S March

Erfahrungen mit der Datenverknüpfung von Primär- und Sekundärdaten in einer Interventionsstudie

The data linkage of health-related primary and secondary data provides new opportunities for health services research. The advantages of both data sources can be used synergistically, in this way their disadvantages can be overcome. In the context of the evaluation of a health intervention - the integrated health services project (Gesundes Kinzigtal) - the conditions and requirements for an individualised data linkage of primary data (survey) and claims data of a statutory health insurance are described in this paper. The integration of secondary data permits us not only to assess the intervention concerning physical activity, nutrition and social participation of elderly people (AGil) but, above all, also to measure and analyse the program effects on the utilisation of health care services. Recommendations regarding the data linkage of primary and secondary data in health services research are derived from the results and experiences of the AGil study. Suggestions are made concerning the suitable pseudonymisation algorithm for primary and secondary data, the matching method, approaches to reduce mismatching and their validation, as well as the legal basis for such a data linkage. Overall, an individualised data linkage of primary and secondary data does not pose any technical problems. Nevertheless a couple of data protection rules have to be followed; the data linkage offers a high knowledge insight to many health and epidemiological research questions and might be the new gold standard for health services research.

Datenschutzrechtliche Vorgehensweise bei der Verknüpfung von Primär- und Sekundärdaten in einer Kohortenstudie: die lidA-Studie

In the German health service research there exists, unlike in labour market research, no experience with the combination of personal primary and secondary data. One of the reasons for this is, among other things, data protection. The lidA cohort study analyses persons in employment (excluding civil servants and self-employed), born in 1959 and 1965. It is intended to give answers to questions from the health services research as well as from the labour market research. It relies on different primary and secondary data sources: survey data, process data from the Federal Employment Agency, aggregated and individual health insurance data. The experiences made in the lidA study, in addition to the data protection needs and the expenditures for the implementation, are summarised as best practice. The procedure for the application process according to § 75 SGB X, the directive to develop data security concepts, the informed consent for the linkage of personal information are described and the importance of a transparent approach is explained. So far it has been shown that the preparation and approval process for the release of the actual data, both within the project consortium, but also with external parties such as health insurance companies or the responsible data protection officer, requires a major effort. In view of all the identified legal and organisational challenges, our findings should be extremely useful for answering different research questions in the fields of labour market and health services research. In combination with primary data, they may even represent a gold standard for epidemiology and health services research.

Datenlinkage von Primär- und Sekundärdaten

In Germany, research on health-care services addresses many topics within a regional context, and it predominantly uses a single (typically secondary) data sources for this purpose. The specific disadvantages and methodological challenges associated with these data sources may limit analysis. Various data sources break the data down by region and may be of interest in regional health-care research. Linking multiple data sources (data linkage) could therefore expand analysis options in this area. Researchers in this field are currently discussing various approaches for using data linkage to overcome the respective weaknesses of primary and secondary data. This contribution covers the various types of data linkage (on an aggregate or individual level) and their potentials and limitations in small area health services research. The focus lies on individual data linkage, which requires written informed consent. Taking into account methodological and particularly data protection challenges, conclusions are drawn regarding future application areas and options of small area health services research and specific examples are provided.ZusammenfassungDie Versorgungsforschung in Deutschland behandelt eine Vielzahl von Themen im regionalen Kontext und nutzt dafür überwiegend eine (in der Regel: Sekundär-)Datenquelle. Deren spezifische Nachteile und methodischen Einschränkungen können sich limitierend auf eine Analyse auswirken. Zur regionalen Aufgliederung existieren vielfältige Datenquellen, die für die regionale Versorgungsforschung von Interesse sein könnten. Eine Verknüpfung verschiedener Datenquellen (Datenlinkage) könnte somit die Analysemöglichkeiten erweitern. In der Versorgungsforschung selbst werden derzeit verschiedene Ansätze diskutiert, um die jeweiligen Schwächen von Primär- und Sekundärdaten über ein Datenlinkage zu überwinden. Der vorliegende Beitrag thematisiert die verschiedenen Formen des Datenlinkage (auf aggregiertem bzw. individuellem Niveau) sowie deren Potenziale und Restriktionen für die kleinräumige Versorgungsforschung. Der Fokus liegt auf dem individuellen Datenlinkage, das ein schriftliches Einverständnis voraussetzt (informed consent). Unter Berücksichtigung der methodischen und insbesondere datenschutzrechtlichen Herausforderungen werden Schlussfolgerungen über zukünftige Anwendungsfelder und -möglichkeiten der kleinräumigen Versorgungsforschung gezogen und an Beispielen konkretisiert.AbstractIn Germany, research on health-care services addresses many topics within a regional context, and it predominantly uses a single (typically secondary) data sources for this purpose. The specific disadvantages and methodological challenges associated with these data sources may limit analysis. Various data sources break the data down by region and may be of interest in regional health-care research. Linking multiple data sources (data linkage) could therefore expand analysis options in this area. Researchers in this field are currently discussing various approaches for using data linkage to overcome the respective weaknesses of primary and secondary data. This contribution covers the various types of data linkage (on an aggregate or individual level) and their potentials and limitations in small area health services research. The focus lies on individual data linkage, which requires written informed consent. Taking into account methodological and particularly data protection challenges, conclusions are drawn regarding future application areas and options of small area health services research and specific examples are provided.

Are status inconsistency, work stress and work-family conflict associated with depressive symptoms? Testing prospective evidence in the lidA study

BACKGROUNDnDepressive symptoms are common and economically relevant. Women suffer more often than men do. We analyze associations between social status inconsistency, psychosocial factors, and depressive symptoms stratified by gender.nnnMETHODSnIn the present study, 3340 employees of two age cohorts (1959, 1965) working in two waves (2011, 2014) of the prospective German lidA-study and who gave written consent to link register data regarding their employment histories were included. Gender-specific influences of social status inconsistency (deviation of observed income from expected average income based on acquired education) on depressive symptoms and mediation of these associations by work stress in terms of effort-reward-imbalance (ERI) and work-family-conflict (WFC) were analyzed with confirmatory cross-lagged path models.nnnRESULTSnAmong men, consistent status (i.e., average income in a specific educational group) increased the frequency of depressive symptoms. No association between negative SSI (i.e., income below the average income given a specific educational attainment) or positive SSI (i.e., income above the average income given a specific educational attainment) and depressive symptoms was observed among men or women. ERI and WFC were longitudinally associated with the outcome and differed slightly regarding gender, i.e., showing stronger effects of ERI for women and of WFC for men. Mediation of the association between social status and depressive symptoms was observed for men and for consistent status (path: consistent status → ERI → depressive symptoms) but not for SSI.nnnCONCLUSIONSnERI and WFC increase the risk of future episodes with depressive symptoms in men and in women irrespective of SSI, occupational position, full- or part-time work, regional factors or individual characteristics.

Berufliche Gratifikationskrisen und Arbeitsunfähigkeit in Deutschland

BACKGROUNDnDemographic change is leading to a shrinking and ageing workforce in industrialized nations. Therefore, sickness absence may become a relevant problem. Increasing absenteeism and retirement rates due to mental disorders raise the question of an association between work-related stress and sickness absence. Studies on this matter, particularly in older employees, are rare.nnnOBJECTIVESnWe studied for the first time in Germany the relationship between effort-reward imbalance (ERI) and overall or long-term sickness absence.nnnMATERIALS AND METHODSnLidA ( Living at Work) is a German cohort study on work, age, health, and work participation. A total of 6,339 employees born in 1959 and 1965 who were subject to social insurance contributions were interviewed nationwide using a representative sample concept. The response rate was 27.3u2009%. The sample showed high representativeness and no selectivity relating to 16 sociodemographic items. Sickness absence was defined as at least one long-term sickness absence with at least 43 days of absenteeism. Work-related stress was parameterized by ERI tertiles. Multiple logistic regression adjusting for age, sex, mental disorders, social status, and working time was performed.nnnRESULTSnHigh levels of work-related stress were significantly associated with overall and long-term sickness absence among older employees after adjusting for covariates.nnnCONCLUSIONSnOur unique findings on work-related stress and sickness absence in Germany are in agreement with the results of most international studies. Reducing work-related stress could help to preserve the workforce.ZusammenfassungHintergrundDer demografische Wandel geht in Industrienationen mit abnehmendem Arbeitskräfteangebot und alternden Belegschaften einher. Arbeitsunfähigkeit kann zu einem zusätzlichen Arbeitskräfteverlust führen. Zunehmende Krankmeldungen aufgrund psychischer Einschränkungen werfen Fragen zum Zusammenhang zwischen Arbeitsstress und Arbeitsunfähigkeit auf. Studien dazu sind gerade bei älteren Arbeitnehmern selten.ZielUntersucht wird der Einfluss von arbeitsbezogenem Stress aufgrund eines Ungleichgewichts zwischen beruflicher Verausgabung und dafür empfangener Belohnungen (Effort-Reward-Imbalance(ERI)-Modell) auf Arbeitsunfähigkeit bzw. Langzeitarbeitsunfähigkeit.Material und MethodenlidA („leben in der Arbeit“) ist eine deutschlandweite Kohortenstudie zu Arbeit, Alter, Gesundheit und Erwerbsteilhabe. 6339 repräsentative, sozialversicherungspflichtig Beschäftigte der Jahrgänge 1959 und 1965 wurden eingeschlossen. Die Teilnahmequote lag bei 27,3u2009% mit hoher Repräsentativität und ohne Selektivität der Stichprobe in 16 soziodemografischen Variablen. Arbeitsunfähigkeit war definitionsgemäß mindestens ein Fehltag, Langzeitarbeitsunfähigkeit mindestens 43 Fehltage in den letzten 12 Monaten. Arbeitsbezogener Stress wurde mit ERI-Terzilen parametrisiert. In der multiplen logistischen Regression wurde für Alter, Geschlecht, psychische Störungen, sozioökonomischen Status und Arbeitszeit adjustiert.ErgebnisseHochgradiger arbeitsbezogener Stress war bei älteren Beschäftigten unabhängig von Kovariaten mit Arbeitsunfähigkeit und Langzeitarbeitsunfähigkeit verbunden.DiskussionDer für Deutschland erstmals beobachtete Zusammenhang zwischen ERI und Arbeitsunfähigkeit stimmt mit den diesbezüglichen Ergebnissen der Mehrzahl internationaler Studien überein. Arbeitsstressreduktion könnte helfen, Arbeitskraft zu erhalten.AbstractBackgroundDemographic change is leading to a shrinking and ageing workforce in industrialized nations. Therefore, sickness absence may become a relevant problem. Increasing absenteeism and retirement rates due to mental disorders raise the question of an association between work-related stress and sickness absence. Studies on this matter, particularly in older employees, are rare.ObjectivesWe studied for the first time in Germany the relationship between effort–reward imbalance (ERI) and overall or long-term sickness absence.Materials and methodsLidA ( “Living at Work”) is a German cohort study on work, age, health, and work participation. A total of 6,339 employees born in 1959 and 1965 who were subject to social insurance contributions were interviewed nationwide using a representative sample concept. The response rate was 27.3u2009%. The sample showed high representativeness and no selectivity relating to 16 sociodemographic items. Sickness absence was defined as at least one long-term sickness absence with at least 43 days of absenteeism. Work-related stress was parameterized by ERI tertiles. Multiple logistic regression adjusting for age, sex, mental disorders, social status, and working time was performed.ResultsHigh levels of work-related stress were significantly associated with overall and long-term sickness absence among older employees after adjusting for covariates.ConclusionsOur unique findings on work-related stress and sickness absence in Germany are in agreement with the results of most international studies. Reducing work-related stress could help to preserve the workforce.

Methodische Überlegungen für das Datenlinkage von Primär- und Sekundärdaten im Rahmen arbeitsepidemiologischer Studien

ZusammenfassungMit Blick auf die alternde Bevölkerung erlangt der Themenkomplex „Arbeit, Alter und Gesundheit“ eine zunehmende Bedeutung. Ein zentraler Aspekt arbeitsepidemiologischer Forschung ist daher die Frage, welche Arbeitsbedingungen krank machen und welche Faktoren für ein langes Verbleiben im Berufsleben maßgeblich sind. Bislang bedient sich die arbeitsepidemiologische Forschung hierfür unterschiedlicher Primär- und Sekundärdatenquellen, aber nur vereinzelt des Instruments des Datenlinkage. Die hier vorgestellte Studie verknüpft 2 große Datensätze zu einer „Age-Work-Matrix“ auf Basis der Klassifikation der Berufe von 1988 (berufliche Tätigkeit als Schlüsselvariable). Einer der verwendeten Datenkörper besteht aus der repräsentativen BIBB/BAuA-Befragung für Erwerbstätige aller Berufsgruppen in Deutschland 2005/06, der andere aus den Arbeitsunfähigkeitsmeldungen von Versicherten einer deutschlandweit vertretenen gesetzlichen Krankenkasse. Mit dem Matrix-Ansatz sollen Zusammenhänge zwischen subjektiv erlebten psychosozialen Belastungen und möglichen gesundheitlichen Auswirkungen untersucht werden. Die verwendeten Krankenkassendaten bieten mit den Angaben zur Arbeitsunfähigkeit einen Indikator für gesundheitliche Beeinträchtigungen. Die Nutzbarkeit der Arbeitsunfähigkeitsdaten in arbeitsepidemiologischen Studien, deren methodische Herausforderungen sowie die realisierten Lösungen werden diskutiert.AbstractWithin the scope of an aging population, the topic age, work and health becomes more and more important. So far, research in occupational epidemiology utilizes various primary or secondary data sources. However, data linkage has rarely been used as an instrument in this field. The study presented here combines two large databases within a so-called “age–work matrix”, stratified by sex, age group and occupational group. This matrix is based on the German classification of occupations and uses its occupation codes as a key variable. The first database is the representative BIBB/BAuA employment survey for employees of all occupations in Germany 2005/06. The second database consists in sickness absence data of the insurees of a German statutory health insurance fund. Using the matrix approach, the study investigates associations of reported subjectively perceived psychosocial work strains and health impairments provided by health insurance claims data. These claims data offer sickness absence data as an indicator for health impairments. Usability of sickness absence data for studies in occupational epidemiology, their methodological challenges and the solutions realized in this study are discussed.Within the scope of an aging population, the topic age, work and health becomes more and more important. So far, research in occupational epidemiology utilizes various primary or secondary data sources. However, data linkage has rarely been used as an instrument in this field. The study presented here combines two large databases within a so-called age-work matrix, stratified by sex, age group and occupational group. This matrix is based on the German classification of occupations and uses its occupation codes as a key variable. The first database is the representative BIBB/BAuA employment survey for employees of all occupations in Germany 2005/06. The second database consists in sickness absence data of the insurees of a German statutory health insurance fund. Using the matrix approach, the study investigates associations of reported subjectively perceived psychosocial work strains and health impairments provided by health insurance claims data. These claims data offer sickness absence data as an indicator for health impairments. Usability of sickness absence data for studies in occupational epidemiology, their methodological challenges and the solutions realized in this study are discussed.

Gesundheit von älteren Erwerbstätigen

ZusammenfassungHintergrund und ZielstellungAufgrund des demografischen Wandels altert das Erwerbspersonenpotenzial zunehmend. Maßgeblich für die Erwerbsteilhabe bis ins höhere Alter ist die Gesundheit. Die Kenntnis von deren Determinanten und Verteilung ist wichtig, um Risikogruppen für einen Ausstieg aus dem Erwerbsleben zu identifizieren. Der vorliegende Beitrag untersucht die Gesundheit der Jahrgänge 1959 und 1965.Material und MethodenGenutzt wurden Daten von sozialversicherungspflichtigen Erwerbstätigen aus der Ersterhebung der lidA – leben in der Arbeit-Studie (2011; nu2009=u20096339). Aus computergestützten Interviews wurden Angaben zum subjektiven Gesundheitszustand, zu ärztlich diagnostizierten Krankheiten bzw. Gesundheitsbeeinträchtigungen, differenziert nach Jahrgang, Geschlecht und Berufsgruppe, analysiert.ErgebnisseBeide Jahrgänge weisen einen hohen Anteil positiver Gesundheit auf mit geringfügigen geschlechtsspezifischen Unterschieden (1959: Männer 50u2009% vs. Frauen 51u2009%; 1965: jeweils 58u2009%). Agrarberufe, einfache manuelle Berufe und einfache Dienste zählen zu den Risikogruppen für eine eingeschränkte Gesundheit. Die „Gesündesten“ sind die Professionen, Manager und Ingenieure. Weiterhin steigt die Krankheitsprävalenz (mindestens 1 ärztlich diagnostizierte Krankheit) mit zunehmendem Alter (1965: 78u2009%; 1959: 82u2009%). Die höchste Prävalenz weisen Arthrose und Hypertonie auf, die höchste 12-Monats-Inzidenz findet sich bei Migräne/Spannungskopfschmerzen und Heuschnupfen/allergische Bindehautentzündung.DiskussionBis zur Analyse der Follow-up-Befragung können über den prädiktiven Wert der Ergebnisse aus der Ersterhebung noch keine Aussagen gemacht werden. Dennoch sind Risikogruppen für eingeschränkte Gesundheit und ggf. Ausstieg aus dem Erwerbsleben erkennbar.AbstractBackgroundDue to the demographic changes, the potential labor force is increasingly aging. The most important factor to successfully participate in the workforce at a higher age is health. In order to identify groups at risk of exiting the labor market, it is important to know the factors involved and distribution of health. This article explores the health of workers who were born in 1959 and 1965.Material and methodsThe analysis is based on the data of workers included in the social insurance system from the baseline survey of the lidA (living at work) study, a German cohort study on work, age, health and work participation (2011, nu2009=u20096339). Data from computer-assisted interviews about self-rated health, medically diagnosed diseases and health impairments are considered in detail and differentiated by year of birth, sex and occupational group.ResultsThe data analyzed showed a high proportion of positive health, with slight gender differences (1959: men 50u2009%, women 51u2009% and 1965: both sexes 58u2009%). Agricultural occupations, simple manual occupations and simple services were the occupational groups with a risk for impaired health. The healthiest were professional groups, managers and engineers. The disease prevalence (at least one medically diagnosed illness) increased with age (1965: 78u2009% and 1959: 82u2009%). Osteoarthritis and hypertension had the highest prevalence, whereas migraine and tension headaches, hay fever and allergic conjunctivitis showed the highest 12-month incidence.ConclusionWithout the analysis of the follow-up survey no statements can be made about the predictive value of the results from the baseline survey. Nevertheless, risk groups for impaired health and exiting the labor market could be shown.

[Data linkage of primary and secondary data: a gain for small-area health-care analysis?].

In Germany, research on health-care services addresses many topics within a regional context, and it predominantly uses a single (typically secondary) data sources for this purpose. The specific disadvantages and methodological challenges associated with these data sources may limit analysis. Various data sources break the data down by region and may be of interest in regional health-care research. Linking multiple data sources (data linkage) could therefore expand analysis options in this area. Researchers in this field are currently discussing various approaches for using data linkage to overcome the respective weaknesses of primary and secondary data. This contribution covers the various types of data linkage (on an aggregate or individual level) and their potentials and limitations in small area health services research. The focus lies on individual data linkage, which requires written informed consent. Taking into account methodological and particularly data protection challenges, conclusions are drawn regarding future application areas and options of small area health services research and specific examples are provided.ZusammenfassungDie Versorgungsforschung in Deutschland behandelt eine Vielzahl von Themen im regionalen Kontext und nutzt dafür überwiegend eine (in der Regel: Sekundär-)Datenquelle. Deren spezifische Nachteile und methodischen Einschränkungen können sich limitierend auf eine Analyse auswirken. Zur regionalen Aufgliederung existieren vielfältige Datenquellen, die für die regionale Versorgungsforschung von Interesse sein könnten. Eine Verknüpfung verschiedener Datenquellen (Datenlinkage) könnte somit die Analysemöglichkeiten erweitern. In der Versorgungsforschung selbst werden derzeit verschiedene Ansätze diskutiert, um die jeweiligen Schwächen von Primär- und Sekundärdaten über ein Datenlinkage zu überwinden. Der vorliegende Beitrag thematisiert die verschiedenen Formen des Datenlinkage (auf aggregiertem bzw. individuellem Niveau) sowie deren Potenziale und Restriktionen für die kleinräumige Versorgungsforschung. Der Fokus liegt auf dem individuellen Datenlinkage, das ein schriftliches Einverständnis voraussetzt (informed consent). Unter Berücksichtigung der methodischen und insbesondere datenschutzrechtlichen Herausforderungen werden Schlussfolgerungen über zukünftige Anwendungsfelder und -möglichkeiten der kleinräumigen Versorgungsforschung gezogen und an Beispielen konkretisiert.AbstractIn Germany, research on health-care services addresses many topics within a regional context, and it predominantly uses a single (typically secondary) data sources for this purpose. The specific disadvantages and methodological challenges associated with these data sources may limit analysis. Various data sources break the data down by region and may be of interest in regional health-care research. Linking multiple data sources (data linkage) could therefore expand analysis options in this area. Researchers in this field are currently discussing various approaches for using data linkage to overcome the respective weaknesses of primary and secondary data. This contribution covers the various types of data linkage (on an aggregate or individual level) and their potentials and limitations in small area health services research. The focus lies on individual data linkage, which requires written informed consent. Taking into account methodological and particularly data protection challenges, conclusions are drawn regarding future application areas and options of small area health services research and specific examples are provided.

Linking primary study data with administrative and claims data in a German cohort study on work, age, health and work participation: is there a consent bias?

OBJECTIVESnWe analysed the degree and impact of consent bias in the prospective study leben in der Arbeit (lidA) after linking primary interview data with claims data from German statutory health insurance funds as well as with administrative data provided by the German Federal Employment Agency.nnnSTUDY DESIGNnProspective cohort study.nnnMETHODSnWithin two study waves (2011, 2014) primary data were collected based on computer-assisted personal interviews. During interview informed consent to data linkage was obtained. We used binary logistic regression analyses with participants consent for record linkage as the dependent variable calculating odds ratios (ORs) and 95% confidence intervals (95% CIs) for independent variables. Several sociodemographic, socio-economic and work-related factors were modelled as potential determinants of consent.nnnRESULTSnA total of 4244 participants took part in both waves. After excluding invalid consent, 4178 participants were included in the analysis. About 3918 (93.8%) of these participants gave their consent to link their primary data with data from at least one source. Within regression analyses only moderate bias was found due to region of residence, apprenticeship, professional affiliations, income and number of diseases. Participants from former West Germany were less likely to have their study data linked with both data sources (OR 0.63 [95% CI 0.42-0.96]) than those from the former East Germany. Participants with no information on income were more likely to refuse consent to both data sources compared to the reference group (net income: under EUR 1000; OR 0.15 [95% CI 0.08-0.30]). Respondents with two (OR 1.37 [95% CI 1.06-1.77]) or three and more diseases (OR 1.30 [95% CI 1.02-1.66]) diagnosed by a doctor agreed more frequently to linking both data sources than participants without disease. There is just a small proportion of variance in consenting explained by the models (R2: 0.063-0.085). Also, only small changes of factors prevalence were observed in consenters.nnnCONCLUSIONSnFor the first time in Germany, the lidA-study links primary survey data with health claims and administrative employment data. We conclude that there is only a minor relation between the analysed factors and consent behaviour of the participants. A linked data set may be used in further analyses without substantial biases.

Ausgewählte Erkrankungen älterer Erwerbstätiger

ZusammenfassungHintergrund und ZielDie prospektive Kohortenstudie lidA (leben in der Arbeit) untersucht für die Erwerbstätigenkohorten der Geburtsjahre 1959 und 1965 den Zusammenhang zwischen Arbeit, Alter, Gesundheit und Erwerbsteilhabe. Am Beispiel der Prävalenz von Arthrose/Arthritis und Hypertonie wird untersucht, inwieweit sich die Ergebnisse mit anderen deutschen Surveys vergleichen lassen. Die Entwicklung von Prävalenzen soll beispielhaft für Hypertonie anhand eines virtuellen Längsschnitts dargestellt werden.MethodenDie Prävalenzen der lidA-Jahrgangskohorten werden mit den Surveys des Robert Koch-Instituts (RKI) verglichen und damit die externe Validität überprüft. Durch eine Kombination der Altersgruppen aus lidA und den RKI-Surveys wird ein virtueller Längsschnitt auf Basis verschiedener Querschnittstudien (1998–2014) gebildet. Für die Analysen werden die lidA-Wellenxa01 und 2 sowie die Scientific Use Files des „Bundesgesundheitssurvey 1998“ (BGS), des „Telefonischen Gesundheitssurvey“ 2003 (GSTel) und von „Gesundheit in Deutschland aktuell“ 2009 (GEDA) genutzt.ErgebnisseDer Vergleich der Studien zeigt, dass die Prävalenz für Arthrose/Arthritis und Hypertonie bei älteren Befragten deutlich höher ist als bei jüngeren. Im virtuellen Längsschnitt wird ersichtlich, dass mit zunehmendem Alter die Prävalenz für Hypertonie innerhalb der erwerbstätigen Bevölkerung kontinuierlich und nahezu linear steigt.DiskussionDie RKI-Surveys weisen eine gute Vergleichbarkeit der Ergebnisse mit denen von lidA auf. Der virtuelle Längsschnitt, der methodisch zu diskutieren ist, zeigt eine plausibel erscheinende steigende Prävalenz für Hypertonie, die anderen Längsschnittanalysen aus anderen Studien ähnelt.AbstractBackground and objectiveThe prospective cohort study lidA (“living at work”) examines the relationship between work, age, health and labor participation for the employment cohorts from the years 1959 and 1965. With a focus on the prevalence of arthritis/osteoarthritis and hypertension the analysis investigated whether the lidA survey can be compared with the results of other German surveys. The development of prevalences can be exemplarily shown for hypertension with the help of a virtual longitudinal section.MethodsThe prevalences of the lidA age cohorts were compared with surveys by the Robert Koch-Institute (RKI) to test the external validity. A virtual longitudinal section was formed by a combination of age cohorts from lidA and the RKI surveys and based on various cross-sectional studies (1998–2014). The analysis examined the data from the first and second lidA surveys as well as scientific use files of the “National Health Survey” in 1998 (Bundesgesundheitssurvey, BGS), the “Telephone Health Survey” in 2003 (Telefonischer Gesundheitssurvey, GSTel) and the telephone survey “German Health Update” in 2009 (Gesundheit in Deutschland aktuell, GEDA).ResultsThe comparison of the studies showed that the prevalence for arthritis/osteoarthritis and hypertension was clearly higher for older than for younger respondents. The virtual longitudinal section of the fictive period of observation showed that the prevalence for hypertension within the employed person population continuously rises and nearly linearly with increasing age.ConclusionThe various RKI surveys demonstrated a good comparability with the results of the lidA study. The virtual longitudinal section, which has to be methodologically discussed, showed a plausible increase in the prevalence of hypertension and is therefore similar to longitudinal analyses from other studies.