Text

Names of the moderators and speakers:

Chair: Prof. Dr. Tamara Schikowski

Speakers: F.-S. Rodriguez2, M. Jung3, S. Götz4, A. Sprenger-Vukovic4

Background: Social determinants of health such as socioeconomic position, employment status, living arrangements, and gender play a key role in shaping health behaviors, disease risk, and health inequities. Large population-based cohorts with detailed social, psychosocial, and biological data allow robust analyses to explore these relationships. The German National Cohort (NAKO) provides a unique research infrastructure with extensive phenotyping, imaging data, and longitudinal follow-ups to study how social determinants interact with biological and behavioral pathways.

Aim/scientific question: This symposium provides an overview how social determinants of health can be studied using NAKO data. Selected research projects highlight the potential of the cohort to analyze associations between socioeconomic, occupational variables and diverse health outcomes.

Topic for discussion: The symposium discusses the value of large cohort studies for research on social determinants and health inequities, focusing on integrating (psycho-)social, biological, and imaging data, and the advantages of longitudinal analyses to understand health pathways.

Content: NAKO is the largest population-based cohort study in Germany. Between 2014 and 2019, over 205,000 individuals aged 20–74 were recruited at 18 study centers. Participants completed standardized interviews, questionnaires, biomedical assessments, and provided biological samples. A subgroup also underwent whole-body MRI, enabling detailed analyses of body composition and organ characteristics.

Follow-ups (FU) occur every ~5 years. The 5-year FU (10/2018–07/2024) included over 138,000 participants (response rate: 67,5%), including >18,000 with a second MRI. The 10-year FU started in June 2024 and aims to re-examine 85,000 participants.

The symposium presents study design, methods, and selected results from four projects: 1) associations of low income, unemployment, and living alone with cognitive function; 2) whole-body MRI assessed sex differences in body composition; 3) work-related stress and inflammatory markers (CRP); 4) longitudinal links between working from home and depressive symptoms.

Take Home Message: NAKO provides critical insights into the health impact of social, occupational factors and gender. Findings can inform public health strategies and support targeted prevention and health promotion interventions to promote equity. To access NAKO data and biological samples visit: NAKO TransferHub at www.nako.de/transferhub.

Competing interests: None