The major outcome of this thesis is the detection and identification of profound spatial inequalities. These inequalities differ by the level of spatial aggregation, the selected health indicator, the birth cohort, but only partly by sex. The inequalities are exposed by using established population health measures which depict disparities in an absolute (prevalence, life years with and without care need), relative (Health ratio, Odds ratio, Risk ratio), or theory-driven perspective (health scenarios).
The major outcome of this thesis is the detection and identification of profound spatial inequalities. These inequalities differ by the level of spatial aggregation, the selected health indicator, the birth cohort, but only partly by sex. The inequalities are exposed by using established population health measures which depict disparities in an absolute (prevalence, life years with and without care need), relative (Health ratio, Odds ratio, Risk ratio), or theory-driven perspective (health scenarios).
"In order to make precise and forward-looking decisions in nearly all social fields, detailed information on the size and structure of prospective populations in specific regional areas is needed. For that purpose, this article will show how current trends of demographic parameters affect the development of the population in administrative districts of the federal state of Mecklenburg-Western Pomerania until 2030. Based upon population data from 1982 until 2005, provided by the Federal State Agency of Statistics of Mecklenburg-Western Pomerania, this paper presents a projection of the population as well as the aging and the sex proportion of the federal state until 2030. The development of off-county cities, counties and the whole federal state were calculated by applying the cohort-survival- method and prediction module of the Federal State Agency of Statistics of Mecklenburg-Western Pomerania. The fertility and migration assumptions chosen, are following the assumptions of the last coordinated population projection of the Federal State Agency of Statistics of Mecklenburg-Western Pomerania (2007). The mortality assumptions enter the analysis analogously to the county- and sex-specific projections of life expectancy, as they are used within the Lee-Carter-method (1982 - 2005). The results show a population decrease of about 180.000 inhabitants until 2030 for the entire federal state with strongest population loss until 2012. In the following years the outflow of people strongly decreases, because cohorts in migration relevant ages are missing. The population development of the six off-county cities is rather different. Rostock and Greifswald will note a population increase until 2030, whereas the number of residents in Wismar and Stralsund will be stable. Schwerin and Neubrandenburg will lose residents. Every county will diminish enormously; except Bad Doberan which has to count on a population increase, while Uecker-Randow and Demmin will lose most inhabitants. In the forthcoming years the counties will not only be shrinking, but they will also age above average. The mean age of all counties will grow by 10.5 years until 2030. In the cities it will increase by 4.4 years and for entire Mecklenburg-Western Pomerania it will increase by 8.2 years. Counties with positive population development will age most slightly. The absolute quantity as well as the relative proportion of seniors (aged 64+) and oldest old (aged 79+) will grow in all counties. A similar picture can be seen in the cities, where the absolute quantities of oldest old and seniors will also increase, wheras the relative proportions are smaller. In 2030 the proportion of seniors of all cities will be below the federal state mean, except for Neubrandenburg. Overall, inhabitants aged 50 and older will increase, whilst persons in reproductive ages between 15 and 49 years will exhibit a declining proportion of population. Hence, the birth deficit will be further intensified. Moreover, a high predominance of men within the younger population could be discovered for the 1990s. This predominance of men will be put forward as a cohort effect in older age groups during the following years. At county level it can be shown, that the projected values for the cities comparatively turn out to be more positive, whilst the projections for some counties give a more pessimistic outlook. The latter finding has to be traced back to the migration assumptions. This projection is on par with results of previous projections which also showed shrinkage and aging trends for Mecklenburg-Western Pomerania. Updated federal state population quantities reflect both processes as well. The projected, further increasing absolute quantities of older and the decreasing quantities of young people in urban and less populated regions, imply an urgent need for action from political and economical decision makers. An age-appropriate infrastructure as well as a good performing care- and health system for the growing number of further aging persons are required to absorb the ongoing and projected trends. Political decisions have especially to be made for sparsely populated regions to maintain security of supply and infrastructure." (author's abstract)
