title: [How does the Social Gets under the Skin? A Mediator Analysis with Data from the German Socioeconomic Panel 2011].
abstract: Background:The relationship between socioeconomic status and health is explained by the unequal distribution of material, psychosocial and behavioral factors. The aim of this study is to analyze the relative contribution of these factors for the association between income and different indicators of health and diseases.Method:Analyses were based on data from the "German Socioeconomic Panel (GSOEP)" in 2011. We estimated the relative contribution of material, psychosocial and behavioral factors in income-related inequalities in health by logistic mediator analyses focusing on following outcomes: self-rated health, diabetes, cardiac disease, sleep disorder, joint diseases, depression and chronical back trouble.Results:The material, psychosocial and behavioral factors mediate between 45.2 and 97.7% of the association between income and health, depending on the health outcome. The material factors contributed most to health inequalities, separately (28.6-59.8%) and together with the psychosocial factors (39.8-87.4%). Health behavior plays a prominent role in diabetes and contributed separately 32.5% to the inequalities. Material deprivation and economic worries were the most significant indicators contributing to inequalities in health.Conclusions:The results indicate the high relevance of material, psychosocial and behavioral factors for explaining income-related inequalities in health. The identified patterns across multiple health outcomes illustrate the relevance of psychosocial and material factors and the need for health policy to increase the awareness about these mechanisms in the medical education and practice as well as in prevention.
authors.affiliation: Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Medizinische und Humanwissenschaftliche Fakultät, Universität zu Köln.
authors.forename: Timo-Kolja
authors.initials: TK
authors.lastname: Pförtner
authors.affiliation: Institut für Medizinische Soziologie, Universitätsklinikum Halle.
authors.forename: Irene
authors.initials: I
authors.lastname: Moor