Poverty makes people ill: Social inequality and health is the motto of the Local Health Authority Day 2024

The local health authority is a central pillar for protecting the health of the population. People in socially disadvantaged circumstances are an important target group for the public health service. Social inequality and health is the motto for this year's Local Health Authority Day on 19 March. "Education, occupation and income also influence health opportunities and life expectancy in Germany," emphasises Prof. Dr Lars Schaade, President of the Robert Koch Institute. The social inequality of health opportunities and disease risks is also a focus of epidemiological research and health reporting at the Robert Koch Institute.

People with a low social status are more frequently affected by chronic illnesses, accident injuries and disabilities. They rate their health less favourably and report more frequent health-related restrictions in their everyday lives. The utilisation of preventive services, such as vaccinations, decreases with lower education and income. The consequences of this inequality of opportunity are a greater need for services from the medical care system and social security in the event of illness. The effects of social disadvantage accumulate over the life course and lead to a significantly shorter life expectancy: "Women in the highest income group have a life expectancy that is more than 4 years longer than women in the lowest group. For men, this difference is more than eight years," emphasises Lars Schaade.

The social status also influences behaviour. Health scientists assume that a healthy lifestyle is not determined by what you want to do, but by what you can do. Doing more sport does not work in a socio-economically disadvantaged neighbourhood, even after poster campaigns, if there are hardly any green spaces or walking paths or no sports club is accessible. The COVID-19 pandemic has also "made social and health inequalities in Germany visible as if under a magnifying glass", according to a conference report on the "Poverty and Health" Congress 2023. At the annual congress in spring, researchers from the Robert Koch Institute, among others, reported that "the opportunities that individuals had to implement the prescribed or recommended measures to protect against infection played an important role. For example, people from lower-skilled and lower-status occupational groups had less opportunity to reduce their professional contacts and switch to working from home," according to the conference report.

The Federal Association of Physicians of German Public Health Departments states on its website: "The public health service has a key function ... in addressing socially disadvantaged groups. This focus can be justified in particular by the fact that these groups are less easily reached by the standard care system, which is primarily focussed on individual medicine."

The Local Health Authority Day was proclaimed by the RKI for the first time in 2019 to pay tribute to the work of local health authorities and to draw attention to their situation. 19 March is the birthday of Johann Peter Frank. The physician and social medicine specialist born in the mid-18th century, is regarded as the founder of the public health service. The Johann Peter Frank Medal is awarded by the Federal Association of Physicians of German Public Health Departments for services to the public health system in Germany.

Further information:

• www.rki.de/local-health-authority-day
• RKI website on Socioeconomic Status and Social Inequality

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