New information website to help those in poverty or debt access health care system services

In order to help break through the vicious circle that can develop when people in poverty or debt become ill and fail to utilize the health care options open to them, the Debt Counseling Center (SFZ) of Johannes Gutenberg University Mainz and the Institute of Vocational, Social and Environmental Medicine of Mainz University Medical Center have together launched the project "Sozialvital". From November 2011, a new website will be available on the net that will provide information on the services provided by the German health care system in a readily understandable form. The website is not only designed to be used by those directly affected, but is also targeted at counselors, teachers and educators who act as information distributors, providing them with brochures in various languages. The project is being sponsored by the "Art, Culture and Society" Foundation of the Sparda-Bank Südwest as part of the "Mainz - City of Science 2011" program. 

At the very latest, statistical evidence that there is a higher relative rate of illness among people in debt became available on completion of the "Poverty, Debt and Health" survey ("ASG study") undertaken by the Institute of Vocational, Social and Environmental Medicine in 2006 and 2007 in collaboration with debt counseling agencies in Rhineland-Palatinate and Mecklenburg-Western Pomerania. Such people also tend to use the services provided by the health care system less frequently. There is clear evidence that some individuals avoid going to a doctor because they are unable to afford the €10 consultation fee; quite often, they are unaware that if they meet certain requirements they can be exempted from payment of this fee. "While information on this area is available from doctors, health insurance organizations and on the internet, all too often one gets conflicting and in some cases even inaccurate responses", explains Professor Dr. Stephan Letzel, Director of the Institute of Vocational, Social and Environmental Medicine of Mainz University Medical Center. "Our aim with our 'Sozialvital' project is to ensure that the correct information is made readily accessible for everyone," he continues. 

It is the view of the Debt Counseling Center and the Institute of Vocational, Social and Environmental Medicine that those with statutory health insurance cover do not receive appropriate advice in a form they can understand. Letzel adds: "We know from our research during the project that the hotlines of health insurance organizations often fail to provide accurate information." He also points out that the health insurance organizations are actually required by law to provide detailed and correct information on the services provided by the health care system. A survey conducted by the Institute of Vocational, Social and Environmental Medicine found, for example, that more than 50% of the insurance organizations contacted gave basically misleading information with regard to six-monthly dental checkups. "There is no doubt that persons with health insurance cover in Germany are not being provided with information they find intelligible." And this is something that is particularly important for those with limited means who may also be in debt. 

It is here that the "Sozialvital" project looks to provide help with its concept of ensuring that those in poverty and/or debt will be able to find information on their rights in an easily understandable form. The website will also provide cross-references to the relevant passages of Volume Five of the Social Insurance Code (SGB V). Three brochures have already been prepared. These list those services that are free or attract charges, the special services available to children and young people and explain who is eligible to claim refunds of health care charges. These brochures are available in German, English, Turkish, Arabic and Russian and can be downloaded from the website www.sozialvital.de. 

"In our application to be awarded the title of 'City of Science 2011', we cited the 'Sozialvital' project as one of the main elements of our 'Healthy City' program," states Head of Mainz's Social Services, Kurt Merkator. "Many of our citizens are at very real risk of slipping into poverty. As their city of residence, we intend to provide them with support from various sides: In our 'City of Science', the evidence that has already been collated by the Institute of Vocational, Social and Environmental Medicine of Mainz University Medical Center and the Debt Counseling Center is to be put to practical use on the new homepage and in the translations of the brochures into various languages, thus providing for long term improvement of public health and prevention and advice." 

The project initiators hope to be able to network with other stakeholders in this sector within the "Mainz - City of Science 2011" program, thus extending the range of their preventative strategy. They are receiving financial support from by the "Art, Culture and Society" Foundation of the Sparda-Bank Südwest. This cooperative bank, which has only private individuals as customers, aims to make a contribution through this project towards helping people break out of the vicious circle of debt and lead a healthy life as fully privileged members of society. 

The Sparda-Bank Südwest Foundation is thus also sponsoring the "finanziell fit" program, an educational concept of the Debt Counseling Center designed to improve the financial competence of families, youngsters and young adults. One of the "finanziell fit" strategies is to provide appropriate training to volunteer assistants in Rhineland-Palatinate. They are provided with essential insight into financial aspects that they can pass on through their work as continuing education supervisors in youth centers, schools, seminars and workshops to families and particularly to young people. The concepts and materials that have been developed are also to be used in the educational sector in future. Initial plans have already been drawn up to employ the basic knowledge and educationally processed materials in the training and continuing education of teachers. With the cooperation of the Center for Educational and Higher Educational Research, the material developed during the project in the "Mainz - City of Science 2011" program will continue to be used and refined through the "Education" axis in future. 

The Debt Counseling Center of Johannes Gutenberg University Mainz was originally established in June 1999 following the introduction of the new consumer insolvency system in Germany. It is a unique body in this country, both providing support to the state debt counseling agencies and conducting academic research. 

The Institute of Vocational, Social and Environmental Medicine of of Mainz University Medical Center has an interdisciplinary team consisting of medical specialists, scientists and social scientists who initiate innovative projects in research and teaching on behalf of the three relevant faculties. The institute also plays an advisory role within the health care system. Among its facilities are a vocational and environmental medical outpatient department and a toxicological and neurophysiological laboratory. In 2011, a vocational medical counseling center specializing in the sector of teachers' health was established at the institute. The "Social Medicine/Public Health" Work Group focuses on the subject of "Social networks and the management of poverty and debt" and has thus been contributing since 2005 towards the work of the Rhineland-Palatinate "Social dependence and social networks" cluster of excellence maintained by the Universities of Mainz and Trier.