Small-area mortality variation in Germany: trends, dispersion, and explanatory factors

Eva Kibele, Max Planck Institute for Demographic Research

Small-area mortality differentials in Germany have gained only limited attention in the past although it is yet another dimension of societal inequality. This work shows how mortality is spread over space and how this pattern developed over time. It shows whether inequality increased or decreased. In the second part, explanatory factors at the small-area level are analysed. Life expectancy for 438 districts in Germany for the years 1995-2006 is studied. Small-area mortality dispersion is measured and a decomposition reveals the impact of age groups on dispersion. A pooled cross-sectional time series analysis reveals the impact of explanatory variables at the small-area level on the distribution of life expectancy over space and time. Life expectancy is lower in the eastern compared to the western part of Germany and lower in the northern compared to the southern part. Apart from the general pattern, areas of low life expectancy are found in Saarland, the Ruhr area and the north-eastern border of Bavaria while large parts of Saxony can be considered as high-life expectancy areas. Dispersion in life expectancy across all German districts decreased over time, although it increased across the West German districts. Mainly regional variation in old-age mortality is driving this inequality. Explanatory factors point to the fact that life expectancy is higher in wealthier districts as well as life expectancy gains are larger where the economic achievement is greater. Although often neglected in the past, small-area variation in life expectancy in Germany exists. In order to reduce small-area mortality differentials, public health policies must focus on the reduction of old-age excess mortality. Evidence shows that widespread economic prosperity supports small-area equality.