["Are rich people healthier?"--Representative epidemiological data on socioeconomic group-specific disease prevalences among adults in Germany].
OBJECTIVE
The aim of this study was to determine representative nationwide data on differences in the prevalence of specific diseases between socioeconomic groups.


METHODS
The "First National Health Survey for the Federal Republic of Germany" was conducted from October 1997 to March 1999 in the form of a standardized cross-sectional questionnaire study. The data were elicited about the 35 most common diseases and socioeconomic status. The net sample was made up of a total of 7125 persons aged 18 to 79.


RESULTS
A significantly higher prevalence in subjects of lower socioeconomic status was identified for typical orthopaedic diseases as well as for hypertension, chronic bronchitis, gastric and vascular disease. The most apparent socioeconomic difference to the detriment of socially deprived subjects was identified for addiction disease and diabetes. In contrast, numerous allergic diseases such as food allergies, urticaria, and allergic diseases of the respiratory tract and eyes were approximately twice as common among members of higher socioeconomic groups. Various gastrointestinal and renal diseases (hepatitis, gastritis, pyelonephritis) were also more common in higher socioeconomic groups. These socioeconomic differences were still apparent after adjustment for age and gender.


CONCLUSIONS
This study provides representative socioeconomic group-specific prevalence data on a total of 35 clinical entities for the Federal Republic of Germany. Although the self-reporting involved in large epidemiological studies of this kind is associated with a certain amount of bias, it is nonetheless clear that the frequently cited "socioeconomic gradient", i. e., a higher disease prevalence among lower socioeconomic groups, seems not to apply for numerous disease entities; for which the association seems to be in the opposite direction. This phenomenon requires explanation.
Schneider
S
S
Forschungsabteilung, Orthopädische Universitätsklinik Heidelberg. s.schneider@dkfz.de
Mohnen
S
S
Schiltenwolf
M
M
D000328:Adult; D004812:Epidemiologic Methods; D005858:Germany; D006304:Health Status; D006801:Humans; D011203:Poverty; D015995:Prevalence; D012959:Socioeconomic Factors