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The European Journal of Public Health Advance Access published online on May 21, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp060
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health status of ‘Ruhr-City’ in 2025 – predicted disease burden for the metropolitan Ruhr area in North Rhine-Westphalia

Claudia Terschüren1, Odile C. L. Mekel1, Reinhard Samson2, Thomas K. D. Claßen2, Claudia Hornberg2 and Rainer Fehr1

1 NRW Institute of Health and Work (LIGA.NRW), Westerfeldstr. 35-37, 33611 Bielefeld, Germany
2 Faculty of Health Sciences, University of Bielefeld, AG 7 – Environment and Health, 33501 Bielefeld, Germany

Correspondence:Dr Claudia Terschüren, NRW Institute of Health and Work, Westerfeldstr. 35-37, 33611 Bielefeld, Germany, tel: +49 521 8007 246, fax: +49 521 8007 299, e-mail: claudia.terschueren{at}liga.nrw.de

Received July 30, 2008 , accepted April 17, 2009

Background: Demographic change is a driving force of disease burden. The German population is aging and simultaneously shrinking, due to a rising life expectancy and a declining fertility rate. North Rhine-Westphalia (NRW) is the most populous federal state of Germany including the Ruhr metropolitan area. The NRW population is expected to shrink by 2.5% until 2025, the population of the Ruhr area by 9.5%. At the same time, the population forecast predicts a growth of 30% in the age group ≥55 years for NRW. Methods: The ‘burden of disease’ approach of the World Health Organisation (WHO) summarizes the health status of populations. This approach was used to predict the regional disease burden in 2025 by calculating disability adjusted life years (DALY) as the sum of life years lost due to premature death and years lived with disability due to selected diseases. Our projection included selected tumours, myocardial infarction (MI) and dementia. Results: For the Ruhr area, increases in DALYs are expected for all causes studied, i.e. selected tumours (20%), MI (17%) and dementia (36%). The increase in the Ruhr area was estimated to be proportionally lower than in NRW in total, but the disease burden per inhabitant is higher. Conclusion: The population shrinking is no cure for ‘Ruhr City’. The projection of disease burden shows that health status will decrease due to the demographic change. DALY estimates show the potential health gains, which can be won by implementing measures to reduce premature deaths and to prevent new cases.

Keywords: burden of disease, chronic diseases, demographic change, urbanized area, Germany.


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