Case report Germany

Abstract Health data in Germany is collected through official statistics, registries, health insurance and population-based health information surveys. These data are used for monitoring progress of the Sustainable Development Goal on Good Health and Well-being (SDG3). According to the Sustainable Development Report 2022, Germany has achieved an overall high-performance score; however, there are still two health indicators which are stagnating or back-warding: “Gap in self-reported health status by income” and “Gap in life expectancy at birth among regions”. In order to illustrate regional inequalities in health, the Robert Koch Institute has developed the German Index of Socioeconomic Deprivation, which merges the dimensions of education, employment and income. It has been estimated that life expectancy between the least and most deprived district in Germany in 2017 differed by 6.0 years among men and by 3.2 years among women. In addition, data on all-cause premature mortality in Germany between 1992 and 2016 showed that while 13% of women and 27% of men from the lowest income group died before reaching the age of 65, this was the case for 8% of women and 14% of men from the highest income group. Self-rated health (SRH) according to income showed in Germany 2019 the largest gap (31% points) compared to other high-income OECD countries. Data from the German Health Update 2019/2020 also showed differences in SRH according to educational background. These differences were more pronounced among women (54% vs. 82%) than men (64% vs. 81%) and largely persisted across all age groups. Unfavorable SRH is an indicator known to be associated with increased morbidity and health-related limitations in daily life as well as a predictor of premature mortality. In Germany progress towards achieving SDG3 has been made; however, it is important to identify vulnerable groups and health inequalities in order to develop target-oriented interventions.