FAQ

Healthy ageing in Germany – common care and insurance funding. Institutional and financial dimension of health promotion for older people

Publication date: 30.01.2017

Public Health and Governance, 2017, Volume 15, Issue 1, pp. 20 - 33

https://doi.org/10.4467/20842627OZ.17.004.6230

Authors

,
Stanisława Golinowska
Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow / Institute of Labour and Social Studies, Warsaw, Poland
https://orcid.org/0000-0002-1382-4741 Orcid
All publications →
,
Kai Huter
University of Bremen, SOCIUM – Research Center on Inequality and Social Policy, Germany
High-profile area Health Sciences, University of Bremen, Bremen
All publications →
,
Christoph Sowada
Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
https://orcid.org/0000-0002-8900-1119 Orcid
All publications →
,
Milena Pavlova
Department of Health Services Research; CAPHRI, Maastricht University Medical Center; Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands / Top Institute Evidence-Based Education Research (TIER), Maastricht University, The Netherlands
https://orcid.org/0000-0002-6082-8446 Orcid
All publications →
,
Agnieszka Sowa
Department of Social Policy, Institute of Labour and Social Studies, Warsaw, Poland
All publications →
Heinz Rothgang
High-profile area Health Sciences, University of Bremen, Bremen
All publications →

Titles

Healthy ageing in Germany – common care and insurance funding. Institutional and financial dimension of health promotion for older people

Abstract

In Germany responsibilities for health promotion and prevention lies with a multitude of different actors and institutions. The institutional arrangement of health promotion is shaped by the German federal structure of the state on the one hand and by a health care system that is characterized by divided responsibilities between governmental organisations, self-administered bodies and non-governmental organisations on the other hand. Although federal-level programs are successfully implemented in the country, the attempt of the Federal government to consolidate and clarify responsibilities in the public health area meets resistance. The Preventive Health Care Act from 2015 is an attempt to strengthen health promotion, its effective impact will be for the future to show.
Health promotion activities are initiated and provided by a variety of institutions: governmental, self-administered and voluntary (NGOs) often based on networks form. They cover activities on federal, Länder and local level. The Federal Ministry of Health and federal health agencies (specially BZgA) play an important role in this field. They created a number of health promotion regulation and activities initiatives which added to disease and addiction prevention. In health promotion for older people (HP4OP) programs, there is also a number of regionally and locally oriented initiatives. 
In this paper, we outline main features of the HP4OP activities in Germany with regard to institutions and financing mechanism. In addition, we describe health-targeting programmes/projects indicated as good practices:(a) established and developed in Germany and (b) provided by the European Commission with significant participation of German institutions. The multitude and variety of HP4OP programs differentiate positively German health system from other health systems in ageing countries. 

References

1. Busse R., Blümel M., Germany: health system review, “Health Systems in Transition” 2014; 16 (2): 1–331, http://www.euro.who.int/__data/assets/pdf_file/0008/255932/HiT-Germany.pdf?ua=1; accessed: 17.03.2016.

2. Raphael D., The political economy of health promotion: part 1, national commitments to provision of the prerequisites of health, “Health Promotion International” 2011; 28 (1): 91–111.

3. Robert Koch Institut, Gesundheitsberichterstattung des Bundes gemeinsam getragen von RKI und Destatis, Gesundheit in Deutschland, Berlin 2015.

4. Kaba-Schönstein L., Gesundheitsförderung V: Die Entwicklung in Deutschland ab Mitte der 1980er Jahre, Leitbegriffe der Gesundheitsförderung, Bundeszentrale für gesundheitliche Aufklärung, letzte Aktualisierung am 15.02.2011, http://www.leitbegriffe.bzga.de/alphabetisches-verzeichnis/gesundheitsfoerderung-v-die-entwicklung-in-deutschland-ab-mitte-der-1980er-jahre/; accessed: 30.08.2016.

5. Sitko S., Kowalska-Bobko I., Mokrzycka A., Zabdyr-Ja­mróz M., Domagała A., Magnavita N., Poscia A., Rogala M., 
Szetela A., Golinowska S., 
Institutional analysis of health promotion for older people in Europe, “BMC Health Services Research” 2016; 16 (Suppl. 5): 327.

6. Blümel S., Akteure, Angebote und Strukturen in: Bundeszentrale für gesundheitliche Aufklärung (eds), Leitbegriffe der Gesundheitsförderung und Prävention, Verlag für Gesundheitsförderung, Werbach–Gamburg 2011.

7. Kunkel T., Good practices in the field of health promotion and primary prevention, Germany Country Review, JA-Chrodis Project, Federal Centre for Health Education (BZgA), Cologne 2015, http://www.chrodis.eu/wp-content/uploads/2015/02/Germany-country-review; accessed: 14.09.2016.

8. Walter U., Schwartz W., Prävention: Institutionen und Strukturen, in: Public Health Buch. Gesundheit und Gesundheitswesen, F.M. Schwartz (red.), Urban & Fischer, München 2003, 2012.

9. Kooperationsverbund gesundheitsziele.de, Nationales 
Gesundheitsziel “Gesund älter werden”
, Bundesministerium für Gesundheit (red.), Berlin 2012, http://gesundheitsziele.de//cms/medium/814/Gesund_aelter_werden_020512.pdf; accessed: 30.08.2016.

10. Statistisches Bundesamt, Gesundheit, Ausgaben, Wiesbaden 2015, https://www.destatis.de/DE/Publikationen/Thema­tisch/Gesundheit/Gesundheitsausgaben/AusgabenGesund
heitLangeReihePDF_2120712.pdf?__blob=publicationFile; accessed: 10.03.2016.

11. Häring H.-U., Fritsche A., Prävention des Typ-2-Diabetes. 
TULIP-Studie – Tübinger Lebensstil Interventionsprogramm

in: Stierle M., Stierle G., Roth B., Bertelsmannstiftung (eds),
 Deutscher Präventionspreis 2005. Gesund in der zweiten Lebenshälfte (50plus). Die Preisträger und Nominierten, Druckerei festge, Oelde 2005.

12. Kuhlmann A., Koch K., Gesundheitsförderung und Prävention für ältere Menschen im Setting Kommune, Institut für Gerontologie an der Technischen Universität Dortmund, Dortmund 2009, http://www.kas.de/wf/doc/13261-1442-
1-30.pdf; accessed:14.04.2016

13. Gerlinger T., Präventionsgesetz, Leitbegriffe der Gesundheitsförderung, Bundeszentrale für gesundheitliche Aufklärung, letzte Aktualisierung am 12.07.2016, http://www.bzga.de/leitbegriffe/?id=angebote&idx=296; accessed: 20.10.2016.

Legal and policy documents:

1. BMEL (Federal Ministry of Food) and BMG (Federal Ministry of Health), Mehr Bewegung im Alter – Aktives Leben im Alter fördern, 2014, http://www.bewegung-foerdern.de/fileadmin/user_upload/MAIN-bilder/ZfB/Berlin/Mehr-Bewegung-im-Alltag.pdf; accessed: 14.09.2016.

2. Bundeszentrale für gesundheitliche Aufklärung (BZgA), Good Practice in the Field of Health Promotion and Primary Prevention, Joint Action on Chronic Diseases and Promoting Healthy Ageing Across the Life Cycle, EU project JA-CHRODIS, 2013.

3. Deutsche Bundesregierung, Deutschlands Zukunft gestalten. Koalitionsvertrag zwischen CDU, CSU und SPD–18. Legislaturperiode, 2013, http://www.bundesregierung.de/Content/DE/_Anlagen/2013/2013-12-17-koalitionsvertrag.pdf; accessed: 25.08.2016.

4. EuroHealthNet (Ingrid Stegeman, Terese Otte-Trojel, Caro­line Costongs and John Considine), Healthy and active ageing. compendium of programmes, good practices and other resources for promoting and sustaining the well-being of “younger” older people, with a specific reference to socially deprived and migrant groups in EuropeBundeszentrale für gesundheitliche Aufklärung (BZgA) incorporating work under taken by Thomas Altgeld, Landesvereinigung für Gesundheit und Akademie für Sozialmedizin Niedersachsen e. V. and Judith Sinclair-Cohen, 2012.

5. Gesetz zur Stärkung der Gesundheitsförderung und der 
Prävention (Präventionsgesetz – PrävG), vom 17. Juli 2015, Bundesgesetzblatt Jahrgang 2015, Teil Nr. 31, Bonn 24.07.2015, http://www.bgbl.de/xaver/bgbl/start.
xav?startbk=Bundesanzeiger_.BGBl&jumpTo=bgbl115s1368.pdf; accessed: 30.08.2016.

6. Gesetz über die Durchführung von Maßnahmen des Arbeitsschutzes zur Verbesserung der Sicherheit und des Gesundheitsschutzes der Beschäftigten bei der Arbeit (Arbeitsschutzgesetz – ArbSchG). 07.08.1996, last amended 31.08.2015, https://www.gesetze-im-internet.de/bundesrecht/arbschg/gesamt.pdf; accessed: 30.08.2016.

7. GKV-Spitzenverband/Medizinischer Dienst des Spitzenverbandes, Präventionsbericht 2015. Leistungen der gesetzlichen Krankenversicherung: Primärprävention und betriebliche Gesundheitsförderung Berichtsjahr 2014. GKV Spitzenverband, Medizinischer Dienst des Spitzenverbandes, Verbände der Krankenkassen auf Bundesebene, Berlin 2015.

8. GKV-Spitzenverband, Leitfaden Prävention. Handlungsfelder und Kriterien des GKV-Spitzenverbandes zur Umsetzung der §§ 20 und 20a SGBV vom 21. Juni 2000 in der Fassung vom 10. Dezember 2014, Berlin 2014.

9. GKV, Prävention und Gesundheitsförderung weiterentwickeln. Positionspapier des GKV-Spitzenverbandes beschlossen vom Verwaltungsrat am 27. Juni 2013, https://www.gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/praevention__selbsthilfe__beratung/praevention/2013-07-11_Positionspapier_Praevention_und_Gesundheit.pdf; accessed: 25.08.2016.

Information

Information: Public Health and Governance, 2017, Volume 15, Issue 1, pp. 20 - 33

Article type: Original article

Titles:

Polish:

Healthy ageing in Germany – common care and insurance funding. Institutional and financial dimension of health promotion for older people

English:

Healthy ageing in Germany – common care and insurance funding. Institutional and financial dimension of health promotion for older people

Authors

https://orcid.org/0000-0002-1382-4741

Stanisława Golinowska
Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow / Institute of Labour and Social Studies, Warsaw, Poland
https://orcid.org/0000-0002-1382-4741 Orcid
All publications →

Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow / Institute of Labour and Social Studies, Warsaw, Poland

University of Bremen, SOCIUM – Research Center on Inequality and Social Policy, Germany

High-profile area Health Sciences, University of Bremen, Bremen

https://orcid.org/0000-0002-8900-1119

Christoph Sowada
Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
https://orcid.org/0000-0002-8900-1119 Orcid
All publications →

Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland

https://orcid.org/0000-0002-6082-8446

Milena Pavlova
Department of Health Services Research; CAPHRI, Maastricht University Medical Center; Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands / Top Institute Evidence-Based Education Research (TIER), Maastricht University, The Netherlands
https://orcid.org/0000-0002-6082-8446 Orcid
All publications →

Department of Health Services Research; CAPHRI, Maastricht University Medical Center; Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands / Top Institute Evidence-Based Education Research (TIER), Maastricht University, The Netherlands

Department of Social Policy, Institute of Labour and Social Studies, Warsaw, Poland

High-profile area Health Sciences, University of Bremen, Bremen

Published at: 30.01.2017

Article status: Open

Licence: CC BY-NC-ND  licence icon

Percentage share of authors:

Stanisława Golinowska (Author) - 16%
Kai Huter (Author) - 16%
Christoph Sowada (Author) - 16%
Milena Pavlova (Author) - 16%
Agnieszka Sowa (Author) - 16%
Heinz Rothgang (Author) - 20%

Article corrections:

-

Publication languages:

English