德国的贫困、健康与营养

Helmert U, Mielck A, Shea S

Center for Social Policy Research, University of Bremen, Germany.

Rev Environ Health. 1997 Jul-Sep;12(3):159-70. doi: 10.1515/REVEH.1997.12.3.159.

OBJECTIVE

To investigate the relation between poverty and several variables describing health and nutrition behavior in East Germany and West Germany.

METHODS

Data are from the third National Health Survey in West Germany and the first Health Survey for the new federal states of Germany (1991/92). Both health surveys included a self-administered questionnaire ascertaining sociodemographic variables, smoking history, nutritional behavior (using a food-frequency list), physical activity, and a medical examination comprising measurements of height, weight, blood pressure, and blood sampling for serum cholesterol determination. Participants included 4958 subjects in the West Survey and 2186 subjects in the East Survey aged 25-69 years, with a respective net response rate of 69.0% and 70.2%. Poverty was defined as a household equivalence income of 62.5% or less of the median income of the general population.

RESULTS

The lowest income group (poverty or near poverty) comprised 11.6% of East German versus 15.9% of West German males and 14.8% of East German versus 19.3% of West German females. For most but not all health and nutrition parameters, less favorable results were obtained for subjects with an equivalence income below or near poverty. The most striking poverty-related differences regarding cardiovascular disease risk factors were found for lack of regular exercise for both genders and obesity in females. No poverty-related differences were found for the prevalence of hypercholesterolemia, despite a much higher prevalence of obesity in persons with an income below the poverty line. Current nutritional behavior and changes in nutritional behavior during the last three years was strongly related to income status, with a more unhealthy status for low-income population groups in both East and West Germany.

CONCLUSIONS

In Germany, poverty has strong effects on individual health status and nutritional behavior. Because of rising unemployment rates and reductions in social security payments for low-income groups, it is likely that the negative consequences of poverty on health are increasing.

目的

研究德国东部和西部贫困与若干描述健康及营养行为的变量之间的关系。

方法

数据来自西德第三次全国健康调查以及德国新联邦州第一次健康调查（1991/92年）。两项健康调查均包含一份自填式问卷，用以确定社会人口统计学变量、吸烟史、营养行为（使用食物频率清单）、身体活动情况，以及一次包含身高、体重、血压测量和采集血样以测定血清胆固醇的医学检查。参与者包括西德调查中的4958名25至69岁的受试者以及东德调查中的2186名25至69岁的受试者，各自的净应答率分别为69.0%和70.2%。贫困定义为家庭等价收入为总人口中位数收入的62.5%或更低。

结果

收入最低组（贫困或接近贫困）在东德男性中占11.6%，在西德男性中占15.9%；在东德女性中占14.8%，在西德女性中占19.3%。对于大多数但并非所有的健康和营养参数而言，等价收入低于或接近贫困水平的受试者得到的结果较差。在心血管疾病风险因素方面，与贫困相关的最显著差异在于，男女缺乏定期锻炼以及女性肥胖。尽管收入低于贫困线者的肥胖患病率高得多，但在高胆固醇血症患病率方面未发现与贫困相关的差异。当前的营养行为以及过去三年中营养行为的变化与收入状况密切相关，德国东部和西部的低收入人群营养状况更不健康。