The magnitude of socioeconomic inequalities in mortality differs importantly between countries, but these variations have not been satisfactorily explained. We explored the role of behavioral and structural determinants of these variations, by using a dataset covering 17 European countries in the period 1970–2010, and by conducting multilevel multivariate regression analyses. Our results suggest that between-country variations in inequalities in current mortality can partly be understood from variations in inequalities in smoking, excessive alcohol consumption, and poverty. Also, countries with higher national income, higher quality of government, higher social transfers, higher health care expenditure and more self-expression values have smaller inequalities in mortality. Finally, trends in behavioral risk factors, particularly smoking and excessive alcohol consumption, appear to partly explain variations in inequalities in mortality trends. This study shows that analyses of variations in health inequalities between countries can help to identify entry-points for policy.

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Keywords Determinants, Europe, Health inequalities, International variations, Mortality
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Journal Health & Place
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)
Mackenbach, J.P, Bopp, M, Deboosere, P, Kovács, K, Leinsalu, M, Martikainen, P, … de Gelder, R. (2017). Determinants of the magnitude of socioeconomic inequalities in mortality: A study of 17 European countries. Health & Place, 47, 44–53. doi:10.1016/j.healthplace.2017.07.005