Zusammenfassung
In Deutschland ist soziale Ungleichheit in Gesundheit selten Gegenstand der öffentlichen Diskussion, obwohl auch hier besser gebildete, reichere und in der beruflichen Hierarchie höher stehende Menschen zeitlebens gesünder sind und länger leben als andere. Soziale Ungleichheit wird dadurch entlang einer weiteren wichtigen Dimension verstärkt. In diesem Beitrag werden kurz Ausmaß und Dimensionen derartiger Ungleichheit in Deutschland dargestellt. In Abgrenzung zur vorherrschenden sozialepidemiologischen Literatur wird auf Basis der aktuellen gesundheits- und bildungsökonomischen Literatur diskutiert, ob und wie soziale Ungleichheit in Gesundheit mit wirtschafts- und sozialpolitischen Mitteln vermindert werden kann. Dabei wird als Defizit erkannt, dass wir aufgrund einer ausnehmend schlechten Datenlage viel zu wenig über ihre Entstehung wissen. Dies mündet in der Forderung nach einer neuen Evaluationskultur im Bereich der Bildungs- und Gesundheitspolitik.
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Anmerkung
Das vorliegende Manuskript ist die Ausarbeitung eines Vortrags im Wirtschaftswissenschaftlichen Seminar Ottobeuren zum Generalthema Rationalisierung im Gesundheitswesen im Jahr 2012. Ich danke den Teilnehmern der Tagung, insbesondere Carl-Christian von Weizsäcker und Andreas Mielck, sowie zwei anonymen Gutachtern für kritisch-konstruktive Kommentare zu meinem Vortrag bzw. Manuskript.
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