Social Epidemiology after the German Reunification: East vs. West or Poor vs. Rich?
Social Epidemiology after the German Reunification: East vs. West or Poor vs. Rich?
复制标题
德国统一后的社会流行病学：东方与西方还是贫穷与富裕？
DOI：
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发表时间：
2007
影响因子：
4.6
通讯作者：
S. Voigtländer
中科院分区：
文献类型：
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作者：
O. Razum;T. Altenhöner;J. Breckenkamp;S. Voigtländer
摘要目的：社会流行病学一致证明社会经济劣势与健康状况不佳之间存在关联。统一十七年后，前“东德”和“西德”之间的经济差距仍然存在。我们研究是否存在相应的健康差异以及它们如何随着时间的推移而发展。方法：对德国的社会经济和健康数据进行二次分析。结果：东西方之间的健康差异（例如预期寿命）正在缩小。然而，在整个德国，城市和县一级的生活条件和人口趋势差异正在扩大。当仅比较东西方时，很容易忽视这一发展。 结论：需要进行小范围分析来理清德国社会经济不平等与健康之间的联系。在此类分析中，不仅需要包括个人特征，还需要包括背景特征（例如区域级别）。上下文变量可用于将较小的区域（例如县）分组为具有相似属性的集群。因此，个人调查数据可以与背景特征联系起来，同时保持数据保护并同时实现足够大的案例数量。与此同时，需要进一步发展解释健康不平等的理论模型，以使其包含背景特征。
SummaryObjective:Social epidemiology has consistently demonstrated an association between socio-economic disadvantage and ill health. Seventeen years after reunification, economic disparities persist between former “East” and “West” Germany. We examine whether there are according health disparities and how they developed over time.Methods:Secondary analysis of socio-economic and health data for Germany.Results:Health disparities, for example in life expectancy, are decreasing between East and West. Throughout Germany, however, differences in living conditions and demographic trends are widening at city and county level. This development is easily missed when only East and West are compared.Conclusion:Small-area analyses are required to disentangle the association between socio-economic inequalities and health in Germany. In such analyses, not only individual but also contextual (e.g. area level) characteristics need to be included. Contextual variables can be used to group smaller areas such as counties into clusters with similar properties. Thus, individual survey data can be linked with contextual characteristics while maintaining data protection and at the same time achieving sufficiently large case numbers. Concurrently, theoretical models explaining health inequalities need to be further developed so that they embrace contextual characteristics.