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.

Additional Metadata
Persistent URL dx.doi.org/10.1377/hlthaff.2016.1674, hdl.handle.net/1765/100391
Journal Health Affairs: the policy journal of the health sphere
Grant This work was funded by the European Commission 7th Framework Programme; grant id fp7/278511 - Developing methodologies to reduce inequalities in the determinants of health (DEMETRIQ)
Citation
Mackenbach, J.P, Hu, Y, Artnik, B, Bopp, M, Costa, G, Kalèdiené, R, … Nusselder, W.J. (2017). Trends in inequalities in mortality amenable to health care in 17 european countries. Health Affairs: the policy journal of the health sphere, 36(6), 1110–1118. doi:10.1377/hlthaff.2016.1674