Juliane Tetzlaff

• Dr. Public Health; M.Sc. Demography
• Hannover Medical School

Background While social disparities in mortality have been shown in the majority of high-income countries, research on inequalities in the German population is still limited. This applies especially to studies investigating time trends in social inequalities with respect to life expectancy. The aim of this study is to examine income inequalities in...

Background Despite substantial improvements in prevention and therapy, myocardial infarction (MI) remains a frequent health event, causing high mortality and serious health impairments. Previous research lacks evidence on how social inequalities in incidence and mortality risks developed over time, and on how these developments affect the lifespan...

Cancer represents a major burden of morbidity and mortality globally. So far, however, little is known on time trends and inequalities in the lengths of life spent free of any cancer. This study steps into this gap by analyzing time trends and income inequalities in cancer-free life expectancy (CFLE). For this retrospective cohort study, data of a...

Unlabelled: Population ageing poses growing challenges to social security systems, in particular to public pension funds. The study analyses how Working Life Expectancy (WLE) and Healthy Working Life Expectancy (HWLE) in terms of three health indicators developed in Germany. Based on the German Socio-Economic Panel (GSOEP) from 2002 to 2018 (n = 2...

Against the backdrop of population aging and growing strain on pension systems, monitoring the development of Working Life Expectancy (WLE) is vital to assess whether the policies taken are effective. This is the first study investigating time trends and educational inequalities in WLE based on German health insurance data. The analyses are based o...

Background Successful prevention of cardiovascular diseases (CVD) may reduce the burden of diseases. Preventive medication is an important measure to decrease the risks of cardiovascular events, in particular myocardial infarction and stroke. The aim of this study is to analyze the prevalence of CVD preventive medication in Germany over time with r...

Background Low back pain (LBP) is a common health problem in workers that contributes to work disability and reduces quality of life. However, studies examining vulnerable groups in relation to sociodemographic differences in LBP remain scarce. Therefore, the current study investigates which sociodemographic groups of workers are most affected by L...

Einleitung: Bei Menschen in sozioökonomisch benachteiligten Verhältnissen wird oftmals eine höhere Krankheitslast und früheres Versterben beobachtet [1]. Für Deutschland konnten die ursächlichen Erkrankungen, die maßgeblich zur sozioökonomischen Lücke in der Lebenserwartung beitragen, aufgrund fehlender Daten auf Individualebene bislang nicht unter...

Background Against the backdrop of the debate on extending working life, it is important to identify vulnerable occupational groups by analysing inequalities in healthy life years. The aim of the study is to analyse partial life expectancy (age 30–65) [1] free of musculoskeletal diseases (MSD) and [2] free of cardiovascular diseases (CVD) in occupa...

Background Limited lung function represents a serious health impairment. However, studies investigating social inequalities in limited lung function are rare. Thus, the current study investigates which socioeconomic groups are the most affected by overall limited lung function and severely limited lung function. Methods Data from the population-ba...

Background: Earlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life-expectancy gap between socioeconomic groups. We examined how age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy have chan...

Objectives This study examined the contribution of obesity to the development of educational inequalities in physical health. Methods We used data from the German Socio-Economic Panel for the period 2002–2020. Physical health was measured with the modified SF12-questionnaire. Logistic regression analyses were applied to estimate time trends. The R...

We examined trends in severe functional limitations among working and non-working adults in Germany (ages 40–65). Four population-based samples of 11,615 participants were used, spanning the time periods 2002–2021. The overall prevalence of severe limitations was found to be 12.8% in the sample, but also varied from 10 to 20% according to occupatio...

Zusammenfassung Einleitung Der langfristige Anstieg der Lebenserwartung wirft die Frage auf, ob die gewonnene Lebenszeit mit einer Verlängerung der Jahre ohne gesundheitliche Einschränkungen einhergeht. Die Studie untersucht, wie sich die Lebenserwartung ohne funktionelle und Mobilitätseinschränkungen ab dem Alter 46 und 65 Jahre sowie ihre Anteil...

Zusammenfassung Hintergrund Unsere Studie fokussiert auf die Entwicklung der erkrankungsfreien Lebensjahre in Bezug auf 2 Erkrankungsgruppen mit hoher Public-Health-Relevanz: Muskel-Skelett- (MSE) und Herz-Kreislauf-Erkrankungen (HKE). Vor dem Hintergrund der steigenden Lebensarbeitszeit wird die Entwicklung der erkrankungsfreien Jahre der Bevölke...

Musculoskeletal diseases (MSDs) are a major predictor of early retirement. Against the backdrop of the extension of working life, we investigated time trends and educational inequalities in years spent in the labour market free of MSD. Based on German statutory health insurance data (N = 3,405,673), total life years free of MSD (Healthy Life Expect...

Limited lung function represents a serious health impairment. However, studies investigating changes in limited lung function over time are rare. Thus, the current study investigates time-related changes in limited lung function and potential social inequalities. Data from the 2008 and 2017 waves of the population-based German Aging Survey were use...

Background Due to the rising life expectancy in Western countries, the discussion about the increase in the retirement age is becoming more important. However, the prolongation of working lives cannot be implemented successfully without considering the health status of the (potential) employees. In this study, time trends in working life expectancy...

Background Earlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life expectancy gap between socioeconomic groups. This study examines how age- and cause-specific mortality contributions to the socioeconomic gap in life expectancy have chang...

Chronic obstructive pulmonary disease (COPD) is associated with smoking and work-related health hazards. Most studies have reported prevalences, and the number of studies examining incidences and social inequalities is small. We analyzed the development of social inequalities of COPD-incidences in terms of income and exacerbations in terms of hospi...

Background Against the backdrop of population ageing, governments are facing the need to raise the statutory retirement age. In this context, the question arises whether these extra years added to working life would be spent in good health. As cancer represents a main contributor to premature retirement this study focuses on time trends and educati...

Objectives Previous studies have observed increasing limitations among the middle-aged, including those aged 40–64, raising the question how healthy work participation has changed. Helping answer this question, we ask: How have general and specific limitations changed in working and non-working adults in Germany? Methods We used population-based d...

Zusammenfassung Ziele Zur Ermittlung der Prävalenz von chronischen Erkrankungen auf Basis von ambulanten Krankenkassendaten wird häufig auf eine wiederholte Nennung einer Diagnose im Laufe eines Jahres zurückgegriffen, meist in zwei oder mehr Quartalen (M2Q). Dabei bleibt bisher unklar, ob sich die Prävalenzschätzungen stark verändern, wenn anstatt...

Background Extending the number of active working years is an important goal both for maintaining individual quality of life and safeguarding social security systems. Against this background, we examined the development of healthy and unhealthy working life expectancy (HWLE/UHWLE) in the general population and for different educational groups. Met...

Objectives: Examine trends in limitations among young (15–39), middle-aged (40–64) and older age-groups (>=65) and their socioeconomic differences. Methods: Population-based European Social Survey data (N = 396,853) were used, covering 30 mostly European countries and spanning the time-period 2002–2018. Limitations were measured using a global acti...

Background Against the backdrop of prolonged working lives, more research is needed on whether the additional years in labour are spent in good health and which social inequalities exist. Previous studies investigating trends in working life expectancy (WLE) are usually based on survey data. Health insurance data represent an additional database th...

Angesichts der demografischen Alterung der Bevölkerung wird von einer wachsenden Zahl chronisch kranker Menschen ausgegangen und vor diesem Hintergrund ein Anstieg des gesundheitlichen Versorgungsbedarfs prognostiziert. Dieser eher pessimistischen Einschätzung einer Morbiditätsexpansion wird mit der These der Morbiditätskompression ein positives Zu...

Background Breast and prostate cancer represent two of the most common cancers in many high-income countries. So far, however, evidence is missing on time trends and social inequalities in life years spend free of cancer (CFLY). The aim of the study is to analyse time trends and income inequalities in CFLY. Methods The analyses are based on the da...

Background: While numerous studies suggest that single motherhood is associated with socioeconomic disadvantages and poor health, few studies have analyzed how these conditions have evolved over time. Addressing this gap, we examined the temporal development of self-rated health (SRH) among single compared to partnered mothers, and the role of soc...

Aims of the study: This study compared prevalences of myocardial infarction between data drawn from health interviews and claims data from statutory health insurance. Previous comparative studies have drawn comparisons without having considered possible differences in the sociodemographic structure of the underlying study populations. The approach...

Zusammenfassung Ziel der Studie Routinedaten von Krankenkassen sind als Datenquelle mittlerweile gut etabliert. Hinsichtlich der Verallgemeinerbarkeit der Ergebnisse bei Analysen mit Daten einer Krankenkasse treten Fragen der Repräsentativität der Versichertenpopulation auf, insbesondere da nicht alle Studien auf soziodemografische Merkmale adjusti...

Hintergrund: Trotz deutlicher Fortschritte bei der Prävention und Therapie ist Herzinfarkt (HI) noch immer eine der Haupttodesursachen und häufig mit langzeitzeitlichen Einschränkungen verbunden. Die bisherige Forschung zeigt, dass deutliche soziale Ungleichheiten bei Herzinfarkt bestehen. Bisher fehlt es jedoch an Studien zu Ungleichheiten in der...

Hintergrund: Die demografische Alterung stellt die sozialen Sicherungssysteme, allen voran das gesetzliche Rentensystem, vor wachsende Herausforderungen. Die Studie analysiert, wie sich die Lebenszeit, die gleichzeitig in Arbeit und in guter Gesundheit verbracht wird (Healthy Working Life Expectancy, HWLE), in der deutschen Bevölkerung entwickelt h...

Background Lung Cancer (LC) is one of the most prevalent cancer diseases. Due to the lack of databases which allow the combination of information on individual socioeconomic status (SES) and cancer incidence, research on social inequalities in LC among the German population is rare. The aim of the study is to analyse time trends in social inequalit...

Objectives While evidence suggests persisting health inequalities, research on whether these trends may vary according to different stages of life has rarely been considered. Against this backdrop, we analysed life stage-specific trends in educational inequalities in health-related quality of life (HRQOL) and poor self-rated health (SRH) for indivi...

Background Acute myocardial infarction (MI) remains a frequent health event and a major contributor to long-term impairments globally. So far, research on social inequalities in MI incidence and mortality with respect to MI severity is limited. Furthermore, evidence is lacking on disparities in the length of life affected by MI. This study investig...

The question of whether rising life expectancy has led to additional life years spent in good health or poor health is of major public health relevance. We tested the theories of compression or expansion of morbidity for Germany with respect to the mental and physical component summary scales (MCS/PCS) of the health-related quality of life (HRQOL)...

Background Lung Cancer (LC) is one of the most common malign diseases worldwide. So far, it is unclear if the development of LC incidence and mortality leads to morbidity compression or expansion and whether these developments differ by socioeconomic characteristics. This study analyses time trends in social and gender inequalities in life years wi...

Objectives: We investigated changes in the prevalence of disabilities among individuals with type 2 diabetes and analyzed the contribution of comorbidities on this change. Methods: Data were drawn from the Survey of Health, Ageing, and Retirement in Europe (SHARE). We estimated predicted probabilities of impaired (instrumental) activities of daily...

Background: Defining incident cases has always been a challenging issue for researchers working with routine data. Lookback periods should enable researchers to identify and exclude recurrent cases and increase the accuracy of the incidence estimation. There are different recommendations for lookback periods depending on a disease entity of up to...

Background Type 2 diabetes (T2D) is a rising global epidemic with lower socioeconomic status (SES) groups being more affected. Considering specific population subgroups to examine prevalence and SES inequalities in T2D is rare. In addition, using only one indicator to depict SES inequalities in health has been a common practice despite evidence on...

Type 2 diabetes (T2D) is a rising global epidemic with lower socioeconomic groups being more affected. Considering specific population subgroups to examine prevalence and socioeconomic inequalities in T2D is rare. Moreover, using one indicator to depict socioeconomic inequalities in health is a common practice despite evidence on differences in wha...

Background: Against the backdrop of rising statutory retirement age in Germany, we analyzed time trends in self-rated health (SRH) among the elderly population between 50 and 70 years of age and explored the mediating role of leisure time physical activity (LTPA) on the relationship between time period and self-rated health (SRH). Methods: We used...

Background Due to substantial improvements in prevention and therapy, stroke incidence and mortality rates have decreased during the last decades, but evidence is still lacking on whether all socioeconomic groups benefited equally and how the length of life affected by stroke developed over time. Our study investigates time trends in stroke-free li...

Objectives This study analyzes longitudinal trends in self-rated health (SRH) by taking age- and gender-specific differences into account. Methods Data of 29,251 women and 26,967 men were obtained from the German Socio-Economic Panel between 1995 and 2014. Generalized Estimation Equation analysis for logistic regression was used to estimate change...

Objectives International comparisons are suggesting that mortality inequalities may have changed in the last years, although not always into the same direction. Only a few studies examined myocardial infarction (MI). In our study, long-term developments of MI and all-cause mortality were considered by analysing social gradients by income. Methods...

Background According to James Fries morbidity compression is present if morbidity rates are decreasing to a larger extent than mortality rates. Compression also occurs if age at onset is increasing at a faster pace than age at death. These two variants of the compression hypothesis were formulated as a population concept. Compression has seldom bee...

Background: Previous research has produced evidence for social inequalities in multimorbidity, but little is known on how these disparities change over time. Our study investigates the development of social inequalities in multimorbidity among the middle-aged and older working population. Special attention is paid to whether differing time trends...

Die Entwicklung der Gesundheitsausgaben und der Einfluss des demografischen Wandels sind ein kontrovers diskutiertes Dauerthema. Die jährlichen Gesundheitsausgaben haben sich zwischen 1992 und 2015 absolut gesehen mehr als verdoppelt. Diese Steigerung wird häufig mit der demografischen Entwicklung begründet. Der größte Teil der Ausgaben wird durch...

AimTime trends in multimorbidity have rarely been examined and no criteria have been developed to measure the development of multimorbidity over time. Against the backdrop of increasing numbers of diagnoses a robust measure is needed that is sensitive to changes over time and allows to differentiate between multimorbid and non-multimorbid individua...

Objectives Our study examined how life years spent in multimorbidity changed over a period of 10 years (2005–2014) and whether morbidity expansion or compression has taken place. There is a little evidence on whether life years gained due to increasing life expectancy are spent in good health, or if they are accompanied by morbidity expansion. Meth...

Background This study estimates life expectancy with and without type 2 diabetes for individuals in Lower Saxony, Germany in order to detect a trend in population health. Methods Morbidity and mortality data derived from German administrative claims data (statutory health insurance, AOK Niedersachsen, N = 2,900,065) were used covering 10 years from...

AimThe population ageing raises the question of the further morbidity development. Morbidity compression, morbidity expansion, and dynamic equilibrium describe possible morbidity trends. So far, little research has been conducted on type 2 diabetes in this context. We examined which one of these concepts matches the development of the disease. Subj...