[Causes of socioeconomic group-related mortality in the Federal Republic of Germany--tobacco consumption is the predominant risk factor].

OBJECTIVE: To establish whether socioeconomic differences in mortality exist in the Federal Republic of Germany and whether any such differences are attributable to material, structural, and lifestyle factors.
METHODS: The database was the WHO-MONICA cohort study with two cross-sectional surveys performed in the Augsburg area in 1984/85 and 1989/90, and a mortality follow-up performed in 1997/98. The dataset comprised a total of 7268 persons of German nationality aged 25 to 72.
RESULTS: Both men and women with lower educational qualifications have less economic resources (materialist thesis), are exposed to higher levels of physical stress at work (structuralist thesis) and lead a significantly less healthy lifestyle (cultural-behavioral thesis). Both males and females with the highest secondary school qualifications are more likely to engage in leisure-time physical activity, have a lower BMI and are less likely to be smokers, passive smokers or heavy drinkers. While these differences are reflected in a socioeconomic group-related mortality risk in males, our data disclose no significant correlation between socioeconomic group (operationalized on the basis of years of education) and mortality in females.
CONCLUSIONS: This paper investigates the four most common hypotheses for the internationally well-documented phenomenon of socioeconomic group-related mortality on the basis of nationwide German longitudinal data. Regular nicotine consumption is by far the most significant controllable risk factor for mortality in both genders.