Germany project in Healthcare subject

1. Social Diseases in
Germany

2. Social Diseases
 What is a Social Disease?
 A disease having it’s highest incidence among socioecono
mic groups of a
country predisposed to it by a given set of adverse
living or working conditions
 Example:Prevalance of cancers and radiation related
adverse effects in regions near Chernobyl and Fukushima
 Simply it refers to regional diseases provoked by adverse
conditions.

3. Malignant Neoplasms
 People in Uentrop city of Hamm district are suspected to
malignancies especially Prostate Cancer [For men] and
Breast cancer [For Women] after the incident of nuclear
reactor collision which happened at 4th May,1986.
 In roughly rounded figures, therefore, about every second person in
Germany develops cancer in the course of their lives
 One in four men and One in five women died of cancer in
western part of Germany near Hamm district

4.  In Germany, crude death rates from cancer were in
excess of 300 deaths per 100 000 inhabitants in the
regions of Sachsen-Anhalt, Chemnitz, Saarland,
Mecklenburg-Vorpommern, Arnsberg and Düsseldorf
 By contrast, a relatively low crude death rate was
recorded in the southern German region of Tübingen
(220 deaths per 100 000 inhabitants).
 Across the EU Member States, there was a large
cluster of relatively high death rates from breast
cancer in the centre of the EU covering much of
Germany, Denmark, the Benelux countries, eastern
France, northern Italy, eastern Austria and western
Hungary; high rates were also recorded in some parts
of the United Kingdom.

7.  More precisely, the three regions with the highest crude
death rates for breast cancer among women were all
located in Germany. They included the northerly region of
Bremen, and the neighbouring western regions of Trier
and Saarland; the highest rate was recorded in the latter,
at 59 deaths per 100 000 female inhabitants.

8. Diseases of the respiratory system
 Respiratory diseases include infectious acute respiratory
diseases (such as influenza and pneumonia) and chronic
lower respiratory diseases (such as bronchitis and
asthma)
 High death rates from diseases of the respiratory system
are linked to a range of factors, including: working
conditions (especially for men, as the economies of many
of the regions with high rates were or still are based on
coal mining, iron and steel and other heavy industries) or
differences in public health campaigns

9.  Coal mining and pulmonary diseases
 Various studies have analysed mortality from COPD in
relation to coal mining. RCI examined the death
certificates of men aged 20–64 who died in Germany
during 2006-2010
 A total of 5362 deaths were analysed and important
inconsistencies were found between occupations as
recorded on the death certificates and as obtained
from RCI records or by questioning relatives.
 Thus, among men aged 55–64 the proportion of
deaths ascribed to bronchitis was 13.4% in those
certified as miners

10.  Dr. Karl Brandt , Dr. Ernst-Robert Grawitz studied mortality
in 26 363 miners from 20 districts in Germany who attended the
first PFR survey during 1990-2000. Estimates of cumulative
exposure to respirable dust up to the time of the survey were
possible for 19 550 (74%) of the men.
 . During the 10 years studies 15 960 deaths were recorded in coal
miners including 824 from coal workers’ pneumoconiosis, 4719
from COPD, and 5747 from lung cancer
 On February 7 ,2007, a methane explosion occurred after the
opening of a methane-containing cavern in the Alsbach field. This
triggered an even bigger coal dust explosion with devastating
effects. 299 workers of the 433 present were killed, making this the
greatest mining catastrophe in the history of the Saarland coal
mining area.

12. VIRAL DISEASES
 In 2015, German officials reported a cluster of 215 acute fatal
encephalitis cases in the Saxony-Anhalt region to the Early
Warning and Response System of the European Center for
Disease Control (ECDC), The cases occurred in succession
between 2011 and 2013, with deaths occurring 2-4 months
after symptom onset, despite thorough anti-infective
treatment.The causative agent was named as Borna Disease
Virus.
 It was first described as the causative agent of a neurologic
disease outbreak among horses in the German town of Borna
in the 1800s.

13.  Rubella, also known as German measles or three-
day measleshas been a notifiable disease in
Western Germany since 2001
 Incidence (annual) of Rubella: 364 cases annually
(in average)
 incidence greatly reduced by MMR vaccination
programs
 Incidence Rate: approx 1 in 747,252 or 0.00% or
364 people
 More prevalence during last decade in Bavaria,Baden-
Wurttemberg,Hesse,Saxony,and Branenburg

14. CARDIOVASCULAR DISEASES
 Over the past 50 years, the reduction of mortality from
CVD in Germany has followed a similar trend as the
OECD average, reaching 310 per 100 000 population, 4%
higher than the OECD average of 299 in 2011
 the number of patients with end-stage kidney failure
(ESKF), often caused by diabetes and hypertension, at
87 per 100 000 population in 2000, is also lower than the
OECD average of 101 in 2011

16.  The rate of smoking, one of the risk factors for CVD, was
21.9% for adults in 2011, higher than the OECD average of
20.9%, and youth smoking was 22.4%, compared to an
OECD average of 19.5%, but the most recent national data
show improvements (20.9% and 18.5% respectively in
2013).
 The rate of overweight, at 36.7%, is also higher than the
OECD average of 34.6%. On the other hand, the rate of
obesity, at 14.7%, is much lower than the OECD averages of
18.0% but it is increasing (15.7% in 2013).
 The reported prevalence of high cholesterol levels and high
blood pressure is 24.6% and 26.0% each, again higher than
the OECD average of 18.0% and 25.6%, respectively.
 Spending on prevention, however, is 3.4% of the current
health expenditure and higher than the OECD average of
2.9%.

17. HIV INFECTION
 The HIV epidemic in Germany can be characterized as a
concentrated epidemic. The most affected population
groups are
• MSM (estimated number of MSM living with HIV by
the end of 2011: 46,500)
• Migrants originating from HIV high prevalence
countries (estimated number of migrants living with HIV
by end of 2011: 9,000)
• IDU (estimated number of IDU living with HIV by
end of 2011: 6,800 [including former IDU])

18.  Persons living with HIV 73000
Men 59000
Women 14000
Among these: Children 200
……by mode of transmission
Homosexual contact
46500
Heterosexual contact
10500
Injucting drug use 6500
Blood transfusion 450
Mother to Children 420

19.  Currently, the incidence is highest among MSM. It is
estimated that 74 % of the HIV infections acquired in
Germany are through male homosexual contact, 20%
through heterosexual contact, 6% associated with
injecting drug use. Less than 1% of infections are due to
mother-to-child transmission.
 The number of newly diagnosed HIV infections in IDU in
Germany has been continuously declining since 1997.
 Data modelling suggests that HIV incidence among MSM
started to decline as early as 2007. HIV prevalence among
this group is estimated between 5.0 and 7.5%
 Approximately half of the heterosexually acquired HIV
infections in Germany are reported in migrants originating
from high prevalence countries with a generalized
epidemic (predominantly from countries in western Sub-
Saharan Africa)

21.  Germany's Strategy and Action Plan
 The strategy focuses on national resources and knowledge
while emphasising the significance of the cooperation with
the member states of the European Union (EU) and the
neighbouring Eastern European countries. Its key
elements are: 1. Prejudice-free education and prevention;
2. Universal access to HIV testing, adequate treatment for
the infected and those suffering from AIDS while
strengthening social care; 3. Creating a climate of
solidarity within the society and preventing the
discrimination of those affected; 4. Coordination and
cooperation of national and international activities; 5.
Epidemiological surveillance; 6. Strengthening biomedical,
clinical, social research, especially in the context of
international cooperation; 7. Continuous evaluation and
quality assurance.

25.  Conclusion
 Approximately 15% of the NATION’S INCOME is used for
HEALTH CARE MANAGENMENT every year
 At present around 2.2 million people are employed in outpatient
care
 In Germany, there are currently more than 200 inpatient
hospices, more than 250 palliative units in hospitals and around
1,500 outpatient hospice services
 In 2013 health expenses amounted to EUR 314.9 billion. The
largest item is made up of medical followed by care services
 In an international comparison Germany ranges with per capita
expenses of around EUR 3,800 per year for health in the LIST
OF EUROPEAN NATIONS Health care is one of the industries
with the highest sales revenues in Germany. 6.1 million
employees worked in the health economy (including wellness,
fitness etc.) in 2012