nach oben

Journal of Public Health

Erschienen in:

01.06.2005 | Original Article

The impact of occupation and family status on overall mortality in a cohort of male members of a health insurance fund in Germany

verfasst von: Uwe Helmert

Erschienen in: Journal of Public Health | Ausgabe 3/2005

Einloggen, um Zugang zu erhalten

Abstract

Aim

The aim of the study was to evaluate the impact of occupation, family status, and smoking on overall mortality in males in Germany.

Subjects and methods

This study used data from a longitudinal register of the “Gmuender Ersatzkasse” (GEK), a German health insurance fund, for the time period between January 1989 and December 2000. Included in the analysis were male members of the GEK who were employed on 1 January 1989 and who were born between 1935 and 1950. Only those occupations were considered for which the frequency exceeded 1,000 cases. Thus, 17 occupations comprising 80,716 individuals were included. The statistical analysis was performed utilizing the software package “Transitional Data Analysis” (TDA) and employing the Kaplan-Meier life-table approach and a multivariate survival analysis applying the Cox regression method.

Results

Statistically increased relative risks for total mortality were observed for non-married persons, for the four main occupational groups with a lower status, for 13 occupations with medium or lower status, and for occupations yielding a smoking prevalence rate of 40% and more.

Conclusions

Longitudinal data from health insurance funds in Germany provide a valuable resource for social epidemiological investigations. The findings suggest that the occupational setting has a strong impact on overall mortality experience in Germany.

Berkman LF, Syme SL (1979) Social networks, host resistance and mortality: a nine-year follow-up study of Alameda Country residents. Am JEpidemiol 109:186–204

Blossfeld HP (1989) Kohortendifferenzierung und Karriereprozeß Eine Längsschnittstudie über die Veränderung der Bildungs- und Berufschancen im Lebensverlauf. Frankfurt/Main, Campus

Blossfeld HP, Rohwer G (2002) Techniques of event history modeling. New approaches to causal analysis, 2nd edn. Lawrence Erlbaum, Mahwah

Davey Smith G (2003) Health inequalities: lLife course approaches. Studies in poverty, inequality and social exclusion. Policy Press, Bristol

Diderichsen F, Hallqvist J (1997) Trends in occupational mortality among middle-aged men in Sweden 1961–1990. Int J Epidemiol 26:782–787

Doll R (2000) Fifty years of research on tobacco. J Epidemiol Biostat 5:321–329

Geyer S, Peter R (1999) Occupational status and all-cause mortality: a study with health insurance data from Nord Rhein-Westfalen, Germany. Eur J Public Health 9:119–123

Helmert U (2003) Soziale Ungleichheit und Krankheitsrisiken. Maro, Augsburg

Helmert U, Borgers D (1998) Rauchen und Beruf. Eine Analyse von 100 000 Befragten des Mikrozensus 1995. Bundesgesundheitsblatt 41:102–107

Helmert U, Shea S, Bammann K (1997) The impact of occupation on self-reported cardiovascular morbidity in Western Germany: gender differences. Rev Environ Health 12:25–42

Helmert U, Shea S, Bammann K (1999) Social correlates of cigarette-smoking cessation. Rev Environ Health 14:239–250

Huber L, Hebel D, Stahl R (1998) 120 Jahre GEK. Eberle, Schwäbisch Gmünd

Hu Y, Goldman N (1990) Mortality differentials by marital status: an international comparison. Demography 27:233–250

Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481

Klein T (1993) Soziale Determinanten der Lebenserwartung. Kölner Z Soziol Sozialpsychol 45:712–730

Klosterhuis H, Müller-Fahrnow W (1994) Sozialschicht und Sterblichkeit bei männlichen Angestellten aus den alten Bundesländern. In: Mielck A (ed) Krankheit und soziale Ungleichheit. Ergebnisse der sozialepidemiologischen Forschung in Deutschland. Leske und Budrich, Opladen, pp 319–330

Kunst AE (1997) Cross-national comparisons of socio-economic differences in mortality. Erasmus University, Rotterdam

Kunst AE, Groenhof F, Mackenbach JP, EU Working Group on Socioeconomic Inequalities in Health (1998) Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. BMJ 316:1636–1642

Lahelma E, Arber S (1994) Health inequalities among men and women in contrasting welfare states. Britain and three Nordic countries compared. Eur J Public Health 4:213–226

Mackenbach JP, Kunst AE, Cavalaars AEJM, Groenhof F, Geurts JJM, EU Working Group on Socioeconomic Inequalities in Health (1997) Socioeconomic inequalities in morbidity and mortality in Western Europe. Lancet 349:1655–1659

Mackenbach JP, Kunst AE, Groenhof F, Borgan JK, Costa G, Faggiano F, Jozan P, Leinsalu M, Martikainen P, Rychtarikova J, Valkonen T (1999) Socioeconomic inequalities in mortality among women and among men: an international study. Am J Public Health 89:1800–1806

Mackenbach JP, Bos V, Andersen O, Cardano M, Costa G, Herding S, Reid A, Hemström Ö, Valkonen T, Kunst AE (2003) Widening socioeconomic inequalities in mortality in six Western European countries. Int J Epidemiol 32:830–837

Marmot M, Wilkinson RG (1999) Social determinants of health. Oxford University Press, Oxford

Mielck A, Giraldes MR (1993) Inequalities in health and health care. Review of selected publications from 18 Western Europe countries. Waxman, Muenster

Neumann G, Liedermann A (1981) Mortalität und Sozialschicht. Bundesgesundheitsblatt 24:173–181

Peto R, Lopez AD, Boreham J, et al (1992) Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet 339:1268–1278CrossRefPubMed

Rosenbrock R (2001) Der neue § 20 SGB V als Gestaltungsherausforderung für die Selbstverwaltung der GKV. Die Betriebskrankenkasse 20:12–17

Sorlie PD, Backlund E, Keller JB (1995) U.S. mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am Journal Public Health 85:949–956

Statistisches Bundesamt (1992) Klassifizierung der Berufe. Abgeleitete Fassung für Zwecke des Mirkozensus und der EG-Arbeitskräftestichprobe, Wiesbaden

Valkonen T (1998) Die Vergrößerung der sozioökonomischen Unterschiede in der Erwachsenenmortalität durch Status und deren Ursachen. Z Bevölkerungswis 23:263–292

Titel: The impact of occupation and family status on overall mortality in a cohort of male members of a health insurance fund in Germany
verfasst von: Uwe Helmert
Publikationsdatum: 01.06.2005
Verlag: Springer-Verlag
Erschienen in: Journal of Public Health / Ausgabe 3/2005
Print ISSN: 2198-1833
Elektronische ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-005-0100-7

Springer Medizin

Abstract

Aim

Subjects and methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2005

Active health promotion in old age: methodology of a preventive intervention programme provided by an interdisciplinary health advisory team for independent older people

First results of the introduction of DRGs in Germany and overview of experience from other DRG countries

Comparative health assessment among migrants and Germans: combined results of a school health examination and a health survey among parents

Changes in society’s fabric

Use of medical emergency services

Award for junior scientists at German universities in the field of Medical Sociology