The role of national heritage in shaping Germany’s public health and data governance

Abstract

Abstract Aim This paper aims to explain how political culture has influenced the scope of prevention measures, disease surveillance, and health data integration strategies in the German health system to date. Subject and methods Political culture is a major determinant of national health policies in countries, defining the means and scope of governmental authority for ensuring population health. This paper explains the role of political culture in shaping prevention and health promotion measures in the German health system, based on a public policy theory. Results During the post-war period, the structure of the German health system was (re-)designed to focus on curative medicine at the expense of public health. Current prevention and health promotion measures, often characterised as ‘too little, too late’, lead to medical treatments that are ‘too costly, too risky’. Linking data sources in Germany today is much more challenging than in other European countries, with health-relevant data often remaining in isolated silos that could be used for population health. Conclusion The analysis suggests that the national heritage shaping the political culture in Germany had a great influence on the limited role of government intervention, the interpretation of public health, and the state’s role in collecting and processing health data of citizens for research and policymaking.