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An Innovative Visual Approach to Monitor Simultaneously Two Dimensions of Progress in Longevity: An Application to French and German Regions

Bonnet, F.; Klusener, S.; Mesle, F.; Muhlichen, M.; Grigoriev, P.

2023-09-14 health policy
10.1101/2023.09.13.23295507 medRxiv
Show abstract

BackgroundBoth enhancing life expectancy as well as diminishing inequalities in lifespan among social groups represent significant goals for public policy. However, there is a lack of methodological tools to simultaneously monitor progress in both dimensions. Additionally, there is a consensus that absolute and relative inequalities in lifespan must be scrutinized together. MethodsWe introduce a novel graphical representation that combines national mortality rates with social inequalities, considering both absolute and relative measures. We use French and German data stratified by place of residence to illustrate this representation. ResultsFor all-age mortality we detect for France a rather continuous pace of decline in both mortality levels and variation. In Germany, substantial progress was made in the 1990s, which was mostly driven by convergence between eastern and western Germany, followed by a period with less progress. Age-specific analyses reveal for Germany some worrying regional divergence trends at ages 35-74 in recent years. This is particularly pronounced among women. ConclusionOur novel visual approach allows evaluating easily the dynamics of societal progress in terms of longevity, and facilitates meaningful comparisons between populations, even when their current mortality rates differ. The methods we employ can be reproduced easily in any country with longitudinal mortality data stratified by relevant socio-economic information or regions. It is both useful for scientific analyses as well as policy advice. Key messagesO_ST_ABSWhat is already known on this topicC_ST_ABSImproving life expectancy as well as reducing social inequalities in longevity are major public policy objectives. However, there is a lack of proper methodological tools to evaluate progress on these objectives. What this study addsThis study proposes an innovative graphical representation that combines national mortality and social inequalities in both absolute and relative terms in order to assess the dynamics of societal progress in longevity and make relevant comparisons between populations whose mortality rates are not at the same level nowadays. How this study might affect research, practice or policyMethods are freely and easily reproducible for all countries with longitudinal mortality data stratified by socio-economic information or geographic regions.

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