IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v72y2011i7p1205-1210.html
   My bibliography  Save this article

How relevant are district characteristics in explaining subjective health in Germany? - A multilevel analysis

Author

Listed:
  • Diehl, Katharina
  • Schneider, Sven

Abstract

This study was the first multilevel analysis to investigate the possible impact of macro-level factors on individual self-rated health over and above individual characteristics across Germany. This is especially interesting against the background of German history and the persistent disparity between Eastern and Western Germany. In this paper, the 439 German administrative districts, called Landkreise, provided the macro-level characteristics for this study. Altogether, 5516 individuals in 437 districts were included from data collected between 2005 and 2007. Our results show a significant association between the district unemployment rate and subjective health. The impact remains significant after adjusting for individual variables, including individual employment status. Furthermore, a significant association was found between subjective health and the degree of rurality, the proportion of elderly inhabitants and the proportion of foreigners. However, the variance of these was zero. In conclusion, our findings indicate an independent association between the unemployment rate of districts and individual self-rated health. Area mechanisms identified for other countries seem to exist in Germany, too, beyond the well-known differences between the Federal Republic of Germany and the German Democratic Republic that still influences individual health outcomes.

Suggested Citation

  • Diehl, Katharina & Schneider, Sven, 2011. "How relevant are district characteristics in explaining subjective health in Germany? - A multilevel analysis," Social Science & Medicine, Elsevier, vol. 72(7), pages 1205-1210, April.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:7:p:1205-1210
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(11)00099-2
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Oliver Razum & Thomas Altenhöner & Jürgen Breckenkamp & Sven Voigtländer, 2008. "Social Epidemiology after the German Reunification: East vs. West or Poor vs. Rich?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 53(1), pages 13-22, January.
    2. Wen, Ming & Browning, Christopher R. & Cagney, Kathleen A., 2003. "Poverty, affluence, and income inequality: neighborhood economic structure and its implications for health," Social Science & Medicine, Elsevier, vol. 57(5), pages 843-860, September.
    3. Stafford, M. & Cummins, S. & Macintyre, S. & Ellaway, A. & Marmot, M., 2005. "Gender differences in the associations between health and neighbourhood environment," Social Science & Medicine, Elsevier, vol. 60(8), pages 1681-1692, April.
    4. Jaffe, Dena H. & Eisenbach, Zvi & Neumark, Yehuda D. & Manor, Orly, 2005. "Individual, household and neighborhood socioeconomic status and mortality: a study of absolute and relative deprivation," Social Science & Medicine, Elsevier, vol. 60(5), pages 989-997, March.
    5. Fagg, James & Curtis, Sarah & Stansfeld, Stephen A. & Cattell, Vicky & Tupuola, Ann-Marie & Arephin, Muna, 2008. "Area social fragmentation, social support for individuals and psychosocial health in young adults: Evidence from a national survey in England," Social Science & Medicine, Elsevier, vol. 66(2), pages 242-254, January.
    6. Malmström, M. & Sundquist, J. & Johansson, S.-E., 1999. "Neighborhood environment and self-reported health status: A multilevel analysis," American Journal of Public Health, American Public Health Association, vol. 89(8), pages 1181-1186.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Johanna Muckenhuber & Nathalie Burkert & Franziska Großschädl & Wolfgang Freidl, 2014. "Income Inequality as a Moderator of the Relationship between Psychological Job Demands and Sickness Absence, in Particular in Men: An International Comparison of 23 Countries," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-6, February.
    2. Eibich, Peter & Ziebarth, Nicolas, 2014. "Examining the Structure of Spatial Health Effects in Germany Using Hierarchical Bayes Models," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 49, pages 305-320.
    3. Eva Kibele, 2014. "Individual- and area-level effects on mortality risk in Germany, both East and West, among male Germans aged 65+," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(3), pages 439-448, June.
    4. Eva U. B. Kibele & Sebastian Klüsener & Rembrandt D. Scholz, 2014. "Regional mortality disparities in Germany: long-term dynamics and possible determinants," MPIDR Working Papers WP-2014-009, Max Planck Institute for Demographic Research, Rostock, Germany.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Wight, Richard G. & Cummings, Janet R. & Miller-Martinez, Dana & Karlamangla, Arun S. & Seeman, Teresa E. & Aneshensel, Carol S., 2008. "A multilevel analysis of urban neighborhood socioeconomic disadvantage and health in late life," Social Science & Medicine, Elsevier, vol. 66(4), pages 862-872, February.
    2. Nieuwenhuis, Jaap, 2020. "Neighborhood social capital and adolescents’ individual health development," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Wen, Ming & Hawkley, Louise C. & Cacioppo, John T., 2006. "Objective and perceived neighborhood environment, individual SES and psychosocial factors, and self-rated health: An analysis of older adults in Cook County, Illinois," Social Science & Medicine, Elsevier, vol. 63(10), pages 2575-2590, November.
    4. Ivory, Vivienne C. & Collings, Sunny C. & Blakely, Tony & Dew, Kevin, 2011. "When does neighbourhood matter? Multilevel relationships between neighbourhood social fragmentation and mental health," Social Science & Medicine, Elsevier, vol. 72(12), pages 1993-2002, June.
    5. Kravdal, Øystein, 2009. "Mortality effects of average education in current and earlier municipality of residence among internal migrants, net of their own education," Social Science & Medicine, Elsevier, vol. 69(10), pages 1484-1492, November.
    6. Hutchinson, Rebbeca N. & Putt, Mary A. & Dean, Lorraine T. & Long, Judith A. & Montagnet, Chantal A. & Armstrong, Katrina, 2009. "Neighborhood racial composition, social capital and black all-cause mortality in Philadelphia," Social Science & Medicine, Elsevier, vol. 68(10), pages 1859-1865, May.
    7. Lei, Lei, 2017. "The impact of community context on children's health and nutritional status in China," Social Science & Medicine, Elsevier, vol. 179(C), pages 172-181.
    8. Youngkook Kim, 2016. "Impacts of the perception of physical environments and the actual physical environments on self-rated health," International Journal of Urban Sciences, Taylor & Francis Journals, vol. 20(1), pages 73-87, March.
    9. Nummela, Olli & Raivio, Risto & Uutela, Antti, 2012. "Trust, self-rated health and mortality: A longitudinal study among ageing people in Southern Finland," Social Science & Medicine, Elsevier, vol. 74(10), pages 1639-1643.
    10. Ziliang Jin & Jiangping Wang & Xu Liu & Xu Han & Jiaojiao Qi & Jingyong Wang, 2022. "Stress Recovery Effects of Viewing Simulated Urban Parks: Landscape Types, Depressive Symptoms, and Gender Differences," Land, MDPI, vol. 12(1), pages 1-23, December.
    11. Stafford, Mai & Cummins, Steven & Ellaway, Anne & Sacker, Amanda & Wiggins, Richard D. & Macintyre, Sally, 2007. "Pathways to obesity: Identifying local, modifiable determinants of physical activity and diet," Social Science & Medicine, Elsevier, vol. 65(9), pages 1882-1897, November.
    12. Colette Cunningham-Myrie & Katherine P Theall & Novie Younger-Coleman & Lisa-Gaye Greene & Parris Lyew-Ayee & Rainford Wilks, 2021. "Associations of neighborhood physical and crime environments with obesity-related outcomes in Jamaica," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-19, April.
    13. Steffen Andreas Schüle & Gabriele Bolte, 2015. "Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-31, April.
    14. Zhang, Wei & Ta, Van M., 2009. "Social connections, immigration-related factors, and self-rated physical and mental health among Asian Americans," Social Science & Medicine, Elsevier, vol. 68(12), pages 2104-2112, June.
    15. Badland, Hannah & Whitzman, Carolyn & Lowe, Melanie & Davern, Melanie & Aye, Lu & Butterworth, Iain & Hes, Dominique & Giles-Corti, Billie, 2014. "Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health," Social Science & Medicine, Elsevier, vol. 111(C), pages 64-73.
    16. Stephanie A. Prince & Elizabeth A. Kristjansson & Katherine Russell & Jean-Michel Billette & Michael Sawada & Amira Ali & Mark S. Tremblay & Denis Prud’homme, 2011. "A Multilevel Analysis of Neighbourhood Built and Social Environments and Adult Self-Reported Physical Activity and Body Mass Index in Ottawa, Canada," IJERPH, MDPI, vol. 8(10), pages 1-26, October.
    17. Tian Gao & Rui Song & Ling Zhu & Ling Qiu, 2019. "What Characteristics of Urban Green Spaces and Recreational Activities Do Self-Reported Stressed Individuals Like? A Case Study of Baoji, China," IJERPH, MDPI, vol. 16(8), pages 1-16, April.
    18. Biglan, Anthony & Cody, Christine, 2013. "Integrating the human sciences to evolve effective policies," Journal of Economic Behavior & Organization, Elsevier, vol. 90(S), pages 152-162.
    19. Ahnquist, Johanna & Wamala, Sarah P. & Lindstrom, Martin, 2012. "Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes," Social Science & Medicine, Elsevier, vol. 74(6), pages 930-939.
    20. Anne Ellaway & Ruth Dundas & Tony Robertson & Paul G Shiels, 2019. "More miles on the clock: Neighbourhood stressors are associated with telomere length in a longitudinal study," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-11, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:72:y:2011:i:7:p:1205-1210. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.