Comparison of Health Inequalities between East and West Germany

Background. The major objective of the study was to assess whether the extent of health inequalities varies between East and West Germany and whether differences in social inequalities between both parts of Germany are associated with differences in health inequalities. Method. Data were available from a representative sample of 5,311 persons from West Germany and 2,414 persons from East Germany in the same age group (25-69 years). The study protocol was nearly identical in both studies. Socioeconomic status (SES) was assessed by household equivalent income and by educational level. Health status was assessed by perceived general health and by the number of chronic conditions. Absolute differences as well as relative differences (odds ratios) in the morbidity rates between low and high SES groups were calculated. All analyses were performed separately for men and women. Results. Income inequalities are larger in West Germany as compared with East Germany, but there are minor differences between East and West Germany concerning educational inequalities and morbidity rates. Just about all measures indicated that health inequalities favouring the upper socioeconomic groups exist in East Germany as well as in West Germany and that there are no significant differences in the extent of health inequalities between both parts of Germany. Conclusion. Using two data sets which were raised with nearly identical study protocols, it can be concluded that health inequalities are very stable as they do not seem to differ substantially despite the fact that both parts of Germany have experienced different social systems during the past 45 years