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Cross-State Health Report 2022

In the first two years of the pandemic, absenteeism due to mental illness continued to increase in Berlin and Brandenburg, while the diagnosis COVID-19 was only found on a rather small proportion of sick leave. This is one of the results of the current Cross-State Health Report for the years 2019 to 2021. This is now the sixth health report presented by the Healthcare Industries Cluster Berlin-Brandenburg - Health Capital. The report takes a comprehensive look at the health of the workforce.

The sickness rate in the region has fallen and was 4.6 per cent in Berlin and 6.3 per cent in Brandenburg in 2021. Berlin's sickness rate was well below the national average, while Brandenburg's was above. The frequency of sick leave in particular declined in both federal states, while the average length of sick leave increased. In particular, in the first year of the COVID-19 pandemic, there were significantly more longer and less short sick leaves. In 2021, employees in Berlin and Brandenburg were on sick leave for an average of 19.4 days overall.

Looking at the main causes of absenteeism, it can be seen that respiratory diseases decreased during the first two years of the pandemic, while absenteeism due to mental illness continued to increase. For the first time, mental illnesses accounted for the most days of absence in Berlin in 2021, closely followed by diseases of the musculoskeletal system. In Brandenburg, on the other hand, musculoskeletal disorders continued to cause the most days of absence; in 2020, which was also still the case in Berlin.

It can be assumed that the general decline in sick leave was largely a result of the hygiene measures taken in the wake of the COVID-19 pandemic. In particular, the significant decline in respiratory diseases in both federal states is due to this.

Sick leaves due to COVID-19 infections can be found in the work incapacity data of the health insurance funds from 2020. In 2021, 1.4 per cent of sick leaves in Brandenburg and 1.1 per cent in Berlin listed a COVID-19 infection as the cause. It should be noted that the diagnosis of COVID-19 was only introduced in the reporting period and presumably not all COVID-19 cases were recorded as such. The same applies to the post-COVID-19 state, which appears even less frequently in the incapacity data at 0.11 percent of cases of illness based on 100 insured years. This is a very complex clinical picture that requires comprehensive diagnostics for clarification and is associated with long periods of absence. In 2021, for example, sick leave with this diagnosis lasted an average of 46.7 days in Berlin and 35.9 days in Brandenburg.

There has been a massive increase in the number of recognised occupational diseases due to an infectious disease. While there were 60 cases in Berlin and 17 in Brandenburg in 2019, these figures rose to 1003 (Berlin) and 422 (Brandenburg) in 2020 and further to 6381 (Berlin) and 4396 (Brandenburg) in 2021. Accordingly, COVID-19 diseases dominated occupational diseases in Berlin and Brandenburg during the pandemic years. They were responsible for more than 50% of all recognised occupational diseases in the region in 2020 and even more than 90% in 2021. COVID-19 is recognised as an occupational disease in particular for persons who become infected with SARS-CoV-2 and contract the disease as a result of their work in the health care or welfare sector or in a laboratory.   

The incidence of disease varies by sector and region

The sectors with the highest sickness rates in both federal states continue to be

  • water supply, sewage and waste disposal
  • public administration, defence; social security
  • transportation and storage
  • health care and social services

The order of the sectors varies between the federal states. In Berlin, water supply, sewage and waste disposal led with the highest sickness rate (7.6% in 2021), in Brandenburg public administration, defence; social security (7.9% in 2021).

The decline in sick leave in 2020 and 2021 is visible in almost all sectors and professional groups. It is particularly noticeable where the professional activity could also be done from the home office. However, in sectors such as health and social services, as well as in the construction industry, sickness rates have risen in these years, in contrast to many other sectors. The health and social care sector also has by far the highest number of days of absence due to COVID-19. The fact that most recognised occupational diseases are recorded in the healthcare professions in 2020 and 2021 is also due to COVID-19. In the health professions as well as professions in the field of education, domestic work and theology, a significant increase in retirements due to reduced earning capacity was also visible in both federal states.

Regional differences also become apparent. In Berlin, the districts of Marzahn-Hellersdorf (5.8 per cent), Spandau (5.8 per cent) and Reinickendorf (5.7 per cent) had particularly high sickness rates in 2021. Friedrichshain-Kreuzberg (3.3 percent), Mitte (3.5 percent) and Charlottenburg-Wilmersdorf (3.8 percent) recorded comparatively low levels of sick leave. In Brandenburg, people in the Elbe-Elster district (7.3 per cent) and in the districts of Prignitz (7.1) and Ostprignitz-Ruppin (7.1 per cent) had comparatively many days of absence. In contrast, there were rather low sickness rates in Potsdam (4.9 per cent), Cottbus (5.5 per cent) and Frankfurt/Oder (5.6 per cent). Reasons for the regional differences in both Berlin and Brandenburg can be a different age structure, a different socio-economic structure and the employment of employees in different sectors. In terms of tendency, there have been no serious changes in the ranking of districts and regions with regard to their sickness levels compared to previous reports. For Berlin, it is noticeable that in districts with below-average sickness rates, mental illnesses usually cause the most days of absence. In districts with above-average sick leave, on the other hand, it is musculoskeletal disorders. In Brandenburg, mental illnesses are only responsible for the most absenteeism days in Potsdam; in all other regions, musculoskeletal disorders are the number one cause of illness.

Implications for the working world of tomorrow

The COVID 19 pandemic has also changed the world of work beyond mere cases of illness. A clear push towards digitalisation and increased working from a home office is particularly noticeable. The trend towards forms of New Work has thus intensified further and confronts occupational health management with new tasks. Working environments that are not limited in terms of time and space require new skills from employees. Health services should be offered more decentrally, also using digital possibilities. Workplace integration management will have to take into account the special features of the new clinical picture of the "post-Covid 19 condition". These and other implications of the findings of the new Cross-State Health Report for occupational health management will be discussed in an online event on 28 February 2023. Interested parties can register for this free of charge under the following link: The health situation of employees - what can we learn from the COVID-19 pandemic? | Healthcare industries cluster Berlin-Brandenburg (

Opinions on the Cross-State Health Report

Ulrike Gote, Senator for Science, Health, Nursing and Gender Equality: "Prevention and occupational health management are important concerns for the Berlin Senate. With the current report, the partners of the cross-state health report have made it possible to evaluate the incidence of incapacity to work during the Covid 19 pandemic in detail. We will take this evaluation as an opportunity to work together with those involved in health management in companies to counteract mental illnesses among employees and the consequences of Long-Covid and to further strengthen the professional reintegration of those affected.”

Michael Ranft, State Secretary in the Ministry of Social Affairs, Health, Integration and Consumer Protection of the State of Brandenburg: "The Berlin-Brandenburg Cross-State Health Report provides a valid overview of the health status of employees in our region and thus a good basis for decision-making for politicians, companies and social partners. Health promotion and prevention must take place where people live and work. Healthy, motivated and efficient employees are an essential prerequisite for the success of the company. A good, healthy working environment that complies with occupational health and safety standards is becoming a decisive competitive factor for companies and administration in times of a shortage of skilled workers."

Dr. Kai Uwe Bindseil, Head of Department Healthcare Industries | Industry | Infrastructure of Berlin Partner: “With the Cross-State Health Report Berlin-Brandenburg, we are now presenting a comprehensive analysis of the health situation of employees in our region for the sixth time. It offers the actors in the health economy cluster, companies, social insurance institutions and politics a sound basis for monitoring short- and longer-term developments in detail. Building on this, they can develop new measures, concepts and solutions to strengthen and promote the health of workers in the context of existing challenges."      

Susanne Hertzer, Head of Techniker Krankenkasse TK in Berlin and Brandenburg: "Hygiene measures helped to prevent infections and respiratory diseases during the corona pandemic. But the Cross-State Health Report shows: Especially now we have to do more for our own mental and physical health - hygiene measures for body and mind. Early detection and preventive medical check-ups should be carried out regularly. Working from home should not mean sitting at a desk with a fever. The many changes in everyday working life require adjustments in occupational health management. And importantly: Long Covid sufferers must not be forgotten by us just because the pandemic is over for now."

The Berlin-Brandenburg 2022 Cross-State Health Report is published by the Berlin-Brandenburg Healthcare Industry Cluster – HealthCapital with the support of the BGF Coordination Offices in Berlin and Brandenburg. It was developed in cooperation with AOK Nordost, BARMER, the company health insurance funds, IKK Brandenburg and Berlin, KNAPPSCHAFT, Techniker Krankenkasse, Deutsche Rentenversicherung and Deutsche Gesetzliche Unfallversicherung. The report is thus based on data from around 82 per cent of all employees subject to social insurance contributions in Berlin and Brandenburg for the years 2019 to 2021. The Berlin IGES Institute, as an independent research and consulting institute, brought the data together, carried out the analyses for the reporting years 2019 to 2021 and created the report.

Download the Health Report

The sixth cross-state health report is available for download free of charge at or can be ordered as a printed booklet from the Berlin-Brandenburg Health Capital Cluster (email: info(at), Tel. 030-46302-463).

Berlin Partner für Wirtschaft und Technologie – We work for innovation and growth!
The business development company Berlin Partner für Wirtschaft und Technologie is Berlin’s service provider for growth and innovation. Berlin Partner supports companies and investors in their move to Berlin and in their development in this city. Berlin Partner’s experts provide information on financing options, advise on finding suitable premises or qualified personnel and help build networks with partners from the world of science. The State of Berlin and more than 230 companies committed to promoting their city stand behind Berlin Partner für Wirtschaft und Technologie as a unique public/private partnership. Berlin Partner is also responsible for marketing the German capital worldwide.

Cross-state cluster management 
The HealthCapital cluster management supports and networks stakeholders from business, science, care and politics. The task of the cluster management is to implement the master plan for the health region of the state governments of Berlin and Brandenburg and to further develop the region internationally into the leading centre for health management and life sciences. A volunteer cluster spokesman and groups of experts advise on strategic decisions and take on representational tasks. Berlin Partner and the Economic Development Agency Brandenburg are re-sponsible for the joint cluster management. The activities of the cluster management are co-financed by the European Regional Development Fund. The aim is to promote innovation and cooperation between companies and research institutions, resulting in increased competitiveness for intelligent, sustainable and integrative growth.

BGF-Coordination Office: 
The BGF Coordination Office is a cooperative association of all statutory health insurance funds for advising and supporting companies across all types of funds in accordance with § 20b SGB V in workplace health promotion,  






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