Hoebel Jens, Rommel Alexander, Schröder Sara Lena, Fuchs Judith, Nowossadeck Enno, Lampert Thomas
Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
Division of Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany.
Int J Environ Res Public Health. 2017 Sep 26;14(10):1127. doi: 10.3390/ijerph14101127.
Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived from the Robert Koch Institute's cross-sectional German Health Update study. The sample was restricted to participants aged 50-85 years ( = 11,811). Socioeconomic status (SES) was measured based on education, (former) occupation, and income. Odds ratios and prevalence differences were estimated using logistic regression and linear probability models, respectively. Our results show that self-reported health problems were more prevalent among men and women with lower SES. The extent of SES-related health inequalities decreased at older ages, predominantly among men. Although the prevalence of perceived unmet needs for healthcare was low overall, low SES was associated with higher perceptions of unmet needs in both sexes and for several kinds of health services. In conclusion, socioeconomic inequalities in health exist in a late working age and early retirement but may narrow at older ages, particularly among men. Socially disadvantaged elderly people perceive greater barriers to accessing healthcare services than those who are better off.
对德国老年人口健康不平等问题的研究相对较少。本研究考察了健康方面的社会经济不平等以及对医疗保健未满足需求的感知情况，并探讨了德国老年人健康不平等随年龄的变化动态。数据来源于罗伯特·科赫研究所的横断面德国健康状况更新研究。样本仅限于50 - 85岁的参与者（ = 11,811）。社会经济地位（SES）基于教育程度、（以前的）职业和收入来衡量。分别使用逻辑回归和线性概率模型估计比值比和患病率差异。我们的结果表明，自我报告的健康问题在社会经济地位较低的男性和女性中更为普遍。与社会经济地位相关的健康不平等程度在老年时有所下降，主要是在男性中。虽然总体上对医疗保健未满足需求的感知患病率较低，但低社会经济地位与男女对多种健康服务未满足需求的更高感知相关。总之，社会经济不平等在临近工作年龄后期和提前退休阶段存在，但在老年时可能会缩小，尤其是在男性中。社会处境不利的老年人比条件较好的老年人感受到获取医疗服务的障碍更大。
