Jp. Mackenbach et Cwn. Looman, LIVING STANDARDS AND MORTALITY IN THE EUROPEAN-COMMUNITY, Journal of epidemiology and community health, 48(2), 1994, pp. 140-145
Objective - The association between living standards and mortality in
the European Community (EC) was investigated using regional level data
from all EC member countries. Data and methods - Data covering the 19
80s were extracted from various publications. Data on ''all cause'' mo
rtality (standardised mortality ratios, both sexes, all ages), living
standards (gross domestic product, car access, unemployment rates), an
d some potential confounders (population density, agricultural employm
ent, industrial employment, country) were available for 133 regions. M
ultiple regression analysis was used for each living standard variable
, taking InSMR as the dependent variable. Results - It is only after t
aking into account potential confounders that higher living standards
are associated with lower mortality. Unemployment rates have the stron
gest association - each additional percentage in unemployment in the r
egional population is associated with an increase in mortality by 0.81
%. There is important variation between countries in the living standa
rds-mortality relationship. The latter ranges from relatively strong i
n the UK to absent in Italy. Discussion - The results of this study sh
ow that there is an association between living standards and mortality
at the regional level in the EC, but that this association comes to l
ight only after controlling for confounding variables. It effects ing
standards and mortality in the European Community (EC) was investigate
d of high living standards. In addition, factors specific to countries
founders. The latter finding is interpreted in the light of differenc
es between countries in the way in which they have gone through the ''
epidemiologic translation'' from infectious diseases to the ('western'
' diseases that currently dominate the mortality pattern. (such as die
tary habits) act as conseems the mortality increasing