Trends In Inequalities In Mortality Amenable To Health Care In 17 European Countries

Publication date: 
June, 2017

Johan P. Mackenbach, Yannan Hu, Barbara Artnik, Matthias Bopp, Giuseppe Costa, Ramune Kalediene, Pekka Martikainen, Gwenn Menvielle, Bjørn H. Strand, Bogdan Wojtyniak, Wilma J. Nusselder

Little is known about the effectiveness of health care in reducing inequalities in health. We assessed trends in inequalities in mortality from conditions amenable to health care in seventeen European countries in the period 1980–2010 and used models that included country fixed effects to study the determinants of these trends. Our findings show remarkable declines over the study period in amenable mortality among people with a low level of education. We also found stable absolute inequalities in amenable mortality over time between people with low and high levels of education, but widening relative inequalities. Higher health care expenditure was associated with lower mortality from amenable causes, but not from nonamenable causes. The effect of health care expenditure on amenable mortality was equally strong, in relative terms, among people with low levels of education and those with high levels. As a result, higher health care expenditure was associated with a narrowing of absolute inequalities in amenable mortality. Our findings suggest that in the European context, more generous health care funding provides some protection against inequalities in amenable mortality.