- Germany has a population of over 82 million people with a life expectancy of 78 years for males and 83 years for females. It does not have a national health care system but instead uses several autonomous bodies. - The top causes of death are diseases of the circulatory system like heart disease and stroke. Cancer is also a leading cause of death. - HIV prevalence is highest among men who have sex with men, accounting for nearly half of new HIV diagnoses. Prevalence is also high among migrants from countries with generalized epidemics. - Over 10 million people in Germany are officially recognized as disabled. The majority have a severe disability and over half are over 65 years old. Germany provides strong legal protections and social support for

1. Germany
SIRTRARASASAN BHARATHIDHASAN
1319

2. Deutschland
• Germany is a densely populated and highly industrialized country
with more than 82 million inhabitants. The life expectancy at birth is
77.6 years for males and 82.8 years for females. The percentage of
the population aged 65 years or more is rising. Germany does not
have a national health care system. The health care system is
administered through several autonomous bodies and associations
such as the statutory health insurance system (GKV), the
association of physicians under contract with the GKV, and the
hospitals association.

4. Indicators Values
POPULATION 82,727,000
% of population aged 0–14 years 13
% of population aged 65+ years 21
Crude death rate per 1000 population 11
Estimated infant mortality per 1000 live births (world health report) 3
Estimated life expectancy (world health report) 81
Life expectancy at birth (years), females 83
Life expectancy at birth (years), males 78
Hospital beds per 100 000 828
Physicians per 100 000 405

5. Indicators Values
SDR all causes, all ages, per 100 000 564
SDR, diseases of circulatory system, all ages, per 100 000 200
SDR, external causes of injury and poisoning, all ages, per 100 000 28
SDR, malignant neoplasms, all ages, per 100 000 157
Total health expenditure as % of GDP, WHO estimates 11
Total expenditure on health per capita 4812
All the details mentioned above are the extracts from a survey taken by Robert Koch Institute(RKI) in
2014

7. TOP 10 CAUSES OF DEATH
per 10000 population
• Disease rate global rank
• Coronary Heart Disease 62.93 133
• Lung Cancers 27.78 30
• Stroke 27.32 163
• Breast Cancer 21.84 32
• Prostate Cancer 15.98 93

8. • Colon-Rectum Cancers 15.17 41
• Hypertension 15.05 04
• Alzheimers/Dementia 13.39 25
• Diabetes Mellitus 11.43 138
• Influenza and Pneumonia 9.86 189

10. Social Diseases
• What is a Social Disease?
• A disease having it’s highest incidence among socioeconomic group
of a country predisposed to it by a given set of adverse
living or working conditions
• Example:Prevalance of cancers and radiation related adverse
effects in regions near Chernobyl and Fukushima
• Simply it refers to regional diseases provoked by adverse
conditions.

11. PREVALENCE OF HIV IN GERMANY
• Diagnoses of new HIV infections in Germany rose by 20% in the first half of 2014
compared with the first half of 2010, according to the latest figures from the Robert
Koch Institute, Germany's centre for public health and disease control. Gay and
bisexual men accounted for almost 60% of these new HIV diagnoses, a 30% rise from
four years ago.
• With a population of 82.5 million, Germany is Europe's most populous nation.
Historically, HIV prevention has been relatively successful and new HIV diagnoses
have tended to total under 2,000 each year for the past decade. Even though in
2014 new HIV diagnoses totalled 2,058 - the highest since 2002 - this compares with
7,000 new HIV diagnoses in 2003 in the United Kingdom, the third most populous
country in Europe with around 60 million inhabitants

13. • The Institute also reports on the cities with the highest HIV incidence
rates between July 2004 and June 2005. Cologne, with an incidence
rate of 12.42 per 100,000 population had the highest rate. However, the
highest absolute numbers were seen in Germany's two biggest cities,
Berlin and Hamburg, which had incidence rates of 10 per 100,000 and
9.57 per 100,000, respectively. Other cities with high HIV incidence
included Munich, Frankfurt and Düsseldorf.

14. • According to the latest estimate, there were a total of 436,500 new cancer
cases in Germany in 2004. The most common cancer in men is prostate cancer
with over 58,000 new cases per annum, followed by colorectal and lung cancer.
In women, breast cancer remains the most common cancer with an estimated
57,000 new cases every year, also followed by colorectal cancer. These and
further findings on selected cancer sites can be found in the current brochure
on "Cancer in Germany“ which is regularly published by rki.
• In addition, the RKI made cancer-prevalence estimates and calculated current
morbidity and mortality risks at the federal level for the first time
• According to these figures, the 5-year partial prevalence - i.e. the total
number of cancer patients diagnosed over the past five years who are currently
still living - exceeds 600,000 in men; the figure is about the same among
women.
Prevalence of Cancers in Germany

16. • Here, too, the most common cancers are prostate cancer in men and breast
cancer in women. The lifetime risk of developing cancer, which is more related
to the individual, is estimated to be higher among men (48.5%) than among
women (40.3%)
• In roughly rounded figures, therefore, about every day, a person in Germany
develops cancer in the course of their lives
• One in four men and one in five women die of cancer.

18. • In Germany, crude death rates from cancer were in excess of 300
deaths per 100 000 inhabitants in the regions of Sachsen-Anhalt,
Chemnitz, Saarland, Mecklenburg-Vorpommern, Arnsberg and
Düsseldorf
• By contrast, a relatively low crude death rate was recorded in the
southern German region of Tübingen (220 deaths per 100 000
inhabitants).
• Across the EU Member States, there was a large cluster of
relatively high death rates from breast cancer in the centre of the
EU covering much of Germany, Denmark, the Benelux countries,
eastern France, northern Italy, eastern Austria and western
Hungary; high rates were also recorded in some parts of the
United Kingdom.

19. • The HIV epidemic in Germany can be characterized as a concentrated
epidemic. The most affected population groups are
• MSM (estimated number of MSM living with HIV by the end of 2011:
46,500)
• Migrants originating from HIV high prevalence countries (estimated
number of migrants living with HIV by end of 2011: 9,000)
• IDU (estimated number of IDU living with HIV by end of 2011: 6,800
[including former IDU])
HIV INFECTION

20. Men 59000
Women 14000
Among these: Children 200
……by mode of transmission
Homosexual contact 46500
Heterosexual contact 10500
IV drug use 6500
Blood transfusion 450
Mother to Children 420
Persons living with HIV 73000

21. • Currently, the incidence is highest among MSM. It is estimated that
74 % of the HIV infections acquired in Germany are through male
homosexual contact, 20% through heterosexual contact, 6%
associated with injecting drug use. Less than 1% of infections are
due to mother-to-child transmission.
• The number of newly diagnosed HIV infections in IDU in Germany
has been continuously declining since 1997.
• Data modelling suggests that HIV incidence among MSM started to
decline as early as 2007. HIV prevalence among this group is
estimated between 5.0% and 7.5%
• Approximately half of the heterosexually acquired HIV infections
in Germany are reported in migrants originating from high
prevalence countries with a generalized epidemic (predominantly
from countries in western Sub-Saharan Africa)

23. • Over the past 50 years, the reduction of mortality from CVD in
Germany has followed a similar trend as the OECD average,
reaching 310 per 100 000 population, 4% higher than the OECD
average of 299 in 2011
• the number of patients with end-stage kidney failure (ESKF),
often caused by diabetes and hypertension, at 87 per 100 000
population in 2000, is also lower than the OECD average of 101 in
2011
CARDIOVASCULAR DISEASES

25. • The rate of smoking, one of the risk factors for CVD, was 21.9% for
adults in 2011, higher than the OECD average of 20.9%, and youth
smoking was 22.4%, compared to an OECD average of 19.5%, but the
most recent national data show improvements (20.9% and 18.5%
respectively in 2013).
• The rate of overweight, at 36.7%, is also higher than the OECD
average of 34.6%. On the other hand, the rate of obesity, at 14.7%, is
much lower than the OECD averages of 18.0% but it is increasing
(15.7% in 2013).
• The reported prevalence of high cholesterol levels and high blood
pressure is 24.6% and 26.0% each, again higher than the OECD
average of 18.0% and 25.6%, respectively.
• Spending on prevention, however, is 3.4% of the current health
expenditure and higher than the OECD average of 2.9%.

26. DISABLED PERSONS IN GERMANY
• In 2013, 10.2 million people with an officially recognised disability - on
the basis of microcensus results - were living in Germany
• On average, more than one in eight inhabitants (13%) was disabled
• More than half of them (52%) were men.
• The majority, that is, roughly 7.5 million people were severely
disabled, while 2.7 million people suffered from a moderate disability

27. Severely disabled people (in 2013) 7,548,965
Men 51.0%
Women 49%
>65 Years 53.4%
Age groups Disability rate
1-20 years of age 8%
20-30 6%
30-45 15%
45-65 6.8%
>65 25%

28. Overview of the facilities, organizations and support
available for people with disabilities in Germany...
• German law (Grundgesetz) forbids discrimination on the basis of physical or mental
disability.
• The Social Welfare Code IX (SGBIX), which came in to force in April 2001, is based
on the idea of equal opportunities and participation rather than merely welfare
• It focuses on rehabilitation and access for disabled people and stipulates levels of
support depending on measurement of the degree of disability

29. • According to the German Federal Statistical Office, or Destatis,
the impact of the disability on the participation in the life of
society is graded from 20 to 100.
• People are classified as severely disabled in Germany if a pension
office has determined a degree of disablement of 50 or more.
• As easily disabled persons are referred to with a degree of
disability of less than 50.

30. There is a great deal of support available to disabled people
(behinderter Menschen) in Germany, from general counselling to
specific institutions such as:
• Advice centres
• Early support centres for children (Frühförderung)
• Integrated kindergartens
• Special kindergartens (Sonderkindergarten or Förderkindergarten)
• Special Schools (Sonderschulen)
• Special professional schools (Berufsschulen), for instance for deaf pupils

31. • Apprenticeships for visually impaired and deaf people
(Ausbildungsplaetze)
• Employment integration support
• Care and accommodation grants for disabled people
• Workshops for disabled people (Werkstätten für behinderte
Menschen)
• Transport services (Fahrdienste)

32. To conclude……
• Approximately 15% of the NATION’S INCOME is used for HEALTH CARE
MANAGENMENT every year
• At present around 2.2 million people are employed in outpatient care
• In Germany, there are currently more than 200 inpatient hospices, more than
250 palliative units in hospitals and around 1,500 outpatient hospice services
• In 2013 health expenses amounted to EUR 314.9 billion. The largest item is made
up of medical followed by care services
• In an international comparison Germany ranges with per capita expenses of
around EUR 3,800 per year for health in the LIST OF EUROPEAN NATIONS Health
care is one of the industries with the highest sales revenues in Germany. 6.1
million employees worked in the health economy (including wellness, fitness
etc.) in 2012

33. References:
• Germany’s health profile -http://www.worldlifeexpectancy.com/country-health-
profile/Germany
• Causes of deaths in Germany-
https://www.destatis.de/EN/FactsFigures/SocietyState/Health/CausesDeath/Causes
Death.html
• Prevalence of various diseases in Germany-
http://www.healthdatanavigator.eu/national/Germany
• People with disabilities in Germany-https://www.angloinfo.com/germany/how-
to/germany-healthcare-people-with-disabilities
• http://www.bmas.de/EN/Our-Topics/Participation-of-Persons-with-
Disabilities/disability-policy.html
• Robert Koch Institute-
http://www.rki.de/EN/Content/Health_Monitoring/health_monitoring_node.html