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Socioeconomic inequalities in mortality among elderly people in 11 European populations
  1. M Huisman1,
  2. A E Kunst1,
  3. O Andersen2,
  4. M Bopp3,
  5. J-K Borgan4,
  6. C Borrell5,
  7. G Costa6,
  8. P Deboosere7,
  9. G Desplanques8,
  10. A Donkin9,
  11. S Gadeyne7,
  12. C Minder10,
  13. E Regidor11,
  14. T Spadea6,
  15. T Valkonen12,
  16. J P Mackenbach1
  1. 1Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
  2. 2Research and Methodology, Statistics Denmark, Copenhagen, Denmark
  3. 3Institute for Social and Preventive Medicine, University of Zurich, Switzerland
  4. 4Division for Health Statistics, Statistics Norway, Oslo, Norway
  5. 5Municipal Health Service, Barcelona, Spain
  6. 6Department of Public Health and Microbiology, University of Turin, Italy
  7. 7Interface Demography, Free University Brussels, Belgium
  8. 8INED, Paris, France
  9. 9Health and Care Division, Office for National Statistics, London, UK
  10. 10Institute for Social and Preventive Medicine, University of Bern, Switzerland
  11. 11Department of Preventive Medicine and Public Health, University of Madrid, Spain
  12. 12Department of Sociology, University of Helsinki, Finland
  1. Correspondence to:
 Dr M Huisman
 Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, Netherlands;


Study objective: To describe mortality inequalities related to education and housing tenure in 11 European populations and to describe the age pattern of relative and absolute socioeconomic inequalities in mortality in the elderly European population.

Design and Methods: Data from mortality registries linked with population census data of 11 countries and regions of Europe were acquired for the beginning of the 1990s. Indicators of socioeconomic status were educational level and housing tenure. The study determined mortality rate ratios, relative indices of inequality (RII), and mortality rate differences. The age range was 30 to 90+ years. Analyses were performed on the pooled European data, including all populations, and on the data of populations separately. Data were included from Finland, Norway, Denmark, England and Wales, Belgium, France, Austria, Switzerland, Barcelona, Madrid, and Turin.

Main results: In Europe (populations pooled) relative inequalities in mortality decreased with increasing age, but persisted. Absolute educational mortality differences increased until the ages 90+. In some of the populations, relative inequalities among older women were as large as those among middle aged women. The decline of relative educational inequalities was largest in Norway (men and women) and Austria (men). Relative educational inequalities did not decrease, or hardly decreased with age in England and Wales (men), Belgium, Switzerland, Austria, and Turin (women).

Conclusions: Socioeconomic inequalities in mortality among older men and women were found to persist in each country, sometimes of similar magnitude as those among the middle aged. Mortality inequalities among older populations are an important public health problem in Europe.

  • socioeconomic inequalities
  • mortality
  • elderly population

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  • Funding: This study is based on a grant (contract QLK6-CT-1999-02161) of the Fifth Framework Programme on “Quality of Life and Management of Living Resources” of the European Union. The construction of the Swiss National Cohort has been supported by the Swiss National Science Foundation, grants number 32-5884.98 and 32-63625.00.

  • Conflicts of interest: none declared.