How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example

Stefanie Hahm; Laura Altweck; Silke Schmidt; Toni Fleischer; Claudia Helmert; Christine Ulke; Sven Speerforck; Georg Schomerus; Johanna Klinger-König; Hans J Grabe; Carsten Oliver Schmidt; Manfred E Beutel; Elmar Brähler; Holger Muehlan

doi:10.1136/jech-2023-221549

How socio-political change is associated with the number of individually reported negative life events: a population-based study using the German reunification 1989/1990 as an example

J Epidemiol Community Health. 2024 Apr 10;78(5):311-318. doi: 10.1136/jech-2023-221549.

Authors

Affiliations

¹ Department Health and Prevention, University of Greifswald, Greifswald, Germany stefanie.hahm@uni-greifswald.de.
² Department Health and Prevention, University of Greifswald, Greifswald, Germany.
³ Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
⁴ Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
⁵ German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Rostock, Germany.
⁶ ICM - SHIP/KEF, University Medicine Greifswald, Greifswald, Germany.
⁷ Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Abstract

Background: Socio-political change often leads to disruptions in employment and social networks, which can exacerbate health issues and increase mortality rates. These consequences are likely observed as an increase in negative life events (NLEs), serving as indicators of the broader social and health impacts. Using the German reunification in 1989/1990 as an example, this study investigates changes in reported numbers of NLEs and differences regarding sociodemographic characteristics.

Methods: We used data from the population-based Study of Health in Pomerania (SHIP-START-0, SHIP-Life-Events and Gene-Environment Interaction in Depression; N=1932). Numbers of NLEs in different categories (work/financial, social/interpersonal, illness (own) and illness/death (others)) were measured retrospectively in 5-year intervals (1980-2004) using a semistructured interview. Pre-reunification and post-reunification changes were modelled using piecewise mixed-effects Poisson regressions with the 1990-1994 interval (reunification) as change point. Interactions with age, sex and education were examined.

Results: The number of most NLE categories, except social/interpersonal NLEs, increased at reunification. Whereas work/financial NLEs slightly decreased post-reunification, illness-related NLEs continued to increase. Higher numbers of social/interpersonal NLEs were found with younger age. More illness-related NLEs were reported with older age, lower education (illness (own)) and by women (illness/death (others)). However, the majority reported no NLEs at reunification (68.2%-80.7%, varying by category).

Conclusion: Our findings suggest that although some individuals experience a marked increase in NLEs due to socio-political changes, many remain unaffected, emphasising the need for a differentiated understanding of these effects. This increase in NLEs may partly account for ongoing health and well-being disparities among countries with differing transformation histories.

Keywords: COHORT STUDIES; Life course epidemiology; PUBLIC HEALTH; SOCIAL SCIENCES.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Employment*
Female
Health Status*
Humans
Life Change Events
Retrospective Studies