The impact of occupation and family status on overall mortality in a cohort of male members of a health insurance fund in Germany

Abstract

The aim of the study was to evaluate the impact of occupation, family status, and smoking on overall mortality in males in Germany. This study used data from a longitudinal register of the “Gmuender Ersatzkasse” (GEK), a German health insurance fund, for the time period between January 1989 and December 2000. Included in the analysis were male members of the GEK who were employed on 1 January 1989 and who were born between 1935 and 1950. Only those occupations were considered for which the frequency exceeded 1,000 cases. Thus, 17 occupations comprising 80,716 individuals were included. The statistical analysis was performed utilizing the software package “Transitional Data Analysis” (TDA) and employing the Kaplan-Meier life-table approach and a multivariate survival analysis applying the Cox regression method. Statistically increased relative risks for total mortality were observed for non-married persons, for the four main occupational groups with a lower status, for 13 occupations with medium or lower status, and for occupations yielding a smoking prevalence rate of 40% and more. Longitudinal data from health insurance funds in Germany provide a valuable resource for social epidemiological investigations. The findings suggest that the occupational setting has a strong impact on overall mortality experience in Germany.