Background
Methods
Study design and study population
Men (n = 10 406) | Women (n = 16 149) | |||||
---|---|---|---|---|---|---|
n | %1
| %2
| n | %1
| %2
| |
Age
| ||||||
35–44 years | 2816 | 27.1 | 26.0 | 4591 | 28.4 | 22.8 |
45–54 years | 2747 | 26.4 | 25.9 | 4313 | 26.7 | 23.0 |
55–64 years | 2082 | 20.0 | 18.8 | 3203 | 19.8 | 17.8 |
65–74 years | 2004 | 19.3 | 20.6 | 2748 | 17.0 | 22.9 |
75+ years | 757 | 7.3 | 8.8 | 1294 | 8.0 | 13.5 |
Socioeconomic status
| ||||||
Low | 1205 | 11.6 | 20.5 | 2034 | 12.6 | 24.2 |
Medium | 5826 | 56.0 | 61.2 | 10180 | 63.0 | 62.6 |
High | 3291 | 31.6 | 18.3 | 3893 | 24.1 | 13.2 |
Missing | 84 | 0.8 | – | 42 | 0.3 | – |
Marital status
| ||||||
Single | 1555 | 14.9 | 12.0 | 1704 | 10.6 | 6.9 |
Separated/divorced/widowed | 1786 | 17.2 | 13.4 | 5089 | 31.5 | 29.5 |
Married and living together | 7046 | 67.7 | 74.6 | 9337 | 57.8 | 63.6 |
Missing | 19 | 0.2 | – | 19 | 0.1 | – |
Health check attendance
Predisposing factors
Enabling factors
Need factors
Statistical analysis
Results
Bivariate analysis
Men | Women | |||
---|---|---|---|---|
% (95% CI) | p-value | % (95% CI) | p-value | |
Total
| 50.8 (49.6–52.0) | 49.8 (48.8–50.9) | ||
Predisposing factors
| ||||
Age
| ||||
35–44 years | 32.7 (30.5–34.9) | 36.1 (34.4–37.8) | ||
45–54 years | 48.8 (46.5–51.2) | 48.5 (46.6–50.4) | ||
55–64 years | 61.0 (58.3–63.6) | 54.7 (52.5–56.9) | ||
65–74 years | 64.7 (61.8–67.4) | 59.7 (57.2–62.2) | ||
75+ years | 55.9 (51.2–60.6) | <0.001 | 52.4 (48.8–56.0) | <0.001 |
Socioeconomic status
| ||||
Low | 45.0 (41.7–48.4) | 45.5 (42.9–48.3) | ||
Medium | 51.1 (49.5–52.6) | 51.3 (50.1–52.6) | ||
High | 55.9 (53.9–57.9) | <0.001 | 50.6 (48.7–52.5) | <0.001 |
Marital status
| ||||
Single | 36.0 (32.9–39.3) | 40.2 (37.2–43.2) | ||
Separated/divorced/widowed | 47.2 (44.0–50.4) | 51.4 (49.5–53.3) | ||
Married and living together | 53.8 (52.4–55.3) | <0.001 | 50.2 (48.8–51.5) | <0.001 |
Enabling factors
| ||||
Statutory health insurance
| ||||
AOK | 47.8 (45.4–50.3) | 47.3 (45.2–49.4) | ||
EK | 55.0 (53.1–56.9) | 51.3 (49.9–52.8) | ||
BKK | 50.1 (47.5–52.7) | 50.6 (48.1–53.0) | ||
Other | 47.8 (44.1–51.5) | <0.001 | 50.4 (46.8–53.9) | <0.05 |
Social support
| ||||
Poor | 43.6 (40.4–46.8) | 45.5 (42.9–48.2) | ||
Intermediate | 51.9 (50.1–53.6) | 50.5 (49.0–52.0) | ||
Strong | 54.0 (51.8–56.1) | <0.001 | 51.9 (50.1–53.7) | <0.001 |
Type of residential area
| ||||
Rural and sparsely populated | 50.2 (47.1–53.2) | 48.0 (45.3–50.6) | ||
Rural with concentration signs | 52.3 (49.3–55.3) | 49.6 (46.9–52.2) | ||
Urban | 52.5 (50.5–54.5) | 51.0 (49.3–52.7) | ||
Metropolitan | 48.4 (46.0–50.8) | n.s. | 49.7 (47.8–51.6) | n.s. |
Need factors
| ||||
Obesity
| ||||
No | 50.2 (48.8–51.6) | 49.6 (48.4–50.8) | ||
Yes | 53.6 (50.7–56.5) | <0.05 | 52.7 (50.0–55.3) | <0.05 |
Physical activity
| ||||
Active | 52.0 (50.1–54.0) | 51.5 (49.8–53.2) | ||
Slightly active | 50.5 (48.5–52.5) | 51.5 (49.8–53.2) | ||
Not active at all | 49.1 (46.4–51.7) | n.s. | 46.3 (44.2–48.5) | <0.001 |
Smoking
| ||||
Non-smoker | 55.2 (53.7–56.7) | 52.9 (51.7–54.2) | ||
Smoker | 41.2 (39.0–43.4) | <0.001 | 40.0 (38.1–41.9) | <0.001 |
Alcohol consumption
| ||||
Never | 48.3 (44.9–51.9) | 45.0 (42.7–47.2) | ||
Moderate | 51.9 (50.2–53.5) | 51.9 (50.5–53.3) | ||
Hazardous | 50.0 (47.8–52.3) | n.s. | 51.1 (48.8–53.3) | <0.001 |
Fruit/vegetable consumption
| ||||
Low | 42.7 (40.3–45.0) | 38.9 (36.3–41.5) | ||
Medium | 53.2 (51.6–54.8) | 51.0 (49.6–52.4) | ||
High | 59.6 (56.1–63.0) | <0.001 | 54.6 (52.6–56.7) | <0.001 |
Self-rated health
| ||||
Very good/good | 49.6 (48.1–51.1) | 48.1 (46.8–49.3) | ||
Fair/poor/very poor | 53.1 (50.8–55.3) | <0.05 | 52.8 (50.9–54.6) | <0.001 |
Outpatient care use
| ||||
Low | 35.1 (33.0–37.2) | 33.2 (31.2–35.2) | ||
Medium | 57.2 (55.5–58.9) | 54.1 (52.7–55.4) | ||
High | 60.2 (57.0–63.3) | <0.001 | 58.3 (55.7–60.8) | <0.001 |
Age-adjusted analysis
Men | Women | |||
---|---|---|---|---|
Age-adjusted OR (95% CI) | Multiple-adjusted OR (95% CI) | Age-adjusted OR (95% CI) | Multiple-adjusted OR (95% CI) | |
Predisposing factors
| ||||
Age
| ||||
35–44 years | – | 1.00 (Ref.) | – | 1.00 (Ref.) |
45–54 years | – | 2.03 (1.75-2.36)*** | – | 1.63 (1.45-1.83)*** |
55–64 years | – | 3.21 (2.71-3.80)*** | – | 2.03 (1.78-2.31)*** |
65–74 years | – | 3.33 (2.76-4.01)*** | – | 2.54 (2.18-2.96)*** |
75+ years | – | 2.52 (1.92-3.30)*** | – | 2.26 (1.82-2.81)*** |
Socioeconomic status
| ||||
Low | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Medium | 1.34 (1.15–1.57)*** | 1.22 (1.02-1.45)* | 1.42 (1.26–1.61)*** | 1.35 (1.16-1.56)*** |
High | 1.70 (1.44–2.00)*** | 1.43 (1.18-1.74)*** | 1.56 (1.37–1.79)*** | 1.34 (1.14-1.59)*** |
Marital status
| ||||
Single | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Separated/divorced/widowed | 1.07 (0.87–1.31) | 1.08 (0.87-1.35) | 1.16 (0.99–1.35) | 1.19 (1.00-1.41) |
Married and living together | 1.55 (1.32–1.82)*** | 1.44 (1.21-1.72)*** | 1.26 (1.09–1.45)** | 1.17 (1.00-1.36)* |
Enabling factors
| ||||
Statutory health insurance
| ||||
AOK | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
EK | 1.34 (1.18–1.53)*** | 1.06 (0.91-1.23) | 1.21 (1.09–1.34)*** | 1.04 (0.92-1.17) |
BKK | 1.26 (1.09–1.47)** | 1.09 (0.92-1.29) | 1.28 (1.12–1.47)*** | 1.25 (1.08-1.45)** |
Other | 1.11 (0.92–1.33) | 1.00 (0.82-1.23) | 1.17 (0.98–1.38) | 1.10 (0.91-1.32) |
Social support
| ||||
Poor | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Intermediate | 1.49 (1.28–1.74)*** | 1.33 (1.13-1.58)*** | 1.28 (1.13–1.45)*** | 1.15 (1.00-1.32) |
Strong | 1.73 (1.47–2.04)*** | 1.49 (1.24-1.78)*** | 1.41 (1.24–1.61)*** | 1.24 (1.07-1.43)** |
Type of residential area
| ||||
Rural and sparsely populated | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Rural with concentration signs | 1.10 (0.92-1.31) | 1.17 (0.96-1.42) | 1.07 (0.92-1.21) | 1.05 (0.89-1.24) |
Urban | 1.14 (0.98–1.33) | 1.18 (0.99-1.39) | 1.15 (1.01–1.30)* | 1.13 (0.98-1.30) |
Metropolitan | 0.94 (0.80–1.11) | 1.09 (0.91-1.30) | 1.06 (0.92–1.21) | 1.08 (0.93-1.26) |
Need factors
| ||||
Obesity
| ||||
No | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Yes | 1.08 (0.95–1.24) | 1.03 (0.88-1.19) | 1.02 (0.91–1.15) | 1.08 (0.94-1.23) |
Physical activity
| ||||
Active | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Slightly active | 0.92 (0.81–1.03) | 0.87 (0.77-0.99)* | 1.01 (0.92–1.11) | 0.94 (0.85-1.04) |
Not active at all | 0.70 (0.61–0.81)*** | 0.79 (0.68-0.93)** | 0.70 (0.62–0.79)*** | 0.78 (0.69-0.89)*** |
Smoking
| ||||
Non-smoker | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Smoker | 0.68 (0.61–0.76)*** | 0.78 (0.68-0.88)*** | 0.67 (0.61–0.74)*** | 0.77 (0.69-0.85)*** |
Alcohol consumption
| ||||
Never | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Moderate | 1.21 (1.03–1.41)* | 1.07 (0.90-1.28) | 1.43 (1.28–1.60)*** | 1.30 (1.15-1.48)*** |
Hazardous | 1.12 (0.95–1.33) | 1.05 (0.86-1.27) | 1.38 (1.21–1.58)*** | 1.29 (1.11-1.50)*** |
Fruit/vegetable consumption
| ||||
Low | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Medium | 1.39 (1.23–1.57)*** | 1.19 (1.04-1.36)* | 1.51 (1.34–1.71)*** | 1.39 (1.21-1.59)*** |
High | 1.69 (1.41–2.01)*** | 1.36 (1.12-1.65)** | 1.70 (1.48–1.96) *** | 1.43 (1.23-1.68)*** |
Self-rated health
| ||||
Very good/good | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Fair/poor/very poor | 0.91 (0.81–1.02) | 0.82 (0.71-0.94)** | 1.03 (0.93–1.13) | 0.94 (0.83-1.05) |
Outpatient care use
| ||||
Low | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) | 1.00 (Ref.) |
Medium | 2.25 (1.99–2.54)*** | 2.26 (1.98-2.58)*** | 2.26 (2.03–2.52)*** | 2.16 (1.93-2.42)*** |
High | 2.41 (2.04–2.85)*** | 2.86 (2.35-3.47)*** | 2.55 (2.22–2.93)*** | 2.59 (2.21-3.04)*** |