Project 1: REGIO HEALTH

PHASE 2

Demographic fabric at small-area scale: the impact of neighbourhood compositions on health status and infrastructure access

Demographic changes at the regional level may result from various factors, such as economic recession, which can drive healthy, economically active individuals to leave, or economic thriving, which can attract such individuals into neighborhoods. These demographic shifts alter the social fabric of neighborhoods, influencing social norms that may, in turn, impact individuals and their health. This study will utilize longitudinal SOEP data, including the regional information (from county level to specific geo-coded addresses), to examine if and how demographic and socio-economic changes at the regional level affect social norms and in turn individuals and their health. We will employ a life-course perspective, with a special attention to families, refugees, and individuals with unique healthcare needs. Methodologically, we will source historical data on demographic and socio-economic characteristics at various spatial levels within selected cities to integrate them with SOEP data. We will also explore methods for defining spatial units (e.g., size, density) to account for heterogeneity across available spatial boundaries and to examine to optimal spatial and temporal scales at which regions and individuals interact.

PHASE 1

Regional infrastructures, living conditions and perceptions of inequality

In phase one we hat two separate direction of investigation: Healthcare infrastructure and individual health and regional demographic changes, neighbourhood social structures, and health.

All the reserach questions were based on SOEP Data using Individual measure of mental and physical health (SF-12) Measures of well being and mental health
providing 20 years of longitudinal data which we linked to INKAR Data. We used historical demographic measures at Kreis-Kreisfreier Stadt level Data on geolocation of Hospital and GP practice were used to obtain a measure of accessibility to health care for SOEP participants.

Key results: 

Healthcare infrastructure and individual health: Work on loneliness, well-being after a diagnostic of chronic diseases, time to diagnostic for depression. Spatial accessibility to health care is not a factor in explaining variability in these outcomes but a large spatial disparity in feeling of loneliness which poses a major mental as well as physical health risk might lead to regional difference in health care needs (Various works all including Barbara Stacherl with either Theresa Entringer, or Odile Sauzet) .

Regional demographic changes, neighbourhood social structures, and health: We have shown that health outcomes are associated with county demographic changes and these associations are modified by the perception of neighbourhood social cohesion. While more understanding about underlying mechanisms are lacking, the exposition to some county demographic changes seems to reduce the positive effects of a high perception of social cohesion on health making them a potential health stressor (Work by Maria Schäfer and Odile Sauzet).

Selected key publications: 

Stacherl, B., & Sauzet, O. (2024). Chronic disease onset and wellbeing development: longitudinal analysis and the role of healthcare access. European Journal of Public Health, 34(1), 29-34.

Stacherl, B., & Sauzet, O. (2023). Gravity models for potential spatial healthcare access measurement: a systematic methodological review. International Journal of Health Geographics, 22(1), 34.

Sauzet, O., & Schäfer, M. (2024). Interaction effects on health between perceived neighbourhood social cohesion and demographic changes: a longitudinal study (Social Epidemiology Discussion Papers (SEDiP), 6/2024). Bielefeld: Universität Bielefeld. https://doi.org/10.4119/unibi/2994192