Cohort effects of smoking, obesity and sickness in East and West Germany: how are they modulated by education?

Christina Westphal, University of Rostock
Gabriele Doblhammer-Reiter, University of Rostock

This paper examines differences in the risk factors ‘smoking’ and ‘obesity’ and the health variable ‘accident or sickness within the last four weeks’ between East and West Germany and analyzes differences in risks by birth cohorts. Further it is investigated how these differences are modulated by educational status. The analysis is based on the German Microcensus for the years 1995, 1999, 2003 and 2005 and we distinguish between cohort and age effects. Results show strong cohort effects and large differences between similar cohorts in East and West Germany especially for smoking and obesity. Concerning smoking, most improvements result from a continuous decrease of prevalences from the 1915 birth cohorts to the 1946-55 birth cohort. For obesity, reductions are highest in East Germany for cohorts born after WWII. For both risk factors, the downward trend is particularly strong in the highest educational group. For the health variable accident or sickness there is a strong decrease in prevalences for the cohorts born before 1915 up to the post WWII cohort (1946-55), particularly in the highest educational group in East Germany. There is no particular cohort pattern up to the reunification cohort (1981-1985). From these cohorts onwards, a strong increase of prevalences can be observed for all educational groups in both parts of Germany. If trends continue, we can expect that future older generations will in general be healthier than the elderly today. However, East - West differences might persist, especially for smoking. This holds especially true for East German females in the low educational group. For obesity we can observe a convergence of trends up to the reunification cohort. For the health variable, no differences in trends between the two parts of the country are expected.