Social Determinants of Remaining Life Expectancy at Age 60: A District-Level Analysis in Germany

Abstract

Remaining life expectancy at age 60 (in short: RLE) is an important indicator of the health status of a population’s elders. Until now, RLE has not been thoroughly investigated at the district level in Germany. In this study we analyzed, based on recent publicly available data (2015–2017), and for men and women separately, how large the RLE differences were in Germany across the 401 districts. Furthermore, we examined a wide range of potential social determinants in terms of their bivariate and multivariate (i.e., partial) impact on men’s and women’s RLE. Men’s district-level RLE ranged between 19.89 and 24.32 years, women’s district-level RLE between 23.67 and 27.16 years. The best single predictor both for men’s and women’s RLE at district level was ‘proportion of employees with academic degree’ with standardized partial regression coefficients of 0.42 (men) and 0.51 (women). Second and third in rank were classic economic predictors, such as ‘household income’ (men), ‘proportion of elder with financial elder support’ (women), and ‘unemployment’ (men and women). Indicators expressing the availability of medical services and staffing levels of nursing homes and services had at best a marginal partial impact. This study contributes to the growing body of evidence that a population’s educational level is a decisive determinant of population health resp. life expectancy in contemporary industrialized societies.

Quantifying the contribution of smoking to regional mortality disparities in Germany: a cross-sectional study

“…There is a general tendency to explain the existing regional differentials in Germany by the role of contemporary factors, notably by differences in socioeconomic conditions. 21 22 Contrary to this traditional view, the present analysis highlights the prominent role of past smoking behaviour.…”

Life expectancy at birth for the rf population: prediction based on modeling influence exerted by a set of socio-hygienic determinants on age-specific mortality rates exemplified by diseases of the circulatory system

“…Our estimates of priority regarding influence of the analyzed factors on LEB in older age groups are similar to the results obtained in the study [23]. The authors examined remaining life expectancy 12 in various administrative districts in Germany by using twodimensional analysis.…”

Impact of Economic Freedom and Educational Attainment on Life Expectancy: Evidence From the New EU Member States

“…Educational attainment has been accepted as a crucial factor in explaining the differences in life expectancy among countries, because education can influence the life expectancy through many diverse channels such as economic growth and development, access to health-related information, employment of healthcare opportunities, planning horizon and risk perception at the subsequent period, raising the efficiency of health production (21)(22)(23)25). The extensive literature about the influence of educational attainment proxied by different education indicators on life expectancy has mainly reached a positive relationship between two variables (5,8,26,(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Furthermore, educational attainment together with real GDP per capita have been suggested as the dominant factors for explaining the differences in life expectancy among the countries (8,21,23).…”

“…The first empirical studies on determinants of life expectancy have generally focused on the validity of Preston curve suggesting the relationship between GDP per capita and life expectancy. However, the influence of educational attainment, a crucial factor for the differences in life expectancy among the countries, on life expectancy has begun to be investigated as of 2000 s. The empirical studies have mainly represented the education by literacy, secondary and tertiary enrollment and education index and employed the regression analysis, cointegration analysis, and cluster analysis and have found that different education indicators have a positive influence on life expectancy in the countries with different development levels (5,8,26,(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). However, Hazan (43)(44)(45) revealed an insignificant influence of educational attainment of life expectancy for some countries.…”

“…Case and Deaton (41) explored the role bachelor's degree (BA) on life expectancy in the United States over the 1990-2018 period and revealed that persons with BA had increased life expectancy and the gap in life expectancy between the ones with BA and the ones with no-BA consistently increased during this period. A recent study was conducted by Siegel et al (42) regarding the social determinants of remaining life expectancy in Germany, by using data of 2015-2017 period and underlined the education level as a significant determinant of remaining life expectancy. Some researchers such as Hazan (43)(44)(45) have noticed an insignificant effect of educational attainment of life expectancy for some countries.…”