Ursachen schichtspezifischer Mortalität in der Bundesrepublik Deutschland: Tabakkonsum dominiert alle anderen Risikofaktoren

Abstract

To establish whether socioeconomic differences in mortality exist in the Federal Republic of Germany and whether any such differences are attributable to material, structural, and lifestyle factors. The database was the WHO-MONICA cohort study with two cross-sectional surveys performed in the Augsburg area in 1984/85 and 1989/90, and a mortality follow-up performed in 1997/98. The dataset comprised a total of 7268 persons of German nationality aged 25 to 72. Both men and women with lower educational qualifications have less economic resources (materialist thesis), are exposed to higher levels of physical stress at work (structuralist thesis) and lead a significantly less healthy lifestyle (cultural-behavioral thesis). Both males and females with the highest secondary school qualifications are more likely to engage in leisure-time physical activity, have a lower BMI and are less likely to be smokers, passive smokers or heavy drinkers. While these differences are reflected in a socioeconomic group-related mortality risk in males, our data disclose no significant correlation between socioeconomic group (operationalized on the basis of years of education) and mortality in females. This paper investigates the four most common hypotheses for the internationally well-documented phenomenon of socioeconomic group-related mortality on the basis of nationwide German longitudinal data. Regular nicotine consumption is by far the most significant controllable risk factor for mortality in both genders.