title: Social status and participation in health checks in men and women in Germany: results from the German Health Update (GEDA), 2009 and 2010.
abstract: BACKGROUND
  Representative data for Germany were used to determine whether a person's social-status characteristics affect the likelihood of having a check-up for the early detection of disease.
  
  
  METHODS
  The analyses reported here were performed on data obtained in the Robert Koch Institute's German Health Update (GEDA) in 2009 and 2010. The survey responses of 26 555 people about whether they had had a check-up were evaluated. For inclusion, participants were required to be over age 35 and covered by statutory health insurance. To study the potential links between social status and check-up participation rates, a multidimensional social-status index was used in addition to three individual components of social status (highest educational level attained, occupational status, income).
  
  
  RESULTS
  50.8% of the men and 49.8% of the women surveyed had had a check-up in the two years before the survey. Low social status was associated with a lower rate of check-ups for both sexes (for men, odds ratio [OR] 0.59, 95% confidence interval [CI] 0.50-0.70, p<0.001; for women, OR 0.63, 95% CI 0.55-0.72, p<0.001). For both men and women, occupational status and income each had independent effects on check-up participation, while educational level was not found to have any independent effect.
  
  
  CONCLUSIONS
  These findings indicate that socially disadvantaged persons are less likely to have check-ups than others. Efforts to increase check-up rates should take account of the demonstrated effects of income level and occupational status.
authors.affiliation: Department of Epidemiology and Health Reporting, Robert Koch Institute Berlin.
authors.forename: Jens
authors.initials: J
authors.lastname: Hoebel
authors.forename: Matthias
authors.initials: M
authors.lastname: Richter
authors.forename: Thomas
authors.initials: T
authors.lastname: Lampert
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010808:Physical Examination / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000706:statistics & numerical data*