Health inequalities in terms of myocardial infarction and all-cause mortality: a study with German claims data covering 2006 to 2015

Siegfried Geyer (), Juliane Tetzlaff, Sveja Eberhard, Stefanie Sperlich and Jelena Epping
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Siegfried Geyer: Medical Sociology Unit, Hannover Medical School
Juliane Tetzlaff: Medical Sociology Unit, Hannover Medical School
Sveja Eberhard: AOK Niedersachsen (Local Statutory Health Insurance of Lower Saxony)
Stefanie Sperlich: Medical Sociology Unit, Hannover Medical School
Jelena Epping: Medical Sociology Unit, Hannover Medical School

International Journal of Public Health, 2019, vol. 64, issue 3, No 10, 387-397

Abstract: Abstract Objectives International comparisons are suggesting that mortality inequalities may have changed in the last years, although not always into the same direction. Only a few studies examined myocardial infarction (MI). In our study, long-term developments of MI and all-cause mortality were considered by analysing social gradients by income. Methods German claims data covering 2006 to 2015 (N = 2,474,448) were used with myocardial infarction and all-cause mortality as outcomes. Socio-economic position was depicted by individual income. Health inequalities were measured by hazard ratios between and within income groups for 10 consecutive calendar years. Results In men, income gradients of MI and all-cause mortality were decreasing. In women, no income gradients emerged for MI, and they disappeared in mortality. In men, hazard ratios of MI and mortality decreased in the intermediate and in the lowest income thirds, thus leading to a reduction of MI-related health inequalities. Conclusions Income inequalities in terms of myocardial infarction and of mortality have narrowed in men, and those in the lowest income third were profiting most. No such changes were observed in women.

Keywords: Social inequality; Health inequalities; Long-term trends; Myocardial infarction; Income; Claims data (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s00038-019-01224-1

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