Utilization of Prevention Services by Gender, Age, Socioeconomic Status, and Migration Status in Germany: An Overview and a Systematic Review

  • Christoph Kowalski
  • Julika Loss
  • Florian Kölsch
  • Christian Janssen



In Germany, like in other countries, there are strong associations between the individual factors gender, age, migration status, and socioeconomic status on one hand and morbidity and mortality on the other. This chapter aims to investigate if these different factors are associated with differences in the utilization of prevention services.


A systematic literature search was conducted using the PubMed database to identify relevant empirical articles published between 2002 and 2012.


A total of 48 empirical articles met the criteria for inclusion in the review. Most of the 48 reviewed studies provided relatively clear evidence of a significant association between higher socioeconomic status, female gender, or nonmigrant status and the use of prevention services. Studies dealing with tertiary prevention were rare and less conclusive. No studies using qualitative methods to explore their research questions were identified.


Overall, the review shows evidence for the relationship between social inequalities and the use of prevention services. There is, however, a lack of studies in tertiary prevention and of published intervention studies demonstrating how to better reach the socially disadvantaged.


Prevention Service Health Inequality High Social Status Tertiary Prevention Workplace Health Promotion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Christoph Kowalski
    • 1
  • Julika Loss
    • 2
  • Florian Kölsch
    • 3
  • Christian Janssen
    • 4
  1. 1.Faculty of Human Sciences and the Faculty of Medicine, Institute for Medical Sociology, Health Services Research, and Rehabilitation ScienceUniversity of CologneCologneGermany
  2. 2.Division of Medical Sociology, Institute for Epidemiogy and Social MedicineUniversity of RegensburgRegensburgGermany
  3. 3.Faculty of Human Sciences and the Faculty of Medicine, Institute for Medical Sociology, Health Services Research, and Rehabilitation ScienceUniversity of CologneCologneGermany
  4. 4.Department of Applied Social SciencesMunich University of Applied SciencesMunichGermany

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