Background: Secular trends in health-related behavior, the frequency of illness, and life satisfaction in rural areas are inadequately documented. Such information is essential for the planning of health-care policy.
Methods: In 1973 and 1994, surveys were performed on the health and lifestyle of all adult inhabitants of 14 selected rural communities in the northern part of the former East Germany. The inhabitants were surveyed again in 2008, and the findings of the surveys were compared.
Results: Both the number of respondents and the response rate of the officially registered population in the 14 rural communities declined over the years, from 3603 (83%) in 1973 to 2155 (68%) in 1994 and 1246 (37%) in 2008. In 1973, 3.2% of the women and 2.7% of the men responding to the survey reported that they had diabetes mellitus. For arterial hypertension, the corresponding figures in 1973 were 21.7% and 11.4%; for chronic heart diseases, 16.7% and 12.8%. In 2008, most of the prevalence figures for these conditions were higher: for diabetes, 12.4% and 12.8%; for arterial hypertension, 34.7% and 33.9%; for chronic heart diseases, 12.3% and 15.0%. Men became less likely to report being in good or very good health (decline from 51.1% to 45.0%), while women became more likely to report being in good health (rise from 36.7% to 49.3%). Women generally had a more healthful lifestyle than men.
Conclusion: Over the long term, there have been both improvements, particularly in lifestyle, and turns for the worse, e.g., in life satisfaction. While the latter might be due to the increasing marginalization of rural eastern Germany, we interpret the observed improvements as benefits of modernization.