Changing health inequalities in Germany from 1994 to 2008 between employed and unemployed adults

Abstract

Objectives: Unemployment is a major determinant of health. We investigate whether health inequalities with regards to employment status have changed in Germany.

Methods: We used longitudinal data for the years 1994-2008 from a representative panel study (GSOEP). The sample consisted of respondents aged 30-59 years (15 waves, 21,329 persons, 129,526 observations). We analyzed trends and determinants of self-rated health status by employment status using logistic regression and fixed-effects logistic panel models.

Results: Health inequalities by employment status increased significantly by 72% in men and by 16% in women after controlling covariates. The trends were partly mediated by consequences of unemployment such as income loss, income poverty, life satisfaction and economic sorrows. Using regression models for panel data we confirmed that the observed increases in health inequalities at the population level also exist at the individual level.

Discussion: Altogether, our findings indicate that health inequalities with regards to employment status increased among men between 1994 and 2008. This observation is in line with increasing income inequalities in Germany and with increasing health inequalities in other European countries.