Social Gradient of CVD Risk in Germany before/after Unification

Heinemann, L.; Helmert, Uwe; Claßen, Elvira; Greiser, Eberhard

doi:10.1515/reveh.1996.11.1-2.7

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…The present findings contribute to filling the research gap for Germany in that this study was the first to examine time trends in socioeconomic obesity inequalities since German reunification beyond the turn of the millennium. Previous German trend studies on socioeconomic obesity inequalities ended in the 1990s and covered much shorter periods of less than a decade [34, 35]. This may also be one reason why no marked changes in socioeconomic obesity inequalities were found in the previous studies.…”

Section: Discussionmentioning

confidence: 94%

“…Recent international comparative studies on trends in obesity inequalities were mainly based on self-report data, and did not consider data from Germany, Europe’s most populous country [11, 13]. The few available time-trend studies of socioeconomic inequalities in obesity among German adults ended in the 1990s and considered relatively short time spans [34, 35]. In this context, the present study used standardised measurements from national health examination surveys to investigate secular trends in the socioeconomic patterning of obesity among men and women in Germany from 1990 to 2011.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Inequalities in the Rise of Adult Obesity: A Time-Trend Analysis of National Examination Data from Germany, 1990–2011

et al. 2019

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Objective: Despite extensive study of the obesity epidemic, research on whether obesity has risen faster in lower or in higher socioeconomic groups is inconsistent. This study examined secular trends in obesity prevalence by socioeconomic position and the resulting obesity inequalities in the German adult population. Methods: Data were drawn from three national examination surveys conducted in 1990–1992, 1997–1999 and 2008–2011 (n = 18,541; age range: 25–69 years). Obesity was defined by a body mass index ≥30 kg/m² using standardised measurements of body height and weight. Education and equivalised household disposable income were used as indicators of socioeconomic position. Time trends in socioeconomic inequalities in obesity were examined using linear probability and log-binomial regression models. Results: In each survey period, the highest socioeconomic groups had the lowest prevalence of obesity. The low and medium socioeconomic groups showed increases in obesity prevalence, whereas no such trend was observed in the high socioeconomic groups. Absolute inequalities in obesity by income increased by an average of 0.53 percentage points per year (95% confidence interval [CI] 0.01–1.05, p = 0.047) among men and 0.47 percentage points per year (95% CI 0.05–0.90, p = 0.029) among women. Absolute inequalities in obesity by education increased on average by 0.64 percentage points per year (95% CI 0.19–1.08, p = 0.005) among women but not among men (0.33 percentage points, 95% CI –0.27 to 0.92, p = 0.283). Conclusions: These findings suggest a widening obesity gap between the top and the bottom of the socioeconomic spectrum. This has the potential to have adverse consequences for population health and health inequalities in coming decades. Interventions that are effective in preventing and reducing obesity in socially disadvantaged groups are needed.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Socioeconomic Inequalities in the Rise of Adult Obesity: A Time-Trend Analysis of National Examination Data from Germany, 1990–2011

et al. 2019

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“…In the 1980s, smoking prevalences for men were almost identical in both parts of the country (Heinemann et al, 1996), and since 1990, they have decreased equally in both East andWest, from 40% to 35% in 2009 (Robert-Koch-Institut, 2009). Hence, we would expect to fi nd no difference in the diffusion process for men in East and West Germany.…”

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confidence: 99%

The Diffusion of Smoking in East and West Germany: Smoking Patterns by Birth Year

Westphal¹,

Doblhammer²

2012

Population (English Edition)

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Along with remarkable increases in life expectancy in recent decades (Christensen et al., 2009;Oeppen and Vaupel, 2002), there has been a shift away from acute illnesses and towards chronic diseases -e.g. cardiovascular diseases, cancers, respiratory diseases, skin diseases and metabolic diseasesthat now pose major challenges for the health care system (Hurrelmann, 2006). Besides overweight and obesity, which can lead to chronic illness, smoking has been identifi ed as one of the most important risk factors for population health and premature mortality (Cutler et al., 2007;Doblhammer et al., 2009;Peto and Lopez, 2004;Preston et al., 2010;Preston and Wang, 2006;Sassi, 2010). While smoking was an almost exclusively male habit in the nineteenth and twentieth centuries, it has also become common among women in recent decades. As a consequence, the gender gap in smoking has been narrowing across

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“…25,26 Whereas a consistent association between high lipid levels and lower socio-economic conditions has been found in women, 23,27-29 the relationship in men has been less consistent. 23,[27][28][29] Using data from the MRC National Survey of Health and Development (NSHD), we study the association between birth weight and lipids in a sample of 53-year-old British men and women followed-up since their birth in 1946. The sample is large enough to allow us to formally test for sex differences in the relationship between birth weight and lipid levels.…”

mentioning

confidence: 99%

“…Results of studies relating childhood socio-economic conditions to adult lipid levels have been inconsistent. 25,26 Whereas a consistent association between high lipid levels and lower socio-economic conditions has been found in women, 23,[27][28][29] the relationship in men has been less consistent. 23,[27][28][29] Using data from the MRC National Survey of Health and Development (NSHD), we study the association between birth weight and lipids in a sample of 53-year-old British men and women followed-up since their birth in 1946.…”

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confidence: 99%

Birth Weight and Lipids in a National Birth Cohort Study

Skidmore

Hardy

Kuh

et al. 2004

ATVB

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Objective-To investigate the association between birth weight and lipid levels in a 53-year-old birth cohort from England, Scotland, and Wales. Methods and Results-Lipid levels were obtained from nonfasting blood samples, collected at the most recent follow-up of the MRC National Survey of Health and Development, for 2559 men and women. Regression models indicated that in men, a 1-kg increase in birth weight was associated with a 0.13-mmol/L decrease (95% CI: Ϫ0.23, Ϫ0.01) in total cholesterol at age 53 years (Pϭ0.03), compared with a 0.02-mmol/L (95% CI: Ϫ0.11, 0.15) increase in women and a 0.06-mmol/L (95% CI: Ϫ0.15, 0.02) decrease in men and women combined. Adjustment for current height and body mass index (BMI) in men reduced the size of the relationship, with height being responsible for the reduction. Adult height and height at 2 and 4 years were significantly associated with total cholesterol in men and in men and women combined. The negative association between total cholesterol and birth weight was strongest among men with high BMI at age 53 years (Pϭ0.03 for test for interaction between birth weight and BMI). There was no significant association between birth weight and LDL or HDL cholesterol in men or women before adjustment, but there was a positive association with HDL in women. When both sexes were analyzed together, an association was seen after adjustment for current body size. No confounding of these findings with social class was observed in this study. Conclusions-Our results suggest that the small effect of birth weight on lipid levels at age 53 years has a limited public health impact. The findings suggest that childhood height growth may be more important than prenatal growth. Key Words: birth weight Ⅲ height Ⅲ body mass index Ⅲ cholesterol Ⅲ epidemiology H igh blood cholesterol is an important risk factor for cardiovascular disease 1 and may be programmed in early life. 2 According to Barker's fetal origins hypothesis, 2 impaired fetal growth that leads to changes in lipid metabolism is one explanation for the observed inverse associations between birth weight and other measures of size at birth and adult cardiovascular disease. 3,4 Results from studies relating markers of fetal growth to adult lipid levels have, however, been inconsistent 3,5-9 and a recent meta-analysis estimated a decrease of only 0.05 mmol/L per 1 kg increase in birth weight. 10 To our knowledge, all except one study 7 of European adults 3,5,6,8,[11][12][13][14][15] have fewer than 800 subjects and may therefore have lacked the power to test for sex differences. Sex differences in the association between fetal growth and later coronary heart disease risk might be anticipated if fetal nutrition is the underlying mechanism because male fetuses grow at a faster rate, on average, than female fetuses. 16 However, discussion of sex differences based on separate analyses for males and females, without statistical tests of interaction, may result in an overemphasis of chance differences. 17 Adjustment of the birth weight effec...

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Social Gradient of CVD Risk in Germany before/after Unification

Cited by 12 publications

References 10 publications

Socioeconomic Inequalities in the Rise of Adult Obesity: A Time-Trend Analysis of National Examination Data from Germany, 1990–2011

Socioeconomic Inequalities in the Rise of Adult Obesity: A Time-Trend Analysis of National Examination Data from Germany, 1990–2011

The Diffusion of Smoking in East and West Germany: Smoking Patterns by Birth Year

Birth Weight and Lipids in a National Birth Cohort Study

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