Materielle Deprivation und subjektive Gesundheit: Eine Längsschnittanalyse mit den Daten des Sozio-oekonomischen Panels (2001–2015)

Zusammenfassung

Hintergrund Während die negative Beziehung zwischen Armut und Gesundheit vielfach dokumentiert wurde, ist bislang unklar, ob diese auf soziale Verursachung oder auf indirekte oder direkte Selektion zurückzuführen ist. Des Weiteren wird Armut bislang meist aus dem Einkommen abgeleitet, obwohl dieses nur gering mit den tatsächlichen materiellen Lebensbedingungen korreliert ist. Die vorliegende Studie untersucht erstmals für Deutschland, ob sich materielle Deprivation auch unter verbesserter Kontrolle von indirekter Selektion auf die subjektive Gesundheit auswirkt.

Methodik Die Analyse basiert auf den Daten des für Deutschland repräsentativen Sozio-oekonomischen Panels (SOEP) der Jahre 2001 bis 2015. Das Analysesample enthält 54 995 Beobachtungen von 14 434 Männern und 60 766 Beobachtungen von 15 912 Frauen, jeweils mit einem durchschnittlichen Alter von 50 Jahren. Zunächst wird versucht, die bisherigen Forschungsergebnisse in gepoolten OLS- (POLS) und Random Effects-Modellen (RE) zu bestätigen. Anschließend werden lineare Fixed Effects-Regressionen (FE) berechnet, um für indirekte Selektion in Armut als Resultat von unbeobachteten zeitstabilen Merkmalen zu kontrollieren.

Ergebnisse In den POLS-Modellen zeigt sich, im Einklang mit früheren Studien, sowohl bei Männern als auch bei Frauen ein negativer Zusammenhang von materieller Deprivation und subjektiver Gesundheit. Diese Beziehung reduziert sich in den FE-Modellen stark. Aber auch nach verbesserter Kontrolle von indirekter Selektion lässt sich weiterhin eine signifikante Verschlechterung der Gesundheit durch materielle Deprivation feststellen, die mit steigender Intensität der materiellen Deprivation graduell zunimmt.

Schlussfolgerung Die Ergebnisse legen nahe, dass der negative Zusammenhang zwischen materieller Deprivation und subjektiver Gesundheit zu einem großen Teil durch indirekte Selektion bedingt ist. Der im FE-Modell verbleibende negative und graduelle Zusammenhang deutet darauf hin, dass materielle Deprivation die Gesundheit verschlechtert.

Abstract

Background Although the negative relationship between poverty and health is well-documented, it is still unclear whether it can be explained by social causation or by indirect or direct selection. Moreover, most studies measure poverty by income, which is only weakly correlated with the actual material living conditions. This study is the first to examine for Germany whether material deprivation still influences subjective health after accounting for indirect selection

Methods The analysis is based on the data from the German Socio-Economic Panel (GSOEP) 2001–2015. The sample consists of 54,995 observations on 14,434 men and 60,766 observations on 15,912 women, both with an average age of 50 years. In a first step, pooled OLS (POLS) and random effects models (RE) were applied to confirm the results of previous studies. In a second step, linear fixed effects regressions (FE) were applied to control for indirect selection into poverty as a result of time-constant unobserved heterogeneity.

Results In the POLS models, in line with previous studies, a negative association between material deprivation and subjective health was found for men and women. This relationship was considerably weaker in the FE models. However, even after better controlling for indirect selection, a significant deterioration of health through material deprivation could be observed, which gradually increased with the intensity of material deprivation.

Conclusion The results suggest that a large part of the negative correlation between material deprivation and subjective health can be explained by indirect selection. The remaining negative linear relationship in the FE model also indicates that material deprivation impairs health.

Schlüsselwörter

Armut - Materielle Deprivation - Subjektive Gesundheit - Gesundheitliche Ungleichheit - Fixed Effects-Regression - SOEP

Key words

Poverty - Material Deprivation - Subjective Health - Health Inequality - Fixed Effects Regression - GSOEP

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