Self rating of health is associated with stressful life events, social support and residency in East and West Berlin shortly after the fall of the wall

Study objective-To compare the health status and factors influencing the he alth of populations that had previously lived under different political sys tems. Design-Cross sectional health and social survey using postal interviews. Th e relation between self reported health and psychosocial factors (stressful Life events, social support, education, health promoting life style and he alth endangering behaviour) was investigated. To determine East-West differ ences a logistic regression model including interaction terms was fitted. Setting-East and West Berlin shortly after reunification 1991. Participants-Representative sample of 4430 Berlin residents aged 18 years a nd over (response rate 63%). Results-Of all respondents, 15.4% rated their health as unsatisfactory. Res idents of East Berlin rated their health more frequently as unsatisfactory than residents of West Berlin (Or(age adjusted) = 1.29, 95%CI 1.08, 1.52),t hese differences occurred predominantly in the over 60 years age group. Log istic regression showed significant independent effects of stressful life e vents, social support, education, and health promoting life style on self r ated health. The effects of education and health promoting life style were observed to be more pronounced in the western part of Berlin. Old age and f emale sex showed a stronger association with unsatisfactory health status i n the eastern part of Berlin. Conclusions-For subjects aged over 60 years there was evidence that Living in the former East Berlin had an adverse effect on health compared with Wes t Berlin. The impact of education and a health promoting lifestyle on self rated health seemed to be weaker in a former socialist society compared wit h that of a Western democracy. This study supports an "additive model" rath er than a "buffering model" in explaining the effects of psychosocial facto rs on health.