Determinants of health check attendance in adults: findings from the cross-sectional German Health Update (GEDA) study

Abstract

BackgroundIn Germany, adult health checks are carried out in the primary care setting for early detection of chronic conditions, such as cardiovascular diseases, diabetes, and kidney disease. This study aims to examine the social, behavioural, and health-related determinants of health check attendance among eligible adults in Germany.MethodsData were derived from the cross-sectional German Health Update (GEDA) study, a national health survey among adults in Germany carried out by the Robert Koch Institute. Analyses were restricted to respondents with statutory health insurance aged 35 years or older (n = 26,555). Logistic regression models were fitted to estimate associations between health check attendance and factors selected on the basis of Andersen’s Behavioral Model of Health Services Use.ResultsAfter mutual adjustment, higher health check attendance was associated with a higher age, higher socioeconomic status, being married, stronger social support, physical activity, non-smoking, greater fruit and vegetable consumption, and higher use of outpatient care in both sexes. In women, higher attendance was related to alcohol consumption and having company health insurance (BKK) after multiple adjustment. In men, higher attendance was associated with better self-rated health after adjusting for all other factors.ConclusionsThe findings of this study suggest that people with an unfavourable risk factor profile, such as socioeconomically disadvantaged groups, smokers, physically inactive people, and persons with a low fruit and vegetable intake, are less likely to have health checks than those with a more favourable risk profile. Health checks carried out in the primary care setting should be evaluated for their effects on population health and health inequality.

Patterns of attendance to health checks in a municipality setting: the Danish ‘Check Your Health Preventive Program’

“…Furthermore, our findings confirm those of previous studies; that the relative risk of attending the health check was higher in persons of higher age, with higher educational attainment, and more use of preventive services. In contrast, factors associated with a reduction in the relative risk of attending were: living alone, receiving social welfare or being un-employed, and morbidity (Artac et al, 2013, Hoebel et al, 2014, Fossa et al, 2015, Tolonen et al, 2015, Hoebel et al, 2013). The findings on morbidity and treatment are novel and provide a detailed picture of the diagnosis and treatment status and how this is associated with attendance.…”

“…A well-known challenge of screening and systematic health checks is low uptake (Krogsbøll et al, 2012) which seems to be influenced by a number of factors (Dryden et al, 2012, Bender et al, 2012). A higher participation rate has, in many studies, been found to be associated with higher age (Jones et al, 1993, Waller et al, 2013, Artac et al, 2013), being a woman (Waller et al, 2013, Culica et al, 2002, Thomas et al, 1993), and with socio-demographic factors such as having a job; higher educational level; higher income; and living with a partner (Bender et al, 2012, Boshuizen et al, 2006, Hoebel et al, 2014). Only a few studies have investigated the association of people's morbidity with non-attendance in general health examinations (Dryden et al, 2012, Boshuizen et al, 2006, Thorogood et al, 1993), since it is difficult to obtain records of disease for those who do not want to participate.…”

Factors influencing young men's decision to undergo health screening in Malaysia: a qualitative study

“…[24][25][26] Currently, health screening uptake in young men remains low in Malaysia as well as globally. [27][28][29][30][31] The American Time Use Survey found that men aged 25-44 years spent most hours in work-related activities and the least time for personal care, including screening. 32 Compared with women, men are less likely to attend health screening, [33][34][35] which may explain why men have poorer health.…”

Fatores Socioeconômicos Relacionados Às Doenças Cardiovasculares: Uma Revisão

“…De maneira geral, os mais pobres são menos propensos a fazer exames de saúde preventivos em relação aqueles com condições socioeconômicas mais favoráveis (HOEBEL et al, 2014). Indivíduos de menor renda buscam por serviços de saúde apenas quando há aparecimento de sintomas das doenças, enquanto aqueles de maior renda procuram os serviços para prevenção e realização de exames rotineiros (MEDEIROS; MENEGHEL, 2012;SOARES et al, 2013).…”