Skip to main content
SpringerLink
Log in

Health Promotion and Preventive Healthcare in Germany

  • Chapter
  • First Online:
Erwerbsverlauf und sozialer Schutz in Europa

  • 1236 Accesses

Abstract

Against the background of a predicted reduction in the workforce due to the age structure of the population, and the associated problem of financing social security and public health care systems, people must remain longer in occupations. However, the employment rate in Germany among individuals aged 65–74 remains below the OECD average, and the number of remaining healthy life years expected at age 65 is low compared to other countries with comparable life expectancy. To a significant degree, stressful working conditions and unhealthy lifestyles contribute to poor health and reduce the ability and willingness to work into later life. In light of this development, a stronger focus is needed on preventive healthcare, especially among the older workforce. This is partially reflected in a number of social law provisions dealing with the promotion of healthy life styles and working conditions, as well as primary prevention. The discussion and passing of the Act to Strengthen Health Promotion and Preventive Health Care (the Prevention Act) in July 2015 has moved primary prevention and health promotion, at least in the context of the statutory health insurance, back into the political spotlight. Annual expenditure for primary prevention by health insurance funds is due to increase by 2016 from the current value of 289 million Euros to around 500 million Euros according to the Act. Nonetheless, extending working lives requires that regulations are reviewed and adapted to the specific needs of an aging population and, particularly, to an aging workforce.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    The definition of an “aging workforce” is still controversial, since different agencies and organizations are using a broad spectrum of ages, ranging from 40–65 years, or more. In the following, in agreement with most of the literature, “aging workforce” refers to people of 55 years and above.

  2. 2.

    Life expectancy is projected to increase continuously, by seven years for men and six years for women until 2060 (OECD 2016). Other trends driving the aging of the workforce are the decline in fertility rates (Germany: 1.4 children per woman) and the progression of large cohorts, such as the post-World War II baby boom generation, to older ages (ibid.).

  3. 3.

    The earnings quality indicator captures the level of earnings and degree of inequality. It corresponds to the weighted mean of individual earnings, calculated with higher weights attributed to the bottom part of the earnings distribution.

  4. 4.

    The labour market security dimension reflects the expected earnings loss associated to unemployment, as a function of the risk of becoming unemployed, the expected duration of unemployment and the degree of income protection provided by unemployment benefit systems.

  5. 5.

    The quality of the working environment captures the incidence of jobs that involve high demands with few resources through the nature and content of the work, working time and workplace relationships.

  6. 6.

    Three previous attempts at legislation – in 2005, 2008 and most recently in 2013 – failed due to differences of opinion in the respective coalitions, as well as disagreements between the Federation and the Länder.

  7. 7.

    Gesetz zur Stärkung der Gesundheitsförderung und der Prävention – Präventionsgesetz vom 17.7.2015, BGBl. I 1368.

  8. 8.

    The German provisions of SGB V have been adjusted to English citation rules. E.g. the German provision of § 20 Absatz 1, Satz 1 SGB V is cited as “Sec. 20 (I)(1) SGB V”.

  9. 9.

    Leitfaden Prävention, Handlungsfelder und Kriterien des GKV-Spitzenverbandes zur Umsetzung der §§ 20 und 20a SGB V vom 21. Juni 2000 in der Fassung vom 10. Dezember 2014.

  10. 10.

    See e.g. Sec. 5 SGB XI for long-term care, Sec. 3 SGB IX for rehabilitation and Sec. 14 (I) SGB XII for social assistance.

  11. 11.

    The National Disease Prevention Conference, constituted on 26 October 2015, adopted a nationwide framework recommendation for disease prevention and health promotion (Bundesrahmenempfehlung der Nationalen Präventionskonferenz nach § 20d Abs. 3 SGB V) on 19 February 2016.

References

  • Argaw BA, Bonin H, Mühler G, Zierahn U (2013) Arbeitsqualität Älterer in belastenden Berufen. Bundesministerium für Arbeit und Soziales, Mannheim

    Google Scholar 

  • Bäcker G, Kistler E, Trischler F (2010) Rente mit 67? Zu wenig Arbeitsplätze und zu wenig gute Arbeit für ein Arbeiten bis 67. Vierter Monitoring-Bericht des Netzwerks für eine gerechte Rente. Berlin

    Google Scholar 

  • Banafsche M (2014) Zielsetzungen und Instrumente der Prävention im Sozialrecht. Brockmann J (ed) Prävention an der Schnittstelle von Arbeits- und Sozialrecht. LIT, Berlin, pp 7–32

    Google Scholar 

  • Bellmann L, Kistler E, Wahse J (2007) Demographischer Wandel. Betriebe müssen sich auf alternde Belegschaften einstellen. IAB Kurzbericht. Aktuelle Analysen aus dem Institut für Arbeitsmarkt- und Berufsforschung der Bundesagentur für Arbeit. Heft Nr. 21

    Google Scholar 

  • Bödeker W, Moebus S (2015) Normen- und Anreizkonflikte für die gesetzlichen Krankenkassen in Gesundheitsförderung und Prävention. Das Gesundheitswesen 77(6):397–404

    Google Scholar 

  • Bundesministerium des Innern (BMI) (2011) Demografiebericht – Bericht der Bundesregierung zur demografischen Lage und künftigen Entwicklung des Landes, Berlin

    Google Scholar 

  • Bundesregierung (2012) Jedes Alter zählt – Demografiestrategie der Bundesregierung. Berlin

    Google Scholar 

  • Bundeszentrale für gesundheitliche Aufklärung (BZgA) (2011) The Young Old. An Expert Report on the Situation of People Between 55 and 65 Years of Age. Research and Practice of Health Promotion, vol 16. Cologne

    Google Scholar 

  • Dal Bianco C, Trevisan E, Weber G (2015) I want to break free”. The role of working conditions on retirement expectations and decisions. Eur J Ageing 12(1):17–28

    Article  Google Scholar 

  • Ebsen I (ed) (2015) Handbuch Gesundheitsrecht. Huber, Bern

    Google Scholar 

  • Edison T (1903) “The Edison Wizard”. The Newark Advocate: n. pag. Print

    Google Scholar 

  • GKV-Spitzenverband (2014) Leitfaden Prävention. Handlungsfelder und Kriterien des GKV-Spitzenverbandes zur Umsetzung der §§ 20 und 20a SGB V vom 21. Juni 2000 in der Fassung vom 10. Dezember 2014. Berlin

    Google Scholar 

  • Günster C, Klose J, Schmacke N (eds) (2011) Versorgungsreport 2012. Schwerpunkt: Gesundheit im Alter. Schattauer, Stuttgart

    Google Scholar 

  • Heinrich-Böll-Stiftung (2013) Wie geht es uns morgen? Wege zu mehr Effizienz, Qualität und Humanität in einem solidarischen Gesundheitswesen. Schriften zu Wirtschaft und Soziales. Vol 11. Berlin

    Google Scholar 

  • Jagger C, Weston C, Cambois E, Van Oyen H, Nusselder W, Robine J-M (2008) Inequalities in healthy life years in the 25 countries of the European Union in 2005. The Lancet 372(9656):2124–2131

    Article  Google Scholar 

  • Jürges H (2009) Healthy minds in healthy bodies. An international comparison of education-related inequality in physical health among older adults. Scot J Polit Econ 56:296–320

    Article  Google Scholar 

  • Kladny B (2015) Stationäre und ambulante Rehabilitation in Deutschland. Der Unfallchirurg 118:103–111

    Article  Google Scholar 

  • Leitherer S (ed) (2016) Kasseler Kommentar Sozialversicherungsrecht. Loseblattsammlung, June 2016. vol 2. Munich

    Google Scholar 

  • Loeppke RR, Chosewood LC, Grosch JW, Allweiss P, Burton WN et al (2013) Advancing Workplace Health Protection and Promotion for an Aging Workforce. J Occup Environ Med 55(5):500–506. https://doi.org/10.1097/JOM.0b013e31829613a4

    Article  Google Scholar 

  • Ludewig K, Wolf R (2016) Prävention aus Sicht der Krankenkassen. Pohlmann S (ed) Alter und Prävention. Springer, Wiesbaden, pp 271–299

    Google Scholar 

  • Meffert C, Mittag O, W H J (2013) Betriebsnahe Präventionsprogramme der Deutschen Rentenversicherung. Die Rehabilitation 52(06):391–398

    Article  Google Scholar 

  • Myck M (2015) Living longer, working longer: the need for a comprehensive approach to labour market reform in response to demographic changes. Eur J Ageing 12(1):3–5

    Article  Google Scholar 

  • OECD (2014) OECD Economic Surveys: Germany 2014. OECD Publishing, Paris

    Google Scholar 

  • OECD (2014a) How is life in Germany? OECD Better Life Initiative. OECD Publishing, Paris

    Google Scholar 

  • OECD (2014b) How does Germany compare? Health at a Glance. Europe 2014. OECD Publishing, Paris

    Book  Google Scholar 

  • OECD (2014c) How does Germany compare? OECD Employment Outlook 2014. OECD Publishing, Paris

    Book  Google Scholar 

  • OECD (2015) Fit Mind, Fit Job. From Evidence to Practice in Mental Health and Work. Mental Health and Work. OECD Publishing, Paris

    Google Scholar 

  • OECD (2016) Economic Surveys: Germany 2016. OECD Publishing, Paris

    Book  Google Scholar 

  • Ploubidis GB, Grundy E (2009) Later-Life Mental Health in Europe. A Country-Level Comparison. J Gerontol 64B(5):666–676

    Article  Google Scholar 

  • Robert Koch Institut (2015) Gesundheit in Deutschland 2015. Ch. 4. Wie steht es um Prävention und Gesundheitsförderung? Bundesgesundheitsberichtserstattung, Berlin

    Google Scholar 

  • Sachverständigenrat (SVR) Gesundheit (1996) Sondergutachten 1996. Gesundheitswesen in Deutschland. Kostenfaktor und Zukunftsbranche. Bd I: Demografie, Morbidität, Wirtschaftlichkeitsreserven und Beschäftigung. Baden-Baden

    Google Scholar 

  • Sassi F, Cecchini M, Lauer J, Chisholm D (2009), Improving Lifestyles Tackling Obesity. The Health and Economic Impact of Prevention Strategies. Health Working Papers. No. 48. OECD, Paris

    Google Scholar 

  • Schempp N, Strippel H (2015) Präventionsbericht 2014. Leistungen der gesetzlichen Krankenversicherung. Primärprävention und betriebliche Gesundheitsförderung. Berichtsjahr 2014. MDS, Essen

    Google Scholar 

  • Schnalzenberger M, Schneeweis R, Winter-Ebmer R, Zweimüller M (2008) Job Quality and Retirement Decisions. In: Börsch-Supan A, Brugiavini A, Jürges H, Kapteyn A, Mackenbach J, Siegrist J, Weber G (eds) First results from the Survey of Health, Ageing and Retirement in Europe (2004–2007). Mannheim Research Institute for the Economics of Aging, Mannheim, pp 215–221

    Google Scholar 

  • Schöllgen I, Huxhold O, Tesch-Römer C (2010) Socioeconomic status and health in the second half of life: findings from the German Ageing Survey. Eur J Ageing 7(1):17–28

    Article  Google Scholar 

  • Seifert U, Schlanstedt-Jahn U, Klug SJ (2015) Screening für Krebserkrankungen. Der Internist 56(10):1114–1123

    Article  Google Scholar 

  • Sternberger-Frey B (2014) Invalidität als Armutsrisiko – Können private Berufsunfähigkeitsrenten die Versorgungslücken schließen? Analyseergebnisse einer unabhängigen Testorganisation. DIW-Vierteljahreshefte zur Wirtschaftsforschung 83:113–117

    Article  Google Scholar 

  • SVR Gesundheit (2000) Gutachten 2000/2001. Bedarfsgerechtigkeit und Wirtschaftlichkeit. Vol I-2: Optimierung des Systems durch Gesundheitsförderung und Prävention. Baden-Baden

    Google Scholar 

  • SVR Gesundheit (2007) Gutachten 2007. Kooperation und Verantwortung. Voraussetzungen einer zielorientierten Gesundheitsversorgung. Baden-Baden

    Google Scholar 

  • Walter U, Reuter D (2013) Prävention und Gesundheitsförderung als politische Strategien für Beschäftigungsfähigkeit und Teilhabe im Alter. In: Hüther M, Naegele G (eds) Demografiepolitik. Springer, Wiesbaden, pp 223–244

    Chapter  Google Scholar 

  • Welti F (2015) Das Gesetz zur Stärkung der Gesundheitsförderung und der Prävention – was bringt dieses Präventionsgesetz? Gesundheit und Pflege 6:211–216

    Google Scholar 

  • Zelen K, Strippel M (2010) Präventionsbericht 2010. Leistungen der gesetzlichen Krankenversicherung. Primärprävention und betriebliche Gesundheitsförderung. Berichtsjahr 2009. MDS, Essen

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Max-Planck-Institut für Sozialrecht und Sozialpolitik, Amalienstr. 33, 80799, München, Deutschland

    Nikola Wilman

Authors
  1. Nikola Wilman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nikola Wilman .

Editor information

Editors and Affiliations

  1. Max-Planck-Institut für Sozialrecht und Sozialpolitik, München, Germany

    Eva Maria Hohnerlein

  2. Institut de l’Ouest: Droit et Europe (UMR CNRS 6262), Université de Rennes 1 , Rennes, France

    Sylvie Hennion

  3. Puyrolland, France

    Otto Kaufmann

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wilman, N. (2018). Health Promotion and Preventive Healthcare in Germany. In: Hohnerlein, E., Hennion, S., Kaufmann, O. (eds) Erwerbsverlauf und sozialer Schutz in Europa. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56033-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-56033-4_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56032-7

  • Online ISBN: 978-3-662-56033-4

  • eBook Packages: Social Science and Law (German Language)

Publish with us

Policies and ethics

Search

Navigation