Hoebel Jens, Kuntz Benjamin, Moor Irene, Kroll Lars Eric, Lampert Thomas
Unit of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Straße 62-66, 12101, Berlin, Germany.
Institute of Medical Sociology, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Germany.
BMC Res Notes. 2018 Mar 27;11(1):200. doi: 10.1186/s13104-018-3299-4.
Time trends in health inequalities have scarcely been studied in Germany as only few national data have been available. In this paper, we explore trends in socioeconomic inequalities in the prevalence of chronic illness using Germany-wide data from four cross-sectional health surveys conducted between 2003 and 2012 (n = 54,197; ages 25-69 years). We thereby expand a prior analysis on post-millennial inequality trends in behavioural risk factors by turning the focus to chronic illness as the outcome measure. The regression-based slope index of inequality (SII) and relative index of inequality (RII) were calculated to estimate the extent of absolute and relative socioeconomic inequalities in chronic illness, respectively.
The results for men revealed a significant increase in the extent of socioeconomic inequalities in chronic illness between 2003 and 2012 on both the absolute and relative scales (SII = 0.06, SII = 0.17, p-trend = 0.013; RII = 1.18, RII = 1.57, p-trend = 0.013). In women, similar increases in socioeconomic inequalities in chronic illness were found (SII = 0.05, SII = 0.14, p-trend = 0.022; RII = 1.14, RII = 1.40, p-trend = 0.021). Whereas in men this trend was driven by an increasing prevalence of chronic illness in the low socioeconomic group, the trend in women was predominantly the result of a declining prevalence in the high socioeconomic group.
由于仅有少量全国性数据，德国几乎未对健康不平等的时间趋势进行研究。在本文中，我们利用2003年至2012年间进行的四项全国性横断面健康调查的数据（n = 54197；年龄在25 - 69岁之间），探讨慢性病患病率方面社会经济不平等的趋势。我们通过将重点转向慢性病作为结果指标，从而扩展了对千禧年后行为风险因素不平等趋势的先前分析。计算基于回归的不平等斜率指数（SII）和不平等相对指数（RII），分别估计慢性病中绝对和相对社会经济不平等的程度。
男性的结果显示，2003年至2012年间，慢性病社会经济不平等程度在绝对和相对尺度上均显著增加（SII = 0.06，SII = 0.17，p趋势 = 0.013；RII = 1.18，RII = 1.57，p趋势 = 0.013）。在女性中，也发现慢性病社会经济不平等有类似增加（SII = 0.05，SII = 0.14，p趋势 = 0.022；RII = 1.14，RII = 1.40，p趋势 = 0.021）。在男性中，这一趋势是由低社会经济群体中慢性病患病率上升推动的，而女性中的趋势主要是高社会经济群体患病率下降的结果。
