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This article examines educational differences in the prevalence of behavioural risk factors among adults and compares the results for Germany with the average from the European Union (EU). Data were derived from the second wave of the European Health Interview Survey, which took place between 2013 and 2015 (EHIS 2). Analyses were conducted using a regression-based calculation of relative and absolute educational differences in the prevalence of behavioural risk factors, based on self-reported data from women and men aged between 25 and 69 (n=217,215). Current smoking, obesity, physical activity lasting less than 150 minutes per week, heavy episodic drinking and non-daily fruit or vegetable intake are more prevalent among people with a low education level than those with a high education level. This applies to Germany as well as the EU average. Overall, the relative educational differences identified for these risk factors place Germany in the mid-range compared to the EU average. However, relative educational differences in current smoking and heavy episodic drinking are more manifest among women in Germany than the EU average, with the same applying to low physical activity among men. In contrast, relative educational differences in non-daily fruit or vegetable intake are less pronounced among women and men in Germany than the average across the EU. Increased efforts are needed in various policy fields to improve the structural conditions underlying health behaviour, particularly for socially disadvantaged groups, and increase health equity.

The scientific assessment of health issues, the design and further development of political guidelines as well as the targeted planning of measures in the European Union (EU) require data on population health. For this reason, all EU Member States regularly collect data on the health status, provision of healthcare, health determinants and socioeconomic situation of their respective populations in the European Health Interview Survey (EHIS). Participants are at least 15 years old and live in private households. The second wave of EHIS (EHIS 2) was conducted between 2013 and 2015. For EHIS 2, each EU Member State drew a nationally representative population sample from population registers, censuses, dwelling registers or other statistical or administrative sources. Data collection modes within individual EU Member States were used, according to nationally established methods, including the use of mixed-mode surveys. Across all EU Member States, data collection took an average of eight months to complete. Member States made considerable efforts to achieve the highest possible response rates. The harmonised EHIS data collected are highly comparable and constitute an important information base for European health policy and health reporting.

This study examines the extent to which health inequalities among children and adolescents in Germany have developed over the past decade. The analyses are based on data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which are representative of the 0- to 17-year-old population in Germany. The KiGGS data were collected in three waves: the KiGGS baseline study (2003-2006), KiGGS Wave 1 (2009-2012) and KiGGS Wave 2 (2014-2017). Prevalences of five health outcomes are considered: general health, mental health problems, physical activity, the consumption of sugary soft drinks, and smoking. Moreover, it defines health inequalities in relation to differences in the socioeconomic status of the family (SES), an index derived from the parents’ level of education, occupation and income, and considers both absolute and relative health inequalities. In order to do so, the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were calculated using linear probability or log-binomial models. Significant inequalities were identified to the detriment of young people from families with a low SES. These inequalities were particularly pronounced in the KiGGS Wave 2 data with regard to general health and the consumption of sugary soft drinks. Additionally, evidence from trend analyses for these two outcomes suggests that relative inequalities have increased. However, absolute inequalities decreased during the same period, and this also applies to smoking. The persistently high and, in some cases, widened levels of health inequalities indicate that adolescents from families with a low SES do not benefit to the same extent from disease prevention and health promotion measures for children and adolescents as young people from families with a higher SES.

This article focuses on selected indicators related to sports and dietary behaviour – two important factors that influence the development of obesity. The analyses are based on data collected for the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2), which was conducted between 2014 and 2017. These data were collected, using a questionnaire, from 6,810 girls and 6,758 boys aged between 3 and 17. The analyses also compare the data collected for wave 2 with those from the KiGGS baseline study (2003-2006). More than 70% of 3- to 17-year-olds state that they participated in sports. However, boys do so significantly more often than girls, and 11- to 17-year-olds do so more frequently than 3- to 10-year-olds. In addition, there is a correlation between children’s and adolescents’ sports participation and those of their parents, and with an activity-friendly living environment. Younger children and girls have healthier diets than older children and boys. However, although the consumption of confectionery and sugary drinks by 3- to 17-year-olds has declined significantly since the KiGGS baseline study was conducted, 11- to 17-year-olds, in particular, eat significantly smaller amounts of vegetables than they did about ten years ago. Significantly more 3- to 10-year-olds currently eat at least five servings of fruit and vegetables per day than ten years ago, although the proportion of the children who reach this recommendation continues to remain very low at 14% overall. It is important to set an example by following a healthy lifestyle within families and other settings in early life. Furthermore, the living environments also need to be made more health-oriented to support children and adolescents in reaching the national recommendations on physical activity and healthy eating.

Childhood and adolescence are key determining stages for health behaviour in the life course. Frequently, health-related attitudes and patterns of behaviour that develop at young age are also maintained at adult age. As studies show, already during childhood and adolescence, patterns of health risk behaviour are more common in certain population groups. KiGGS Wave 2 results confirm that 3- to 17-year-old children and adolescents from families with low socioeconomic status (SES) eat a less healthy diet, do fewer sports and are more often overweight or obese than their peers from more affluent backgrounds. Whereas socioeconomic differences appear to have little effect on levels of alcohol consumption among 11- to 17 year-olds, girls and boys with low SES smoke more frequently than their peers with high SES. Prevention and health promotion encourage children and adolescents to adopt healthy lifestyles, and aim to drive structural changes to stimulate behaviour which promotes good health. Combining measures that target individual behaviour and a settings-based approach appears to be the most promising preventative approach to reduce health inequalities among young people. Due to the clear impacts of socioeconomic differences on health behaviour already at young age measures for disadvantaged children and adolescents and their living conditions should be given an even stronger focus in the future.

Self-reported data from wave 2 of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) provides the basis for assessing whether the levels of physical activity of children and adolescents in Germany meet the levels recommended by the World Health Organization (WHO). Merely 22.4% of girls and 29.4% of boys in the 3-17 age group are physically active for at least 60 minutes per day and therefore meet the WHO recommendations. Prevalence of recommended levels of physical activity decreases continuously with age, both for girls and boys. In KiGGS Wave 2, girls in the 3-10 age group met the levels of physical activity recommended by the World Health Organization significantly less often than in KiGGS Wave 1. Low levels of physical activity were highest amongst adolescent age girls, as well as among boys and girls of low socioeconomic status. The results indicate a great potential to promote physical activity.

Demographic change, new health threats, but also inequalities in health and health care provision in and between European Union (EU) member states pose major albeit similar challenges to European health systems. Regular information on health and health-related behaviour is essential if member states’ health systems are to respond and develop appropriately to these challenges. The ‘European Health Interview Survey’ (EHIS) is a vital source of data for indicators of health status and health-related behaviour in the EU. This article presents a comparative review of health-related behaviour at the European level. Health-related behaviour is of particular relevance because an unhealthy diet, physical inactivity, obesity, smoking, and harmful use of alcohol are among the most important determinants associated with non-communicable chronic diseases. Eurostat has used data from EHIS Wave 2 to publish details about the current prevalence of obesity, daily fruit and vegetable intake, health-enhancing aerobic physical activity, smoking and heavy episodic drinking for the EU’s member states. In the following, the figures for Germany are compared to the European average. A wide range of prevalences exists between the various EU member states, in some cases stretching to more than 50 percentage points. In Germany, the prevalence of obesity and smoking remains relatively close to the EU average. Moreover, the results on physical activity are especially welcome. In particular, the proportion of women and men who undertake adequate levels of physical activity decreases more slowly with increasing age compared to the EU average. Nevertheless, the low fruit and vegetable intake, especially among younger generations, and the high proportion of women and men who drink six or more alcoholic beverages on one occasion (heavy episodic drinking) at least once a month pose problems for Germany. In summary, the results provided by EHIS offer a basis for sharing experiences between EU member states regarding effective measures in health promotion and disease prevention.

Self-reported data from the GEDA 2014/2015-EHIS study was used to calculate the level of compliance among adults in Germany with the World Health Organization’s (WHO) recommendations on physical activity. The WHO’s recommendations distinguish between ‘aerobic activity’ and ‘muscle-strengthening activity’. In Germany, 42.6% of women and 48.0% of men reported that they conduct at least 2.5 hours of aerobic physical activity per week, and therefore meet the WHO’s recommendation on this form of activity. A higher level of education among women and men of all ages is associated with a higher frequency of meeting the WHO’s recommendations on aerobic activity. In addition, 27.6% of women and 31.2% of men conduct muscle-strengthening activity at least twice a week, thereby meeting the WHO’s recommendations on this form of activity. About one fifth of women (20.5%) and one quarter of men in Germany (24.7%) meet both of these recommendations. In summary, the results point to the value of encouraging people to conduct more physical activity during their leisure time. In fact, inactive people who begin to follow the WHO’s recommendations can significantly reduce their long-term risk of premature mortality.

In GEDA 2014/2015-EHIS the prevalence of work-related physical activity was estimated based on respondents’ self-reported data. 47.5% of women and 47.2% of men mostly sit or stand during work. The highest proportion of people who mostly sit or stand during work is found among 18- to 29-year-old women (55.5%) and men aged 30 to 44 (50.2%). A significantly higher proportion of men (14.8%) than women (3.2%) have jobs involving mostly heavy manual labour. For both genders, the higher a person’s level of education, the more likely it is that physical activity during work is limited to sitting or standing. The results highlight great potential to promote physical activity.

GEDA 2014/2015-EHIS is an up-to-date health survey of the adult population undertaken within the framework of the Robert Koch Institute’s (RKI) health monitoring system. It uses the EHIS (European Health Interview Survey) Wave 2 questionnaire and includes four modules covering health status, health care, health determinants, and socio-economic variables. Data on nationally relevant issues is also collected. The study employs a mixed-mode design, using both online and paper-based questionnaires to gather data from 24,016 people aged 18 and above: the response rate was 26.9%. The Statistical Office of the European Union (Eurostat) provides prepared data from 28 European Union (EU) member states (plus Norway and Iceland) on the Eurostat website. National analyses for Germany are published as Fact sheets on health reporting in the Journal of Health Monitoring.

In den letzten Jahren hat sich unterhalb von Rechtsprechung und Rechtsetzung ein Diskurs ausgebreitet, demzufolge die staatlich geförderte Zivilgesellschaft den gleichen Äußerungsregeln wie der Staat unterliegt. Da Gerichte sich zu solchen Neutralitätsanforderungen an die Zivilgesellschaft kaum geäußert haben, ist die Verunsicherung entsprechend groß. Doch der Äußerungsspielraum ist größer als vielfach angenommen. Eine verfassungsrechtliche Pflicht des Förderstaates, ihn zu beschränken, besteht in den meisten Fällen nicht.

Mit einem umfangreichen Sonderbericht hat der Sächsische Rechnungshof kürzlich die finanzielle Förderung der Zivilgesellschaft durch das Sächsische Staatsministerium für Soziales und Gesellschaftlichen Zusammenhalt auf den Prüfstand gestellt. Der Rechnungshof bemängelt nicht nur ein fehlendes rechtsstaatliches Verwaltungshandeln und „Anhaltspunkte für Interessenkollision und Befangenheitstatbestände“ (S. 11 f.), sondern auch die fehlende politische Neutralität der geförderten Projekte (S. 111 ff.). Tatsächlich ist der Sonderbericht ein weiterer Erfolgsschritt einer langjährigen Strategie der AfD, genau dieses staatliche Neutralitätsprinzip als Waffe zur Einschüchterung einer demokratischen Zivilgesellschaft zu instrumentalisieren.

Jüngst hat das VG Dresden den rechten Referendar Matthias B. zum Examen zugelassen (Urt. v. 04.04.2023, Az.: 11 K 1918/21). Diesen Weg hatte ihm der Sächsische Verfassungsgerichtshof mit seinen argumentationsgleichen Entscheidungen aus dem Oktober und November 2021 sowie Oktober 2022 geebnet. Um ihn wieder zu schließen, strengt die Landesjustizministerkonferenz Berichten zufolge nun eine Reform der Bundesrechtsanwaltsordnung (BRAO) an. Damit legt die Ministerkonferenz die Axt an die freie Advokatur an und leistet einen Bärendienst im Kampf gegen Rechts.