Compression of morbidity and its alternatives with the context of health inequalities

• Applicant: Professor Dr. Siegfried Geyer
• Subject Area: Empirical Social Research
• Term: from 2017 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 389292058

Fries' hypothesis of morbidity compression refers to the shortening of time periods between the onset of disease, disability, and death. It is assumed that prevention and improved living conditions are contributing to changes of morbidity. As a pessimistic alternative Gruenberg put up the hypothesis of morbidity expansion as an unplanned consequence of medical progress. As a last alternative the dynamic equilibrium according to Manton describes an expansion of lifetimes spent in states of illness and disability, but with improved abilities for managing everyday life. For Germany and for the cases of myocardial infarction, stroke, multimorbidity and functional impairments it will be examined whether the development of morbidity can be described as morbidity compression. As a second step it will be considered whether morbidity changes are developing along the lines of social inequalities. As the third step it will be explained whether and to what extent the development of morbidity can be explained by health-related behaviours and/ or by changes of preventive and curative measures. The main basis of the analyses are data of the Statutory Health Insurance of Lower Saxony (AOK Niedersachsen) of the years 2005 to 2015. During the course of the project the data of 2016 and 2017 will be supplemented. The number of individuals in the annual datasets are approx. 2 Mio. per year. The health insurance data will be used for performing analyses on myocardial infarction, stroke, and multimorbidity. The data of the KORA/ KORA-Age study shall be used for replicating the findings on myocardial infarction, and also behaviour-based explanations shall be developed. Finally, the data of the Survey of Health, Ageing and Retirement in Europe (SHARE) shall be used for examining the development and the explanation of functional impairments. The development of morbidity compression affects major areas of the future development of welfare and the health care system. This refers e.g. to the development of working lifetime, priority setting in health care, the care of the elderly, or on how to develop residences for self-determined housing at old age.

• DFG Programme: Research Grants