Background The magnitude of educational inequalities in mortality avoidable by medical care in 16 European populations was compared, and the contribution of inequalities in avoidable mortality to educational inequalities in life expectancy in Europe was determined.
Methods Mortality data were obtained for people aged 30–64 years. For each country, the association between level of education and avoidable mortality was measured with the use of regression-based inequality indexes. Life table analysis was used to calculate the contribution of avoidable causes of death to inequalities in life expectancy between lower and higher educated groups.
Results Educational inequalities in avoidable mortality were present in all countries of Europe and in all types of avoidable causes of death. Especially large educational inequalities were found for infectious diseases and conditions that require acute care in all countries of Europe. Inequalities were larger in Central Eastern European (CEE) and Baltic countries, followed by Northern and Western European countries, and smallest in the Southern European regions. This geographic pattern was present in almost all types of avoidable causes of death. Avoidable mortality contributed between 11 and 24% to the inequalities in Partial Life Expectancy between higher and lower educated groups. Infectious diseases and cardiorespiratory conditions were the main contributors to this difference.
Conclusions Inequalities in avoidable mortality were present in all European countries, but were especially pronounced in CEE and Baltic countries. These educational inequalities point to an important role for healthcare services in reducing inequalities in health.
- Avoidable mortality
- health services research
- public health Europe
- Accepted 28 August 2009
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Funding This investigation has been funded by the Health & Consumer Protection Directorate-General of the European Union and was carried out as a part of the Eurothine project (Grant number 2003125). The study sponsors have not influenced in any form study design, collection, analysis and interpretation of data, writing of the paper and decision to submit it for publication.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.