The contextual and household contribution to individual health status: what is the role of gender and migration background?

Daniela Georges, Universität Rostock
Daniel Kreft, Universität Rostock
Gabriele Doblhammer-Reiter, Universität Rostock

Households determine the long-term framework for health and thus act as an important factor in the preservation and promotion of individual health. Using data available from the German Microcensuses 2005 and 2009, we examine the effects of various generational constellations (one generation households, two generations with one and two children, two generations with three and more children, two generations with (grand)parents, three and more generations) on health outcomes, namely longstanding illness. We assume that different arrangements result in different health situations. Since (a) within households, gender roles are produced and reproduced in different ways, and (b) different groups of migrants live in Germany (we focus on the two largest groups: Turkish migrants and Aussiedler), which differ in their familial and health-related characteristics from the German population, we hypothesize to find differences by gender and migration background in terms of these effects. Our hypotheses are tested by sex-specific logistic regression models and multilevel regression models, each controlling for several other explanatory variables (e.g. socio-economic characteristics and lifestyle factors). Our results show that persons in one generation households (couples without children, singles) have worst health, while persons in two generation households with three and more children have best health. This effect is particularly applicable for women, whereas among men, much of the variance is explained by socio-economic characteristics. Socio-economic differences are also the main cause of differences by migration background. Controlled for these, the ethnic origin is insignificant among men and among women only Aussiedler differ significantly from native Germans; they show slightly better health. Neither socio-economic nor sex nor ethnic background superimpose the effect of the generation composition. Our results demonstrate the importance of the household as a largely independent health resource – especially among women. This indicates the need for and the potential of health interventions at the household level.