Regional Mortality Disparities in Germany

While regional mortality inequalities in Germany tend to be relatively stable in the short run, over the course of the past century marked changes have occurred in the country’s regional mortality patterns. These changes include not only the re-emergence of stark differences between eastern and western Germany after 1970, which have almost disappeared again in the decades after the reunification of Germany in 1990; but also substantial changes in the disparities between northern and southern Germany. At the beginning of the twentieth century, the northern regions in Germany had the highest life expectancy levels, while the southern regions had the lowest. Today, this mortality pattern is reversed. In this paper, we study these long-term trends in spatial mortality disparities in Germany since 1910, and link them with theoretical considerations and existing research on the possible determinants of these patterns. Our findings support the view that the factors which contributed to shape spatial mortality variation have changed substantially over time, and suggest that the link between regional socioeconomic conditions and recorded mortality levels strengthened over the last 100 years

Health and Its Relationship with Residential Relocations of Older People to Institutions versus to Independent Dwellings

Research into older people's relocations to independent dwellings has largely remained separate from research into moves to institutions. Yet, both types of moves could be a response to health problems and to a certain extent they could be substitutes for each other. Using Litwak and Longino's model of moves of older people, this study assesses the extent to which three commonly used health measures (limitations in activities of daily living [ADL], self-rated health, and the prevalence of [limiting] chronic conditions) predict older people's moves to subsidized care institutions and elsewhere, in one multinomial logistic regression model. The data were derived from the POLS survey for the Netherlands (N=8306) enriched with administrative data on subsequent moves. In line with Litwak and Longino's model, the findings indicate that older people's moves to institutions were more likely among those with more severe health problems, whereas moves elsewhere were more likely among those with moderate health problems. Among the three investigated health measures, limitations in ADL had the strongest predictive value, and was the only one for which the difference in effect between relocations to care institutions and relocations elsewhere was statistically significant

Healthy life expectancy differences between older migrants and non-migrants in three European countries

Migration, ageing and health are on the political agenda in all European countries, but so far little attention has been devoted to the health among older migrants in Europe. At the same time, the share of older migrants in European countries is rising steadily and there are reasons to believe that substantial differences in health exist between older migrants and non-migrants in Europe. Our aim is to analyse health differences between older migrants and non-migrants in three European countries (Belgium, the Netherlands, and the England and Wales) and to assess how these potential differences in health vary over time. Population and mortality data are derived from official statistics, and health data are derived from either surveys or censuses, depending on the country. Healthy life expectancy is calculated for older migrants and non-migrants for different time periods. Decomposition techniques are applied to identify to what extent differences in healthy life expectancy are attributable to differences in mortality or rather to differences in morbidity. We expect that older migrants have poorer health compared to older non-migrants, regardless of whether their life expectancy is higher or lower than that of non-migrants, although this will differ particularly by area of origin. The results will show whether there is a trend towards morbidity compression or expansion over time among older migrants and non-migrants. Knowledge about the health of older migrants is crucial when judging the future health care demand in culturally diverse and ageing populations, and to inform policies and interventions. The study is innovative by focusing on health differences specifically between migrants and non-migrants at older ages, by considering both the country of origin and destination, and by analysing whether there is a trend towards morbidity compression or expansion over time

Do social relations buffer the effect of neighborhood deprivation on health-related quality of life? Results from the LifeLines Cohort Study

We investigated whether social relations buffer the effect of neighborhood deprivation on mental and physical health-related quality of life. Baseline data from the LifeLines Cohort Study (N=68,111) and a neighborhood deprivation index were used to perform mixed effect linear regression analyses. Results showed that fewer personal contacts (b, 95%CI: 0.88(-1.08;-0.67)) and lower social need fulfillment (-4.52(-4.67;-4.36)) are associated with lower mental health-related quality of life. Higher neighborhood deprivation was also associated with lower mental health related quality of life (-0.18(-0.24;-0.11)), but only for those with few personal contacts or low social need fulfillment. Our results suggest that social relations buffer the effect of neighborhood deprivation on mental health-related quality of life