(2012), "Germany - East-west divide evident in some aspects of Germans’ health", International Journal of Health Care Quality Assurance, Vol. 25 No. 3. https://doi.org/10.1108/ijhcqa.2012.06225caa.008Download as .RIS
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Copyright © 2012, Emerald Group Publishing Limited
Germany - East-west divide evident in some aspects of Germans’ health
Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 25, Issue 3
Keywords: National healthcare strategy, Patient care access, Healthcare delivery improvement programmes
Older Germans and those with lower incomes are more likely to report various chronic conditions. German adults are more likely to report having been diagnosed with high blood pressure at some point in their lives (27.1 per cent) than various other chronic conditions, including high cholesterol (16.7 per cent), diabetes (8.4 per cent), asthma (7.4 per cent), heart attack (5.4 per cent), and cancer (5.4 per cent).
Highlighting important regional differences, in eastern Germany, more than a third of respondents report having been diagnosed with high blood pressure (35.9 per cent), which is more than 10 percentage points higher than in western Germany (25.1 per cent). The frequency of those reporting a diabetes diagnosis is also much higher in eastern Germany (12.9 per cent) than it is in western Germany (7.3 per cent). There is no meaningful difference between eastern and western Germany in terms of a diagnosis of high cholesterol, asthma, heart attacks, and cancer.
Overall, the German figures compare favourably with the US, where diagnosis rates on several chronic diseases – except for heart attacks – are higher than in Germany. In the UK, significantly fewer people report diagnoses of high blood pressure (20.7 per cent) than in Germany. However, more people report having been diagnosed with asthma (13.5 per cent) in the UK than in Germany (7.4 per cent).
Women in Germany report statistically significant higher rates of asthma (8.7 per cent) than men (5.9 per cent). Also, more women report having been diagnosed with cancer (6.3 per cent) than men (4.4 per cent). The differences between men and women on diagnoses of high blood pressure, high cholesterol, diabetes, and heart attacks are not statistically significant.
The data show a higher prevalence of most chronic condition diagnoses among older respondents than among younger respondents, with 18- to 29-year-olds always reporting the lowest chronic conditions rates and those aged 65 and older always reporting the highest rates – even after controlling for income. For example, while 7 per cent of people aged 18 to 29 report having been diagnosed with high blood pressure, this proportion rises to 48.7 per cent among people 65 years old and older. Differences in age are not statistically significant for an asthma diagnosis.
Lower income adults are more likely to report having been diagnosed with high blood pressure, diabetes, asthma, and heart attacks. High blood pressure diagnosis is more than 20 points higher among people making less than €2,300 per month than among those making more than €5,451 per month (37.2 vs 16.9 per cent). Lower income Germans are also three times as likely to report having been diagnosed with diabetes (11.6 vs 3.5 per cent) or heart attacks (7.8 vs 2.1 per cent) than those in the highest income group. These differences are still significant after controlling for age. Differences in monthly income are not statistically significant for high cholesterol and cancer diagnoses.
Research Gallup and Healthways conducted in the US has found similar results on chronic conditions for lower income groups, reinforcing the health risks poorer people face.
More than a quarter of the adult population in Germany reports having been diagnosed with high blood pressure at some point in their lives, and many also report high cholesterol – two conditions linked to other serious health conditions. High blood pressure and high cholesterol are also problems in the US and the UK.
Such chronic conditions are a major cost to individuals, businesses, and societies. They increase the burden on the healthcare system and lower workplace productivity and overall wellbeing.
Germany is facing the challenge of an aging population and an increasingly costly healthcare system. It is important for Germany’s leaders to understand the underlying role chronic conditions play in Germans’ lives and the regional and demographic differences that are apparent.
The behavioural data collected can help leaders in government, business, and civil society shape policies and outcomes to improve all Germans’ health.
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