Abstract
BackgroundThis study aims at quantifying the level and changes over time of inequality in age-specific mortality and life expectancy between the 19 Norwegian counties from 1980 to 2014.MethodsData on population and mortality by county was obtained from Statistics Norway for 1980–2014. Life expectancy and age-specific mortality rates (0–4, 5–49 and 50–69 age groups) were estimated by year and county. Geographic inequality was described by the absolute Gini index annually.ResultsLife expectancy in Norway has increased from 75.6 to 82.0 years, and the risk of death before the age of 70 has decreased from 26 to 14% from 1980 to 2014. The absolute Gini index decreased over the period 1980 to 2014 from 0.43 to 0.32 for life expectancy, from 0.012 to 0.0057 for the age group 50–69 years, from 0.0038 to 0.0022 for the age group 5–49 years, and from 0.0009 to 0.0006 for the age group 0–4 years. It will take between 2 and 32 years (national average 7 years) until the counties catch up with the life expectancy in the best performing county if their annual rates of increase remain unchanged.ConclusionUsing the absolute Gini index as a metric for monitoring changes in geographic inequality over time may be a valuable tool for informing public health policies. The absolute inequality in mortality and life expectancy between Norwegian counties has decreased from 1980 to 2014.
Highlights
This study aims at quantifying the level and changes over time of inequality in age-specific mortality and life expectancy between the 19 Norwegian counties from 1980 to 2014
This study aims to provide an empirical illustration of how geographic inequalities can be monitored using the Gini index by applying this metric to Norwegian mortality data from the past 35 years
We assumed deaths to be evenly distributed across the time interval age x to age x + 1 years, with exception of the age group 0–1 years where we estimated the distribution of the deaths according to the methodology described in the Human Mortality Database’s Methods Protocol [19]
Summary
This study aims at quantifying the level and changes over time of inequality in age-specific mortality and life expectancy between the 19 Norwegian counties from 1980 to 2014. Geographical differences in life expectancy and mortality has been shown to be present within several countries [1,2,3,4]. Even if equality in health is an important political goal, countries rarely systematically report the size of inequality in survival across geographical areas. A numerical distributive metric needs to be implemented if the performance on geographical inequality is to be tracked and used to inform policies. The causes of geographic inequality are complex and only partly known, and may be amenable to interventions both within and outside the health sector. Constant or increasing geographic inequality in life expectancy have
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