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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 2/2019

14.03.2019 | Themenschwerpunkt

Vor dem Tod sind alle ungleich

30 Jahre Forschung zu Mortalitätsunterschieden nach Sozialstatus im europäischen Ländervergleich

verfasst von: Dr. Matthias Bopp, MPH, Johan P. Mackenbach

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 2/2019

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Zusammenfassung

Hintergrund

Im Jahr 1989 erschienen die ersten Ländervergleiche zu Mortalitätsunterschieden nach Bildung und Berufsstatus. Wenige Jahre später begannen die systematischen Ländervergleiche an der Erasmus-Universität in Rotterdam, die mehrere europäische Kollaborationsprogramme zur Erforschung sozialer Unterschiede in der Gesundheit auslösten. Dabei zeigten sich markante Sterblichkeitsunterschiede in und zwischen europäischen Populationen.

Zielsetzung

Diese Arbeit soll eine Synthese der wichtigsten Forschungsresultate aus den letzten 30 Jahren liefern und auf noch bestehende Lücken und Potenziale hinweisen.

Material und Methoden

Deskriptive Synthese der Forschungsresultate aus europäischen Ländervergleichen der Gesamt- und ursachenspezifischen Sterblichkeit nach Geschlecht, Bildungsstand und Berufsstatus.

Ergebnisse

Überall in Europa zeigt sich ein konsistentes Gefälle mit erheblichen und teilweise zunehmenden Vorteilen für statushöhere Gruppen – allerdings mit beträchtlichen Unterschieden zwischen den einzelnen Ländern. Dies gilt auch für Trends und todesursachenspezifische Auswertungen. Die relativen Unterschiede haben praktisch durchwegs zugenommen, die absoluten dagegen bei etlichen Populationen abgenommen. Bei Frauen und mit zunehmendem Alter sind die relativen Unterschiede kleiner. Innerhalb Europas sind die Unterschiede im Süden am geringsten und im Osten am größten. Eine besondere Rolle für die Trends und Gradienten spielen die tabak- und alkoholassoziierten Krankheiten.

Schlussfolgerung

Die Evidenz für soziale Unterschiede im Gesundheitszustand und ihre Determinanten hat sich in den letzten 30 Jahren signifikant verbessert. In Zukunft sind wichtige weitere Fragestellungen denkbar, z. B. welche Lebensphasen wie viel beitragen für ein gesundes Altern.
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Metadaten
Titel
Vor dem Tod sind alle ungleich
30 Jahre Forschung zu Mortalitätsunterschieden nach Sozialstatus im europäischen Ländervergleich
verfasst von
Dr. Matthias Bopp, MPH
Johan P. Mackenbach
Publikationsdatum
14.03.2019
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 2/2019
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-019-01530-6

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