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Trends in good self-rated health in Germany between 1995 and 2014: do age and gender matter?

  • Original article
  • Published:
International Journal of Public Health

Abstract

Objectives

This study analyzes longitudinal trends in self-rated health (SRH) by taking age- and gender-specific differences into account.

Methods

Data of 29,251 women and 26,967 men were obtained from the German Socio-Economic Panel between 1995 and 2014. Generalized Estimation Equation analysis for logistic regression was used to estimate changes in odds of (very) good SRH over time. Development of (un)healthy life expectancy was calculated by applying the Sullivan method.

Results

While in women, the odds of good SRH increased significantly over time for the ages 41–50 to 71–80 years, improvements among men were most apparent for the ages 61–70 and 71–80 years. By contrast, for both genders, no improvements in SRH were found in the youngest (31–40 years) and eldest age group (81–90 years) and in men aging 51–60 years. Over time, healthy life expectancy at age 31 increased by 3 years in women and 2 years in men, leading to a reduced but not eliminated gender gap in SRH.

Conclusions

Our findings support the hypothesis of relative compression of morbidity. However, trends in SRH differed according to age and gender, calling for health promotion efforts that meet diverse needs at different stages of life.

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References

  • Aguilar-Palacio I, Carrera-Lasfuentes P, Sánchez-Recio R, Alonso JP, Rabanaque MJ (2018) Recession, employment and self-rated health: a study on the gender gap. Public Health 154:44–50

    Article  CAS  PubMed  Google Scholar 

  • Assari S (2016) Gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults. SAGE Open Med 4:1–8

    Article  Google Scholar 

  • Boerma T, Hosseinpoor AR, Verdes E, Chatterji S (2016) A global assessment of the gender gap in self-reported health with survey data from 59 countries. BMC Public Health 16:675

    Article  PubMed  PubMed Central  Google Scholar 

  • Clarfield AM (2018) Healthy life expectancy is expanding. JAGS 66:202

    Article  Google Scholar 

  • Clause-Verdreau AC, Audureau É, Leplege A, Coste J (2019) Contrasted trends in health-related quality of life across gender, age categories and work status in France, 1995–2016: repeated population-based cross-sectional surveys using the SF-36. J Epidemiol Community Health 73:65–72

    Article  PubMed  Google Scholar 

  • Cummings JL, Jackson PB (2008) Race, gender, and SES disparities in self-assessed health, 1974-2004. ROA 30:137–168

    Google Scholar 

  • Debiasi E (2018) Age-period-cohort analysis: a summary of analytical approaches and results. Centre for Economic Demography and Department of Economic History, Lund University. http://longpop-itn.eu/wp-content/uploads/2018/05/EDebiasi_Age-Period-Cohort-Analysis.pdf. Accessed 02 Feb 2018

  • Denton M, Prus S, Walters V (2004) Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health. Soc Sci Med 58:2585–2600

    Article  PubMed  Google Scholar 

  • DeSalvo KB, Fan VS, McDonell MB, Fihn SD (2005) Predicting mortality and healthcare utilization with a single question. Health Serv Res 40:1234–1246

    Article  PubMed  PubMed Central  Google Scholar 

  • Destatis (2017) Sterbetafel—Methoden- und Ergebnisbericht zur laufenden Berechnung von Periodensterbetafeln für Deutschland und die Bundesländer. www.destatis.de. Accessed 02 Feb 2018

  • European Union (2013) Health inequalities in the EU—final report of a consortium. Consortium lead: Sir Michael Marmot. https://ec.europa.eu/health/sites/health/files/social_determinants/docs/healthinequalitiesineu_2013_en.pdf. Accessed 02 Feb 2018

  • Fiedler C, Grünheid E, Sulak H (2017) Bevölkerung in Deutschland. Geographische Rundschau 11/2017. Bundesinstitut für Bevölkerungsforschung (BiB) (Hrsg.), Wiesbaden

  • Franke J, Wetzel M (2017) Länger zufrieden arbeiten? Qualität und Ausgestaltung von Erwerbstätigkeit in der zweiten Lebenshälfte. In: Mahne K, Wolff JK, Simonson J, Tesch-Römer C (eds) Altern im Wandel. Zwei Jahrzehnte Deutscher Alterssurvey (DEAS). Springer, Wiesbaden, pp 47–63

    Google Scholar 

  • Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303:130–135

    Article  CAS  PubMed  Google Scholar 

  • Fries JF, Bruce B, Chakravarty E (2011) Compression of morbidity 1980–2011: a focused review of paradigms and progress. J Aging Res. https://doi.org/10.4061/2011/261702

    Article  PubMed  PubMed Central  Google Scholar 

  • Galenkamp H, Braam AW, Huisman M, Deeg DJ (2013) Seventeen-year time trend in poor self-rated health in older adults: changing contributions of chronic diseases and disability. Eur J Public Health 23:511–517

    Article  PubMed  Google Scholar 

  • Gärtner K, Scholz R (2005) Lebenserwartung in Gesundheit. In: Gärtner K, Grünheid E, Luy M (eds) Lebensstile, Lebensphasen, Lebensqualität. Interdisziplinäre Analysen von Gesundheit und Sterblichkeit aus dem Lebenserwartungssurvey des BIB. VS Verlag für Sozialwissenschaften, Wiesbaden, pp 311–331

    Google Scholar 

  • Golinowska S, Groot W, Baji P, Pavlova M (2016) Health promotion targeting older people. BMC Health Serv Res 16:345

    Article  PubMed  PubMed Central  Google Scholar 

  • Gruenberg EM (1977) The failures of success. Milbank Meml Fund Q Health Soc 55:3–24

    Article  CAS  Google Scholar 

  • Hanibuchi T, Nakaya T, Honjo K (2016) Trends in socioeconomic inequalities in self-rated health, smoking, and physical activity of Japanese adults from 2000 to 2010. SSM Popul Health 2:662–673

    Article  PubMed  PubMed Central  Google Scholar 

  • Hill TD, Needham BL (2006) Gender-specific trends in educational attainment and self-rated health, 1972–2002. Am J Public Health 96:1288–1292

    Article  PubMed  PubMed Central  Google Scholar 

  • Hobcraft J, Menken J, Preston S (1982) Age, period, and cohort effects in demography: a review. Popul Index 48:4–43

    Article  CAS  PubMed  Google Scholar 

  • Howse K (2006) Increasing life expectancy and the compression of morbidity: a critical review of the debate. Working Paper Number 206, Oxford Institute of Aging working papers, Oxford

  • Hu FB, Goldberg J, Hedeker D, Flay BR, Pentz MA (1998) Comparison of population-averaged and subject-specific approaches for analyzing repeated binary outcomes. Am J Epidemiol 147:694–703

    Article  CAS  PubMed  Google Scholar 

  • Idler EL, Russell LB, Davis D (2000) Survival, functional limitations, and self-rated health in the NHANES I epidemiologic follow-up study, 1992. First national health and nutrition examination survey. Am J Epidemiol 152:874–883

    Article  CAS  PubMed  Google Scholar 

  • Jagger C, Cox B, Le Roy S, The EHEMU Team (2007) Health expectancy calculation by the Sullivan method: a practical guide. European health expectancy monitoring unit (EHEMU), 3rd edn. https://webgate.ec.europa.eu/chafea_pdb/assets/files/pdb/2006109/2006109_d5sullivan_guide_final_jun2007.pdf. Accessed 02 Feb 2018

  • Johansson SE, Midlöv P, Sundquist J, Sundquist K, Calling S (2015) Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden. Int J Public Health 60:363–373

    Article  PubMed  Google Scholar 

  • Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards an unified conceptual model. Soc Sci Med 69:307–316

    Article  PubMed  Google Scholar 

  • Keyes KM, Utz RL, Robinson W, Li G (2010) What is a cohort effect? Comparison of three statistical methods for modeling cohort effects in obesity prevalence in the United States, 1971–2006. Soc Sci Med 70:1100–1108

    Article  PubMed  PubMed Central  Google Scholar 

  • Kreft D, Doblhammer G (2016) Expansion or compression of long-term care in Germany between 2001 and 2009? A small-area decomposition study based on administrative health data. Popul Health Metr 14:24

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuh D, Power C, Blane D, Bartley M (2004) Socioeconomic pathways between childhood and adult health. In: Kuh D, Ben-Shlomo Y (eds) A life course approach to chronic disease epidemiology: tracing the origins of ill health from early to adult life. Oxford University Press, Oxford, pp 371–395

    Chapter  Google Scholar 

  • Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22

    Article  Google Scholar 

  • Lievre S, Jusot F, Barnay T, Sermet C, Brouard N, Robine JM, Brieu MA, Forette F (2007) Healthy working life expectancies at age 50 in Europe: a new indicator. J Nutr Health Aging 11:508–514

    CAS  PubMed  Google Scholar 

  • Lowsky DJ, Olshansky SJ, Bhattacharya J, Goldman D (2014) Heterogeneity in healthy aging. J Gerontol A Biolmed Sci Med Sci 69:640–649

    Article  Google Scholar 

  • Luijben AHP, Galenkamp H, Deeg DJH (2013) Mobilising the potential of active aging in Europe. Trends in healthy life expectancy and health indicators among older people in 27 EU Countries. Funded by the European Commission’s Seventh Framework Programme FP7-SSH-2012-1/No 320333

  • Mairey I, Bjerregaard P, Brønnum-Hansen H (2014) Gender difference in health expectancy trends in Greenland. Scan J Public Health 42:751–758

    Article  Google Scholar 

  • Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Meml Fund Q Health Soc 60:183–244

    Article  CAS  Google Scholar 

  • Moor I, Günther S, Knöchelmann A, Hoebel J, Pförtner TK, Lampert T, Richter M (2018) Educational inequalities in subjective health in Germany from 1994 to 2014: a trend analysis using the German Socio-Economic Panel study (GSOEP). BMJ Open 2018(8):e019755. https://doi.org/10.1136/bmjopen-2017-019755

    Article  Google Scholar 

  • Parker MG, Thorslund M (2007) Health trends in the elderly population: getting better and getting worse. Gerontologist 47:150–158

    Article  Google Scholar 

  • Põld M, Pärna K, Ringmets I (2016) Trends in self-rated health and association with socioeconomic position in Estonia: data from cross-sectional studies in 1996–2014. Int J Equity Health 15:200

    Article  PubMed  PubMed Central  Google Scholar 

  • Read JG, Gorman BK (2010) Gender and health inequality. Annu Rev Sociol 36:371–386

    Article  Google Scholar 

  • Rohlfsen L, Kronenfeld JJ (2014) Gender differences in functional limitations among middle-aged and older adults: a two-part latent curve analysis of structural, childhood background, and health factors. J Gerontol B Psychol Sci Soc Sci 69:590–602

    Article  PubMed  Google Scholar 

  • Roqué I, Figuls M, Salvà A, Bolíbar I, Rivero T (2012) Trends in self-perceived health and chronic disability in the elderly Spanish population: evolution between years 1993 and 2006. Med Clin (Barc) 139:284–289

    Article  Google Scholar 

  • Storeng SH, Krokstad S, Westin S et al (2018) Decennial trends and inequalities in healthy life expectancy: the HUNT Study, Norway 2018. Scand J Public Health 46:124–131

    Article  PubMed  Google Scholar 

  • Sullivan D (1971) A single index of mortality and morbidity. HSMHA Health Rep 86:347–354

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Trachte F, Sperlich S, Geyer S (2014) Kompression oder Expansion der Morbidität? Z Gerontol Geriat 48:255–262

    Article  Google Scholar 

  • Unger R, Schulze A (2013) Können wir (alle) überhaupt länger arbeiten? Trends in der gesunden Lebenserwartung nach Sozialschicht in Deutschland. Zeitschrift für Bevölkerungswissenschaft 38:545–564

    Google Scholar 

  • Volken T, Wieber F, Rüesch P, Huber M, Crawford RJ (2017) Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education. Public Health 150:152–165

    Article  CAS  PubMed  Google Scholar 

  • Wagner GG, Frick JR, Schupp J (2007) The German socio-economic panel study (SOEP)—scope, evolution and enhancements. German Socio-Economic Panel Study (SOEP), Berlin. https://www.diw.de/documents/publikationen/73/diw_01.c.60184.de/diw_sp0001.pdf. Accessed 23 Mar 2019

  • Wolff JK, Nowossadeck S, Spuling SM (2017) Altern nachfolgende Kohorten gesünder? Selbstberichtete Erkrankungen und funktionale Gesundheit im Kohortenvergleich. In: Mahne K, Wolff JK, Simonson J, Tesch-Römer C (eds) Altern im Wandel. Zwei Jahrzehnte Deutscher Alterssurvey (DEAS). Springer, Wiesbaden, pp 125–138

    Google Scholar 

  • Zack MM, Moriarty DG, Stroup DF, Ford ES, Mokdad AH (2004) Worsening trends in adult health-related quality of life and self-rated health—United States, 1993–2001. Public Health Rep 119:493–505

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Medical Sociology, OE 5420, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany

    Stefanie Sperlich, Juliane Tetzlaff & Siegfried Geyer

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  1. Stefanie Sperlich
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  2. Juliane Tetzlaff
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Correspondence to Stefanie Sperlich.

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Sperlich, S., Tetzlaff, J. & Geyer, S. Trends in good self-rated health in Germany between 1995 and 2014: do age and gender matter?. Int J Public Health 64, 921–933 (2019). https://doi.org/10.1007/s00038-019-01235-y

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  • DOI: https://doi.org/10.1007/s00038-019-01235-y

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