Lampert Thomas, Hoebel Jens
Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
Z Gerontol Geriatr. 2019 Feb;52(Suppl 1):91-99. doi: 10.1007/s00391-018-01487-y. Epub 2018 Dec 19.
Socioeconomic differences in health and life expectancy are key issues for public health and health policy. In the course of demographic change, in addition to childhood, adolescence and middle adulthood, old age is increasingly becoming the focus of attention in research on health inequalities, with a special emphasis on the transition from working age to retirement.
How do health inequalities change in the transition from middle to older age and then to very old age?
This article reviews the studies available for Germany, supplemented with new analyses based on the German Health Update study and the German Socioeconomic Panel study. In order to set the findings in the context of international research on health inequalities in old age, selected studies from other countries and international comparative studies are additionally considered.
Social differences in health and remaining life-expectancy also exist in older age, although to a slightly lesser extent than in middle age. There is evidence that as age progresses, health inequalities narrow in some health domains but there is also isolated evidence that health inequalities may widen with age.
The existence of health inequalities in old age indicates that older people from disadvantaged social groups have a particular need for healthcare and support. This poses special challenges for the medical, nursing and psychosocial care system as well as for the social security systems.
健康和预期寿命方面的社会经济差异是公共卫生和卫生政策的关键问题。在人口结构变化过程中,除了儿童期、青春期和中年期外,老年期在健康不平等研究中越来越受到关注,特别强调从工作年龄到退休的过渡阶段。
从中年到老年再到高龄阶段,健康不平等是如何变化的?
本文回顾了德国现有的研究,并辅以基于德国健康更新研究和德国社会经济面板研究的新分析。为了将研究结果置于国际老年健康不平等研究的背景下,还考虑了其他国家的部分研究和国际比较研究。
老年阶段也存在健康和剩余预期寿命方面的社会差异,尽管程度略低于中年阶段。有证据表明,随着年龄增长,某些健康领域的健康不平等有所缩小,但也有个别证据表明健康不平等可能会随着年龄增长而扩大。
老年阶段存在健康不平等表明,来自弱势社会群体的老年人对医疗保健和支持有特殊需求。这给医疗、护理和心理社会护理系统以及社会保障系统带来了特殊挑战。