Disease distribution disaggregated by sex and age in employees of the german federal armed forces to improve workplace health promotion measures
Authors: Seeland U , Roy R , Roehle R , Dickob C , Bauer M D , Ucar J , Hauck M , Arnold L , Willich S , Reinhold T , Ludwig S 
Published: June 2024

Abstract

Background
Workplace health promotion (WHP) is an important approach to maintain and improve the health of employees. The German Federal Armed Forces are dependent on daily availability of their employees and are therefore striving to increase participation in WHP measures (WHPM).

Purpose
This study investigates the rate of participation in WHPM distributed by sex and &lt; or ≥ 40 years of age and analyses main diseases and health risk factors within these groups. The aim of this study is to provide data on disease distribution for future concepts aiming at an individualization of health measures for employees disaggregated by sex and age.

Methods
Prospective longitudinal observational study with cross sectional analysis at T0 from 06 to 09/2022. Data were collected at most of the departments of the German Federal Armed Forces with a total of 223.967 employees. Data were obtained with an employee survey to record self-reported endpoints, using the web-based software SoSci Survey and paper and pencil. Included were employees age ≥18 years, civilian and military and all ranks. Statistical analyses were performed using R software. All participants gave their written informed consent.

Results
Of a total of 23568/223967 (10.5%) participants in the survey, 6791/23428 (29.0%) were female, 50 (0.2%) were diverse, and 10366/23520 (44.1%) were &lt;40 years of age. Independent of age, 5634/12406 (45.5%) employees had never participated in WHPM. WHPM participation rate for the age group &lt;40 years was 59.9% (980/1637) in women vs. 51.1% (1561/3052) in men, for the age group ≥40 years 62.0% (1448/2337) in women vs 51.5% (2717/5279) in men. The most frequent diseases in women &lt;40 years were musculoskeletal diseases (MSD) 23.3% (678/2905), psychological disorders (PD) 21.7% (659/3043), respiratory diseases (RD) 14.8% (449/3043); in men &lt;40 years were MSD 21.9% (1423/6508), PD 13.6% (985/7224), RD 11.9% (861/7225); in women ≥40 years were MSD 45.7% (1662/3637), PD 24.7% (922/3738), metabolic diseases 19.1% (715/3728); and in men ≥40 years were MSD 41.4% (3774/9119), hypertension 21.5% (2009/9341), PD 18.1% (1695/9341). Data showed gender and age differences for employees that regularly exercise &gt;2h/week ranging from 52.3% in men &lt;40 years to 31.7% in women ≥40 years. Further analyses showed gender differences with poorer health status among women compared to men.

Conclusion
Musculoskeletal diseases and psychological stress dominate the spectrum of diseases of employees of the German Federal Armed Forces for both women and men in line with overall working population and main reasons for sick leave days. WHPM should be tailored accordingly including particular efforts to enhance participation of all, especially men &lt;40 and women ≥40 years of age. Long-term prevention strategies should also include chronic diseases such as metabolic syndrome and hypertension.
U. Seeland and R. Roy shared authorship