Ageing in rural areas of East and West Germany: increasing similarities and remaining differences.
ABSTRACT: Since unification in 1990, living conditions in Germany's "New Länder" have slowly converged to the conditions in the "Old Länder". One can assume, however, that West-East differences persist more strongly in remote rural areas neglected by economic development. Therefore, this paper aims to investigate and compare the living conditions of older adults in rural areas in East and West Germany with respect to personal and environmental resources which are important preconditions for autonomy and well-being in old age. These conditions were examined in a survey conducted in urban and rural regions of five European countries in 2000. The German rural study was carried out in the districts of Jerichow (Saxony-Anhalt) and Vogelsberg (Hesse), and included 762 men and women aged 55 years or older, randomly chosen in villages of at most 5,000 inhabitants. East-West comparison showed both similarities and differences. Similarities arose in human conditions such as subjective health, parenthood and network variety, and in environmental conditions such as home-ownership, attachment to one's home, length of residence in the same neighbourhood, and satisfaction with mobility options. Differences were found in socio-demographic conditions (e.g. education, income, household composition), basic neighbourhood features, and patterns of social and leisure activities. Regression analysis showed the differing impact of single predictor variables on life satisfaction in the East and West: satisfaction with financial situation and functional health contributes far more to older people's life satisfaction in the West German rural area, whereas mobility-related aspects affect elders' life satisfaction more strongly in the East German countryside. The findings reflect, on the one hand, continuing structural East-West differences and, on the other, diverging socio-cultural habits.
Project description:Before 1990, Germany was divided for more than 40 years. While divided, significant mortality disparities between the populations of East and West Germany emerged. In the years following reunification, East German mortality improved considerably, eventually converging with West German levels. In this study, we explore changes in the gender differences in health at ages 20-59 across the eastern and western regions of Germany using data from the German Socio-Economic Panel (SOEP) for the 1990-2013 period. We apply random-effects linear regressions to the SOEP data to identify trends in health, measured as self-assessed health satisfaction, after German reunification. The findings indicate that women were substantially less satisfied with their health than men in both West and East Germany, but that the gender gap was larger in East Germany than in West Germany. Furthermore, the results show that respondents' satisfaction with their health decreased over time, and that the decline was steeper among men - and particularly among East German men - than among women. Thus, the initial male advantage in health in East and West Germany in the years immediately after reunification diminished over time, and even reversed to become a female advantage in East Germany. One interpretation of this finding is that stress-inducing post-reunification changes in the political and social landscape of East Germany had lasting damaging consequences for men's health. Ongoing risky health behaviors and high levels of economic insecurity due to unemployment could have had long-lasting effects on the health of the working-aged population. A partial explanation for our finding that health declined more sharply among East German men than among their female counterparts could be that women have better compensatory mechanisms than men for dealing with psychosocial stress.
Project description:<h4>Background</h4>While a strong negative impact of unemployment on health has been established, the present research examined the lesser studied interplay of gender, social context and job loss on health trajectories.<h4>Methods</h4>Data from the German Socio-Economic Panel was used, which provided a representative sample of 6838 participants. Using latent growth modelling the effects of gender, social context (East vs. West Germans), unemployment (none, short-term or long-term), and their interactions were examined on health (single item measures of self-rated health and life satisfaction respectively).<h4>Results</h4>Social context in general significantly predicted the trajectories of self-rated health and life satisfaction. Most notably, data analysis revealed that West German women reported significantly lower baseline values of self-rated health following unemployment and did not recover to the levels of their East German counterparts. Only long-term, not short-term unemployment was related to lower baseline values of self-rated health, whereas, in relation to baseline values of life satisfaction, both types of unemployment had a similar negative effect.<h4>Conclusions</h4>In an economic crisis, individuals who already carry a higher burden, and not only those most directly affected economically, may show the greatest health effects.
Project description:During their life course, older persons' income level may become discrepant with the socio-economic status of their neighbourhood. This study examines whether and how such discrepancies affect older persons' physical and mental health. Using baseline data from the Longitudinal Aging Study Amsterdam, 2,540 non-institutionalised persons aged 55-85 years were classified based on self-reported income and neighbourhood status. Two categories defined discrepancies: discrepant-low (DL, low income in high-status neighbourhood), and discrepant-high (DH, high income in low-status neighbourhood). Both categories were compared with the same reference category: matched-high (MH, high personal and high neighbourhood income status). A range of health indicators were examined, as well as mediating effects of neighbourhood and individual characteristics. Among the 504 persons who reported a high income, 16% lived in a low-status neighbourhood (DH). Conversely, among the 757 persons living in a high-status neighbourhood, 24% had a low income (DL). The DL category mainly lived in rural areas, and the DH category predominantly in large cities. The data show discrepant income effects (DL vs. MH) on physical and cognitive ability, self-rated health, and loneliness, and discrepant neighbourhood effects (DH vs. MH) on physical and cognitive ability, depressive symptoms, and loneliness. Personal income effects were partly mediated by other personal characteristics, and neighbourhood effects were fully mediated by socio-economic neighbourhood characteristics as well as by older persons' perceptions of their neighbourhood and their income. It is concluded that discrepancies between personal income and neighbourhood status, accrued throughout the life course, are associated with poor health.
Project description:Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50-69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms.
Project description:Long-term studies of land system change can help providing insights into the relative importance of underlying drivers of change. Here, we analyze land system change in Germany for the period 1883-2007 to trace the effect of drastic socio-economic and institutional changes on land system dynamics. Germany is an especially interesting case study due to fundamentally changing economic and institutional conditions: the two World Wars, the separation into East and West Germany, the accession to the European Union, and Germany's reunification. We employed the Human Appropriation of Net Primary Production (HANPP) framework to comprehensively study long-term land system dynamics in the context of these events. HANPP quantifies biomass harvests and land-use-related changes in ecosystem productivity. By comparing these flows to the potential productivity of ecosystems, HANPP allows to consistently assess land cover changes as well as changes in land use intensity. Our results show that biomass harvest steadily increased while productivity losses declined from 1883 to 2007, leading to a decline in HANPP from around 75%-65% of the potential productivity. At the same time, decreasing agricultural areas allowed for forest regrowth. Overall, land system change in Germany was surprisingly gradual, indicating high resilience to the drastic socio-economic and institutional shifts that occurred during the last 125 years. We found strikingly similar land system trajectories in East and West Germany during the time of separation (1945-1989), despite the contrasting institutional settings and economic paradigms. Conversely, the German reunification sparked a fundamental and rapid shift in former East Germany's land system, leading to altered levels of production, land use intensity and land use efficiency. Gradual and continuous land use intensification, a result of industrialization and economic optimization of land use, was the dominant trend throughout the observed period, apparently overruling socio-economic framework conditions and land use policies.
Project description:OBJECTIVES:To assess disparities in mortality by socioeconomic status in Germany. DESIGN AND PARTICIPANTS:We analyse a large administrative dataset of the German Pension Fund (DRV), including 27?million person-years of exposure and 42 000 deaths in 2013. The data cover the economically active population, stratified by sex and by East and West. OUTCOME MEASURES:Age-standardised mortality rates and Poisson regression mortality rate ratios (MRRs). RESULTS:The risk of dying increases with decreasing income: the MRRs of the lowest to the highest income quintile are 4.66 (95% CI 4.48 to 4.85) among men and 3.06 (95% CI 2.90 to 3.23) among women. The impact of income attenuates after controlling for education and other explanatory variables, especially for females. In the fully controlled model for females, individual income is a weaker predictor of mortality, but there is a clear educational mortality gradient. In the fully controlled model, the MRRs of the unemployed to the employed are 2.09 (95% CI 2.03 to 2.15) among men and 2.01 (95% CI 1.92 to 2.10) among women. The risk of dying is around half as high among foreigners as among German citizens. The socioeconomic disparities are greater among East than West German men. CONCLUSIONS:Low socioeconomic status is a major determinant of excess adult mortality in Germany. The persisting East-West differences in male adult mortality can be explained by the higher socioeconomic status of men living in the West, rather than by contextual differences between East and West. These differences can be further monitored using DRV data.
Project description:In post-unification Germany, lingering conflicts between East and West Germans have found some unusual outlets, including a debate of the relative superiority of East and West German 'Ampelmännchen' pedestrian traffic signs. In our study, we probed the visual efficacy of East and West German Ampelmännchen signs with a Stroop-like conflict task. We found that the distinctive East German man-with-hat figures were more resistant to conflicting information, and in turn produced greater interference when used as distractors. These findings demonstrate Stroop-like effects for real-life objects, such as traffic signs, and underline the practical utility of an East German icon.
Project description:<h4>Objectives</h4>To evaluate the psychometric properties of the Hong Kong version of Neighbourhood Cohesion Instrument (HK-NCI) and examine whether neighbourhood social cohesion as measured using HK-NCI would be associated with evaluative, hedonic and eudaemonic well-being.<h4>Design</h4>A validation analysis followed by a cross-sectional analysis of a community-based survey.<h4>Setting</h4>Communities in two districts (Sha Tin and Tai Po) in Hong Kong.<h4>Participants</h4>301 community-dwelling Chinese men and women aged 60 years and older normally residing in Sha Tin or Tai Po for not less than six consecutive months at the time of participation in the study were interviewed.<h4>Measurements</h4>Neighbourhood social cohesion was measured using the 15-item HK-NCI. The Social Cohesion Scale (SCS) and the Brief Sense of Community Scale (BSCS) were administered for assessing the validity of the HK-NCI. Evaluative (life satisfaction), hedonic (feelings of happiness) and eudaemonic well-being (sense of purpose and meaning in life) were examined. Socio-demographic characteristics, lifestyle and health behaviours, medical history, and neighbourhood characteristics were used as covariates.<h4>Results</h4>For homogeneity, internal consistency of HK-NCI (?=0.813) was good. For stability (test-retest reliability), the averages of mean scores of the 15 items suggested an acceptable repeatability with an intra-class correlation coefficient=0.701(95% CI 0.497 to 0.832). HK-NCI was correlated with SCS (r=0.515-0.635, p<0.001) and BSCS (r=0.500-0.612, p<0.001). Neighbourhood social cohesion was positively and independently associated with life satisfaction, feelings of happiness and sense of purpose and meaning in life (all p values <0.05). Stratified analyses indicated that neighbourhood social cohesion was more strongly associated with all dimensions of subjective well-being in 'young-old' subgroup, and with sense of purpose and meaning in life for women.<h4>Conclusion</h4>The HK-NCI has adequate levels of internal consistency and test-retest reliability. In addition, higher levels of neighbourhood social cohesion were associated with better subjective well-being among older Chinese people.
Project description:The present study extended traditional nation-based research on person-culture-fit to the regional level. First, we examined the geographical distribution of Big Five personality traits in Switzerland. Across the 26 Swiss cantons, unique patterns were observed for all traits. For Extraversion and Neuroticism clear language divides emerged between the French- and Italian-speaking South-West vs. the German-speaking North-East. Second, multilevel modeling demonstrated that person-environment-fit in Big Five, composed of elevation (i.e., mean differences between individual profile and cantonal profile), scatter (differences in mean variances) and shape (Pearson correlations between individual and cantonal profiles across all traits; Furr, 2008, 2010), predicted the development of subjective wellbeing (i.e., life satisfaction, satisfaction with personal relationships, positive affect, negative affect) over a period of 4 years. Unexpectedly, while the effects of shape were in line with the person-environment-fit hypothesis (better fit predicted higher subjective wellbeing), the effects of scatter showed the opposite pattern, while null findings were observed for elevation. Across a series of robustness checks, the patterns for shape and elevation were consistently replicated. While that was mostly the case for scatter as well, the effects of scatter appeared to be somewhat less robust and more sensitive to the specific way fit was modeled when predicting certain outcomes (negative affect, positive affect). Distinguishing between supplementary and complementary fit may help to reconcile these findings and future research should explore whether and if so under which conditions these concepts may be applicable to the respective facets of person-culture-fit.
Project description:Rural-urban inequalities in health status and access to care are a significant issue in China, especially among older adults. However, the rural-urban differences in health outcomes, healthcare use, and expenditures among insured elders following China's comprehensive healthcare reforms in 2009 remain unclear. Using the Chinese Longitudinal Healthy Longevity Surveys data containing a sample of 2,624 urban and 6,297 rural residents aged 65 and older, we performed multivariable regression analyses to determine rural-urban differences in physical and psychological functions, self-reported access to care, and healthcare expenditures, after adjusting for individual socio-demographic characteristics and health conditions. Nonparametric tests were used to evaluate the changes in rural-urban differences between 2011 and 2014. Compared to rural residents, urban residents were more dependent on activities of daily living (ADLs) and instrumental ADLs. Urban residents reported better adequate access to care, higher adjusted total expenditures for inpatient, outpatient, and total care, and higher adjusted out-of-pocket spending for outpatient and total care. However, rural residents had higher adjusted self-payment ratios for total care. Rural-urban differences in health outcomes, adequate access to care, and self-payment ratio significantly narrowed, but rural-urban differences in healthcare expenditures significantly increased from 2011 to 2014. Our findings revealed that although health and healthcare access improved for both rural and urban older adults in China between 2011 and 2014, rural-urban differences showed mixed trends. These findings provide empirical support for China's implementation of integrated rural and urban public health insurance systems, and further suggest that inequalities in healthcare resource distribution and economic development between rural and urban areas should be addressed to further reduce the rural-urban differences.