Do Welfare Regimes Matter? A Comparative Analysis of Spatial Inequalities in Mortality in Germany and the United Kingdom, 2003–2021

Pavel Grigoriev, Federal Institute for Population Research (BiB), Germany
Michael Muehlichen, Federal Institute for Population Research (BiB), Germany
Andreas Höhn, University of St. Andrews
Nik Lomax, University of Leeds
Petra Meier, University of Glasgow

While population health inequalities at a spatial scale are well documented for national contexts in isolation, very little is known how these compare across different countries and welfare state regimes. In this paper, we assessed the magnitude of spatial inequalities in life expectancy across Germany, and the four countries of the United Kingdom (UK): England, Scotland, Wales, and Northern Ireland. We used official mortality data from the respective national statistical offices to derive abridged life tables and life expectancy estimates for the period 2003–2021. We then compared trends over time and assessed the magnitude of mortality inequalities across districts and deprivation deciles, within and between the countries, using different measures of inequality. On average, life expectancy across districts of Germany and the UK were at similar levels. While area-level inequalities in life expectancy have increased among both countries, inequalities were consistently higher and increased more sharply in the UK. Our provisional results suggest that deeply rooted differences in governmental approaches to the provision of equitable living conditions in light of economic pressures could be key for explaining diverging trends in the magnitude of area-level health inequalities between Germany and the UK.

Keywords: Mortality and Longevity, Spatial Demography

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