[Social class and health].

Gesundheitswesen

Robert Koch-Institut, Berlin.

Published: December 1999

This publication deals with the German social class and their interactions with health or illness. The analysis uses the data of the German National Health Interview and Examination Survey 1998. The results are as follows: During the last decade the proportion of inhabitants of lower social class has decreased in favour of the proportions of middle and upper social classes. The formerly observed differences between the eastern part (former GDR) and the western part of Germany have diminished or have even levelled to zero. Even today men in Germany belong more often to the upper social class than women. For the risk factors smoking, massive obesity and inactivity in sports a distinct gradient concerning the social class can be observed. Those belonging to lower social class are more often smokers, have significantly more often massive obesity and show more seldom activities in sports. Hypertension and hypercholesterolemia are more often observed in men of the upper social class than in those belonging to lower class while for women both mentioned risk factors are more often seen in the lower social class. With respect to morbidity different patterns can be observed. NIDDM, chronic bronchitis and gastric and duodenal ulcer are examples for higher prevalence data in the lower social class while allergic rhinitis can be observed more often in the higher class. The level of complaints is higher in the lower class than in the upper class. By differentiating according to the eastern or western part clear differences emerge concerning social class especially in the 'old Bundesländer' (western part). Members of the upper class estimates their health status clearly to be better than those study participants belonging to the lower class. This perhaps can be explained by their lower level of complaints. The contentedness concerning live and health-status is higher in the upper than in the lower class. Respecting the highest level of education, class-specific differences concerning drug utilization are observed doubly frequent in the 'old Bundesländer' compared to the 'new Bundesländer'. According to the level of complaints and the prevalence of diseases most drug groups are used more often in the lower than in the upper class whereas drugs with presumed preventive potential are clearly more often consumed in the upper class.

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