[Social inequalities in health. Analysis using data from statutory health insurance companies]

Abstract

Data from statutory health insurance companies are rarely used for studies in social epidemiology. Nevertheless it has been shown that health insurance data are suitable for studying social inequalities in health, social inequalities in health care utilization and for considering the healthrelated effects of unemployment. If analyses are confined to diseases that are well-documented and that are routinely treated in hospital settings, biases can be kept within acceptable boundaries. This applies particularly to malignant and cardiovascular diseases, diabetes, and accidents. Since the most frequently used indicators of social differentiation (income, education, and occupational position) are routinely recorded, social inequalities in health care can be examined, and unemployment periods of up to 24 months are well documented. The analyses have revealed considerable health inequalities. These may even be underestimated since the higher income groups are usually privately insured. Inpatient treatment in an unemployed compared to an employed insured is lower. Myocardial infarction is an exception since risks increase with increasing length of unemployment.