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

  • Stefanie SperlichEmail author
  • Juliane Tetzlaff
  • Siegfried Geyer
Original article
  • 65 Downloads

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.

Keywords

Self-rated health Germany Healthy life expectancy Sullivan method Compression Morbidity 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

38_2019_1235_MOESM1_ESM.docx (34 kb)
Supplementary material 1 (DOCX 33 kb)

References

  1. 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 154:44–50CrossRefGoogle Scholar
  2. 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 4:1–8CrossRefGoogle Scholar
  3. 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 16:675CrossRefPubMedCentralGoogle Scholar
  4. Clarfield AM (2018) Healthy life expectancy is expanding. JAGS 66:202CrossRefGoogle Scholar
  5. 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 73:65–72CrossRefGoogle Scholar
  6. Cummings JL, Jackson PB (2008) Race, gender, and SES disparities in self-assessed health, 1974-2004. ROA 30:137–168Google Scholar
  7. 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
  8. 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 58:2585–2600CrossRefGoogle Scholar
  9. DeSalvo KB, Fan VS, McDonell MB, Fihn SD (2005) Predicting mortality and healthcare utilization with a single question. Health Serv Res 40:1234–1246CrossRefPubMedCentralGoogle Scholar
  10. Destatis (2017) Sterbetafel—Methoden- und Ergebnisbericht zur laufenden Berechnung von Periodensterbetafeln für Deutschland und die Bundesländer. www.destatis.de. Accessed 02 Feb 2018
  11. 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
  12. Fiedler C, Grünheid E, Sulak H (2017) Bevölkerung in Deutschland. Geographische Rundschau 11/2017. Bundesinstitut für Bevölkerungsforschung (BiB) (Hrsg.), WiesbadenGoogle Scholar
  13. 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 47–63Google Scholar
  14. Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303:130–135CrossRefGoogle Scholar
  15. 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 PubMedCentralGoogle Scholar
  16. 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 23:511–517CrossRefGoogle Scholar
  17. 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 311–331Google Scholar
  18. Golinowska S, Groot W, Baji P, Pavlova M (2016) Health promotion targeting older people. BMC Health Serv Res 16:345CrossRefPubMedCentralGoogle Scholar
  19. Gruenberg EM (1977) The failures of success. Milbank Meml Fund Q Health Soc 55:3–24CrossRefGoogle Scholar
  20. 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 2:662–673CrossRefPubMedCentralGoogle Scholar
  21. Hill TD, Needham BL (2006) Gender-specific trends in educational attainment and self-rated health, 1972–2002. Am J Public Health 96:1288–1292CrossRefPubMedCentralGoogle Scholar
  22. Hobcraft J, Menken J, Preston S (1982) Age, period, and cohort effects in demography: a review. Popul Index 48:4–43CrossRefGoogle Scholar
  23. 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, OxfordGoogle Scholar
  24. 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 147:694–703CrossRefGoogle Scholar
  25. 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 152:874–883CrossRefGoogle Scholar
  26. 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
  27. 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 60:363–373CrossRefGoogle Scholar
  28. Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards an unified conceptual model. Soc Sci Med 69:307–316CrossRefGoogle Scholar
  29. 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 70:1100–1108CrossRefPubMedCentralGoogle Scholar
  30. 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 14:24CrossRefPubMedCentralGoogle Scholar
  31. 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 371–395CrossRefGoogle Scholar
  32. Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22CrossRefGoogle Scholar
  33. 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 11:508–514Google Scholar
  34. Lowsky DJ, Olshansky SJ, Bhattacharya J, Goldman D (2014) Heterogeneity in healthy aging. J Gerontol A Biolmed Sci Med Sci 69:640–649CrossRefGoogle Scholar
  35. 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 320333Google Scholar
  36. Mairey I, Bjerregaard P, Brønnum-Hansen H (2014) Gender difference in health expectancy trends in Greenland. Scan J Public Health 42:751–758CrossRefGoogle Scholar
  37. Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Meml Fund Q Health Soc 60:183–244CrossRefGoogle Scholar
  38. 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 CrossRefGoogle Scholar
  39. Parker MG, Thorslund M (2007) Health trends in the elderly population: getting better and getting worse. Gerontologist 47:150–158CrossRefGoogle Scholar
  40. 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 15:200CrossRefPubMedCentralGoogle Scholar
  41. Read JG, Gorman BK (2010) Gender and health inequality. Annu Rev Sociol 36:371–386CrossRefGoogle Scholar
  42. 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 69:590–602CrossRefGoogle Scholar
  43. 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) 139:284–289CrossRefGoogle Scholar
  44. 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 46:124–131CrossRefGoogle Scholar
  45. Sullivan D (1971) A single index of mortality and morbidity. HSMHA Health Rep 86:347–354CrossRefPubMedCentralGoogle Scholar
  46. Trachte F, Sperlich S, Geyer S (2014) Kompression oder Expansion der Morbidität? Z Gerontol Geriat 48:255–262CrossRefGoogle Scholar
  47. Unger R, Schulze A (2013) Können wir (alle) überhaupt länger arbeiten? Trends in der gesunden Lebenserwartung nach Sozialschicht in Deutschland. Zeitschrift für Bevölkerungswissenschaft 38:545–564Google Scholar
  48. 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 150:152–165CrossRefGoogle Scholar
  49. 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
  50. 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 125–138Google Scholar
  51. 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 119:493–505CrossRefPubMedCentralGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Stefanie Sperlich
    • 1
    Email author
  • Juliane Tetzlaff
    • 1
  • Siegfried Geyer
    • 1
  1. 1.Medical Sociology, OE 5420Hannover Medical SchoolHannoverGermany

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