and adults has more than doubled. The need to prevent excessive alcohol consumption remains a key objective. Preventive measures should begin while children are still at an early age and in adolescence.

Traffic accidents under the influence of alcohol

In 2014, 260 persons were killed in Germany in road traffic accidents under the influence of alcohol. Compared to road traffic accidents in general, accidents under the influence of alcohol frequently have particularly serious consequences. In 2014, police established that 13,742 persons were involved in traffic accidents while under the influence of alcohol. Just under 40% of these were young men aged 18 to 34 years. The number of road traffic accidents under the influence of alcohol has been declining for over 20 years now and in 2014 reached its lowest level since the recording of the relevant data began.