Share:
Health in Germany Current health figures presented
In summary, overarching developments can be identified that are important for all areas considered: from the spectrum of diseases to the distribution of risk factors to prevention and care.
What about our health?
Health and care in Germany are currently dominated by two major developments: demographic change and the strong impact of the social situation on health. About three quarters of women and men in Germany rate their health status as good or very good. This is especially pleasing in terms of life expectancy, which has risen steadily in recent decades: girls born today can count on average 82.7, boys with 77.7 years of age. In our (aging) population, chronic diseases such as cardiovascular diseases, cancer, musculoskeletal diseases and diabetes are increasingly determining the course of the disease. Mental disorders are receiving more attention today. In recent decades, there have been many improvements in health, which, depending on the disease to varying degrees, are due to prevention and early diagnosis, advances in therapy and better care. Chronic diseases, however, are a major challenge not only for those affected and their families, but also for the healthcare system and social systems.
As for our health: New RKI report gives insight. Image: Andrey Popov - fotolia The main diseases
Cardiovascular diseases such as heart attack and stroke continue to be the leading cause of death, accounting for 39.7% of all deaths. In recent decades, however, a positive development is emerging: There are fewer new cases of heart attack and stroke. The mortality from coronary heart disease, myocardial infarction and stroke has also declined significantly.
Even with many cancers, successes have been recorded. Although there was an increase in new cases of about 16% between 2001 and 2011, this was largely due to demographic change. Mortality rates have fallen in recent years for most cancers.
This is explained by advances in therapy and, for some cancers, by a more early detection of disease. However, more women are dying from lung cancer today. Cancers are the second leading cause of death in Germany (25.0%). The widespread prevalence of diabetes mellitus is causing concern. In 7.2% of all adults between the ages of 18 to 79, diabetes mellitus is known, or about 4.6 million people. 2.0% of all adults (about 1.3 million people) have unrecognized diabetes mellitus. Rising case numbers in recent years can only be partially explained by demographic aging. At least in part, they may be due to improved early detection, but possibly also to the increase in lifestyle-related risk factors, particularly obesity. Consequences of diabetes, such as blindness and amputations, but go back.
Diseases of the musculoskeletal system continue to be among the most common and costly diseases in Germany. While osteoarthritis, osteoporosis and rheumatoid arthritis are more common with increasing age, back pain often affects younger people. Musculoskeletal disorders cause most days off and are the second most common cause of health-related early illnesses after mental illness. Even today, infections still cause a high burden of disease, even though in 2013 only one infectious disease was ranked among the ten leading causes of death in Germany: pneumonia.
On the positive side, tuberculosis in Germany has been steadily declining for years - if only marginally in recent years. The number of initial hepatitis C diagnoses rose slightly in 2013 compared to the previous year, to around 5,200. The number of new HIV infections has been increasing since the turn of the millennium: in 2013, there were about 3,300 in Germany. Critical is an increasing antibiotic resistance in tuberculosis and other infectious diseases. Also problematic
Inadequate vaccination rates: In measles, for example, they are insufficient in some regions of Germany to train so-called herd protection for a small number of people who are not vaccinated. Also important are infections that patients contract in connection with medical measures (nosocomial infections). An estimated 400,000 to 600,000 patients are infected each year
in the hospital. Particularly dangerous are infections with so-called multi-resistant germs against which many common antibiotics have become ineffective (including methicillin-resistant Staphylococcus aureus, MRSA).
Special attention requires mental disorders. At the population level, no increase can be observed with frequent diagnoses such as anxiety disorders and depression. However, the number of days lost and early retirements due to mental disorders has increased significantly in the last 20 years. The reasons discussed are changes in the world of work, but above all the de-tabulation of mental illnesses and the associated improved diagnostics.
In 2013, 682,069 children were born in Germany. 93.7% of parents rate the health of children and adolescents as good or very good. The most common childhood and adolescent illnesses are allergies, which have been diagnosed in one quarter of children and adolescents in Germany. Accidents involving medical treatment affect 15.5% of children and adolescents each year. About 0.2% of 7- to 17-year-olds suffer from diabetes mellitus (predominantly type 1). It is worrying that one fifth of children and adolescents have mental disorders. Already in childhood and adolescence there are clear differences in relation to the social situation, in particular with regard to health behavior, health risk factors such as obesity and mental disorders. For example, the proportion of children and adolescents with mental health problems among families with low socioeconomic status is significantly higher than that of families with high social status (33.5% vs. 9.8%)..
What influences our health?
The state of health of Germans is essentially determined by the living conditions (social determinants) and the health behavior and related risk factors. There is a close link between the health and social situation of the population.
Studies have shown that people with low socioeconomic status are more likely to be affected by illness, disability and disability, have a poorer assessment of their own health and die sooner. Women with very low incomes, according to study results, have eight years lower life expectancy than women with high incomes; in men the difference is eleven years. Already in childhood and adolescence, health is characterized by the socioeconomic status of their family of origin.
In the world of work, the overall health situation has improved over the past decades: sick leave and fatal accidents have declined in the workforce. Absenteeism due to mental illness has increased significantly in recent years. There are still major social differences in the health of employees. For example, the number of sick days is significantly higher among low-skilled workers, due to differences in physical and psychosocial workloads. Unemployed people are nearly twice as likely to be sick as workers. Studies also indicate that people with experience of unemployment are more likely to have behavioral health risks and are less likely to participate in prevention activities: in the working environment, most of the population is reached by such measures. The health of people with a migrant background is primarily influenced by the same (social) determinants as those of the majority population. Added to this are migration-specific features, such as the country of origin, the reason for the migration, the status of residence, the degree of integration and the cultural background. In terms of physical health, there are few differences between people with and without a migrant background. Depending on the infection status of the countries of origin, specific risks for the infectious diseases tuberculosis, HIV and hepatitis B occur. Overall, they are less likely to use health care services than people without a migration background.
Health behavior and associated risk factors
A well-balanced diet and exercise can help prevent obesity, lipid metabolism and hypertension, reducing the risk of cardiovascular and other chronic conditions. The results of the nutritional monitoring show that adults in Germany consume too little vegetables, fruits and fish. Adults, children and adolescents are on average but sufficiently supplied with the most vitamins and minerals.
Two-thirds of adults and three-quarters of children are active in sports, but only one in five adults and one in four children reaches the WHO-recommended level of activity (2.5 hours per week or one hour per day for children). Since the late 1990s, physical activity has increased significantly, especially among older adults. Adults with low socioeconomic status continue to do relatively less sport.
An unfavorable relationship between energy intake and energy consumption can lead to obesity in the long term. Especially overweight (obesity) increases the risk for many chronic diseases. In adults, the proportion of overweight people has been at a high level in recent years
stabilized, however, the proportion of adiposis has increased significantly, especially among young men. Even among children and adolescents, the number of overweight since the 1990s has increased, the proportion of Adiposer has even doubled. Almost 25% of all adults in Germany and about 6% of children and adolescents are obese. The prevalence of overweight and obesity follows a social gradient: the lower the social status, the more often overweight and obesity occur
on.
High blood pressure is one of the main risk factors for cardiovascular disease, especially in combination with other risk factors such as lipid metabolism disorders, diabetes mellitus, obesity, smoking and physical inactivity. With age, the risk of hypertension increases sharply. It is estimated that about one third of all men and women in Germany, about 20 million people, are affected by hypertension. Most are treated for medical treatment, and blood pressure can be lowered to normal levels with medication.
Smoking is the leading cause of premature mortality in industrialized nations. In Germany, about 29.0% of men and 20.3% of women aged 15 or over smoked in 2013. Quotas have been falling since the early 2000s, but the decline has been stagnating in women since 2009. Smoking rates have been steadily falling since 2004 among adolescents.
In addition to high blood pressure and tobacco, alcohol consumption is one of the most important risk factors for illness and death in Europe. Germany is one of the countries with a higher than average consumption of alcohol (based on the total population of 9.7 liters of pure alcohol per capita in 2013). On a positive note, over the last 20 years, the proportion of people at high risk of alcohol consumption and intoxication has decreased. Even in adolescence, alcohol consumption is declining. However, between 2000 and 2012, the number of children and adolescents who had to be hospitalized for acute alcohol poisoning almost tripled. It first went back in 2013.
How much do Germans spend on their health?
In 2013, health expenditure amounted to € 314.9 billion. The largest items are medical followed by nursing services. In diseases, cardiovascular diseases are the most important cost factor, as well as diseases of the digestive system, the musculoskeletal system, mental disorders and cancer. In relation to economic output, health expenditure increased by about 1.8 percentage points between 1992 and 2013. In international comparison, Germany is in the upper midfield with per capita expenditure of around 3,800 euros per year for health
of the western industrial nations.
How healthy are older people in Germany?
In surveys, more than half of people aged 65 and over assess their own health as good or very good. However, chronic diseases are widespread in this population group, especially cardiovascular diseases, cancers, chronic lung diseases - all three
among the leading causes of death - as well as musculoskeletal disorders and diabetes. Suicide rates are increasing significantly, especially in older men; a depressive symptomatology is probably often overlooked in the elderly. About one third of people aged 65 and over take at least five medicines at the same time, increasing the risk of adverse side effects and interactions.
In the long term, it can be seen that severe restrictions on everyday activities are decreasing overall. Easier restrictions in everyday life, however, increase. International studies indicate that fewer people are likely to suffer from dementia than estimated due to higher education, better health behavior and the decline in cardiovascular disease. Important resources in older age are targeted health and prevention services and the promotion of social participation. "Getting older and healthier" is one of the national health goals for which important individual goals and possible measures have already been formulated. Adapting health care to the needs of older people is an important challenge now and in the future.