Zusammenfassung
Zahlreiche internationale Studien zeigen, dass Indizes Multipler Deprivation ein geeignetes Instrument zur Messung sozialräumlicher Effekte auf die Gesundheit der Bevölkerung und damit zur Sichtbarmachung sozialer Ungleichheiten darstellen. Auch für Deutschland liegt mit dem German Index of Multiple Deprivation ein derartiges etabliertes Werkzeug vor. Zukünftig sollten entsprechend fundierte Ergebnisse stärkere Berücksichtigung bei der Ressourcenallokation und medizinischen Bedarfsplanung finden.
Abstract
Numerous international studies show that Indices of Multiple Deprivation are a suitable instrument to determine socio-spatial effects on the health of the population and, thereby, to display social inequalities. For Germany, the German Index of Multiple Deprivation is such an established instrument. In the future, corresponding well-founded results should receive more attention when it comes to the allocation of resources or the planning of medical requirements.
Autorenerklärung
Autorenbeteiligung: Alle Autoren tragen Verantwortung für den gesamten Inhalt dieses Artikels und haben der Einreichung des Manuskripts zugestimmt. Finanzierung: Die Autoren erklären, dass sie keine finanzielle Förderung erhalten haben. Interessenkonflikt: Die Autoren erklären, dass kein wirtschaftlicher oder persönlicher Interessenkonflikt vorliegt. Ethisches Statement: Für die Forschungsarbeit wurden weder von Menschen noch von Tieren Primärdaten erhoben.
Author Declaration
Author contributions: All authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. Funding: Authors state no funding involved. Conflict of interest: Authors state no conflict of interest. Ethical statement: Primary data for human nor for animals were not collected for this research work.
Literatur
1. Townsend P. Poverty in the United Kingdom: a survey of household resources and standards of living. Berkeley and Los Angeles: University of California Press, 1979.10.1525/9780520325760Search in Google Scholar
2. Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med 2002;55:125–39.10.1016/S0277-9536(01)00214-3Search in Google Scholar
3. Ramsay SE, Morris RW, Whincup PH, Subramanian SV, Papacosta AO, Lennon LT, et al. The influence of neighbourhood-level socioeconomic deprivation on cardiovascular disease mortality in older age: longitudinal multilevel analyses from a cohort of older British men. J Epidemiol Community Health 2015;69:1224–31.10.1136/jech-2015-205542Search in Google Scholar PubMed PubMed Central
4. Walker JJ, Livingstone SJ, Colhoun HM, Lindsay RS, McKnight JA, Morris AD, et al. Effect of socioeconomic status on mortality among people with type 2 diabetes: a study from the Scottish Diabetes Research Network Epidemiology Group. Diabetes Care 2011;34:1127–32.10.2337/dc10-1862Search in Google Scholar PubMed PubMed Central
5. Fairburn J, Maier W, Braubach M. Incorporating environmental justice into second generation indices of multiple deprivation: lessons from the UK and progress internationally. Int J Environ Res Public Health 2016;13:750.10.3390/ijerph13080750Search in Google Scholar PubMed PubMed Central
6. Smith GD, Hart C, Watt G, Hole D, Hawthorne V. Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study. J Epidemiol Community Health 1998;52:399–405.10.2307/j.ctt1t8955q.12Search in Google Scholar
7. Galobardes B, Shaw M, Lawlor D, Davey Smith G, Lynch J. Indicators of socioeconomic position. In: Oakes JM, Kaufman JS, Hrsg. Methods in social epidemiology. San Francisco: Jossey-Bass, 2006:67–70.Search in Google Scholar
8. Noble M, Wright G, Smith G, Dibben C. Measuring multiple deprivation at the small-area level. Environ Plann A 2006;38:169–85.10.1068/a37168Search in Google Scholar
9. Maier W, Fairburn J, Mielck A. Regionale Deprivation und Mortalität in Bayern. Entwicklung eines Index Multipler Deprivation auf Gemeindeebene. [Regional Deprivation and Mortality in Bavaria. Development of a Community-Based Index of Multiple Deprivation]. Gesundheitswesen 2012;274:416–25.10.1055/s-0031-1280846Search in Google Scholar PubMed
10. Maier W, Holle R, Hunger M, Peters A, Meisinger C, Greiser KH, et al. The impact of regional deprivation and individual socio-economic status on the prevalence of Type 2 diabetes in Germany. A pooled analysis of five population-based studies. Diabet Med 2013;30:78–86.10.1111/dme.12062Search in Google Scholar PubMed
11. Bauer H, Maier W. GIMD 2010 – Ein Update des ‚German Index of Multiple Deprivation‘. Berichte des Helmholtz Zentrums München (2018), doi:10.15134/2018M0001.10.15134/2018M0001Search in Google Scholar
12. Office for National Statistics. Super Output Area (SOA) (Zitierdatum: 19.06.2017), aufrufbar unter http://webarchive.nationalarchives.gov.uk/20160105160709/http:/www.ons.gov.uk/ons/guide-method/geography/.Search in Google Scholar
13. Maier W. Indizes Multipler Deprivation zur Analyse regionaler Gesundheitsunterschiede in Deutschland. Bundesgesundheitsblatt 2017;60:1403–12.10.1007/s00103-017-2646-2Search in Google Scholar PubMed
14. Hofmeister C, Maier W, Mielck A, Stahl L, Breckenkamp J, Razum O. Regionale Deprivation in Deutschland: Bundesweite Analyse des Zusammenhangs mit Mortalität unter Verwendung des ‚German Index of Multiple Deprivation (GIMD)‘ [Regional Deprivation in Germany: Nation-wide Analysis of its Association with Mortality Using the German Index of Multiple Deprivation (GIMD)]. Gesundheitswesen 2016;78:42–8.10.1055/s-0034-1390421Search in Google Scholar PubMed
15. Maier W, Scheidt-Nave C, Holle R, Kroll LE, Lampert T, Du Y, et al. Area level deprivation is an independent determinant of prevalent type 2 diabetes and obesity at the national level in Germany. Results from the national telephone health interview surveys ‘German Health Update’ GEDA 2009 and 2010. PLoS One 2014;9:e8966.1.10.1371/journal.pone.0089661Search in Google Scholar PubMed PubMed Central
16. Kuznetsov L, Maier W, Hunger M, Meyer M, Mielck A. Associations between regional socioeconomic deprivation and cancer risk: analysis of population-based Cancer Registry data from Bavaria, Germany. Prev Med 2011;53:328–30.10.1016/j.ypmed.2011.07.021Search in Google Scholar PubMed
17. Kuznetsov L, Maier W, Hunger M, Meyer M, Mielck A. Regional deprivation in Bavaria, Germany: linking a new deprivation score with registry data for lung and colorectal cancer. Int J Public Health 2012;57:827–35.10.1007/s00038-012-0342-4Search in Google Scholar PubMed
18. Jansen L, Eberle A, Emrich K, Gondos A, Holleczeck B, Kajüter H, et al. Socioeconomic deprivation and cancer survival in Germany: an ecological analysis in 200 districts in Germany. Int J Cancer 2014;134:2951–60.10.1002/ijc.28624Search in Google Scholar PubMed
19. Bozorgmehr K, Maier W, Brenner H, Saum KU, Stock C, Miksch A, et al. Social disparities in Disease Management Programmes for coronary heart disease in Germany: a cross-classified multilevel analysis. J Epidemiol Community Health 2015;69:1091–101.10.1136/jech-2014-204506Search in Google Scholar PubMed PubMed Central
20. Bozorgmehr K, San Sebastian M, Brenner H, Razum O, Maier W, Saum KU, et al. Analysing horizontal equity in enrolment in Disease Management Programmes for coronary heart disease in Germany 2008–2010. Int J Equity Health 2015;14:28.10.1186/s12939-015-0155-1Search in Google Scholar PubMed PubMed Central
21. Siegel M, Mielck A, Maier W. Individual income, area deprivation, and health: do income-related health inequalities vary by small area deprivation? Health Econ 2015;24:1523–30.10.1002/hec.3102Search in Google Scholar PubMed
22. Beyerlein A, Koller D, Ziegler AG, Lack N, Maier W. Does charge-free screening improve detection of gestational diabetes in women from deprived areas: a cross-sectional study. BMC Pregnancy Childbirth 2016;16:266.10.1186/s12884-016-1060-3Search in Google Scholar PubMed PubMed Central
23. Koller D, Hoffmann F, Maier W, Tholen K, Windt R, Glaeske G. Variation in antibiotic prescriptions: is area deprivation an explanation? Analysis of 1.2 million children in Germany. Infection 2013;41:121–7.10.1007/s15010-012-0302-1Search in Google Scholar PubMed
24. Bauer J, Müller P, Maier W, Groneberg DA. Orthopedic workforce planning in Germany – an analysis of orthopedic accessibility. PLoS One 2017;12:e0171747.10.1371/journal.pone.0171747Search in Google Scholar PubMed PubMed Central
25. Eberle A, Luttmann S, Foraita R, Pohlabeln H. Socioeconomic inequalities in cancer incidence and mortality – a spatial analysis in Bremen, Germany. J Public Health 2010;18: 227–35.10.1007/s10389-009-0306-1Search in Google Scholar
26. Meinlschmidt G, Hrsg. Sozialstrukturatlas Berlin 2003 – Ein Instrument der quantitativen, interregionalen und intertemporalen Sozialraumanalyse und – planung. Spezialbericht 20041. Berlin: Senatsverwaltung für Gesundheit, Soziales und Verbraucherschutz, 2004.Search in Google Scholar
27. Albrecht M, Nolting HD, Schliwen A. Konzept zur Neuordnung der ärztlichen Bedarfsplanung. G&S Gesundheits-und Sozialpolitik 2012;66:29–35.10.5771/1611-5821-2012-5-29Search in Google Scholar
28. Schulz M, Czihal T, Erhart M, Stillfried D. Korrelation zwischen räumlichen Sozialstrukturfaktoren und Indikatoren des medizinischen Versorgungsbedarfs. Gesundheitswesen 2016;78: 290–7.10.1055/s-0034-1396888Search in Google Scholar PubMed
29. Kroll L, Schumann M, Hoebel J, Lampert T. Regionale Unterschiede in der Gesundheit – Entwicklung eines sozioökonomischen Deprivationsindex für Deutschland. Journal of Health Monitoring 2017;2:103–19.Search in Google Scholar
30. Asaria M, Griffin S, Cookson R. Distributional cost-effectiveness analysis: a tutorial. Med Decis Making 2016;36:8–19.10.1177/0272989X15583266Search in Google Scholar PubMed PubMed Central
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