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Background: Cardiovascular disease continues to be the single most common cause of death and to account for the largest single portion of treatment costs in Germany. Reliable data on regional differences in the frequency of cardio - vascular disease are important for the planning of targeted care structures and preventive measures., Methods: Pooled data from the German Health Update (GEDA), a nationwide telephone health survey conducted in 2009, 2010 and 2012 (n = 62 214) were used to estimate the lifetime prevalence of major cardiovascular disease (self-reported medical diagnosis of myocardial infarction, other coronary heart disease, stroke, or congestive heart failure) in each of the German federal states. The influence of sociodemographic factors on regional prevalence differences was examined in adjusted logistic regression analyses. Prevalences were compared with mortality rates from cardiovascular disease that were obtained from cause-of-death statistics., Results: The lifetime prevalence of cardiovascular disease in Germany ranged from 10.0% in Baden-W¨rttemberg to 15.8% in Saxony-Anhalt. After adjustment for age, sex, socioeconomic status, and size of the communities of residence, nine of the other 15 states had significantly higher prevalences than Baden-W¨rttemberg, with odds ratios ranging from 1.26 (Hesse) to 1.55 (Saxony-Anhalt). Four of the five states that previously constituted the German Democratic Republic (East Germany) had above-average figures for prevalence and mortality., Conclusion: There are relevant differences among the German federal states in the lifetime prevalence of major cardiovascular disease, which are only partly accounted for by differences in age and sex distribution, socioeconomic status, and community size.

Background: It is well documented that the unemployed have more health problems than the employed, and that social support facilitates coping with unemployment. The association of unemployment and social support with health was examined on the basis of representative data derived from a German study., Methods: The GEDA study (Gesundheit in Deutschland Aktuell [Current Health in Germany]) was conducted in 2008/09 by the Robert Koch Institute, the nationwide governmental public health agency in Germany. For this paper, we analyzed data from the GEDA study that were obtained from 12022 persons aged 30 to 59. We used health indicators taken from the Four-Item Healthy Days Core Module of the Centers for Disease Control (CDC), and we measured social support on the Oslo Three-Item Social Support Scale. We report the findings on impairment in three distinct areas (physical, emotional, and functional) and the results of a multivariate statistical analysis., Results: Unemployed persons aged 30 to 59 years suffer physical, emotional, and functional impairment more commonly than employed persons. Men and women with little social support are more likely to be impaired in these three areas whether they are employed or not. Regression analysis reveals that unemployment and social support have significant, independent effects on both the incidence of such impairments (OR(unemployed)= 1.2-1.7, OR(supported)= 0.4-0.9) and on their duration (IRR(unemployed)= 1.3-1.8, IRR(supported)=0.6-0.8) after age, income, and education have been controlled for., Conclusion: Physicians should be mindful of the deleterious effect of unemployment on health and should encourage unemployed patients to participate in social networks, as the evidence shows that social support can have health benefits.