Project A1.2:

Regional and social disparities in health care. Nursing care provision for women in large cities in NRW


Project Leader:
Prof. Dr. Annette Nauerth

Associate Researcher:
Angela Nikelski

Ministry of Innovation, Science and Research of the German State of North Rhine-Westphalia

Time Scale:
01.12.2012 to 28.02.2017

Assurance of future health care provision undoubtedly poses a challenge for society as a whole, requiring a multi-facetted approach. Initial scientific results indicate that health care provision is influenced by local and social factors, which can lead to considerable variations in service. Therefore, regionally differentiated, small-area and user-orientated considerations are required. Based upon these concerns, the project analyses the interrelations between regional and social disparities in health care. Including perspectives of professionals and users, the project illuminates structures and service provision by using the example of a large city in NRW. The main focus is the health care situation of elderly women in different districts and diverse individual social positions.

Background and Objective:
In consideration of demographic transitions and increasing health care needs, it is essential to deal with possibilities for an appropriate health care arrangement. This discussion has to become more differentiated than previously. Findings indicate that burden of disease and burden of care as well as structures of support are locally and socially unequally distributed and must become a more significant issue in research. Overall there is a lack of sophisticated analysis of health care structures and health care services and its relevance to user needs.

With the objective to investigate the disparity of user needs by using the example of elderly women, the project analyses the metropolitan health care situation using the theoretical framework of social inequality.

Anticipated Results:
The findings will serve further development of the theoretical framework in the research field of ‘social inequalities and nursing care’, leading to new approaches for further development of local care structures and reduce inequalities in health care. With a focus on elderly women, the project will illustrate the situation of this population group and enable deeper insights into their everyday life and experience.
By using the example of a selected large city in NRW, the project analyses structural framework (access to health care etc.) of districts with different social structure. In a further step subjective perceptions and evaluations of local structures and services of users – here elderly women - in different social positions are observed.
The study includes women (>60 years) with a need for support or care, currently living alone. Because of their higher life expectancy, women are more often in need of care and therefore form the biggest user group. The approach is based upon diverse methods such as preparatory secondary data analysis, community health assessment and interviews with professionals and selected female user groups.