Life expectancy | 21.05.2024Inequality between advantaged and disadvantaged regions is increasing
A new study by the Robert Koch Institute (RKI) in collaboration with the Federal Institute for Population Research (BiB) and the Hannover Medical School shows for the first time which causes of death are responsible for the growing regional gap in life expectancy in Germany. The results were published in the scientific journal "The Lancet Public Health" and in the Bundesgesundheitsblatt.
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Research has shown that people living in socio-economically disadvantaged neighbourhoods generally have a higher mortality rate. So far, it was unknown which causes of death have contributed to this gap primarily. To find out, the researchers used the "German Index of Socioeconomic Deprivation" developed at the RKI in their study - a measure of the socioeconomic situation of regions throughout Germany. They linked this index to cause-specific deaths that were observed between the early 2000s and 2021.
Regional differences in life expectancy have increased in recent decades
Over the last 20 years, the study shows that people in socio-economically disadvantaged neighbourhoods have a shorter life expectancy on average than those in more affluent areas, which can be explained in particular by increased mortality in the middle and older age groups. And not only that: inequalities have increased in recent decades, especially during the COVID-19 pandemic.
The difference in life expectancy between the regions with the highest and lowest social deprivation in Germany was 3.1 years for men and 1.8 years for women in 2019. During the pandemic years, the gap in life expectancy widened for both genders (3.5 years for men and 2.2 years for women in 2021).
Main causes: Cardiovascular diseases and cancer
Cardiovascular diseases and cancer are the main reasons for social differences in life expectancy. Of particular importance is the finding that progress in reducing in cancer mortality rates in recent years has not been as successful in disadvantaged regions as in more affluent regions.
"Our analyses show that cancer in particular increases regional inequalities in life expectancy. And here, unfortunately, it is particularly the early deaths from cancer that affect people under the age of 75," says BiB mortality researcher Dr. Markus Sauerberg, co-author of the study.
Potential for equal health opportunities
The researchers emphasise how important the goal of equal living conditions throughout Germany is in order to improve health equality in Germany.
Original publication
Tetzlaff, Fabian; Sauerberg, Markus; Grigoriev, Pavel; Tetzlaff, Juliane; Mühlichen, Michael; Baumert, Jens; Michalski, Niels; Wengler, Annelene; Nowassadeck, Enno; Hoebel, Jens (2024): Age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy in Germany, 2003–21: an ecological study. Lancet Public Health 9(5): 295–305.