- Open Access
Governance and Capacity Building in German and Austrian Public Health Since the 1950s
Public Health Reviews volume 33, pages264–276 (2011)
The German speaking countries (Germany and Austria) have a strong tradition of universal health insurance since the late 19th century. Germany was one of the leading countries in “social hygiene as health science”, an interdisciplinary field of academic work, health policy and practice, providing a comprehensive scientific basis both for professional education and training in the new academies for social hygiene, the schools of public health in the 1920s, and also for a rapidly growing network of municipal public health services. Public health in Austria at that time was less advanced. There was a rupture in the field of public health in these countries as the Nazi regime and World War II destroyed almost all of the human resources, the scientific basis and the institutional infrastructure required for advancement.
In the postwar period Germany was divided with separate social and health systems in East and West Germany until reunification in 1990. Meanwhile, Austria became a democratic federal republic developing a social welfare policy on the basis of a successful economy. Whereas Germany set up national programmes to support the development of a new public health, Austria established a health promotion fund. As a result, there has been more growth in the public health community in Germany than in Austria. However, in both countries strong efforts to strengthen the educational base will be needed to address the complex issues facing public health in the 21st century. For example, health expenditures in Germany and Austria are among the highest in the European Union, but health systems indicators such as healthy life years show values below the European average. The challenge to renew the highly fragmented systems of health/disease care and improve the social determinants of population health underline the need for strengthening public health structures and national policy in the two German speaking countries. Development of the scientific community is underway but has not yet reached the levels of the outstanding achievements of the late 19th and early 20th centuries.
Heinzelmann W. Sozialhygiene als Gesundheitswissenschaft. Die deutsch/jüdische Avantgarde 1897–1933. Eine Geschichte in sieben Profilen. Bielefeld: transcript Verlag; 1990.
OECD. Health at a glance: Europe 2010. Available from URL: http://www.oecd-ilibrary.org
Beaglehole R, Bonita R, Horton, Adams O, McKee M. Public health in the new era: improving health through collective action. Lancet 2004; 363: 2084–86 (Accessed 24 June, 2011).
Antonovsky A. Unraveling the mystery of health–how people manage stress and stay well. San Francisco: Jossey-Bass Publishers; 1987.
American Public Health Association (APHA). Essential Public Health Services. Available from URL: http://www.apha.org/programs/standards/performancestandardsprogram/resexxentialservices.html (Accessed 25 June, 2011).
Hawe P, Noort M, King L, Jordens C. Multiplying health gains: the critical role of capacity-building within health promotion programs. Health Policy 1997; 39: 29–42.
Saltman RB. Social health insurance in perspective: the challenge of sustaining stability. In: Saltmann RB, Busse R, Figueras J (eds.). Social health insurance systems in western Europe. New York: Open University Press, McGraw-Hill; 2004: 3–20. Available from URL: http://www.euro.who.int/__data/assets/pdf_file/0010/98443/E84968.pdf (Accessed 14 September, 20
OECD Health Data 2011. Health expenditure and financing 2010. Available from URL: http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT (Accessed 14 September, 2011).
Busse R, Riesberg A. Health care systems in transition: Germany. WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Copenhagen; 2004 (Accessed 27 June, 2011).
Hofmarcher MM, Rack H-M. Austria: health system review. Health systems in transition. 2006; 8(3):1–247. Available from URL: http://www.euro.who.int /__data/assets/pdf_file/0009/96435/E89021.pdf (Accessed 27 June, 2011).
Organisation for Economic Co-operation and Development (OECD). Change of health expenditures in OECD countries. Available from URL: http://www.oecd.org/document/38/0,3746,en_21571361_44315115_48289894_1_1_1_1,00.html (Accessed 14 September, 2011).
Beck U. Weltrisikogesellschaft. Frankfurt am Main: Suhrkamp; 2007.
Beck U, Giddens A, Lash S. Reflexive modernisation: politics, traditions and aesthetics in the modern social order. Cambridge: Polity Press; 1994.
Rosenbrock R, Gerlinger T. Gesundheitspolitik. Eine systematische Einführung, 2. Auflage. Bern: Huber; 2006.
Hauptverband der österreichischen Sozialversicherungsträger, The London School of Economics and Political Science, April 2010. Available from URL: http://www.hauptverband.at
Bleich SN, Özaltin E, Murray CJL: How does satisfaction with the health-care system relate to patient experience? Bulletin of the World Health Organization 2009;87:271–278. Available from URL: http://www.who.int/bulletin/volumes/87/4/07–050401-table-T1.html (Accessed 9 April, 2011).
McCarthy, Clark A (Guest eds). Public health research literatures in Europe. European Journal of Public Health. 2007;17(Suppl 1): 1–49.
Dierks M-L. Postgraduierte Public-Health-Ausbildung und Berufsfelder im Bereich von Public Health. In: Schwartz FW, Badura B, Leidl R, Raspe H, Siegrist J, Walter U (Eds.). Public Health. Gesundheit und Gesundheitswesen. München Jena: Urban & Fischer: 772–779.
Kälble K. Gesundheitsberufe unter Modernisierungsdruck. In: Pundt J (Ed.). Professionalisierung im Gesundheitswesen. Positionen–Potenziale–Persepektiven. Bern: Verlag Hans Huber; 2006. Pp. 213–233.
Austrian Public Health Association. Österreichische Gesellschaft für Public Health (ÖGPH). Available from URL: http://www.oeph.at/public-health-in-oesterreich/public-health-faq (Accessed 5 July, 2011).
Tulchinsky TH, Varavikova EA. The New Public Health. Public Health Reviews. 2010; 32: 25–53.
Recommended Citation: Noack H. Governance and Capacity Building in German and Austrian Public Health Since the 1950s. Public Health Reviews. 2011;33:264–76.