[Show abstract][Hide abstract] ABSTRACT: This paper reports on selected results from the study “Health and Lifestyle in Rural Northeast Germany”. A special characteristic of this study is the regional focus on peripheral rural communities and the trend study design. It was analyzed whether, and to what extent, associations exist between socioeconomic status and self-rated health in this regional context and over time. Thus, regression analyses were conducted using equivalent income, level of school education, and age as independent variables and self-rated health as the dependent variable. Analyses are based on paper–pencil surveys of the adult residents of 14 rural communities chosen at random in northeast Germany, performed in 1973, 1994, and 2004–2008. In all survey waves, a lower level of school education was associated with poor self-rated health. By contrast, associations between income and health were less consistent and constant over time. The associations between income and health are discussed as being specific to East Germany and as a consequence of social transformation in the context of reunification.
[Show abstract][Hide abstract] ABSTRACT: Secular trends in health-related behavior, the frequency of illness, and life satisfaction in rural areas are inadequately documented. Such information is essential for the planning of health-care policy.
In 1973 and 1994, surveys were performed on the health and lifestyle of all adult inhabitants of 14 selected rural communities in the northern part of the former East Germany. The inhabitants were surveyed again in 2008, and the findings of the surveys were compared.
Both the number of respondents and the response rate of the officially registered population in the 14 rural communities declined over the years, from 3603 (83%) in 1973 to 2155 (68%) in 1994 and 1246 (37%) in 2008. In 1973, 3.2% of the women and 2.7% of the men responding to the survey reported that they had diabetes mellitus. For arterial hypertension, the corresponding figures in 1973 were 21.7% and 11.4%; for chronic heart diseases, 16.7% and 12.8%. In 2008, most of the prevalence figures for these conditions were higher: for diabetes, 12.4% and 12.8%; for arterial hypertension, 34.7% and 33.9%; for chronic heart diseases, 12.3% and 15.0%. Men became less likely to report being in good or very good health (decline from 51.1% to 45.0%), while women became more likely to report being in good health (rise from 36.7% to 49.3%). Women generally had a more healthful lifestyle than men.
Over the long term, there have been both improvements, particularly in lifestyle, and turns for the worse, e.g., in life satisfaction. While the latter might be due to the increasing marginalization of rural eastern Germany, we interpret the observed improvements as benefits of modernization.
Deutsches Ärzteblatt International 04/2012; 109(16):285-92. DOI:10.3238/arztebl.2012.0285 · 3.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The development of the perceived state of health, the lifetime prevalence of chronic heart disease, hypertension and diabetes mellitus, and the life satisfaction of residents in rural communities in north-eastern Germany were analysed over the years 1973, 1994 and 2004/08 with reference to age and sex, and evaluated in comparison with nationally representative data. The analyses are based on data of surveys of the adult residential population of 14 rural communities in north-eastern Germany carried out in 1973 (N=3,603), 1994 (N=2,155) and 2004/08 (N=1,246). While there was an increase over time in the proportion of the population who assessed their health status as very good or good, the prevalence of hypertension and diabetes mellitus also rose successively. Life satisfaction was lower in 2004/08 than in 1994 in terms of almost all factors. A comparison with the results of nationally representative surveys shows that the illness burden of the population in the region we investigated was higher than average, while the perceived health status was considerably below average, as was the satisfaction with the work situation and the financial situation in particular. The development of health and illness parameters in accordance with the general trend is assessed as an expression of the modernisation of the working and living conditions in the region over this period, whereas the observed differences in levels are interpreted as a consequence of the rural nature of the region and peripherisation.
Das Gesundheitswesen 01/2011; 74(3):132-8. DOI:10.1055/s-0030-1270506 · 0.62 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this investigation was to establish thatthe data of the third survey wave 2004/08
of the Rural Health Study was representative of the overall adult population of the region
covered by the study in terms of socio-demographic characteristics.
Method: Initially, specific characteristics of the social structure in rural areas were established
on the basis of the Mikrozensus Regionalfile 2000. The distribution in our survey data of the
demographic parameters age and sex and the social structure indicators family status and
household size, school education level, unemployment and membership in a health insurance
company was then compared with distributions derived from official statistics and registration
data as well as from the microcensus.
Results: The comparison of age and sex distributions with the data from the official
registration offices showed that women and people aged 45 and above were clearly
overrepresented in our random sample. However, these selection effects in terms of age and
sex could be compensated for by introducing statistical weighting factors.
After weighting, the comparison of social structure gave a representative reflection of the
overall population, with the exception of school education. People with higher levels of
school education were overrepresented to some extent, and those with lower levels of school
education were underrepresented. This can have consequences for some analyses of
prevalence and interrelationships, but is not seen to introduce considerable bias, particularly
since other socio-demographic variables compare very well with the available reference data.
Discussion: As a result of the data situation, there are limitations on the extent to which the
representativeness of the Rural Health Study samplecan be determined. This meant that the
reference data for age and sex distribution of the overall population allowed weighting to
compensate for any disproportionality, but the datarelating to the social structure did not. In
cases of doubt, the assessments would have to rely on the opinions of a regional expert
(Stephan Beetz). Overall, the examination of representativeness showed no signs of larger
Edited by Thomas Elkeles, 10/2010; Hochschule Neubrandenburg., ISBN: 978-3-941968-06-6
[Show abstract][Hide abstract] ABSTRACT: Theoretischer Hintergrund: Im Rahmen der Follow-up-„Landgesundheitsstudie“ (1973, 1994, 2008) werden Gesundheit und Gesundheitshandeln hinsichtlich Kontinuität oder Wandel untersucht. Fragestellung: Neben einer Deskription der regionalen Erwerbstätigkeit mit einem ihrer Haupttopoi, der landwirtschaftlichen Beschäftigung, werden Erwerbstätigkeit und Gesundheit im Sektorenvergleich untersucht. Methoden: Neben der Aufbereitung amtlicher Daten wurden Befragungsdaten der Wellen 2 (1994; N=2.285) und 3 (2008, N=1.246) herangezogen und mittels bi- und multivariabler Analysen untersucht (Vollerhebung der erwachsenen Wohnbevölkerung in 14 repräsentativ ausgewählten ländlichen Untersuchungsorten Nordostdeutschlands). Ergebnisse: Eine generell höhere Arbeits- und Gesundheitsbelastung für die Beschäftigten in der Landwirtschaft bestätigte sich nicht. Vielmehr lassen sich unter Einbeziehung von Gratifikationen bzw. Gratifikationskrisen die Sektoren – in ihrem Vergleich – so umschreiben: Primärer Sektor: harte, aber gut bezahlte Arbeit vergleichsweise alter Männer in der Landwirtschaft, sekundärer Sektor: harte und prekäre Männerarbeit auf dem Bau und in der Industrie, tertiärer Sektor: hochqualifizierte, wenig belastende und gut belohnte Dienstleistung v.a. von Frauen. Schlussfolgerungen: Nähere Aufschlüsse über die Stärken der verschiedenen Einflussfaktoren auf die Gesundheit sollten weiterführende Analysen erbringen.